Tuesday, 11 July 2023
Disability (Miscellaneous Provisions) Bill 2023: Second Stage
In this Second Stage debate on a Private Member's Bill, the combined opening speeches of the proposer and seconder shall not exceed 16 minutes and all other Senators have six minutes. The Minister of State has 15 minutes and the proposer has five minutes to reply. I invite Senator Clonan, as the proposer of the Bill, to speak.
I also welcome Senator Clonan's family to the Public Gallery, Dr. Aideen Moran, Eoghan Clonan and Ailbhe Clonan. Eoghan has been the leading research assistant in this Bill. I would say he has done more than lead the research but has done a lot more than that. I thank them for being here today, and I thank Eoghan for his advocacy.
I move: "That the Bill be now read a Second Time."
I am sharing time with Senator Boyhan. I will speak for 12 minutes and he will speak for four minutes.
I thank the Minister of State, Deputy Rabbitte, for coming before the House this evening. I want to introduce to the House the Disability (Miscellaneous Provisions) Bill 2023. I arrived in this House just over a year ago and in my maiden speech, said that I had three objectives here, the first of which was to make friends amongst all parties and none. My second objective was to learn, and I am learning. It has been a very steep learning curve in the Houses of the Oireachtas. The third objective was to try to do some good.
The Members all know the reason I am here. This is a journey that comes from the heart of my family and from my son, Eoghan, who is also my campaign manager. We, as a family, have experienced what is like to have a disability in Ireland. Ireland is the worst country in the European Union in which to have a disability. May God help you if you have a disability or if you are a carer here. It should not be like that, and it does not have to be like that. We are the only country in the European Union, for shame, where there is no legal obligation on the State whatsoever to treat, support or provide therapies or interventions to a disabled citizen. That is why tens of thousands of children and young adults are being failed by this State. These young children are waiting years - way beyond the therapeutic window - for speech therapy, occupational therapy and physiotherapy. These children are deteriorating and suffering life-altering, sub-optimal outcomes on every measure, such as poverty, homelessness and social isolation, to name just a few. It is completely and utterly unnecessary. That is why I am introducing this Bill; to make it obligatory for the State to treat and provide therapies and interventions for our disabled citizens.
I know that the Minister of State is a person of the utmost integrity. I share her frustration at the unwillingness and refusal of very senior people in the Health Service Executive to simply administer and deal with the requirements of persons with disabilities. On the day President Biden addressed the Houses, the Minister of State and I had a meeting with such an individual. At the end of that meeting, I will not give the full quote because there is a word there that is not allowed in Seanad Éireann, the Minister of State turned and looked at me when this senior disability services manager refused to administer a care package to my son and others in our community healthcare organisation. When that MS Teams meeting was complete, the Minister of State looked at me and asked, "Am I challenged, Tom?" This Bill is therefore in the Minister of State's interests and it aligns with her on-the-record statements about our aspirations for disability and all the services that accrue to it.
It is a very short Bill. Part 1 amends the Disability Act 2005. The Government has, which I welcome, made it a right for a disabled person to receive an assessment of need. While there are severe waiting lists for those assessments of need, when you get one it is just a piece of paper. It may recommend occupational therapy, physiotherapy, surgery or personal assistants but you will not get any of those things. Eoghan Clonan has not had any meaningful physiotherapy, occupational or speech therapy for over a decade. As a parent, when we do get the occasional physiotherapy appointment, they measure his deterioration. Can you imagine how it feels as a parent and a carer to see your child deteriorate? We can do something about that in this House.
I believe an amendment will be proposed to delay this Bill for one year. I think that is shameful.
It is cynical. It is hypocritical. You know what? It is consistent. I say this because Eoghan has been on a waiting list for years. Tens of thousands of children and young adults have been on waiting lists. What the Government is doing with this Bill is putting it on a waiting list. If nothing, the Government is consistent. I therefore ask in relation to that amendment that we have a free vote and for the whip to not be applied, so that people can vote with their consciences. I sit on the disability matters committee, as well as the children's committee, with great colleagues who know what is happening in the community. On the disability matters committee, members know the children's development network teams, CDNTs, and the progressing disability services, PDS, programme have failed. Last year, there was an on-the-record admission at the Committee on Disability Matters by Paul Reid, the then CEO of the HSE, when he said that yes, it has failed. We all know this. I am asking the Minister of State to support this Bill, not to put it on the waiting list, not to cynically delay it and not to otherwise interfere with what is absolutely essential.
The first part of the legislation, section 1(1)2B simply states, "The provision of the services identified in the assessment report shall be made as soon as practicable after the completion of a service statement but in any event within the period of time ideally required by the person or persons for the provision of the services identified in the assessment report, whichever is the earliest." In other words, this means that we step up to the plate and meet the needs of our disabled citizens. That is all. The fact that this has to even be introduced as a Bill is a shameful reflection of the failure of the State and its agents in relation to disabled citizens like my son. Article 40 of the Constitution guarantees the right of all our citizens to participate fully in all aspects of Irish life in this Republic, including educational, cultural and political aspects.But disabled citizens are refused this participation. Children are allowed to deteriorate to the extent that they have life-limiting and suboptimal outcomes – citizens like my son who had to wait until he was 17 to get the surgery that should have been carried out when he was 12 or 13. That resulted in years of pain and restricted breathing, which has compromised him for life. It was completely unnecessary. He deteriorated to such a point that he became an anaesthetic risk for the operation on his scoliosis, which was serious spinal surgery that lasted for 12 hours, with litres of blood and blood products replaced during that time. Because of the scoliotic curve, his lungs were compressed. His heart was even in a part of the chest cavity where it should not have been. The anaesthetist stayed in the operating theatre and manually extubated him because she felt that if he had gone to intensive care intubated, that he would not have survived. He suffered that, and we suffered as a family and as parents, and it was completely and utterly unnecessary.
Ireland is one of the richest countries in the world, but it has a cultural attitude of contempt for people who are different by way of disability. This Bill provides in the second Part for an amendment to the Equal Status Act whereby we will actually step up to the plate and acknowledge the difference that disability brings and scaffold and support that. It elaborates on the Supreme Court decision of 1996, which talks about reasonable accommodations. It elaborates on that and gives further clarity as to where the obligations on our public institutions, our most powerful institutions, including the public service, lie. It asks and demands that they step up to the plate and vindicate the fundamental human rights of our citizens. Anybody who would oppose this Bill, seek to frustrate its passage through the House, or seek to delay it, would act fully in the face of our most vulnerable citizens. It is the very opposite of what these Houses are for. We all talk about equality, diversity and inclusion. This is a simple Bill to give voice to inclusion and equality and to vindicate the fundamental human rights of our most precious citizens.
In conclusion, before I hand over to Senator Boyhan, I just want to say that no family should have to watch a child deteriorate. No young adult, on the death of a parent, should be consigned to a nursing home. We have plenty of money, but at the moment there are 2,000 young adults inappropriately housed in nursing homes around the country because of the unwillingness and inability of the HSE to put in place proper care packages and support for people to live with dignity, autonomy and independence in their own homes. They are consigned to nursing homes at huge cost to the State, where they are dumped into a kind of archipelago of misery, hidden behind closed doors all over this country. I came here a year ago with the hope of doing something good, tangible and measurable. Here it is. I again ask that there would be a free vote and that no Whip would be imposed on any amendment designed, cynically, to delay, thwart or frustrate this Bill. The Government should not put this Bill on a waiting list. People like my son and the tens of thousands of children and young adults all over Ireland have been on waiting lists for years. Let us do something right. This is something we can do here, and it aligns with the Minister of State's interests. For the Government to delay this or to vote against it is an act of self-harm, apart from the harm it does to our most vulnerable and precious citizens. I ask, prevail upon and implore the Minister of State not to do that.
