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

I thank Senators for raising this motion. I particularly thank Senators Conway and Lawlor for proposing and seconding it. I also thank Senators Swanick, Coffey, Boyhan, Buttimer, and Devine for their contributions. I welcome the opportunity to restate this Government's commitment to supporting people with disabilities and their families. I also welcome Professor David Keegan and Mr. Kevin Kelly, who I have known for many years and who has made a massive contribution to the disability sector, particularly to the issue of rights and inclusion for all people with disabilities.

As colleagues know, this 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 the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. The overarching principle governing the planning and delivery of services and supports for adults and children with disabilities is that they should be integrated, as much as possible, with services and supports for the rest of the population.

Ireland has now ratified the United Nations Convention on the Rights of Persons with Disabilities which came into force for Ireland on 19 April 2018. The Government's approach to meeting the terms of the convention is one of sustained and ongoing improvement. Work is continuing on the reforms needed for an optimum level of compliance with the convention's requirements. The Department of Justice and Equality is the designated focal point as it has policy responsibility for the equality aspects of disability matters. The Government's approach to meeting the terms of the UN Convention on the Rights of Persons with Disabilities is one of sustained and ongoing improvement. Work is continuing on the reforms needed for an optimum level of compliance with the convention's requirements. The National Disability Inclusion Strategy, NDIS, 2017-2021 contains a wide range of practical commitments to improve the position of people with disabilities. I have just come from chairing the latest meeting of the steering group on the strategy, which was held in Croke Park this morning.The strategy provides a mechanism for joined-up working to deliver on Ireland's commitments to implementing the UNCRPD. The NDIS steering group, which oversees and monitors the implementation of the strategy, has an important role in guiding progress in this area. As stated, all of the disability organisations attended this morning. We sat down and hammered out and identified the positives, what was being done and what needed to be done.

The group is committed to carrying out a mid-term review of the strategy by the end of this year. In the context of this review, it is expected that the group will examine how the strategy is aligned with the articles of the convention and how it could be revised and built upon in order to continue progressive realisation of the aims of the convention. The National Disability Authority will also play a critical part in the implementation of the convention. It will carry out a review of progress with respect to the strategy's key indicators in this regard.

Significant year-on-year budgetary increases in the disability sector have positively impacted upon the lived experience of people with disabilities in Ireland. However, I recognise, and I have listened to colleagues here in the Seanad, that daily challenges remain for many people with disabilities and their families. Addressing the needs and rights of people living with a disability and their families is a priority for me and this Government. It is my primary focus, as Minister of State for disability issues. The UNCRPD supports that priority in providing a comprehensive and robust framework for the realisation of rights.

The Department of Health and the HSE have responsibility for a significant number of actions under the strategy. The HSE national service plan is focused on providing supports to people with disabilities and enabling them to maximise their full potential as independently as possible. The plan also provides for a significant level of funding, some €1.9 billion, to deliver essential front-line services for people with a disability. As much as €1.9 billion is being spent, as I speak, on the provision of disability services in 2019. The funding will increase in 2020. These core services span a spectrum of essential interventions that range from clinical therapeutic supports, rehabilitative training and day services, home care supports as well as respite and residential provision.

All funded service providers, including non-clinical service delivery-focused organisations are required to deliver safe and effective services within a defined budget allocation. The HSE must also ensure that it prioritises available resources on the basis of meeting the health and social needs of people with a disability. Our current policy promotes a non-condition specific approach to disability service provision based on the needs of the individual rather than the provision of services based on a specific disability diagnosis. A Programme for a Partnership Government commits this Administration to improving services and increasing supports for people with disabilities. Significant resources have been invested by the health sector in services for people with disabilities over the past number of years.

In terms of health spending, substantial expenditure has been agreed in recent budgets to support increased provision to people with a disability and their families. I am pleased that we have been able to both build upon significant existing resources and obtain additional funding for disability services in 2020. As I speak, the service plan is being finalised. With these additional moneys, the overall budget for disability services in 2020 is in excess of €2 billion. Please note that we will be spending in excess of €2 billion on disability services in the HSE service plan for 2020.

