Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Senator Wilson. I will begin by thanking Senator Reilly for introducing this important Bill. I share his desire to ensure that people with autism have access to the supports they require to enable them to achieve their full potential and maximise their independence, including living as independently as possible.

I welcome those who have joined us in the Gallery, are following proceedings online or have signed the petition highlighting the importance of this Bill and calling on Ireland to follow other countries in developing a comprehensive national autism strategy. The people in the Gallery at whom I am looking are the advocates, people with autism and families - I recognise many faces - who have been working for many years to arrive at a point in this country where we recognise the need to pull together the various elements of the State and have a national autism strategy - not a siloed mentality of something being a job for this or that Department, but a single national autism strategy. I thank these people for the tireless work that they have done in bringing us to this day, which has inspired and encouraged Senator Reilly to table this Bill.

As most of those present know, autism is an issue that has been close to my heart for many a year. On a personal level, I feel that this Bill is significant. As a teenager when I sat in a cold hall on a February evening in Greystones in County Wicklow, having called a public meeting after being impacted by a family experience with autism and having asked people who were living with autism to come along and share their experiences, I could not have imagined that I would be in the Seanad as the Minister for Health proudly accepting this Bill to develop a national autism strategy. I assure everyone that I am determined to work with Senators and, in due course, Deputies on all sides of the Houses to ensure that we deliver this strategy.

I welcome the cross-party support for Senator Reilly's Bill. All parties and Independents in this and, I expect, the Lower House will put their shoulders to the wheel so that we can devise a wonderful national autism strategy. There is often criticism of what people call "new politics", but if this and the Lower House deliver a national autism strategy in which we work together across party lines and political divisions, the new politics model will have delivered something very important for the many people with autism, their families and society as a whole, and it will say much about us as a country.

I recognise the need for a strategic approach to enhancing the effectiveness and responsiveness of our services to meet the evolving needs of people with autism. This is becoming best practice in other countries, including our nearest neighbour in the UK. In devising a national strategy, we as a country are recognising the complexity of autism as a condition. Crucially, it allows us to consult with the autism community. All too often, we policy makers talk about and at people with disabilities. If we get this right, as we are determined to do across party lines, the consultation process in and of itself will enable people with autism to tell us what sort of society they want to live in and what services and supports they need. Consultation on the development of the national autism strategy is important in terms of providing us with an opportunity to tackle ignorance. Let us not fool ourselves - in many parts of society, there is significant ignorance of autism as a condition. Consultation will allow us an opportunity to raise awareness among our communities, neighbours, friends, policy makers and service delivery organisations. It will allow us to have a true national discussion about autism and the needs of those with autism and their families.

As Senator Reilly alluded to, the scope of the issues raised extends far beyond the scope of the health sector alone. Strong collaboration and joined-up thinking will be required from a number of Departments and stakeholders so as to ensure that we provide the best legislative solutions.As it is not just a health issue, as I think everybody here would appreciate, but touches on the remit of every and any Government Department, I assure the Senators that I will provide the political leadership to drive this within Government and work with colleagues in other Departments.

This evening I can announce two steps which will be very important in bringing us on the road to this strategy. I have requested that the HSE establish a working group spanning its different operational areas, which will look at the delivery of autism services in this country, consider the effectiveness of existing services, identify models of good practice - such models do exist in certain parts of the country - and identify where the shortcomings are. The working group will report back to me on service delivery and operational experience in respect of autism.

The second measure is that my Department will commission an epidemiological research study into the prevalence of and future projections for ASD. As a society, as policy makers and as a Government, we can only properly respond to the present and future needs of people with autism if we actually do the research. What is the prevalence rate of autism in Ireland? What is its projected future prevalence rate? What is the demographic make-up of people with autism here? I know from my own background that there is many a young child with autism who has now grown up into adulthood. There are many parents of children with autism who are now getting on in life and wondering what will happen to their sons and daughters. The research commissioned by my Department will help inform our strategy. When, then, can we have a national autism strategy? If we get those two pieces of work done now, which is my intention, I plan to progress the development of a strategy in 2018 enhancing the health services' response to ASD.

There is a clear overlap between these plans and the very important Bill presented by Senator Reilly. As I have said, a whole-of-Government approach will be required. We will need extensive consideration by the HSE, the Departments of Justice and Equality; Education and Skills; Social Protection; Enterprise, Jobs and Innovation; Children and Youth Affairs; and Housing, Planning, Community and Local Government of the implications of the approach proposed in the Bill. I wish to name all those Departments for the record of the House, as they are all stakeholder Departments with which we will need to work to make sure we have a comprehensive strategy rather than one which just looks at the health piece, important and all as that is.

It should also be noted that as we consider this Bill and as it progresses to other Stages, we will need a detailed examination of the legal implications and equity considerations arising. I intend to consult the Attorney General to ensure that there are no unintended consequences, including equality issues, as a result of making separate legislative provision based on a specific diagnosis. As a result of tonight's proceedings, my Department will request all Government Departments to consider the detail of the proposed commitments within their areas of expertise. I will work with the Senators and Deputies of the Oireachtas to feed these processes into the refinement of the Bill. I know Senator Reilly is very much open to engaging with Government and colleagues in order to make sure we have the best possible Bill, which will adequately and effectively reflect the cross-Departmental, multi agency approach that is required.