I second the motion. I thank Senator Clonan. I also thank and welcome his family here. It is never easy to stand up and share one's own personal experiences and how they impact on one's own family, but the great value of that is that it is a shared experience and I think that is really important.
I thank the Minister of State, Deputy Rabbitte, for coming to the House to deal with this issue. My Independent colleague, Senator Clonan, understands the challenges people with disabilities face in their daily lives. He has clearly outlined that to us here today, but he has outlined that nearly every week since he was elected to Seanad Éireann.
Senator Clonan has long campaigned for people with disabilities and those who care for them in the fight for equality. This is about equality and fair access. He has also campaigned for our elderly citizens, as is stated in the motion, and all those with acquired injuries or who require supports, services and care packages because that is at the very kernel of this proposal today. As a parent and as an advocate, Senator Clonan has witnessed the failures of the health system and the social supports for people with disabilities. He knows, through lived experience, the importance of supports and services for disabled Irish citizens. Senator Clonan continues to campaign in these Houses to have the UN Convention on the Rights of Persons with Disabilities fully ratified in Ireland through his ongoing work within the Oireachtas and the Joint Committee on Disability Matters.
The Disability (Miscellaneous Provisions) Bill 2023 seeks to amend the Disability Act 2005 and the Equal Status Act 2000 to make it legally obligatory for the State and the HSE to provide therapies, interventions and supports, outlined in the assessment of need that the Minister of State and all of us are very familiar with. She has come to this House on many occasions to respond to Commencement matters and set out the difficulties and concerns she has in overseeing this brief. The HSE and other authorities say they will provide those services but then the person with a disability or his or her carer do not receive the necessary supports due, usually for reasons cited as funding resources and other measures.
It was very disappointing this morning when we received correspondence from the Leader that she would table an amendment to defer this matter for 12 months. I too had a similar experience in this House where a matter was deferred for nine months, and 18 months later it came to nothing. When I brought a Commencement matter to the House only two weeks ago I was told that nothing was going to happen, having been brought around the merry-go-round and been told that the Government was going to do something, but it did nothing. My fear today is that this will happen again. Let us be clear: we have people in here and in the Upper House crying and talking about their disappointment. They are rubbing their eyes and condemning the services. We have a tripartite Government Administration made up of Fine Gael, Fianna Fáil and the Green Party. They have it within their power, as they had this morning, to respond favourably to this proposal, which is a reasonable and fair one. Had the Minister of State come to the House and said three months, I could understand it, but the suggestion that this matter will be given a reading in another 12 months is quite frankly a disgrace. I would like if we could engage with the Minister of State until I wrap up. It is a disgrace. It is very disappointing.
We need to demand action. I will close on this: I urge that the Government would not row back from this proposal and that we call a vote and put on the record where people stand, because we must walk our talk not just talk.
The Minister of State is very welcome to the House this evening. First, I thank Senator Clonan for bringing this Bill to the House. Every opportunity we get to speak about disability and disability rights in this House is positive and important.
Given the week that is in it, I am very glad we have this opportunity, because it is the final week, and we are speaking about our budget priorities, what changes we want and what type of attitude we want in budget 2024. We regularly call on the Joint Committee on Disability Matters. Senator Clonan and I are good colleagues on that committee. We ask each Department to look at its policies through a disability lens and a human rights lens and to look at a person's needs in the entire context as opposed to singling out health needs or employment needs. We regularly see that if a person does not fit into a box, he or she is considered to be outside the box.The Minister of State knows this because she has spoken to hundreds and thousands of people all across the country who have come to her because she has been a great spokesperson for disability and Minister of State with responsibility for disability. It is one of the most heartbreaking issues when you look at a family and you feel useless. You feel that all you can do is ask or shout for them, and you are pushing against a door that often feels locked. It is so important to continue advocating for those families. We are standing here and we know that children and adults deserve, and should have the right, to access the therapies.
I am going to take this opportunity to speak on what is stopping the roll-out of these services. Where are we? I think about County Louth in particular in this. I had a recent Commencement matter on the CDNTs. We have a 50% vacancy rate in north Louth and a 30% vacancy rate in south Louth. That is a colossal vacancy rate. You are not going to field half a football team; you will not win the match with that and you will not deliver a service to the people who need it with half a team. That has been one of the greatest challenges of the Minister of State's tenure. I want to recall when she came before the Joint Committee on Disability Matters a year ago on 2 June 2022. We were pushing for an update on the PDS road map and how that would support families. At that meeting the Minister of State suggested various ways that we could bring down those waiting lists. She suggested that we would use private operators and that we would look, for example, at the local Down's syndrome organisations that would relieve the pressure on CDNTs. I know that the Minister of State is working to relieve those waiting lists and get the services in place. As a mammy, as a cousin of someone with disabilities, as a sister of someone with a disability and as a friend of someone with disabilities, this is what we want.
It can be enshrined in law but there is no guarantee, and that is the cruelty of Senator Clonan's Bill. If we enshrine it in law, there is still no guarantee. We have assessments of need, AONs, enshrined in law and we still have no guarantee, and that is the cruelty, discrimination and deplorable situation within our system, and we have to look at why we have that. We do not have the staff. Then we look back down and question why we do not have the staff and ask what is wrong with the system. Why do people not want to work in a system that is an incredibly rewarding place to work in if it is fully staffed? You would be working with the best of people in the best of causes. With a full team, I am sure you would get incredible job satisfaction.
Unfortunately there has been a lack of looking at disability services in the context of what is needed to make sure there is career progression. What is the HSE doing to make sure we have career progression and to keep people in disability services? What is it doing to give them longevity in their careers? Where is the higher education in all of this? I would like to hear from the Minister of State on what asks she has been putting to the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Harris, on what courses we are opening up to make sure we have the critical skills. We have no critical skills or trainees. We have shortages and we have no staff. I thank Senator Clonan and his son Eoghan for their advocacy and presence this evening, and for raising this issue, because it is really important.
I thank Senator Clonan. Unfortunately, due to his experience and Eoghan's experience, he has articulated what is horrific and what we all agree is horrific. I was party to the Joint Committee on Disability Matters report and the Joint Committee on Children, Equality, Disability, Integration and Youth report on the AONs, and it outlines all of the things we need to do. Deputy Rabbitte is an exceptional Minister of State. Working with her has been a great privilege of mine and I hope we will continue to do that for some time to come. My only regret is that she is not at the Cabinet table and that her role is a Ministry of State. It should be a full Cabinet position and that is where I stand on it.
I support the Bill but I agree with Senator McGreehan that passing the Bill will not change anything immediately. It will in principle but not in practice and a lot of the problem is in practice. I head up a policy group within my party that looks at early intervention and what the obstacles have been. We have been carrying out an analysis and process to try to identify what we can practically do. When we look at the vacancy rates, they are extraordinary across all the CDNTs. We have 19,000 special needs assistants, SNAs, across the country and we have people who already have a competence in working with young people within our schools. We have over 1,135,000 therapy hours delivered across 91 network teams throughout the country so there is no question that where it works it works, but we had a vacancy rate of 33% at one point in this year.
