Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Senators James Reilly, Keith Swanick, Máire Devine, John Dolan, Gerald Nash and Colm Burke for their support and the ideas they expressed. I will respond individually to the queries they raised.

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the programme for a partnership Government which is guided by two principles, namely, equality of opportunity and improving the quality of life for people with disabilities. A key element of this is to safeguard and support the delivery of person centred care to vulnerable people of all ages who are receiving residential care services and to ensure their health, well-being and quality of life are promoted and protected.

It is clear that the establishment of the Health Information and Quality Authority, HIQA, and the introduction of its inspection and regulatory frameworks have gone a long way in improving the lives of people with disabilities in residential care. The National Disability Authority was asked by my Department to conduct a study of the first year of operations of HIQA inspections of residential centres for people with disabilities. The authority's review, which was published in May last, confirms the importance and necessity of the regulatory process, an issue raised by many speakers in this debate. It also confirms that the regulatory process is working effectively and protecting vulnerable people in the care of the State.

The purpose of the Bill is not to change any of the fundamentals of the inspection, regulation and registration regime for centres for people with disabilities. It will simply extend the existing transitional period in which residential centres are deemed to be registered in order to allow HIQA the necessary time to ensure every centre is inspected fully and properly. HIQA will not be limited in any way in the application of its powers and sanctions. It will retain its ability to inspect and, if necessary, cancel the registration of residential centres which persistently fail to meet the required standards. This is an important aspect of the legislation.

I will now address some of the issues Senators raised. Senator Swanwick referred to the Áras Attracta facility. I was as shocked and distressed as others by the revelations at the end of 2014 concerning the extremely poor and unacceptable standards of care and mistreatment of vulnerable residents in the centre. An independent review of Áras Attracta's services was also commissioned and is nearing completion. I will ensure I am fully briefed on the findings and recommendations of the review. Anyone who has concerns about the treatment of vulnerable persons in our disability services is urged to contact the Health Information and Quality Authority which, I am assured, will take the matter very seriously and investigate it in the context of its significant regulatory powers of inspection of residential facilities.

Senator Swanwick referred to three centres which were run by the Irish Society for Autism. The Health Service Executive has assumed responsibility for the governance and management of the three centres in question. The HSE has engaged external service providers to assist and manage the services on a temporary basis. I am very familiar with Gheel Autism Services, one of the service providers commissioned to assist in this matter. Significant progress is being made on the issues highlighted by HIQA, with a suite of immediate actions already completed. Appropriate plans to address more long-term regulatory requirements are being implemented. While HIQA's findings in cases such as these may make difficult reading, they also serve as evidence that the regulatory process works effectively in the interests of protecting vulnerable persons in the care of the State.

Cregg House in County Sligo, which was mentioned, is one of the centres prioritised for decongregation and the HSE is working to assist residents of the centre in moving to a new place of residence of their choice.

Senator Gerald Nash referred to capital investment in this area. Funding of €100 million has been provided for this purpose over the next five years.

Senator John Dolan referred to HIQA's annual overview report on the regulation of designated centres for adults and children with disabilities. The review was published today and according to HIQA, the introduction of regulation for residential centres for people with disabilities has brought about a positive cultural change in the sector. HIQA states that two years ago, initial inspections found that residents in many large congregated settings were not being adequately protected or kept safe. It adds that inspections steadily led to improvements in the standards of care in these settings. The review praises the improvements in care and states that last year HIQA inspected 561 of the 937 designated residential centres for adults and mixed centres for adults and children with disabilities. This is important but I concur with Senator Dolan on the need to develop the right type of regulation.

Senator Dolan also referred to people with disabilities living in the community. I am committed to setting up a task force on personalised budgets as soon as possible and I will finalise my plans in this regard next week. By the end of this month, I intend to inform the Government of my decision on the chair of the task force and outline my plans for the appointment of its members and the development of its terms of reference, objectives, scope and key deliverables. With the support of the Government, I will then proceed to appoint members and arrange for its first meeting to take place as soon as practicable. I am, therefore, pushing the idea of personalised budgets.

Senator Colm Burke referred to people at risk and raised fire safety issues. I agree with the Senator's sentiments on these matters, all of which need to be prioritised, and I will highlight them while in office. Senator Devine raised similar issues. It is worth noting that by the end of April, all such centres had been inspected by HIQA at least once. The HSE and HIQA have agreed a priority list of centres which face the greatest challenges in meeting standards and all centres will be required to comply with the timeline.I mentioned HIQA and the standards required. I think it was Senator Reilly who raised the issue of old buildings. We have to ensure that these buildings are brought up to standard. As I said, there will be major investment in these buildings over the next number of years. It is up to me to fight on those particular issues because we have to up our game.

A number of other points were made by Senators, including Senator Swanick, on the issue of competent people being in charge. That applies to both the provision of services and the implementation of HIQA standards and regulations. It also relates to the treatment of people with intellectual or physical disabilities. That is something we have to improve. It is something that we discovered in some of the other cases that were raised by my colleagues. I believe it is important that we deal with these particular issues. On any particular issues that I did not respond to, I will come back to the individual Senators later on with a more detailed response.

The cases of a number of centres taken over by the HSE in recent months show us that the system of regulation works. There is a procedure in place to deal with centres that fail to meet HIQA standards. There is no exception in the case of centres covered in section 69 of the 2007 Act. The extension of the timeframe for registration will not affect this in any way. It will simply ensure that HIQA has the time required to inspect every residential centre in the country for people with disabilities in the full and comprehensive manner that is required. I hope I have addressed the concerns that were expressed and that this Bill will receive broad support from all sides of the House. Once again, I thank all the Senators for their support and for their new and refreshing ideas.