Seanad debates

Thursday, 22 September 2022

New Innovations for People with Disabilities (Digital Assistive Technology): Statements


10:30 am

Photo of Mary Seery KearneyMary Seery Kearney (Fine Gael)
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We will commence with statements on new innovations for people with disabilities - digital assistive technology. I welcome the Minister of State, Deputy Rabbitte, back to the House.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I am thankful I have been given the opportunity to address my Oireachtas colleagues with regard to digital and assistive technologies. I know some Senators present are dependent on glasses, as I am. I am sure everyone is aware of friends, family or colleagues who use hearing aids, screen readers or other items and technologies that help them in their day-to-day lives.That is exactly what digital and assistive technologies are about: making life that bit easier and more accessible for people with different kinds of impairments. The use of technologies has been characterised as a facilitator for the integration of services and the provision of facilities to serve people with disabilities. In other words, their use can allow people with an impairment to play a greater and more fulfilling role in society. According to the WHO, more than 1 billion people worldwide require one or more assistive products. As people turn 50 and get older, they will need an assistive product every year along the way. The bulk of these are disabled or elderly individuals.

People of all ages, including those with disabilities, have a variety of functional impairments as they age, and as a result, they require more support. By 2050, it is anticipated that more than 2 billion individuals will use assistive devices due to the ageing of the global population and the rising prevalence of non-communicable diseases.

With the help of assistive products, people with disabilities can engage in school, the job market and civic life, helping them to live healthy, productive, independent, and dignified lives of their own choosing. Additionally, the use of formal health and support services, long-term care and caregiver labour can all be focused on more critical cases with the aid of assistive products.

Since becoming Minister of State, I have been dedicated to increasing developments, innovation and utilisation of digital and assistive technologies. Globally, I have engaged with the WHO and made sure that Ireland works with the international community, and, critically, with the disabled persons' organisations to ensure people with disabilities are the drivers of the innovative changes they want to see.

As a follow-up to the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, the WHO launched a programme to promote global co-operation on assistive technology entitled GATE. The goal of the GATE programme is to increase accessibility to high-quality, reasonably-priced assistive goods for those with a range of disabilities, illnesses, and age-related ailments. Ireland has been a key stakeholder in this.

The World Health Assembly Resolution 74.8 2021 urges member states to realise the highest attainable standards of health for persons with disabilities, a key part of which is around the development and provision of assistive technologies. This move was co-led by Ireland, and it is Ireland that is leading out on implementing a rights-based approach to building leadership and governance in health services.

I was recently at the WHO's European regional assembly and spoke about how important this is. On a national level, the Government is committed to offering people with disability the services and supports they need to plan their lives, live independently, and customise the supports needed to fit their requirements. Numerous services are available to shield people and families from paying exorbitant prices for their medical and surgical requirements.

Before I get into this, I want to bring it back to why there is such a focus on assistive technologies. As I explained to the Senator before coming in, when Covid-19 landed in this country and people had to go back into their houses, they were very isolated. To be fair to family members and providers, they saw innovative ways of continuing with communication. Hence the use of a tablet and finding ways to better connect people.

I was in west Cork and I went to the Irish Wheelchair Association. I thought I was going to meet a lady but in fact, the lady was waiting to meet me on Zoom. She told me about how she used to come in, using the Irish Wheelchair Association, to attend the service once a week. What Covid-19 showed her was by learning how to use assistive technology, she could go on Zoom, learn to play bridge, which she now does three times a week, and had more access to more friends. She was not judged on her disability but on her ability to play bridge. She had found many more friends. This got me thinking when I went out to the Central Remedial Clinic, CRC, and saw the wonderful work it was doing. I went into a class where people had to socially distance. While there might have been four people in the room, there was another 12 on Zoom. Very large screens were used to enable people to participate, use their connectivity and let the conversation continue. This is extremely important.

I hear about aids and appliances and we talk about the old model of aids and appliances. "Aids and appliances" is a term that is dated and does not keep up with technology. We need to be innovative and creative and support the families who understand best and help us shape the role aids, appliances and technology can play. I have looked to get more involved at an international level to see how Ireland can become part of things and to lever us onto a larger market of access to aids and appliances that will enable our citizens to fulfil what it states in the UNCRPD.

I am going to move on to some of the projects I have funded in the past year under the Cooperative Real Engagement for Assistive Technology Enhancement, CREATE, programme. This initiative seeks to ensure service users and providers work together to identify what will make a real difference to individual users of digital and assistive technology. What I am about to describe are projects funded by once-off funding of €2 million that I got last year in the budget. To be fair to the various groups that came forward, that €2 million has been very well spent.