Many colleagues have asked what we are doing with the money. The increased level of funding in 2020 will enable us to continue to provide residential services to over 8,600 people with disabilities at more than 1,240 locations. Upon taking office, one of my priorities was to ensure that all young adults leaving school or training would have access to supports and services that meet their needs at one of the most crucial transition points of their lives. Additional funding of €13 million will provide supports and day services to approximately 1,600 young people with disabilities who will leave school and training next year.

I recognise the critical importance of respite for the loved ones and families of those with a disability. I am pleased to confirm that an additional €5 million, on top of the money given last year to provide for the opening of 12 new respite houses, will be provided in 2020 to build the capacity of our respite services so that we can better respond to the changing needs of service users and their families. Significantly, this funding will provide intensive support packages for children and young people in response to the changing needs of service users and their families. This initiative will include intensive in-home visiting support, planned overnight, specialist behavioural support and extended day-weekend and day-based activities for families.

Sláintecare is centred around providing services and supports at the lowest level of complexity. Finally, an additional amount of funding will be provided in 2020 to support the implementation of the autism plan, which includes a range of measures to improve services for people with autism and their families. Disability services are provided through the HSE to enable each individual with a disability to achieve his or her full potential and maximise independence, including living as independently as possible.

In terms of this debate, persons with disabilities, blind and vision impaired and deaf-blind can access a broad range of acute, primary and community-based services as well as specialist disability services. These services are provided in a variety of community and residential settings in partnership with service users, their families and carers and a range of statutory and non-statutory voluntary and community groups.

Senators may be aware that the NCBI is a not-for-profit charitable organisation that provides support and services nationwide to people experiencing sight loss. The overall aim of NCBI services is to enable people to live an independent life of their choice. NCBI provides services to over 7,000 people every year. The HSE disability services fund, under section 39 of the Health Act, provides a range of centre, domiciliary and community-based services to people who are blind or vision impaired. The funding is governed by a service arrangement, which identifies service delivery provided by the agency in return for the money being provided to them. The service arrangement is reviewed on an annual basis. NCBI received funding of €6.55 million in 2018 from the HSE disability services and is scheduled to receive similar funding in 2019.

In late 2018, on the basis of a proposal by the NCBI, the HSE provided funding through the Ireland East hospital group for a pilot project with the NCBI to put sight loss advisers in place in the Mater Hospital, the Royal Victoria Eye and Ear Hospital, and the Children's Health Ireland at Temple Street University Hospital. Treating clinicians can refer patients to an adviser who can then assist them to access social and community care. The initiative allows the clinician to focus on the medical management while the eye clinic liaison officer can advise them on the practical questions they may have, and refer them to the NCBI for further support and access to additional services. Earlier this year, a pilot service was established. In October 2019, the NCBI and the hospital group prepared a formal evaluation of the project, which has now been submitted to the HSE. While the HSE will take the time to consider the report in all its detail, the high-level findings of the evaluation are very promising. As many as 46% of patients are new referrals to the NCBI services and 78% of all patients received a referral to community-based services.

The HSE primary care eye services review group report was published in June 2017. The report sets out the way forward for a significant number of eye services to be delivered in primary care settings. Supported by the clinical programme and its model of care, the report recommends integrated care provision with hospital ophthalmic services. This will ensure that hospital departments are focused on patients who require more specialist diagnostics or treatments.

Both the HSE primary care eye services review group report and the model of care developed recommend the integration of hospital and community eye care services through integrated eye care teams. The recommendations of the report are being implemented on a phased basis as resources allow. This includes primary care revenue funding and the Sláintecare integration funding 2019.

Before I run out of time, I shall mention a few points that were raised by my colleagues here during the debate. I hope that is okay with the Acting Chairman.