Therefore a group of us set about seeing what we could do about that. I was not going to come and annoy the Minister of State but I thought I would go and annoy my Ministers and Ministers of State and see what they can do in assisting the Minister of State to deliver what she needs to do. In that, one of things is that we have SNAs who have great competence so what if we could upskill them? They are already in schools, they are already beside young people and they already have a passion for young people. If we could do that, would that not be great? I have put a call to the Minister, Deputy Harris, to put out an expression of interest in the same way that he did with the vets. I have asked him to look at that and put out a call to ascertain the number of college places that could be created across the country. We must look at where we could do a technician grade course and where we could expand that provision. I acknowledge that it is a couple of years away before that would be implemented but that is something I have already spoken to our Ministers about and I have said that we have to deliver this. Then we did an analysis of the therapists who are in place and how many hours of therapy they are delivering. It is as low as 11 hours in a week on a full-time basis.
Part of that is administration. Part of my call in the pre-budget submissions is to say we should make sure everybody has all of the computers or whatever is needed to ease that. We have administrative positions that could take some of that burden. Then I met Inchicore College of Further Education, which runs technical courses, and it said it has the scope to expand the technician places. It already has modules within the SNA training that are perfectly adaptable. People in preschool or school can identify and do AONs and they are competent and qualified to assess children and this prevents children needing the long AON. These children should be diverted off as quickly as possible and then we should make sure we have all the supports. The Minister of State came in here and spoke powerfully about all of the technological supports we could put in place for children and about her vision for that. Let us make sure the Minister of State is supported in rolling all of that out and in making sure that is in place.
Other things I am calling for within that group include an expansion of the National Treatment Purchase Fund, NTPF. Why are we not adapting that, dealing with it and providing therapy hours? Then you hit the concrete wall of CORU. While I respect its independence and its need for that, the speed at which it operates is a disgrace. We need to have psychologists and all of these professions accredited, outside of just those who are in the HSE, so that the NTPF can work, and work at a faster pace, and so it can support all that is being done and all that needs to be done. We have to move quickly and decisively. My fear is that while we can increase the number of college places and have more OTs and more members of all the professions involved here, that is three, four or five years way and many developmental windows will be missed as a consequence. We must move decisively and act quickly on the NTPF and so on. We could provide nurses in all of our schools. That would be another way of doing this and it has been another measure I have been calling for. We could have either play therapists or nurses within the school system. There are many nurses who cannot work hospital hours and have various family commitments but who could work school terms. They could provide all that is needed at local level. Those are the sorts of supports that are needed.
I thank the Minister of State and Senator Clonan. It is very good that we are discussing this matter.
The Minister of State is very welcome, as always. I also welcome our special guests, the Clonan family. In the lifetime of this Seanad, I am challenged to think of more serious legislation that could come before us for consideration.
The Bill seeks to create a legal requirement to provide treatment, therapy supports and services for persons with a disability. It inserts new sections after section 11(2) of the Disability Act 2005. Subsection (2A), as proposed to be inserted, is where an assessment report is furnished to the executive and the report includes a determination of whether the provision of the health service, education services or both is appropriate for the applicant concerned. He or she shall arrange for the preparation by a liaison officer of a statement, referred to in the Act as a “service statement”, specifying that the health service or education services, or both, which will be provided to the applicant by or on behalf of the executive or an education service provider, as appropriate, and the period of time within which such services will be provided.
Senator Clonan commented on the assessment period. There is a huge delay to even get the assessment in the first instance. That is the elephant in the room. Senator Clonan's amendments include a new subsection (2A) that would provide for the inclusion in the service statement services necessary to meet the demands of the applicant. The new subsection (2B) states that the provision of services shall be made as soon as practicable or in the period of time the applicant requires, whichever is the earliest.
I note Senator Clonan's draft and the fact he is so resolute on this issue. Interestingly, this Bill proposes a reference to the Constitution in the primary legislation. That is no harm if the Constitution keeps it front and centre in our thoughts as we legislate. Other speakers referred to Article 40, which provides for equality for all. The State cannot arbitrarily discriminate between citizens. We are all equal before the law, or we are supposed to be. The Minister when formulating policy and providing resources shall be in fulfilment of the State's duty under Article 40 of the Constitution, that being that the resources available to the State and allocated by it in a manner consistent with the common good shall be such as to ensure the equitable treatment of every person in the State.
The objective is to ensure that any person with a disability need will have the same right to avail of and benefit from being active and equal members of society. What this Bill seeks, in my humble opinion, is an implementation and a vindication of the most basic rights. The Government is putting forward a timed amendment. I am not sure if it is wise to do so. I hope that if it happens, the time will be extremely well used. We have had many advocates for disability rights over the years. They are embodied in Senator Clonan. We will not know until later but if the amendment is proceeded with tonight, I hope we use the time very carefully and that it will not be just lip service. I hope we make the Bill better because this has to happen. It is what politics is about.
We have a powerful advocate in Senator Clonan. Tonight he revealed his own family situation, which is not an easy thing to do. In doing so, he painted a powerful picture with words. He brought alive for us first-hand testimony of what is involved here. I hope we collaborate as never before. I want to see a different approach to issues like this in the House. I was very fortunate when I introduced a Bill to restrict and curtail the right of an accused to cross-examine in person a victim in coercive control cases. I was very fortunate to get that legislation adopted by the Government. I am convinced I would not have got it through without co-operation from each and every grouping in this House.
Similarly, the honey bee legislation which has passed Committee Stage was a combined team effort. I ask that we have a new departure in politics and endeavour to do what is best. I am convinced that if the Government Senators were in opposition, they would happily vote for this Bill tonight. I am convinced that previous Governments would be in the same predicament that the current Government is in. Either people are overly deferring to the permanent government or there is a failure to realise that they are the power behind the wheel and they are not fully implementing and asserting themselves as they should.
Senator Clonan is doing his best. He has spoken on many occasions about how proud he is of his son, Eoghan, his director of elections. I have no doubt that is reciprocated. Eoghan must be so proud to have a dad who does not suffer fools gladly and is on a mission to change things. He wants to make sure this House is no longer a talking shop. He wants to ensure that individuals are no longer forced to go to the High Court to vindicate their rights. That is not the position of the courts. The Legislature has failed if people end up going to the courts. The HSE and ultimately the Government have a duty to act to fulfil the rights of our citizens with disabilities and to do so in the most timely manner possible. I welcome the Bill and hope it will get an urgent response from the Government.
I welcome to the Public Gallery, Gill Cotter and Mahai Malone, who are visiting from Raglan in New Zealand. They are here as guests of our colleagues and friend, Senator Lorraine Clifford-Lee. I also welcome our former colleague and friend, Anthony Kelly. Thank you for being here. I hope you have an enjoyable visit to Leinster House. I hope we beat New Zealand in the Rugby World Cup.
I thank Senator Clonan for bringing this Bill forward and allowing many of us across the Houses to co-sign it. It is extremely important legislation. We know that the needs of children should be met by the State through the provision of well resourced public health and education services. We also know how vital early intervention is. No one else here could have outlined as eloquently as Senator Clonan did the impact of early intervention, or lack thereof.
We know that too many young children, including Eoghan, are failed by an under-resourced and over-capacity system for assessment of need and the provision of essential reports and therapies, once a diagnosis or otherwise is secured. With the assessment of needs, we know that there is a window of opportunity through which children must be assessed to get, it is hoped, whatever educational or therapeutic supports they need as they progress through childhood.