The inclusion of the person is what makes this important. Funding for this was assessed on the extent to which each proposal was person-centred, as well as how it demonstrated a willingness to work collaboratively across different service providers and to engage with digital and assistive technologies through a clear process of co-design.

Acquired Brain Injury Ireland will use person-centred digital and assistive technologies to support brain injury survivors, while also establishing a new programme to systematically upskill its staff in a range and functionality of digital and assistive technologies products. The Brothers of Charity service west are establishing a pilot digital and assistive technologies team to develop a multidisciplinary service focusing on communication and access needs and linking with local advocacy groups for people with disabilities.

The CRC will establish Ireland's first sit-to-stand wheelchair service, allowing wheelchair users to stand without the need of assistance. For people with spinal cord injury and Duchenne muscular dystrophy, this may have a range of physical and psychological benefits. The nine children's disability network teams in community health west will establish a community DAT bank with access based on needs and incorporating digital and assistive technologies into family service planning and integrating with the Department of Education's digital strategy for schools. That is where we need connectivity. We need to connect children to their environment, be it in the home or in education. It is not just children but it is adults as well. We need to ensure we work across Departments and across areas of involvement.

Adult disability services in Longford and Westmeath will work with Longford County Council to identify digital and assistive technologies to support people with disabilities living independently in the community and facilitating those on a housing waiting list to take up a house when it becomes available and to ensure that house has the required assistive technology so they can live as independently as possible.

The Rehab Group will develop a digital and assistive technologies ecosystem with a first-stop-shop for information, advice and guidance on how digital and assistive technologies can enhance person-centred planning, independence and participation in all aspects of life. Their new digital and assistive technologies training module will be co­produced with people with disabilities. St. Michael's House will use digital and assistive technologies to enhance the experience of using respite services, incorporating the Sláintecare-funded health passport for people with intellectual disabilities.

Stewarts Care will use digital and assistive technologies to promote the implementation of the meaningful day approach to service provision, by providing a broader range of activities, including greater social interaction between service users and between them and the communities in which they live. Sunbeam House Services will develop a digital and assistive technologies loan library which, among other things, will support the advocacy group viewpoint, to develop a mentorship programme of expert digital and assistive technologies users. The National Council for the Blind, NCBI, will provide timely access to digital and assistive technologies nationwide, addressing delays and shortfalls in their provision and offering consistency of support. I have run out of time.

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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Cuirim fáilte roimh an Aire go dtí an Teach. She and I acknowledge the amazing work done in the past year through the €2 million granted in the last budget. I hope she has a foot against the door on this occasion and that she will get another €2 million, or maybe more, because the money is extremely well spent.

The Minister of State mentioned that many people wear glasses. I believe I will be going down that road as well. I spent three quarters of an hour this morning in south Dublin getting my eyes tested.

The Minister of State said the World Health Assembly's Resolution EB148.R6 of 2021 urges member states to realise the highest attainable standards of health for persons with disabilities, a key part of which will concern the development and provision of assistive technologies. If I had been asked in this House five years ago what assistive technology was, I would not have had a bull's notion. The Minister of State mentioned that she recently visited the constituency of Cork South-West, where I live, and the premises of the Irish Wheelchair Association in Clonakilty. I would like to enlighten her about the fact that, in Bantry, where I lived for many years, CoAction West Cork was set up in the early 1980s. Having had ten clients originally and now more than 100, it has done great work. There is funding for road bowling and days out in the town and surrounding locations. It does not operate in Bantry alone but also in the peninsulas, including in Castletownbere, Goleen and Kilcrohane. There is a wide variety of tremendous work done. For people in Castletownbere or Goleen, which is roughly 100 miles from Cork city, the notion of getting to Cork to a central service was not applicable at the time in question.

Digital and assistive technology can do tremendous work for the affected people. CoAction has been immersed in the community for as long as I can remember. When it was established, it opened a little workshop close to the house in which I lived at the time. It has developed since. It has several houses, and people can live independently in them. Some have physical disabilities and others have all sorts of other disabilities. The community support offered by the organisation not only in Bantry but also in Skibbereen, Clonakilty, Dunmanway and the huge region in which they are located, even going into Cork North-West and Kerry South, is tremendous. It is appropriate that it be mentioned here today. If it has not already contacted the Minister of State, I encourage it to do so. Some extra funding would mean a lot to it. A friend of mine, a councillor who is a wheelchair operator, has worked very closely with the group.

