Wednesday, 19 December 2007
Services for People with Disabilities
I thank the Cathaoirleach for the opportunity to raise this very important matter. I request the Minister for Health and Children to provide a report on the progress of inspections of facilities and residential services for children with disabilities, residential services for adults with disabilities and such services for unaccompanied minors.
It has long been a requirement for residential services for children to be inspected. An anomaly has existed, however, whereby if a residential service provides accommodation for children with disabilities, there was an exemption from inspection. All children are vulnerable and are entitled to a commitment from the State to protect them and ensure their safety. By their nature, children with disabilities have a heightened vulnerability.
I very much welcome the commitment given to develop guidelines and standards for residential services but I am concerned the inspectorate has not yet commenced its work in inspecting these residential facilities. These facilities are funded in many cases by the State and yet we have no means to validate independently the safety of the children in the centres or the quality of service we are paying for to be delivered to the children.
Recent experiences which have highlighted physical and sexual abuse as well as the conditions in some premises have indicated a need to have an inspection system in place. There is also a need to ensure, when we seek value for money from services, it is represented in the quality of care provided to the children who are essentially in our care.
Residential facilities for adults with intellectual disability are not under the ambit of an inspectorate. I welcome the commitment to standards, developing guidelines and commencing inspections but I would appreciate a timeframe for this work. It had been hoped the inspections might have commenced earlier this year.
A number of residential facilities are provided by the State for unaccompanied minors. I have made statements before on their right to protection and a quality of service, and I insist this group also be included in the work of the inspectorate. I would appreciate it if the Minister of State could provide details whether that will be the case.
Pat Carey (Minister of State with special responsibility for Drugs Strategy and Community Affairs, Department of Community, Rural and Gaeltacht Affairs; Dublin North West, Fianna Fail)
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I am pleased to be asked to take this Adjournment debate on behalf of the Minister for Health and Children and I thank Senator Corrigan for raising this important issue. The way in which society acts to protect those with a disability is a true test of how we support the most vulnerable people in society.
The recent report into the Brothers of Charity services in Galway illustrates how vital it is to ensure proper protections are in place for all. The accounts by service users of the type of abuse suffered by them in the late 1960s, up to the early 1990s, is a truly sobering lesson for us all.
The Government is committed to ensuring all residential facilities for people with a disability are independently monitored and inspected by the Health Information and Quality Authority, HIQA. This is provided for in the Health Act 2007 and it gives the HIQA the necessary powers to examine the nature and quality of services and to determine whether they are of the standard to which all people with a disability are entitled as of right.
The HIQA has commenced work on standards for designated residential centres for people with a disability and these will form the basis for statutory regulations and inspections. The HIQA is determined to get these standards right, however, so that it is inspecting all residential facilities against an appropriate benchmark. This cannot happen overnight but we will work with the HIQA to ensure it can be achieved as soon as possible.
The HIQA's aim is to finalise formal standards in 2008 and commence formal inspections in 2009. It is important to stress that other means of protecting service users will be used in the meantime. The Health Service Executive has been asked to take all possible action to ensure the quality and safety of services, and the executive recently published a formal guidance document on residential facilities for children and will do so in respect of adults early in 2008.
The HSE will make it a condition of funding under its service level agreements that the contractual arrangements between the HSE and agencies that provide disability services will include, for the first time, quality and safety measures to ensure the users of a service can enjoy the rewarding and safe experience to which they are entitled.
The immediate and the ongoing needs of unaccompanied minor asylum seekers relating to accommodation, medical and social needs, as well as their application for refugee status, are the responsibility of the HSE in accordance with the Refugee Act 1996, as amended, and the Child Care Act 1991. The majority of unaccompanied minors and separated children seeking asylum are placed in residential care such as a hostel or registered children's centre, and others are placed in foster care and supported lodgings. The hostels accommodating unaccompanied minors are subject to inspection by the social services inspectorate and the registration and inspection unit of the Health Service Executive. On commencement of the Health Act 2007, the Health Information and Quality Authority will have responsibility for inspecting all hostels, whether statutory or non-statutory.
Accommodation for unaccompanied minors and separated children seeking asylum is covered by the national standards for residential centres. It was agreed between the social services inspectorate, the registration and inspection unit and the office of the Minister of State with responsibility for children that guidance notes for the provision of residential care to unaccompanied minors and separated children seeking asylum and who are aged 17 and over would be drawn up by the social services inspectorate in consultation with the Health Service Executive to accompany the national standards for residential centres. These guidelines have been finalised and approved by the office of the Minister of State with responsibility for children and are with the Health Service Executive for implementation. I thank the Senator for raising this important issue.
I thank the Minister of State for the very positive response. Will he convey to the Minister that a requirement for all services in receipt of funding to implement guidelines for the investigations of allegation of non-accidental injury and sexual abuse should be included in the contractual agreement between the HSE and these services? There is no requirement for any service to do that. The inspection process should also include participation or a contribution from the individuals in receipt of service.