A 2022 report from the Ombudsman for Children is titled "Unmet Needs". The title says it all. It is a report on the challenges faced by children in Ireland who require an assessment of their needs.The 2022 annual report entitled Falling Behind: Children's Rights in Ireland - what more do we need to say - highlighted significant delays in the provision of assessment of needs and the subsequent follow-on from that. The report of the Joint Committee on Children, Equality, Disability, Integration and Youth on the assessment of needs of children, which was published in February, made 39 recommendations that need to be implemented. This legislation is especially short. It is not onerous and it should not be necessary to kick it back for a year. It is succinct. It hits the nail on the head in a few key areas and I do not understand why the Government is kicking it down the road. However, I was struck by something a Senator stated earlier: pass the motion or do not. That is a poor indictment, coming from a Government Senator, to say that.
The Bill can pass Second Stage or not. The reality is that we will continue to have assessment delays for children, multiyear waiting lists for therapies and a lack of access to educational supports and appropriate school places. These are profoundly affecting thousands of children. Some areas perform better than others but overall, we know too many children and families are left behind. Therefore, as a goodwill gesture, this Bill should pass Second Stage and be allowed to go through the process. It is a lengthy process anyway for it to pass through the different Stages in both Houses. I encourage Senators to pass Second Stage of the Bill to see whether it can go where it needs to go - to Committee Stage where we can hash out the intricate details - and not to kick it down the road for a year.
First, I thank Senator Clonan. I am proud to be one of the sponsors of this Bill because it is important. I welcome Senator Clonan's family and especially Eoghan to the Gallery.
I thank the Minister of State for the commitment on assessment of needs she gave recently during a debate on a Labour Party motion in the Dáil. It is important in the context of our debate this evening because it is the starting point for what Senator Clonan has spoken about. We are debating, as Senator Clonan said in his contribution, what happens after people get that piece of paper. In fairness to the Minister of State, she gave a commitment that if those centres are not set up by August, we will get private resources. That is to be welcomed.
Tonight we are talking about lists. People I deal with say their loved one is simply a name on a list. That is what this is about. It is totally and utterly unacceptable that the lists Senator Clonan and others spoke about this evening are growing. Unfortunately the Government's attempt to kick the can down the road for another year is not acceptable. It should not be accepted tonight. Senator Clonan has called for a free vote. We support him in that. We must send out a message tonight that we care for those with disabilities and as a result we will put this legislation on a legal footing by passing it to the next Stage.
I received a letter from a constituent whose loved one had received a letter from the CDNT stating that the loved one would be passed on to adult services, having turned 18. This is what is happening day in, day out. The person had not received any services for the previous five years. The letter from the CDNT, which I have to hand, says if the person wants anything in the future to please email or ring a number. That person does not know where to go. That is what Senator Clonan is talking about. We need to put this on a legal footing so the services are available after an assessment of need has been done. I take on board the issue of the number of people we need to run those services. In my area some 30% of posts are vacant. However, this would send out the message once and for all that we in this Chamber take those with a disability seriously. We would be putting on a legal footing that this country stands up for those who need it most. We should all look at ourselves tonight if this ends with a vote and vote accordingly.
Cuirim fáilte roimh an Aire Stáit agus roimh an mBille. Gabhaim buíochas leis an Seanadóir Clonan as ucht an seal an Bille a phlé. I welcome the Minister of State to the House and commend and thank Senator Clonan on the introduction of this Bill, the opportunity to discuss it and the privilege of being able to co-sponsor it with Sinn Féin and other Opposition colleagues.
I am quite angry about some of what I heard from Government Senators tonight. I will do my best to curtail that anger. We heard some Government Senators speaking as though they are not in government; as though it is not the Government's job to act and legislate on these matters; as though it is not our job as an institution of the Oireachtas to legislate; and as though it would be better for us to convene think tanks and talking shops, rather than deal with legislation introduced by one of the foremost campaigners, advocates and activists on this issue when it is before us in the Seanad tonight. It beggars belief. It upsets me that is the approach to an issue such as this one. One Government Senator stated it would work in principle but not in practice. Imagine we took that approach to every Bill that comes before us in this institution. Imagine we took that approach on Second Stage of the Fine Gael Bill on spiking we will debate on Committee Stage tomorrow. Imagine we were to say it would work in principle but not in practice so let us kick it into touch, let us kick the can down the road or let us not deal with it. That is not what we are meant to do as legislators. It is certainly not what the Government is meant to do about an issue of such fundamental importance, when it is brought before the House, such as this one brought by Senator Clonan in this Bill. It is becoming a bit of a pattern which concerns me. We had to deal with some of this in the past during the Covid-19 pandemic when a whole range of group leaders were concerned about the guillotining of Bills or all Stages of Bills being rushed through in one day. Those were exceptional circumstances, but more and more often we are seeing these long-finger amendments come from the Government. This just allows Bills to fall into the ether. They will not be acted upon, instead of the proper, appropriate, laid-out parliamentary and legislative process being followed.
People who live with disabilities, their families and their communities have been failed by the State for far too long. We, in Sinn Féin, have a vision for a society in which all citizens, including those with disabilities, are offered equal access and equal opportunity. This Bill represents an important first step in ensuring people with disabilities have access to the services and support they need. The Bill we are debating tonight is about ensuring a statutory right to services and interventions for children with additional needs that currently does not exist.
As it stands, our two-tier health service is failing people with disabilities. Promises made by successive Fine Gael and Fianna Fáil Governments have failed to materialise. This Government committed to publishing a disability capacity review action plan by December 2021. However, more than two and a half years later, the report has not materialised. The outcome of these empty and broken promises has been devastating for people with disabilities and their families. Approximately 17,000 children are waiting for initial contact with a children's disability network team and the assessment of needs for 2,500 children is overdue. The situation is only getting worse as services become increasingly difficult to access.
Workforce challenges are having a serious impact on service waiting lists. It is shocking that the recent children's disability network team census for 2022 shows a 34% vacancy rate, up from 28% in 2021. That equates to more than 707 vacancies across the 91 CDNTs as opposed to 524 in the previous census. The 62% vacancy rate among clinical specialists is extremely worrying. At a time when we need to be creating additional third level places and delivering additional therapy graduates, the lack of clinical specialists needed to oversee clinical placements prevents it. It is simply not acceptable that more than one third of posts in CDNTs are vacant while parents and guardians are desperately seeking access to assessments of need and therapeutic supports for their children. This Bill is an important first step, but the Government must step up to the plate. It must invest in disability services and address the workforce challenges with a serious workforce planning group, led by An Taoiseach, to include the Departments of Health and Further and Higher Education, Research, Innovation and Science. The Government must live up to its legal and moral obligations and provide people with disabilities with the services they need. While the words we heard from the Government side of the Seanad tonight may be sugar-coated, if the amendment is passed, Senators essentially will be asking people with disabilities and their families to continue to wait. It should be the job of the Government and of this House to act.Without pre-empting what the Minister of State is going to say, I hope she says the right thing in terms of support for Senator Clonan’s Bill. I want her to tell me and, more importantly, the people out there what exactly it is she is waiting for, what it is that she wants from the passage of the amendment today and what exactly it is that she is going to do in that intervening period if the amendment passes.
This is such an important matter. I would not like to say the word “issue” because people with disabilities are not the issue. It is society that is the issue, and previous Governments and the State are the issue.