The Minister of State mentioned the Central Remedial Clinic, which does extraordinary work. Ireland's first sit-to-stand wheelchair service allows wheelchair users to stand without the need of assistance. That is an amazing breakthrough because most people would not even have thought of that historically. The Minister of State said, "For people with spinal cord injury and Duchenne muscular dystrophy, this may have a range of physical and psychological benefits." For some with physical disabilities, which they may have either from birth or because of an accident, the emotional and psychological advantage of the modern technology is a huge boost. When I was growing up, people with a disability, even those with Down's syndrome, were hidden away from society. This was a shame. I had an aunt with Down's syndrome when I was a child. The notion of even taking her out to mass was frowned upon. It was asked why you would take her out. This thinking has turned totally on its head, and we are going in the right direction.

It is interesting that the World Health Organization is totally involved with this. It may be a new awakening not alone internationally, through the WHO, but also nationally. As someone who is fairly well travelled and who lived in England for some years, I believe we are a leading light in this regard. We are stepping forward and are among the best in Europe. I have no doubt that the money that has been provided is just a first. The money is extremely well spent, and I accept the Minister of State's pronouncement in that regard. However, if she got €4 million this year, which might be a bit of an ask, that money could also be spent throughout the country. It is a new beginning. I welcome it.

I laud the Minister of State for her tremendous work in this field. Some do not acknowledge what Ministers do. This is a case in which the public can learn from what we do in public life. Sometimes we get criticism, some of which is deserved, but sometimes Ministers, be they Senators or Deputies, deserve a pat on the back for what they do. Sometimes the public disregards the good things we do and hone in on the negative stuff, which we hear about on social media, etc. We are moving in the right direction. I have no doubt that the Minister of State is pushing an open door as far as the Members of this House are concerned.

Photo of Tom ClonanTom Clonan (Independent)
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I thank the Minister of State for attending. Aids and appliances are a means to an end but not an end in themselves. Although they are very useful, we cannot really consider them in the absence of the requirement for personal assistants and therapists. I will go from the individual experience to the wider experience within the community. I echo what my fellow Senators have said about the Minister of State's absolute sincerity and her persistence in advocating for us and our community. That is without doubt, so she should not take anything I say as a personal criticism. I am speaking from our own lived experience. Eoghan, my son, is 20. Over the years, because of his neuromuscular disease, he has had access to digital and assistive technology. For example, he has a very large iPad. His eyesight is compromised but the large iPad allows him to see the print on the screen. He has had some voice-activated software. It can speak his requests and needs into a device, and it can communicate, by text or another means, with another person. Unfortunately, however, because Eoghan has not had any speech therapy since 2007 or 2008, the voice-activated software can no longer discern his scanning speech. This is one of the points I am trying to make. In the absence of meaningful therapies, the digital and assistive technologies, in and of themselves, cannot really function.

There are also very practical matters to be considered. Eoghan is unable to plug in or unplug his tablet, laptop and other devices and put them on the tray of his wheelchair. He would require a personal assistant to do that but he does not have one. He has somebody who assists him in the morning with getting dressed, showering and going to the toilet, but that person then leaves. He is on his own in the house all day as a 20-year-old man – a young man blossoming, a beautiful young man. Unlike his siblings, he is confined to the house because he cannot go out independently without a personal assistant. I set him up with his tablet in the morning. This summer, he watched the whole show “Friends” from start to finish, but, instead of watching friends on a screen, he would prefer to have friends. He cannot have friends and is isolated despite the state-of-the-art technology because he cannot leave the house. He does not have a personal assistant to bring him to Dundrum Shopping Centre or into town to have a cup of coffee. He is denied all these experiences despite the state-of-the-art technology because an essential support is absent for him, just as it is for tens of thousands of children and young adults throughout the Republic. I am aware that the Minister of State knows this from her visits around the place. There is a recurring theme of unmet needs throughout the State.

Very many of the assistive and digital technology platforms require intensive input, either from an occupational therapist or physiotherapist with a special interest. This is from the end user's perspective.It takes quite a deal of training and reinforcement to enable a child or a young adult to get the most out of the technology. If one has one physiotherapy appointment a year, if one is lucky, that lasts one hour, that meaningful interface does not take place. I know this to be a fact. The progressing disability services for children and young people policy has failed and Paul Reid has acknowledged that on the record at the Committee on Disabilities Matters a number of weeks back. The wonderful steps we have taken forward in digital technology are very much meaningless without those human interfaces. That is the end-user perspective, which I will not beat to death.

From the point of view then of other service provision, I have had a virtual occupational therapist, OT, visit which did actually work, where Fannin Healthcare came and delivered a bath chair. The OT, through my mobile phone, was able to look at the bath chair. One could certainly not provide services such as physiotherapy and occupational therapy virtually or remotely. It is just not possible given the requirement for the physical intervention.

I use this opportunity to say that there is a complete requirement for us, and I know that this is the absolute mission of the Minister of State for the lifetime of this Government, to constantly reiterate the fact that we do not have the basic building blocks, that is, the personal assistant, PA, hours. These are not being provided by the State, by the HSE and are not being provided by the private care providers that are funded by the State. It is just not happening. In the absence of those supports, the digital technology is, to a greater or lesser extent, meaningless.