I welcome the platform provided by this debate to put on the record the Government’s position. As I have already said, the HSE working group will now set about identifying models of good practice that can be replicated. We need to be very conscious of the current geographical lottery in respect of the provision of services. I have talked to parents of children with autism, and in some communities the service seems to be significantly better than in others. We need to identify where it is good, and that good practice needs to become the model rather than the outlier. We will also have the Department's research and will progress the development of a strategy in accordance with the piece of legislation which I hope will pass in both Houses. That strategy will be developed next year and, in response to Senator Reilly's point, will involve comprehensive consultation with people with autism, stakeholders and those working with people with autism.

Since 1996, the overarching principle governing the planning and delivery of health services and supports for adults and children with disabilities, including autism, is that they should be integrated as much as possible with services and supports for the rest of the population. The Government’s agenda in this regard is clearly set out in the current national disability strategy, NDS, which is based on a non-condition specific approach to the delivery of public services and the mainstreaming agenda. National strategies on disability policy such as the comprehensive employment strategy and the forthcoming national disability inclusion strategy have been led by the Department of Justice and Equality under the aegis of my colleague, the Tánaiste. This reflects the shift away from viewing people with a disability as a patient or as solely the responsibility of the health services, towards mainstreaming supports and services into local communities and wider society.

The national disability inclusion strategy, which will shortly be brought to Government by the Minister for Justice and Equality, will take a whole-of-Government approach to improving the lives of people with disabilities. This strategy contains a specific programme of actions on ASD. As many who are following this debate will know, the strategy contains eight themes: equality and choice; joined-up policies and public services; education; employment; health and well-being; person-centred disability services; living in the community; and transport and accessible places. Under those themes, 32 key objectives are identified. These are in turn supported by a range of specific, measurable - that is very important in any strategy - and time-sensitive actions that relate to the areas of education, employment, provision of public services, health, transport, and personal safety and autonomy.

I will dwell briefly on the issue of employment, which is becoming increasingly important. The role of the State in respect of people with disabilities is not just to write cheques to fund service providers. Its role is to meet the whole needs of the person with a disability. Many people with autism have a huge contribution to make when it comes to employment. They have skillsets in many areas, as Senator Burke outlined in respect of the area of art. We have to provide people with an opportunity to contribute fully to society. That is what they want and a comprehensive employment strategy is very important in that regard.

The national disability inclusion strategy is envisaged as a living document. We do not need another report to put on a shelf. It needs to be a living, breathing, evolving document. Implementation will be supported by independent analysis and advice from the National Disability Authority, and also by periodic review and oversight by the Cabinet Committee on Social Policy. As many people know, a significant programme of reform is under way in respect of how we approach the provision of disability services. I had an opportunity recently to bring legislation through these Houses which provides that any child in receipt of a domiciliary care allowance has an automatic entitlement to a medical card. That is one piece of stress less for families that are already often under pressure.

The Department of Health and the HSE's Transforming Lives programme aims to bring about significant and far-reaching change to the delivery of disability services. The national programme on progressing disability services for children and young people aims to bring about equity of access to disability services and consistency of service delivery. The early childhood care and education, ECCE, programme led by the Minister for Children and Youth Affairs incorporates a focus on the developmental level of children with disabilities, their functional ability and their needs. It does not focus on diagnosis, recognising that many children may not have a formal diagnosis at the time of presenting at pre-school.

The Department of Education and Skills will continue to provide a range of supports for schools which have enrolled pupils with special educational needs. The Department invests over €300 million annually in providing additional resources specifically to support students with autism in schools. The number of special classes has increased from 548 in 2011 to 1,152 across the country in 2017, of which 888 are special ASD classes. This includes 126 early intervention classes to support pupils with ASD.

I have mentioned the comprehensive employment strategy for people with disabilities, which sets out a ten-year strategic approach to our commitment to increasing employment opportunities for people with a disability, with a view to increasing the numbers and proportion of people with a disability in the work force. My colleague, the Minister of State, Deputy Finian McGrath is leading work on a task force on personalised budgets. It will make recommendations to the Minister of State by December 2017 on a personalised budgets model which will give people with disabilities more control in accessing health-funded personal social services, giving them greater independence and choice in accessing services which best meet their individual needs. Under the national disability implementation plan, we will shortly see a programme of actions on autism in keeping with the cross-Departmental, whole-of-Government social model approach.

Despite all of the work that has been done, I want to be very clear that the need for a national autism strategy is compelling. I believe that debate is over. We must now get on with passing this piece of legislation, engaging on the detail of the provisions to ensure we have the best Bill possible, and involving all of the relevant Departments and agencies. I am giving the Senators a timeline tonight; I wish to see the strategy developed in 2018. We will get on with the two pieces of work I have outlined, namely the HSE working group and the research study, while these Houses are progressing the Bill.

There is so much more to do in this area. In particular, I want to talk about the difficulty facing parents in accessing services and therapies, and the particular challenges for those children with autism who are now becoming adults with autism and our need to address educational and employment opportunities for them.We must and we will do better in this regard. Last year, we hired 83 additional speech and language therapists to work in our early intervention teams but we have come from a very low base after a number of difficult years. I give a commitment to Senators that we will continue to properly staff and resource our early intervention teams so that we can tackle what are, in certain parts of this country, significant delays in terms of people accessing therapy.

Again, I congratulate Senator Reilly for introducing this Bill. I also congratulate the Seanad, on an all-party basis and grouping basis, for accepting this Bill, which is what I expect the House will do this evening. I thank all of the advocates for their work, personal stories, testimony and tireless campaigning over many difficult years to bring us to this point. If we work together on this matter we can progress this legislation and we can have a national autism strategy in this country by next year.