I thank Senator Clonan for bringing this very important and long overdue Bill to the House. I am very passionate about people's rights and I am passionate about the rights of people with disabilities. I first went on the Joint Committee on Disability Matters two years ago and I learned that people are not just disabled because of their impairment or because of an illness, but it is society and the structures within society that disable people. We are all different. Every single person everywhere is different and we have the right to be different, but we all have equal value in the world and we should be treated with respect and dignity. From my reading of the Bill, which I co-signed along with the other Senators in the Civil Engagement Group, all that people with disabilities and their families are looking for is minimal rights to have access to services. A few weeks ago, one of my friends said to me that it is not just about the bricks and mortar; it is about that wraparound and that support of intervention to protect people.
The UN Convention on the Rights of Persons with Disabilities calls on us to protect the dignity and rights of people with disabilities. This Bill is a good step in the right direction, although it is not going to fix all the inequalities that people with disabilities suffer, including children. Senator Clonan said something in his contribution that really struck me, which is that more than 2,000 young adults are in nursing homes. Shame on this State. We had the mother and baby homes, the institutions for women who had children outside marriage years ago. We are doing the same now to 2,000 young adults who do not have that quality of life, and who have no rights and no say in their own life. Just because people have a disability does not mean they should be treated worse within society. My mother would always say that the truth kills. Unfortunately, and this is not directed at the Minister of State personally, it hurts very much that our State has continued to fail people with disabilities.
I remember that in my community, if someone had a child with a disability, it came with a stigma and people would have been embarrassed and tried to hide for years that their child had a disability. Now we are more accepting. We accept that people do not need to be the same and that we have to recognise each other’s differences, embrace that and meet people where they are at. However, we are failing our children if they have to wait up to two or three years for physiotherapy, for access to services and to have their basic human rights and equality met.
I was privileged to work with the Minister of State in recent years and I know she is very passionate in what she does. I always say to myself to stay true to my values and my principles. I know the Minister she is the type of person who will stay true to her values and principles. She spoke out around the HSE. She can turn this around and she still has a little time to turn it around. She should vote with us today. This Bill is about waiting times. It is about children who have to wait in our system for two or three years and who will probably end up as adults in a nursing home. Today, the Minister of State has the opportunity to stay with her own principles and values and not hold off another year. When we talk about another year, we are talking about thousands of children in our society who are not getting timely access to services.
Again, it comes back to that basic point of access. The Joint Committee on Disability Matters understands that we have a long way to go before we have equal access for people with disabilities. This Bill is not going to fix that but it is there as a guide. If we do anything today, let us allow people with disabilities, in particular children, and their families, to know this. Nearly every day, I wake up and know I am so privileged that my children are full of health and that I am not in a system where I am fighting all the time. In fact, I am fighting at a different level but not as a mother of a child with a disability. That is so tough. I see it all of the time with members of the Traveller community and people from other ethnic minority groups with regard to getting access to services. I urge the Minister of State and my colleagues in the House to do the right thing today. Let us pass this Bill collectively. I like to say that this House is much more approachable and has much more empathy than the Dáil, to be blunt, so I would like to see that acted on today. I again thank Senator Clonan for bringing the Bill forward. The Civil Engagement Group is delighted to stand with him.
I move amendment No. 1:
To delete all words after “That” and substitute the following:
- “Seanad Éireann resolves that the Disability (Miscellaneous Provisions) Bill 2023 be deemed to be read a second time this day 12 months, to allow for time to further examine the issues raised in the Bill alongside ongoing work that underpins significant developments around a program of transformation in disability services.”
I thank Senator Clonan for the Bill. He has been a fantastic advocate for people with disabilities long before he came into this Chamber but, certainly, the Chamber is much richer for his presence, his contribution and his lived experience and that of his family, which is very important.
On the Bill, everybody agrees we have challenges with disabilities, none more so than the Minister of State with responsibility for disabilities. Any objective person will acknowledge the work that Deputy Rabbitte has done in this area and the fight she has taken to try to provide services. Currently, as a Government, we are falling far short of where we need to be in terms of service provision. The Minister of State will be the first to say that and has publicly said it in this House and the other House. We have a lot of work to do. We are not providing assessments when they are needed, we are not providing therapies in a timely manner and they are not early invention because they are not happening early enough, so we have huge problems.
I am conscious in moving the Government amendment that people will not be happy with that. It provides a 12-month move to allow the Minister time to deal with this issue and to provide some sort of solution to it. I am referring to the Minister, Deputy Roderic O'Gorman, who is the lead or senior Minister on this. In giving the benefit of the doubt to the Minister that he genuinely wants this time to deliver, to make improvements in services and to show that in 12 months, we can show a change in service delivery and show we are doing more, we have to hope that is possible.
There are clearly huge constraints in filling vacant posts and we cannot get the staff that we need. We have parents and children who have become advocates by accident as opposed to by design, and we have met many of them in Leinster House at different briefings. It is heartbreaking to see a young child's mother and father have to take time out of what is already a really demanding home schedule, when they are caring for somebody, to come here to tell us what they need in terms of services.
I want to make it very clear that, on this side of the House, we support the Bill and we want to see it enacted. Certainly, there is a very clear message from our side of the House going to the senior Minister, Deputy O'Gorman, that we expect in 12 months time to be able to come back to the Chamber and report significant progress. That is the message we have delivered from his request to us to give him time to do that. They are the conditions that we are attaching to agreeing to move the amendment and give time, namely, we want to see engagement between Senator Clonan and the other signatories of this Bill, our two spokespersons, the Minister and the Minister of State to try to make progress on this issue because we are failing children and their families.
That is not without acknowledging the significant and genuinely passionate effort on behalf of so many, not just the Minister of State, Deputy Rabbitte, but all of those working in the disability sector and all of the organisations and the volunteers on the ground. Huge work is being done but it is not getting us to the point that we need to be at in addressing the seriously long waiting lists. I acknowledge the seriousness of the issue that we are debating. We should have further statements on this at the earliest opportunity in the new term.It would be good for this House to receive regular updates on disability services, as I know many Members have requested. I have no doubt but that the Minister of State will be available to do that. Let us make it a priority for this Chamber to consistently highlight the issue that Senator Clonan always highlights, to keep it top of the agenda and ensure that we are actually seeing delivery and accountability when it comes to disability services. A section of the Bill refers to resources from public expenditure. Resources, in terms of the money, do not seem to be the problem. The problem is that the way the system is set up and organised means we cannot get the staff to fill the posts. If money was the issue, we would have a much better health service than we currently have. That is not the only issue. Certainly, from a Government perspective, we will not be found wanting in terms of funding services. There are other areas we need to address. I want to reiterate, from this side of the House, that we are supportive of the legislation and that we commend Senator Clonan on bringing it. We will be looking to see significant progress, which we can report on in this House, in the coming year to make sure that the Minister of State does use this time wisely to ensure that we can see that progress. I hope people will take this as a constructive contribution, understanding the request that has come in to this side of the House, but also understanding that we get how important an issue this is and how important it is that we see significant change in terms of disability resources, capacity and early intervention - and not intervention in five or six years' time. We must ensure that people get assessments and therapies when they need them and as often as they need them. That is the aspiration that we have for this country in terms of disability services. I know it is shared by every Member of this House and the Minister of State as well.