I will finish on one final negative point and then I will conclude positively. I am very conscious and I have just come from the third level sector where we delivered all of our lectures virtually. Virtual delivery of services in things like education or day services to people with disabilities is a very poor substitute for real-world interactions.

People with disabilities are already isolated because of the lack of support from PAs and so on. I would hope that the providers will not rely upon digital technology to give lip service to day services and other supports because it further isolates people with disabilities. I saw it this summer with my son at home, where he is now. In fact he is on his induction today so he has a PA for the period of the academic year.

On a final note. There is hope and I commend the work of people like Professor Brian MacCraith, former president of DCU, and Professor Daire Keogh. They have the exoskeleton programme in DCU. Eoghan and I went out at Brian MacCraith’s invitation. It is an extraordinary thing and is an actual skeleton that will wrap itself around a disabled person and assist them to walk. The technology now has perhaps 500, 600, 700 and up to 1,000 messages per second. The next generation level of exoskeletons will have hundreds of thousands of messages per second in the sensor so it can tailor itself to an individual person. Eoghan and I went out and he was shivering with excitement to have the opportunity to see if this could help him walk or move. When the physiotherapist did the assessment of Eoghan, he found that because of a lack of physiotherapy over the years, Eoghan’s contractors had deteriorated to such an extent that he was not a candidate for that technology.

Again, this underscores the requirement for the human intervention and while digital technologies provide very significant quantitative leaps forward, qualitatively, they do not really impact to a significant degree on the life and lived experience of people with disabilities. I thank the Acting Chairman.

Photo of Martin ConwayMartin Conway (Fine Gael)
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Gabhaim buíochas leis an gCathaoirleach Gníomhach. At the outset, I acknowledge the great work that an Cathaoirleach Gníomhach, Senator Seery Kearney, is doing as part of the Committee on Disability Matters in advancing the cause of people with disabilities and, indeed, the need for equality in this country.

We have spoken many times on these issues with the Minister of State and her enthusiasm never ceases to amaze me. Even two years into office, I see how determined she is to make a difference. She has made a difference. I consider the particular grant scheme she has spoken about to be a pilot because funding comes with success. If something is seen as successful, one would want to be a brave Minister for Public Expenditure and Reform not to provide the funding to keep it going.

As Senator O’Donovan said, €4 million will be seen as small money in the future. I have no doubt that each and every one of the projects that she has listed out will make full use of the money that is given to it, and I am sure the projects will commit some of their own resources to them also.

In my lifetime, there has been a revolution in technology. When I was in school, apart from a couple of low vision aids, that was all I had. Believe it or not, and the House will be shocked to think of it, I wrote my junior certificate exams. How anyone read them is beyond me but that is another story. When it came to me doing the leaving certificate in 1993, I believe, I typed it on a typewriter. If one made a mistake one was not able to correct it. I then went into UCD where I was lucky enough to do my exams on a PC, and at least I could run a spell check at the end to tidy it up.

When one fasts forward then to coming into the Oireachtas, I had an iPad and iPhone. I can therefore take pictures of something, enlarge it and read it. If I go into a restaurant and there is a menu, I can pick up the phone, take a picture of it, enlarge it and read it, whereas only a few short years ago I would have needed somebody to read the menu to me. That is fine because I do not have any chips on my shoulder and it does not bother me whatsoever, but there are other people who would find it very embarrassing to have somebody read a menu to them. That has now been eliminated with the use of the phone.

The Minister of State and I attended the launch of IA Labs, which is a National Council for the Blind of Ireland, NCBI, initiative to ensure that all people with print and vision disabilities will have access to technology, which will basically enhance and enrich their lives. Every single penny of Government money that is put into technology is worth it and I completely understand what Senator Clonan has just said in regard to people. If the people are not there to create the link between the technology and the individual who needs the technology, that then is an important cog.

My view is that we will have to spend millions of euro on personal assistants because there will be different types of personal assistants. We will need personal assistants who can take advantage of technology and assist people with it. There are other personal assistants in the area of healthcare. We have a serious job of work to do to bridge that gap. When the pandemic occurred I found the Zoom meetings very challenging simply because of the chat function on the screen. I could not read the chat function and it would come and go so quickly. I remember several times in our own parliamentary party meetings asking Ministers, if they were putting important information out there, to please not put it up on the chat function because I could not read it.

