Thomas Byrne (Fianna Fail) | Oireachtas source

Go raibh maith agat, a Chathaoirligh agus fáilte roimh an Aire Stáit. I am glad to see the Minister of State here again today. She is certainly a regular visitor to the Seanad.

We recognise, as I am sure everyone does, the fact that 18.5% of the population has some level of disability. Fianna Fáil has always, and one can say the same for most parties, demonstrated a strong commitment to provide support and services to ensure that people with a disability, either physical or intellectual, fulfil all opportunities that arise. Disability is not just about the health services. The Minister of State spoke about housing which involves the Department of the Environment, Community and Local Government. Disability is a social justice priority for us and certainly for me. Fianna Fáil firmly believes that the strategy must be sustained and implemented.

I support HIQA completely. It does fantastic work but the way it, the Department of Health and the HSE seemed to have a bit of a go at each other in regard to the Portlaoise case was worrying. I have a very close family member who works in the intellectual disability services and obviously supports HIQA and wants to provide the best possible service. However, it is the case that staff in the services find the onset of a HIQA inspection extremely stressful. That should not be the case, although I do not know what HIQA can do to change that. Rushing around in the weeks leading up to a HIQA inspection to ensure everything is in order creates a worse environment. Although there are some exceptions, in general, everything is in order and people do a very good job but I suppose HIQA is trying to ensure that is the case. Perhaps being apprehensive beforehand is the nature of inspections, whether school or HIQA inspections. Could HIQA hold briefing sessions with staff members, through the unions, which people could attend to get more information about the process? It would reduce the strain and reassure the vast majority of staff that their work is good in that they show respect and care for the dignity of the people they look after, which is the most important thing. One must remember one is dealing with a fellow and equal human being and that person, regardless of his or her disability, deserves absolute dignity and respect in the service. If one remembers that, then one will not go far wrong and that is something about which I would be keen to ensure.

Recently, I came across an issue, namely, the anonymity of HIQA reports on intellectual disability services and I do not know what the policy justification is for that.That anonymity means one cannot discover the identity of any particular facility that is inspected. I understand this is a policy decision which might have to do with the privacy and dignity of residents. At least two facilities in my area were closed during the year. I know their names and where they are located, but their closure was not publicised. It would be useful to have information on which services are being closed. In the two cases to which I referred, they were very small units in a particular local authority housing estate. They were closed either before or after a HIQA inspection and we would like to know the reasons for that, what failings were identified and if there are similar failings in other facilities that have not been subject to the prospect of HIQA inspection.

The Minister of State may recall that I raised a matter on the Commencement debate some time ago concerning the HSE's absolutely appalling treatment of an individual. This person's GP had diagnosed him as having an intellectual disability but the HSE denied this was the case. There is sometimes a need to ease up on the bureaucracy and take a slightly more caring approach. We found in this case that the HSE staff member who was dealing directly with the individual was extremely caring and helpful, even perhaps too much so. That member of staff went beyond the call of duty, which might not be the best thing to do in a professional context. However, these things happen and, certainly in that case, everything was done out of concern for the individual in question.

There are problems with intellectual disability services, and waiting lists remain too high for a range of services. There is a substantial level of unmet need in respect of several types of supports. The Health Research Board has pointed to the growing waiting list for personal assistant and home help hours and indicated that there are more than 1,000 people with disabilities waiting to access physiotherapy, nearly 700 awaiting occupational therapy services, and 366 on a list for speech and language therapy. The same difficulties are arising for people without disabilities, of course, but such delays are particularly difficult for those with disabilities, particularly intellectual disabilities, because they may not be able to communicate their frustration and may require family advocates to act on their behalf.

People with disabilities are continuing to bear the brunt of the significant deficit in service provision, particularly when it comes to community services and supporting individuals to remain in their own community. There must be an objective of supporting people to live independently where possible, free from discrimination and able to enjoy the fundamental rights set out in the UN Convention on the Rights of Persons with Disabilities. In order to achieve this objective, the Government must ensure no further undue hardship is imposed on people with disabilities through the reduction of service provision in communities.

The Áras Attracta scandal brought home to every person in this country the vulnerability of people with intellectual disabilities. It must lead to a sea change in how we treat people and the culture that prevails in those facilities which take care of them. In this instance, it seems there were fundamental breaches of codes, regulations, standards and human rights. Indeed, the CEO of HIQA, Mr. Phelim Quinn, said it involved fundamental breaches of the human rights and dignity of individuals. We must never view people with intellectual disabilities as objects but rather as fellow human beings who, although they require care, have the same capacity to love and give as anybody else.

The Minister of State mentioned the move away from congregated care settings, which is welcome. There is an urgent need to implement the recommendations of the report to which she referred in order to ensure such facilities are closed and people are placed in more dignified settings. The best situation is where there is a small number of residents, the facility is like a home rather than an institution and the care that is provided is person-centred.

My final point is slightly off topic, although still related to disability services. Preschool special needs assistants are provided by the HSE in County Meath to children with special needs, many of whom have intellectual disabilities. Despite being assured there would be no reduction in this service, parents have now been told there is to be a 25% cut in the hours provided. We understand there is no major increase in the number of children coming through the ranks for next year. What seems to have happened is that the HSE has decided the budget will be the same as it was last year but it will not allow any overrun. That is apparently where the cut is coming in, the concern being to adhere to budgets. In practice, however, it means a reduction from 6.5 hours to 4.5 hours for the children concerned. That is absolutely appalling and I plead with the Minister of State to address it.