I welcome the Minister of State to the House. I was quite happy to move the motion on the Order Paper to introduce the Bill last week and for Second Stage to be heard today. I thank Senator Clonan for bringing the Bill to the House and welcome his family to the Chamber. I am calling on the Government to withdraw the amendment. All I have heard are words, and everybody is fed up with words. I must say that over the last few weeks I have actually begun to believe that there is a change within certain parts of the Government to do the right thing. Even this morning, during the debate on the Order of Business, we heard about how inclusive this House is with regard to people with disabilities. We are able to live that message in here, yet there are families and children outside these walls who are struggling and need help. They need that help now. They do not need to hear what is going to be done in a year's time. I do not want to hear any more about what the Government is going to do in one year's time. The time for action is now. The time for families is now. I could not get a bus to bring one of the children with me today to visit the House because he is a wheelchair user. It is fine to visit the House, but I could not get a public bus for the child to come here today. These are real live issues that are affecting families. I could go on, and I have a speech prepared. I am asking the Minister of State to accept the Bill today. There is no need for the amendment. There is no need to play politics with it. The Minister of State has heard the passionate plea from our colleague today. We do not need to hear anything else. That is it. I urge her to do the right thing and accept the Bill.
I want to make one or two points at the outset, before making further comments. I congratulate my colleague, Senator Clonan, for bringing the legislation. I know how heartfelt his position is. It is a reasonable proposition. I do not know any Member of this House who is not with Senator Clonan on it and for whom it is not a very real issue. In fact, I know of no family, including my own and every family in the country, that is not affected by this issue. It is not something abstract, and we congratulate the Senator on bringing it forward. I also recognise the Minister of State for her absolute commitment in this area. There is a very active parent's disability group in Cavan and she is aware of it. She has met members of the group at my request, and that of my colleagues, on a number of occasions and not even ten days ago, we had an excellent meeting with her. It was very impressive that she brought representatives from Enable Ireland to the meeting and sought commitments and specific actions on the day. I salute her for that. I also salute the group in Cavan. It would bring tears to a stone to meet the parents and listen to what they go through. It is a wonderful group. My colleague, Senator Seery Kearney, has outlined our party position on the Bill with empathy, ability and great clarity. I would have liked to have been here for the entire debate, but there was a meeting of the Oireachtas Joint Committee on Foreign Affairs and Defence to debate another important issue and I could not avoid that. The issue being debated is particularly relevant to people, but this is a bigger issue.
The Leader of the House has explained that on this side of the House, we completely support the Bill. I have a teaching background and I am the parent of three children. Anyone with normal empathy and normal knowledge supports this and wants action here. What is shocking is that we have these waiting lists. The Minister of State will agree that it is shocking that when people get their assessments and programmes for proposed actions, they are not taking place in real time. It is shocking and it needs to be addressed. That came up at our last meeting, and it will keep coming up. We need speedy assessments, and I think that is improving, but we need the follow-up actions. That is our position. Members will know that the Minister for Children, Equality, Disability and Youth is a regular visitor to this House and is, to be fair, a really sincere and committed Minister. He is for real and he works very hard. The Leader of the House explained that he has requested time on this. We have to take his request in good faith. As the Leader said, we ought to be monitoring this issue constantly. It should be a perennial theme. It would be wonderful if, through the initiative of Senator Clonan and others, this Seanad was remembered as the one that focused on disability issues in a major way, apart from the day-to-day issues. I would like to see that. I echo the fact that we are completely in support of the Bill. I ask Senators to have some confidence in the Minister for Children, Equality, Disability and Youth. He is not a member of my party, so I am not on a partisan rant. He is objectively a decent man who is committed to his Ministry and is very hardworking. In fairness, that cannot be taken from him. If he is looking for time, we have to take him on his word and monitor the situation. If there is no action in a few months, we will come back, change the situation and object then. I ask the Senators to view it as uniting the House behind the issue and giving the Minister the time to respond, with the Minister of State, and monitoring it in a very consistent way.
It is nice to see the Minister of State. I do not have anything prepared. I will be frank. I was not due to be here today, but when I saw Senator Clonan's email saying that the Government was going to try to delay the Bill for 12 months, I thought it was important to come to the Chamber to show solidarity and express my own full support for the Bill, even though we are probably going to lose the vote. I want to put on the record the huge disappointment in terms of the fact that this House has shown, on occasion, that we can unite, across the Chamber, on the things that are really important.
It is such a missed opportunity. By getting behind Senator Clonan and the excellent work he has done for so long, we could have sent a powerful message to Government and, indeed, Opposition that finally, we have to be absolutely serious about giving rights to people with disabilities, and not just talking about it and making promises without timelines and firm commitments. I am hugely disappointed that Government Senators could not do better. In fact, I appeal to them to do better because I know that the Government has put down this amendment to kick the legislation down the road. Let us be clear, we all know what this is about; it is about killing this Bill.There will almost certainly be an election next year, so a 12-month delay is as good as killing this Bill. We all know that; let us not kid ourselves, se should do better. All of us should do better. I commend Senator Clonan on the tremendous work he has done. Collectively, we should do better this evening. I appeal to Members from Fianna Fáil, Fine Gael and the Green Party to stand firm behind what they know to be right rather than the Government line, in inverted commas. We could send a clear message of strength across this Chamber. We still have the ability to do so. I appeal to Government Senators of all parties to do the right thing and support Senator Clonan's excellent Bill.
I commend Senator Clonan not just on bringing forward this legislation but on all his work on disability issues. I am delighted the Minister of State is here, because she is someone who has a passion for this brief. She really understands the sector and wants to deliver on the sector.
As a country we have an opportunity to make a transformation for those with disabilities. That we have moved responsibility from the Department of Health to the Department with responsibility for integration is significant. We are going to be talking about a rights-based approach. I have a frustration I know Minister of State shares, because we have talked about it, and we see it in health and in education. It is that families and individuals who have disabilities must fight every single step of the way. It is about the culture within the system. There is a fear of setting precedents. There is a fear that if we open the door for this person with a disability it means there will suddenly be an avalanche of cases. If there is, in one sense, so what? Let us deal with it. However, in many cases we are talking about individuals who just want the best for their family. The Minister of State knows the cases we are talking about. We are talking about the likes of Andrew Geary, who fought for his deaf son Calum. Andrew would have been very happy to sit down with officials from the Department to look at ways his son and others could get education. We see so often that those with a disability must spend their whole time fighting for their rights against the system, so to speak, and we need a shift in the culture that is happening.
I despair of the HSE's approach in a lot of these issues. I appreciate there are challenges because there can be shortages of staff and so on, but the approach must be about asking how we can best meet the needs of the individual. Individuals and their families are reasonable people. They will totally accept being told they may not be able to get 100% right away, but that there is an end goal and here is where we are going and that we should work together to achieve that. Instead, as the Minister of State knows, case after case is fought. We end up with Commencement debates in here and parliamentary questions in the other House. We end up with court cases. When cases finally get to court, there is frequently either a settlement on the steps or a decision is taken against the State. Consequently, we need more than just legislation in this area but a shift in the culture within Departments.
Frankly, I am fed up, because I know too many people who are battling in these areas. The Minister of State knows them as well. I say genuinely about Anne Rabbitte that there is nobody I know who is battling harder. She and I have talked about the section 39 organisations and getting the issues resolved there. We have talked about a whole range of disability issues. As she knows, our parliamentary party meetings have discussed the budget being able to deliver on those. We can introduce legislation, provide additional resources and so on, but if there is not a shift in culture we will not get change.
I am disappointed there was not consultation about the timed amendment. I will not be supporting the Government amendment.