I made a request to the Houses of the Oireachtas Commission for a big-screen. I got the big screen but it was 12 months late, in that the commission had to obtain three quotations and had to use the cheapest one. The screen ended up having to be imported from China, and by the time it came the pandemic was essentially over. Institutions will probably have to say that they will need to move with the times where, if technology is needed now, it is actually needed now. If we are going to be purchasing it anyway, do not take the good out of it by going through a convoluted procurement process for what is, in truth, just a big monitor.

I look forward to the day, hopefully it will happen in my lifetime, when I will be able to walk out my front door in County Clare, sit into a Google driverless car, and pull up on the Plinth outside Leinster House, where technology will basically have brought me from Clare to Dublin safely. I believe we are not that far away from that happening. There is a great amount of work being done, with investment, research, technology development and so on. I sincerely hope we are not that far away. That helps everyone, not just people with disabilities, as it helps with road safety, etc.

I have one final point. I am running a little campaign at the moment and I have spoken with the Minister of State’s colleague, the Minister for Education, Deputy Foley, about it. The leaving certificate examination papers at the moment are not digitally available and are therefore not digitally accessible. We are an outlier at this point in time in Europe when it comes to that.Somebody with a print disability whether it is dyslexia, vision impairment or whatever else cannot use the technology they are comfortable with to access their leaving certificate papers. We are told it is because they do not want to compromise the integrity of the paper, the confidentiality and so on. There has to be a way around it. I want the students who are doing the leaving certificate in 2023 with a print disability to be able to access their exam papers in the form of technology that they are comfortable with. I want them to be digitally accessible. Any assistance the Minister of State can give in encouraging the Minister for Education, Deputy Foley, to ensure that can happen would be very helpful. I am going to Temple Bar this afternoon to the launch of a policy paper on education from the National Council for the Blind of Ireland. This is a big issue. Readers have to be employed to read the exam papers. People should be able to do it in the sphere they are comfortable in.

With technology and the people to help people access technology, we can reduce the 86% unemployment rate of people with disabilities to the European average of around 40%. It would be positive if we could even get it down to 50%. That can happen with the use of technology and the people to link the individuals to the technology.

Photo of Mary Seery KearneyMary Seery Kearney (Fine Gael)
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I thank the Senator for his kind words and well done to him for his persistent campaigning.

Photo of Niall Ó DonnghaileNiall Ó Donnghaile (Sinn Fein)
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The Minister of State is very welcome. I thank colleagues for the very informative contributions they have made on this issue so far. They certainly informed me and I am sure they have done the same for the Minister of State. It shows the merit and value of having statements like this in the Seanad and taking the time to discuss these issues.

As the Minister of State said, technology has had a far-reaching and positive impact on many areas of life. In particular, it has significantly opened up life for people with disabilities. Assistive technology, AT, a specific branch of general technology, refers to practical tools that can enable people with disabilities and older people to maximise their independence. It refers to any device or system that helps to improve the functional capacity of the person. It has been a central feature of the disability sector for some time.

The smartphone is probably the most obvious and versatile form of assistive technology available. That technology can support people to access their human rights, for example, under the UN Convention on the Rights of Persons with Disabilities. It can support people to complete their education, get and retain employment, live in their community and become digitally literate. Examples of AT include screen-reading software that supports people with vision impairment as well as those with literacy challenges, and voice output communications solutions for those who are non-speaking. It includes control technology such as remote control of doors, windows and lights to enable independence in the home. There is a growing range of mainstream mobile solutions available via apps on smartphones and tablet devices which can support everything from personal mobility to personal organisation and memory aids.

A report based on a survey of 120 service providers by the HSE which examined the impact of AT on disabled people during the Covid-19 pandemic found that people were very positive about how technology helped services continue to varying degrees and helped maintain connectedness, engagement and interaction. The technologies that helped included WhatsApp, Facebook, Zoom, Skype, YouTube, Wi-Fi and JAWS. However, the report also found that nothing replaced face-to-face contact, the in-person human connection. Two leading organisations in the development of AT for disabled people, the Disability Federation of Ireland and Enable Ireland, have raised with the Government their concerns that current service provision for AT is fragmented and under-resourced to meet the emerging challenges of a growing population with disabilities and older people interfacing with technology which is developing at great speed. One of their key recommendations is an AT passport which they believe will help immensely the way people gain access to AT when and where they need it.

AT has brought new approaches in how disabled people and wider society respond to disability. These changes need to be complemented by a change in our attitudes as well. Disability is not solely a health matter. We need to move away from the medical model to a rights-based model. We need to realise that society's attitude to disability is problematic rather than a person's impairment or difference. The Government must also realise that it needs to significantly increase its budgetary commitment to the disabled to do the following: cover housing and individual living supports; eliminate poverty and social exclusion which are among the highest in Europe; end the lowest employment rates in Europe; and significantly improve the educational attainment of the disabled community. I know the Minister of State will lobby and work hard for that.

