Robbie Gallagher (Fianna Fail)
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I will have the Minister of State out of the Chamber before lunchtime. Cuirim fáilte roimh an Aire Stáit go dtí an Teach. She is welcome back to the House. I am seeking an update regarding the transport charge that is being levied on service users who are attending HSE day services in community healthcare organisation 1, CHO 1, which includes counties Monaghan, Cavan, Donegal, Sligo and Leitrim. As the Minister of State knows well, disability is strongly associated with poverty. People with disabilities are twice as likely to be unable to afford to heat their homes, for example. Previously, I quoted the study compiled by Indecon on behalf of the Department of Social Protection that found the cost of having a disability is estimated at between €9,482 and €11,734 extra per year, on top of everyday expenses. Households that include people with a disability have to spend more not only on daily living costs but also on transport, therapeutic equipment, medical expenses, domestic services, equipment aids and appliances, to list but a few. With the cost-of-living issues and increasing inflation, the challenges are more acute. It is serious when extra charges are levied on families of persons with a disability and it is worse when the charge is levied in one area and not in others. CHO 1 is currently the only area in the country where charges are being levied.

As I raised previously, the transport charge has been applied to service users who are attending HSE day services at a cost of €4 per trip or €20 per week in the CHO 1 area. That amounts to a total of €960 per annum for a person with a disability. I am aware of a number of families with two persons with disabilities, which means transport costs of almost €2,000 per annum, which is a huge amount of money. It would be heartbreaking if families were to lose out or suffer a reduced level of service because of these costs.

As the Minister of State knows, the charges have been levied because the routes involved are deemed to be closed routes or exclusive routes. People who are using an open route can use their free travel passes, for example on Bus Éireann services. Unfortunately, that does not apply to this particular service. The problem with the CHO 1 area is that the routes are deemed to be closed routes. The service is top class but, unfortunately, many families simply cannot afford it.

I fully accept that the HSE decision to charge is to ensure there will be a service in the first place. However, by introducing this charge to ensure that no one loses out on a service, the HSE has created an inequality in the CHO 1 area. That is unfair on the people of Monaghan, Cavan, Donegal, Sligo and Leitrim.

When the Minister of State and I previously spoke about this issue, she mentioned that she had taken over the chairmanship of the transport committee, which I had no doubt was a positive development. Knowing the Minister of State as I do, I do not doubt that she will apply a bit of common sense and joined-up thinking in respect of how to address issues such as the one we are discussing this morning. I eagerly await her response about progress on this issue.

Anne Rabbitte (Galway East, Fianna Fail)
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There is nothing like a transport issue affecting healthcare and disability matters as we head into Christmas. I thank the Senator for raising this matter, which he has raised and advocated for on numerous occasions. I have been provided with a script but I am better without one for this matter.

It is the case that CHO 1 charges. That charging mechanism was introduced to ensure all people in CHO 1 could have access to services. That service is being provided but we are now facing a cost-of-living crisis. As the Senator quite rightly said, the cost to individuals is almost €1,000. That has been shown to be an inequality. In other parts of the country, we provide transport for people to attend day services without any charge. The Senator is right that I took up the chairmanship of the transport committee and met all stakeholders and Departments around the issue. We discussed ad nauseamthe open routes model that has been piloted in Leitrim and which has been incredibly successful.

Officials from the Department of Health will be meeting officials from the Department of Transport in the new year to discuss the potential around expanding the open routes project to other areas, including other areas in CHO 1. Routes may move from closed routes to open routes, which will mean there will be no charge for the people who need to access services.

The Senator and I live in the real world. He knows how long that will take to get over the line. However, that is the direction of travel. There is an inequality but a fantastic model has been developed in Leitrim and it can be extended. I have met with the operators of fantastic Local Link services in CHO 1. I see how well that is working in Donegal and Sligo. The system is working very well. At the same time, some people in those areas are being charged almost €1,000 per year while people in Galway are not being charged a single euro. That is inequality and with my functions due to transfer to the Department of Children, Equality, Disability, Integration and Youth, which was approved at Cabinet yesterday, I will find it difficult to charge people with a disability to use bus services while others are not being charged. It is my ambition, working with my adviser, that from January onwards, the open route system will be expanded and services will be brought to the people of CHO 1 on the same basis that services are brought to all others.

It is also important to say that the Department of Health spends in excess of €50 million per year on transport and yet it states it spends no money on transport. Some 90% of the cost of the route in CHO 1 is being provided. Only that 10% shortfall remains. It is incumbent on the Government, the Department of Transport and the providers to respond. The HSE is the main provider. It is not as if we have other providers in CHO 1. The HSE is the provider. It is incumbent on me, as a Minister of State, to ensure funding is found in the next round of budget allocations to ensure that the service can be optimised and that the service users are fully supported, no different from those in other parts of the country. We first need to find that extra 10%. The second piece is to expand the open routes model. The Department of Transport also has a role to play. The same situation should pertain in Donegal and in Wexford. There is a considerable issue in respect of transport in Wexford. We need to ensure that all disability service users have the right and option to access services without a charge and without the fear of losing that service. The service must be regular and consistent. I look forward to working with the Senator in that regard.

Robbie Gallagher (Fianna Fail)
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I welcome the response of the Minister of State and thank her for the work she has done to try to progress this matter. The word "inequality" keeps popping up. All we are looking for is fairness and a level playing field for the people of Monaghan, Cavan, Donegal, Sligo and Leitrim. We want those people with disabilities to be treated no differently from anyone in any other part of the country. That is all we are looking for. I note that discussions are ongoing but I hope they will gather pace in January.I am not going to put the Minister of State on the spot here; I would not do that. Is there a ballpark timeframe for the conclusion of those talks? Would I be too optimistic to say we are perhaps at the beginning of the end? I would welcome her thoughts on that.

Anne Rabbitte (Galway East, Fianna Fail)
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I acknowledge the work CHO 1 has done. It ensured nobody got left behind when people were trying to stretch their money. That is why it has put in place a closed-route door-to-door service. Perhaps other CHOs might have taken the hard view that they do not provide that sort of service and left families with the burden of bringing loved ones to day services. CHO 1 has been fantastic in ensuring all people could attend the service but it has come at a cost. It is a burden of €1,000 in a cost-of-living crisis and if there are two siblings, it would be €2,000 a year. The working group I chair has finished. We had our final meeting last week. Now the matter has gone out for further observation to the various Departments. Anne Melly from the HSE and Department of Transport officials sit on that. I hope we will have a more concrete basis as to our direction of travel in early January. It will be incumbent on me to ensure funding is provided to CHO 1 in 2023's budget but in the interim I would assume, and hope, that the Department of Transport would meet me with the 10% shortfall.