Senator Clonan is a reasonable person. He will be perfectly happy if the Minister comes in here and looks at debating a lot of the issues within the legislation. I am certain the Minister of State will be quite happy to go through this on Committee Stage to look at how we can improve and develop the legislation. The Leader is very happy that we table lots of debates. Everybody in this House knows about the importance of particular cases. I therefore ask the Minister of State that we come back and work together on this. It is only fair. We should not be trying to create division on an issue about which we are all particularly passionate. I am confident the Minister of State can provide a leadership role in this. She knows we will have her back. She can be assured of it in the months ahead when she must go negotiating with the Ministers, Deputies Michael McGrath and Donohoe. However, we need to have that broader debate around the change in culture and society and we need to shine a light on the Departments of Health and Education especially, but on other areas as well, to change that culture. I do not want to have to deal with another case of somebody who feels he or she must spend his or her time fighting against the system. I hope, therefore, we can reach some form of compromise and some form or agreement this evening.
I will not use all my time because I am not going to repeat points. Everything that has been said about why the Bill is necessary has already been said.
I am interested in getting the Minister of State's response to some aspects of this. I am a bit confused about the logistics. We have a Minister who is not in the room, who we have just been told wants a delay of 12 months and needs time. The Minister, Deputy O'Gorman, has been mentioned a few times, yet we are here with the Minister of State. I wonder what power she has. She is a junior Minister and is not at the Cabinet table but she has been given the brief. While she is the one who has been closest to the brief and who has been engaging with the services, she is also the one who comes to committee and makes commitments. On the one hand, therefore, we are saying that as a Minister of State she has the capacity and the ability to make commitments, but there is a Minster who is not in the room who is the one deciding more time is needed and it must be 12 months. Who then has the capacity and the power? I do not understand. We need to have a conversation with the Minister of State here and now, rather than a hypothetical thing about somebody else needing more time. The Minister may need 12 months but families and children are clearly saying they have no more time, so whose time is more precious here?
Let us be realistic. It is very hard for an independent Senator to get a Bill through a load of Stages. The next time Senator Clonan gets to advance a Private Members' Bill could be six or ten months down the line and this Bill is to be stalled for 12 months. We are going into a general election. By the time the Senator gets another slot for a Private Members' Bill, it will probably be October and everyone will be in an election frenzy. I do not understand what is going to happen in the 12 months. This is an area on which I am sure the Minister of State has been extremely well briefed and on which she has briefed the senior Minister at the Department, so if anything the time has already been ticking for the past three years, rather than another 12 months being needed. This is simply a logistical question because I want to be here, as I am sure everyone does, engaging with the Minister of State as a junior Minister who we have taken as giving the commitment, accepting the challenges and coming to committees and being answerable to them. However, the other thing being said is there is a Minister who is not present and who wants a timed amendment on the legislation. Consequently, I am led to wonder who exactly we should be engaging with here. From our understanding it is the Minister of State, even though she is not at the Cabinet table. I therefore ask whether she supports the delay. That is the important thing, because she is the only one in the room with whom we can engage.
I will be brief.I agree with what Senator Gavan said. The effect of this is to kill this legislation. We often come through the gates of Leinster House and see people carrying placards that say "Kill the Bill" in regard to different topics, but every person who goes through the Government lobby tonight should carry that placard because it is trying to kill this Bill. The last thing I want to say is there is a way out of this. It happened before. The Senators refused to appoint tellers.
I thank Senator Clonan for the opportunity to come here this evening. Good evening to him and to his family who are present. I know more than Senator Ruane, yet I too find it all confusing. I will bring Members to where some of this confusion has come from and then I will address the Bill.
I have spent the past two and three quarter years trying to get out of the Department of Health. I am now in the Department of Children, Equality, Disability, Integration and Youth for the last three months. To be fair to the Minister for Health, Deputy Donnelly, he let me operate a little bit on my own within the Department of Health because he knew I was going out the door. Therefore, whenever I went before committee, the Minister, Deputy O'Gorman could not attend because he did not have the transferred function powers. Now I am transferred. Now I am actually working with the Minister, Deputy O'Gorman, in a very close capacity. Up to this I probably had freer rein. I am the Minister of State and I am here this evening. Senator Ó Donnghaile asked me to lay out my stall as to whether I was tabling a timed amendment. That is what I am going to do, to lay out the stall.
I am supportive of the timed amendment but I want to explain why because it is important Members hear why. I was here the day of Senator Clonan's maiden speech when he said he actually wanted to do good, wanted to make friends and wanted to learn. I, no different from him, wanted that in 2020 but it has taken me a while to understand the dynamics and the reasons the system does not work. There are numerous layers as to why the system does not work. Six weeks ago, I took a flyer on the floor of the Dáil and that was my first step towards breaking the system. I made a commitment to families and to children that if they could not get an assessment of need and if the regional assessment hubs were not stood up on 1 August, I would ensure that they could access it through private therapists and be refunded. I still stand over that. The HSE is pedalling really hard to deliver on my six regional assessment hubs. Why is that? It is because the two parts of the HSE do not work at the moment. They cannot do assessments or interventions. They can do one or the other but not both, so we need to take away that which is their legislative requirement. That function cannot be taken from it because it is still legally charged with it. We need, therefore, to stand up the regional assessment hubs. We need to bring private capacity into that in six regional centres. So far I have between six and seven stood up. I have one in CHO 8 being stood up and there is work being done in CHO 2. That is three of them and today is 11 July. I have achieved a fair bit since we started about three weeks ago. That needs to be done so that as children are assessed they can go to a regional assessment forum. This should all happen seamlessly. They can then go back onto their CDNT and get direct intervention. The CDNT manager managing the 91 teams throughout the country is doing only one thing and that is delivering therapies and interventions. That needs to happen. It is not happening. Everybody is moving the bit of paper. One of the Senators talked about how 11 hours a week of a 35-hour working week is spent on direct therapy interventions. The rest is spent on paperwork. The rest is spent on setting up the case and liaising back. We are doing that.
The next part that we spoke about is, "What else do I need to do?" That is the regional assessment hubs. I am now on the PDS roadmap and it is going before the HSE board for approval within the next two weeks. I have spent the past year trying to get this right. I am not saying I am going to have it all right but if it is 80% of the way that is a hell of a lot further than where it is today. The biggest part for me was adding capacity to the teams, the 34% vacancy rate of which Members spoke.
I have a proposal and I have no problem in sharing with Members. I am looking for master's and postgraduate students to be added on to my teams. We all know the class of 2020 never got to sit the leaving certificate but many of them ended up doing science. Others did science too and I want them to pivot into physiotherapy, speech and language and occupational therapy. The HSE pays for those spaces on their master's programme. I do not mind if they pay for the postgraduates. The Psychology Society of Ireland, PSI, has been saying for the past number of years, since I came in here, that we need to do the postgraduate for psychologist places. I have asked the HSE to fund 30-30-30 because 30 is a third of the number of our teams. If I did 30 of all of them this year, and 30 again, then two-thirds of it will be done by the time the timed amendment Bill brings me in here to say where I am at. That is the piece I am trying to do. That is a direct intervention. I am not asking the Department of Further and Higher Education, Research, Innovation and Science to do it. We have to do it ourselves within the Department of Children, Equality, Disability, Integration and Youth, working with the HSE. That is what has to happen. If we got that, we would have more clinical governance. Then I need to work with the Department of Further and Higher Education, Research, Innovation and Science on the actual development of the assistant therapy grade. This is no different from the SNA grade. They would go into our special schools and into our education system, not just special schools, because we have classes in all our schools. It should be a whole-of-community approach by developing our assistant therapy posts in occupational therapy, physiotherapy and speech and language. Only six of our ETBs at the moment are providing therapy supports or developing FETAC level 5 or FETAC level 6. The Cavan-Monaghan area has been a leader in this. Last year, between level 5 and level 6, in physiotherapy we produced 75 assistant grade therapist posts. We provided 18 in occupational therapy. We now need to get that stood up further. That is a game changer.