At a broader health level, last week Sinn Féin launched its €1.1 billion alternative budget for health 2023, Funding Fairer Healthcare. This is a ten-year ambitious health plan which invests in all the major areas of health provision. In the context of the disability debate it commits €153 million to the disability capacity review and the children's disability networks teams. The plan will reduce the cost of healthcare, tackle waiting times, improve primary and community care, and support mental health services. It can end the current crisis in the health service which is similar in origin to the housing crisis - a failure to plan. Sinn Féin's proposals will end the two-tier health system and deliver health and social care on the basis of need, not the ability to pay.

I want to conclude my remarks by thanking the Minister of State for her attention and attendance, and for her hard work and commitment to this issue. I am fully conscious of some of the things I have said in my script. It probably would have been a different speech had I had the opportunity to prepare it having listened to Senators Conway and Clonan and the contributions emphasising the need for human contact, personal assistance and person-to-person supports as well as the technology.

It is quite easy to get caught up in the glamour of innovative technologies and think sin é, that is a great innovative solution to a problem. Really it is as fundamental and as basic as what Senator Clonan rightly said, having somebody to lift the tablet, put it on the desk, switch it on, charge it up. All of those things need to be fully complementary in order to work and deliver.

While investing in and prioritising technologies is key and will continue to have a key role in supporting people to live independently and live the fullest possible lives, it is also so important that we get the basics right alongside it, that we get the human touch right in terms of all this going forward. I really appreciate today's debate and I know we will look to next week's budget with a keen eye to ensure targeted supports are going to the people who need them most.

Photo of Mary Seery KearneyMary Seery Kearney (Fine Gael)
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This is a great opportunity to make statements and look at the innovative developments the Minister of State is leading on in the Department. I thank her most sincerely for the constant advocacy, work and dedication that she shows in this Department. I speak about it every week at my own parliamentary party meeting, as I said to the Minister of State before, also to ensure that she gets all of the supports she deserves. No better woman. I am very proud to have her as a governmental colleague. I think she has been extraordinary and very responsive in ways that are often behind the scenes and that nobody really knows about, in the texts she gets from us sometimes at weekends.

On assistive technologies, it is great that innovation has moved to such a place that it assists people in living their lives in a more full way. I completely take on board everything that Senator Clonan said. His contribution describes that need to ensure we have all the supports. The lack of occupational therapists, speech and language therapy and all that is a travesty across the entire HSE for children and for everybody who needs those services. That is a whole other day's debate but I am highlighting the need for assistance in such very practical ways as well as the more developmental ways.

I always come back to the cost of disability, the cost of the loss of opportunity for persons to live their best life, which is one of the sayings of the chief executive of Cheeverstown, TJ Duggan. TJ has always said to me that this is about making sure people live their best life. Everybody should have equality of opportunity and assistive technology provides that as long as we have all of the clinical services and supports, as long as we have connectivity. I am very pleased that broadband has been rolled out and I thank my own party colleagues for that. We need things like that to make sure there is connectivity wherever people are.There are opportunities in employment. Now that we are working to a hybrid model of employment, there is an opportunity for people with disabilities, mobility issues or challenges to work in a home office that is set up properly, so that they can have the opportunity to reach out and have such access to the workforce.

Under health and safety law, there is an obligation for a risk assessment to be done. Risk assessment is essentially the planning for every scenario that might arise, whether it arises or not. Some part of me believes that schools and employers should be obliged to perform access assessments and inability assessments in the context of enabling. We are working on universal design, as mentioned by the Minister of State during the Commencement debate. I know how much we talk about this on the housing committing, and the Minister of State, Deputy Peter Burke, has been instrumental in that.

I am about to take on an intern who will rely heavily on his assistance dog. When thinking about that I wonder how that will work in the context of Leinster House, accessibility, and working in my office. The college has said that there is no problem with him working from home. I do not want him to work from home. I want him to have the experience of being in Leinster House. I want him to have the fullest experience of being an intern in the same way anyone else would have as an intern. There is no document that I can reach to that has foreseen this and outlines systems in place. There is nothing I can reach to for in the way one might if it related to health and safety - that is me speaking while wearing my employment lawyer hat. There is a way to plan and there should be an obligation to plan for such situations. What do employers do and where do they go to on this? I know the voluntary and sectoral organisations probably have assistance but the question is whether it is formalised. These are matters we need to be thinking about. I appreciate I have gone over time and I thank the Acting Chair for his indulgence.

Photo of Martin ConwayMartin Conway (Fine Gael)
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As there are no other Senators offering, I ask the Minister to conclude.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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As there are no other Senators offering, how much time do I have?

Photo of Martin ConwayMartin Conway (Fine Gael)
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It is open-ended.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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Open-ended is even better. We will make it more intimate so that we can address the matters on which Senators engaged.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank my good colleague, Senator O'Donovan, for bringing us through a step in time to explain how organisations were set up and put in place in remote parts of Ireland to support families with disabilities who could not get into larger urban areas to seek support. The Senator mentioned CoAction which is an organisation that has supported a large part of south Cork in the delivery of services. It continues to do so and it has grown and grown.

Senator Clonan is right. The topic of assistive technology is wonderful, but it is only as good as the people who are supporting the persons with disabilities. It is an enabler and a communication piece. It is not and can never be seen as the end piece. To any providers watching these proceedings I say that this is not a get-out-of-jail card for support individuals. I am trying to ensure that we have equity of access for all people with disabilities, no matter where they live, and in enabling them to participate in work and social life, communication with friends and growing that friendship base. However, that does not take away from my responsibility or the responsibility of Government, or providers of HSE services, in ensuring that we have properly funded PA and home support services. That is and has always been a fundamental piece of my budgetary process. Last year, I was quite happy to say that I grew the budget for PAs by six times that of the previous year's budget. I will continue to do so for the simple reason as mentioned by Senator Clonan. His son, Eoghan, should not have to lose his PA during the summer because he is not in college. Eoghan's life does not stop when he leaves college. He needs to be able to participate equally throughout the summer weeks, no different from the rest of the household. That is what everyone needs to have. That is why it will be a priority for me during the budgetary process that the PA provision will stay in place. This is important for all Senators. Not only will it stay in place, but we were not equal in how we paid the staff delivering PA or home support. We paid them a lower wage than we pay those working in older person services. That is why we have struggled to attract people into the delivery of such services. This is not to give anything away. Let us be clear: I do not have any money bagged yet. I am before Senators in the Seanad now and I have to return to more meetings about money at 4 p.m. I have nothing bagged.

Photo of Martin ConwayMartin Conway (Fine Gael)
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We have every confidence in the Minister of State.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I would like to ensure that I can bring about equity for the staff who deliver PA and home support services, thereby having a good pool of people we can go to so that we are not left short of people, and at the same time, grow the budget of that piece this year. That will support people with physical disabilities or behavioural challenges, or whatever they may face, be it part of the work or education piece.

I refer to the devices. Senator Clonan gave the example of lifting a laptop and the skeletal device that Eoghan missed out on because he did not have that intervention. Senator Carrigy, who joins us in the debate, and I have talked about this on numerous times. We do not need all of them to be clinicians. We need people who can support the delivery of what is prescribed. They can be assistants in occupational therapy, speech and language, or physiotherapy. There does not need to be a weekly meeting with a physiotherapist, but the programme that has been put in place needs to be delivered, sustained and maintained until the programme is followed up six or eight weeks later with a senior level clinician. I genuinely believe we need to make that step change within the delivery of services and not be so protective of the clinicians and their base. We need to look to the assistant role as well. That will be part of the progressing disability services, PDS, roadmap I am sharing with Senators today, so that every child will have a continuation of delivery and access to services.

As I have travelled around I have listened to parents. Some have told me that their child, who is in non-verbal, has access to a tablet with different apps. That is an affordablity issues and that is wrong. We should never deny a person the right to communicate. All of us here have a great opportunity in that we can speak. We can articulate ourselves through our voices. By denying people the right to communicate, we are denying them the right to have their rights and voice heard. I fundamentally believe in the rights and voice of the child, for which I have always campaigned. We need to look to assistive technology and the augmentative and alternative communication, AAC, system such as PECS, so that from an early stage we train the early-years providers on what this device is about. We can then enable children to participate in the room by using their devices with the PECS programme so that they are not frustrated. That should follow on into national school and post-primary school. It is an enabling tool, while not being the only piece. It would ensure that users can participate and say, for example, that they would prefer Ribena to water. Simple things make a huge difference to people.

That is my role regarding technology. What I am looking for from within technology comes from a very basic level. It is like the communication board in playgrounds. That is technology. We do not have them in every playground around the country, although we should have. I would like to see some of my one-off funding going to such initiatives, while at the same time letting our innovative, digital people working in services know how they could bridge gaps to support people. My colleague talked about the health passport. I do believe in getting that up and running through funding. They are the pieces we need to develop. If is for the people who have been sitting there long enough saying "If we had this, it would work". It would provide collaboration.