Another piece in the roadmap has to be a clinical specialist within our CDNTs. There is no point having assistant therapist grades if I do not have that senior post in order that there is a pathway for development, to write the framework to work with a number of schools, and not just special schools. However, I believe we need to put back into special schools what we took out. We levelled down with the PDS roll-out and that reform piece. The assessment of need clinical guidance is about to be signed off. It is finalised with the legal guidance back on it now. We know that back at the start the assessment of need was not working. The PDS then came in January 2020, six months before I became Minister of State. We had the High Court ruling last year where it was not successful. I have now worked with the HSE and all the clinical leads and have final clinical guidance which I have tested. However, I am sure it will be challenged with the legal system. We know that 90 minutes was wrong but we know that not every child needs 34 hours. It should be a range. We are doing that piece. That will be within three weeks.
Finally, the disability capacity action plan, which will fund my budget this year, sets out the roadmap from 2024 to 2026. Officials are meeting with the Department of Public Expenditure, National Development Plan Delivery and Reform at the moment on the negotiations on that. We do not just look at children's disability services. Young adults and older people need therapy and interventions. It has to be looked at in the round, not just for children. Children transition into young adults who transition into older people. This will ensure there is therapy and intervention within all ranges. It is also to ensure that we have adequate housing, respite and personal assistant, PA, support. The disability action plan is about funding that range. I have prioritised three parts of it, respite, residential and PA. They are the three levers I want front-loaded for the next three years. I want the Department of Public Expenditure, National Development Plan Delivery and Reform to give me a funding percentage for the next three years so that I know the disability service providers can actually build capacity.They cannot do so from year to year because they do not know what funding is coming next year. I want to front-load it now so that they can build and add capacity.
Senator Ó Donnghaile, who has left, was right to ask me to set out what actions we are taking. The time for action is now. I am taking action. I apologise to the families who have waited this long. It has taken me this length of time to crack the nut and get all Departments to play their role, as they are now doing. It has taken me this length of time to change the culture of pushback, which is one of the greatest challenges I have met in all of this. I am not a clinician or a parent of a child with lived experience. The cultural pushback and lack of communication, understanding and willingness to change I have experienced have been unbelievable. l have experienced the frustration parents and families must feel on a daily basis for the oast three years. There is no longer any point in having officials from the Department come into a room; I bring the providers into the room. I want to hear what they are doing or not doing. I want the HSE in the room because I need to understand what parts of the cog of the wheel are not working. What I have discovered within the Department in Health and then the Department of Children, Equality, Disability, Integration and Youth is that everybody is willing to change but when we leave the meeting room, the application of that change does not happen.
I am glad to hear of the experience Senator O'Reilly from Cavan-Monaghan had last week. That is the only way I can make change and provide accountability. That is how I am doing my business from now on. I ask Senator Clonan, Senator Chambers and my colleagues on this side of the House to hold me to account over the next 12 months. What I have said here is on the record. I have no fear of coming into the House but I ask Senators to at least give me the chance to make that change. It has taken me three years to get movement. Let me be accountable for the change over the next 12 months.
I commend Senator Clonan on what he has done. He is challenging me further on intervention but if the regional assessment hubs are working, intervention should be happening and we should be hearing that. Let us see if the Senator can afford me that time. If 12 months is too long, hold me to account on a quarterly basis. I am more than willing to come before the Seanad for that reason.
To respond to Senator Ruane, I am taking total ownership of all of this. I have no problem with being accountable to anyone. I have a good working relationship with the Minister for Children, Equality, Disability, Integration and Youth, Deputy O'Gorman. He has been more than supportive, as has the Minister for Health, Deputy Stephen Donnelly. They have helped me move the dial, as has Senator Ruane in her engagement with me since becoming a Senator. She has told me many times where I needed to focus my energies and how to change. I have taken that advice on board. For this reason, the role of personal assistants is one of my main points in the framework coming forward on the disability action plan.
I thank the Minister of State for her comments. Before I conclude, I thank all of my colleagues from the Civic Engagement Group, the Seanad Independent Group, the Labour Party, Sinn Féin and the Green Party who support my Bill. To echo Senator Ruane, I am an independent Senator and it is very difficult for me to secure time for a Private Members' Bill. To push this back for a year is an unnecessary and cruel action. I echo Senator McDowell's statement that this is purely an attempt to kill this Bill.
The contents of the Bill align with the Minister of State's mission. As regards everything she said, I wholeheartedly endorse the Minister of State's efforts and leadership. From the time we met in the Merrion Hotel shortly after she was appointed to her position, I know the Minister of State is a person who is absolutely motivated and of the utmost integrity. She must forgive me, however, because everything she said has absolutely nothing to do with what this Bill seeks to address. She mentioned pushback. We have the resources and specialists. What we do not have is a willingness to deal with and support our disabled citizens. That is why this Bill contains within it an obligation on the State and its agencies to provide therapies and supports. It is to overcome that pushback the Minister of State identified as being her most difficult challenge.
It is meaningless to seek to delay this Bill. By the time we get it through the various Stages, a year will have passed anyway. I am not being personal but this amendment is a cynical act of hypocrisy.
It is designed purely to kill the Bill. It flows from a systemic thinking that a good idea can only come from the Government benches. It is not being accepted because I sit on this side of the House. The Minister of State knows where I am coming from and the journey we have undertaken. I spent 20 years outside those gates holding up placards and made three attempts to get into this House. I have produced a Bill that would simply bring us into line with other civilised countries in the European Union and the Minister of State is prepared to push back on that.
I have learned something new today. When Senators leave, I ask them to walk past that young man, our family, and come back in here and vote. All those who tell me I am a great fella, which is a most compelling argument, are actually going to come in here and press that green button. I am speaking for people who cannot lift their hand to drink a glass of water. These are our most vulnerable and most precious citizens. Senators have an opportunity this evening to do the right thing or the wrong thing. They know in their heart of hearts the purpose of this delaying amendment; it is simply to kill the Bill. If it was about the desire of the Minister, Deputy O'Gorman, to move things forward, why have I had no engagement from the Government parties since I had this Bill drafted? I spoke to members of those parties and they did not come back to me. I heard a deafening silence, with the exception of Senator Martin.
I thank Senator Doherty for facilitating me with a slot. She was very supportive. I asked representatives of each of the parties to come back to me with an indication as to whether they would support the Bill and I heard nothing. I got no response. I do not buy this idea that the Minister, Deputy O'Gorman, is somewhere away in splendid isolation thinking about this and seeking to address the issues I have raised here.
I ask the Senators to do the right thing and support this Bill. This is the last fundamental human rights frontier in Irish society. I ask for a free vote if this amendment is pressed. I ask Senators to vote with their conscience, do the right thing and think about the families. I ask them to think about my daughter. The senior social worker in our community healthcare organisation asked me what I was worried about as I had a daughter who would look after my son when I was dead. That is Ireland. That is the Minister of State's pushback. I ask Members to vote for this Bill, empower people and give them the fundamental human right to the services and supports they need to live autonomous, independent lives with dignity. How could anybody push back on this? That was the very phrase the Minister of State used to describe her most significant and profound challenge. I ask Senators not do this to this Bill. Let me put it through the Stages. Let me take my chances.