Senator Conway and I were at the launch of the IA Labs about six months ago. His story is excellent because he explained that with investment and changing times, developments are changing to meet the needs of people. What we learned from the Senator's story is that the 12 months it took to introduce a piece of technology did not help us.That is exactly what children experience in school. That is exactly that experience. The procurement piece that tethered Senator Lombard is tethering so many more families as well. Health is based on a needs-led approach in that the need is identified and the support should be there. When we have a diagnosis or the child has a need, we should not have to be waiting for the three procurements. What we should be doing is going to what is best in the field.

I know a lady from the Senator's good side in Cork who needs assistance with a car seat. The child has scoliosis. At the same time, she needs to have that car seat. She has been refused the car seat in the past number of weeks for the third time. The child needs to have it because she has to travel to school. She has to hold a particular position and if she does not, given the regression that is going on, she just might not have the scoliosis operation. She should not have to wait to see when and where she can get that. We should have on our appendix board where that can be sourced, that the seat needs to be provided and that it is verified and proved that the seat is what is needed for the child and it should be given. Waiting is what frustrates parents completely.

A number of us here might have met a young lady from the Carlow side who did the junior certificate exam. Her case was to do with the pictures on her English-paper exam. It is very much down to how a student's scribe would describe what was in the picture. One has to see what is in the picture to understand what one is seeing. The student is dependent on a second person to interpret what it should be. Another person has interpreted the picture but the student has to formulate an answer on it. It is not just black and white. That held her back considerably in doing the junior certificate. She felt at a disadvantage because pictures were used a number of times. The exam was actually on the French syllabus. I apologise. The use of these pictures meant that, on a number of her questions, she felt she was being held back completely. We need to think twice as to how we set papers and about the people that are sitting the papers in that the students have to be totally and utterly easily able to access them. I will support Senator Conway's campaign.

Having people able to access employment is the most important piece. It breaks down a considerable barrier. Senator Seery Kearney brought it up. I met with the Tánaiste approximately two years ago. I have to be very fair to him. We were talking about the hubs all over the country. He asked how his Department could help. I said we need to make sure that the digital hubs are accessible. Having the digital hubs accessible would mean having a cubby or the sensory room within the hubs, the accommodation being right at the front and proper changing facilities provided within for people with physical, behavioural or sensory disabilities. Guess what is happening in the PorterShed in Galway, which is PorterShed No. 3? I see every one of those bars being hit. That lets me know that Departments are listening and they are actioning. There is comfort within that but we need to see it happen nationally. That means that people can participate in employment. They can participate if they wish to in the hub, but they can also work remotely at the same time, to prevent isolation and everything else. Progress is being made.

As the Senator can see, I do not see technology as the final solution. No different to the Sinn Féin Senator, my colleague, it is wonderful for me to hear the real-life stories because they shape how I respond to things. The Senators share with me and I share with them. That is my thinking within the Department. It is quite difficult some times to break that down. It does not come in a chapter and verse, as the Senator said, when it comes to how we can take on people who might be visually impaired or who might have a physical disability within Leinster House. If we have the challenge, so do schools and people taking on interns everywhere else.

As to the rule book on what is best code of practice, maybe some disability organisation or disabled persons' organisation, DPO, listening into us today might help us in writing or putting together best practices for interns or taking on somebody for work experience or best practice for the Houses of Oireachtas, which I am not faulting whatsoever. However, service checks could be done on the lifts around the Houses on a regular basis to ensure that they are working and to ensure that, no matter what chair or cane the people that arrive in are using, they can move freely and as independently as possible and be given the respect of dignity and inclusion.

As it was a very close grouping, I decided to go on a little bit. I thank everybody for the opportunity. I wish to get a decent sum in the budget to assist with assistive technology. While there are big visions, the day-to-day pieces make an awful difference in life. It may mean that people can access that technology from very early years and become dependent. At the same time, the human touch cannot be forgotten about. It is not a get-out-of-jail card for anyone. It is an enabler for the young person to be able to communicate.

I will finish on trikes and bikes. The Senators may have seen Variety do something about it recently. I remember this time last year when I had to negotiate within my Department because I did not have enough money. I had to go to ask the Minister, Deputy Eamon Ryan, because I was short money for trikes. Trikes are not to be seen as fun toys for kids with disabilities. I see that movement as occupational therapy. Between the two of us, we managed to muster enough money for 32 trikes, at a cost. They are now being rolled out, but there is a waiting list of 190 people. I wish to see everybody off that waiting list. That trike is OT. It is direct intervention. They can be recycled, upcycled or downcycled, depending on the age, weight, ability or need of the child. If we put the child at the centre and we wrap it around that way, the Upper and Lower Houses could do a really good job for persons with disability.

Cuireadh an Seanad ar athló ar 2.17 p.m. go dtí meán lae, Dé Máirt, an 27 Meán Fómhair 2022.

The Seanad adjourned at 2.17 p.m. until 12 noon on Tuesday, 27 September 2022.