Erin McGreehan (Fianna Fail)
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I welcome the Minister of State. I want to ask the Department of Health to ensure accessibility to healthcare for all patients accessing and engaging with healthcare providers. I ask that all patients are corresponded and communicated with in as accessible a manner as is technologically and physically possible, taking into account the various disabilities within our population. I want to stress the critical importance, which I know the Minister of State understands, of ensuring accessible information and correspondence for individuals, particularly those with disabilities. It is our ethical and moral responsibility to guarantee that everyone, regardless of their abilities, can fully access and comprehend information essential to their health and well-being.

This Commencement matter debate is inspired by two people, a young woman, Niamh Kilcawley, and my sister, Lorna McGreehan, who are both visually impaired and find it really difficult to access healthcare in a fair and equitable way. For example, Niamh contacted me this week. She had received a letter from the hospital. Niamh cannot read the letter. If I closed my eyes and lost my notes, I would be lost. Imagine a scenario where a young woman receives a letter. Her mother rang the hospital and asked if there was no other way that her daughter, who is visually impaired and cannot see this piece of paper, can communicate with the hospital. The answer was "No". She must reply via post. There was no way of emailing it. In this day and age, it is ridiculous, with all the technology we have.

I speak to my sister quite regularly on her interaction with healthcare providers. It is on her file that she is visually impaired, yet when she goes to an appointment, people might wave at her down the hallway. My sister, sitting there, cannot see and feels stupid. She feels abandoned and does not know where she is going. Imagine doing that to somebody when that is on a person's file, with no concern about it. Niamh and Lorna are unfortunately not alone. If it happens to them, it happens to so many more.

We and all our healthcare providers have responsibilities under Article 25 of the UN Convention on the Rights of Persons with Disabilities, which is the right to enjoyment of the highest attainable standard of health without discrimination. Under the public sector duty section, section 42 of the Act that set up the Irish Human Rights and Equality Commission, IHREC, the performance and functions of the public sector must eliminate discrimination and promote equality of opportunity and treatment of its staff and persons who it provides a service to. We can see that the public sector is not upholding the legislation and obligations that these Houses put on it. I would like the Department of Health to mandate this and to ask IHREC to do its duty to uphold section 42, because there have been no cases under the public sector duty section. It has the right to take people to court. There is a complaint procedure. There was a complaint but not a resolution. When people complain to hospitals about not being able to access their own healthcare information, files and so on, it is a complaint procedure, not a resolution.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator very much for raising this issue. It is funny - I will not say funny - but I was wondering what the context behind it was when I was reading the response from the Minister, Deputy Donnelly, who is currently attending an Oireachtas committee hearing. He apologises for not being here. I want to thank Niamh and Lorna for raising this with the Senator. This is not lived experience. This is actually living experience. This is what they are living with every day of the week when trying to navigate things we just take for granted. I am not sure whether the response will really give the Senator any assurance at the moment. There is a lot of work being done, but it does not seem to be to specific people; it seems to be in general.

Patients and service users ask the health services and healthcare professionals to be clear when they give them information about their health. Content for HSE.ie for the general public and HSE social media channels is created in partnership between content designers who are trained in writing in plain English and user-centred content design, alongside relevant subject matter experts who, working together, ensure content is easy to read and factually accurate. That is all very welcome. We all acknowledge that.

As the Senator may be aware, the EU web accessibility directive sets out several requirements that public sector bodies must meet to provide people with disabilities with better access to websites and mobile apps of public services. A dedicated HSE web accessibility group was established to identify issues, work to address these issues and raise awareness about how to best meet the needs of users with various accessibility requirements. That is where Niamh and Lorna and the other people around the country come in. Interestingly, I spoke with the Minister of State, Deputy Rabbitte, last night, who, as the Senator will know, has special responsibility for disability. She is at the moment setting up communication boards across all parks, playgrounds, wooded walks and different places for people who do not have the capacity to read them in the normal way that we would so that they are accessible to all. That is really positive.

The HSE has several guidelines, processes, tools and standards in place to provide digital content in a format that is easy to read. Again, we will go back because we did not really understand that the question was from a visual perspective. Other examples of areas where the HSE has delivered improved accessibility are the use of sign language and subtitles as standard on public health advertising concerning vaccinations, health and well-being messages, as seen throughout the pandemic; the HSE Live information line 1800 700 700 is available to the public to provide information and non-emergency assistance and can be suitable for those who do not wish to communicate in writing; and the publishing of some communication materials in Braille and audio formats.

The Department recently published Digital for Care: A Digital Health Framework for Ireland 2024-2030. That might be worth looking at with regard to the situation Senator McGreehan raised. If she has any suggestions from the living experiences of her sister Lorna and Niamh in that respect, I would love to hear them. These are the everyday issues we as Oireachtas Members pick up about people's day-to-day living experience. It is about how to make life that little bit more accessible for somebody who has some form of a disability.

Erin McGreehan (Fianna Fail)
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Go raibh maith agat. I appreciate this is a general response with regard to accessibility. Absolutely, there has been an awful lot of positive work done with regard to the EU web accessibility directive and we are working through that as a State. Healthcare providers have responsibilities under the existing legislation, which goes back to 2014. People have the right to access healthcare. It is not only for those with visual impairment. I have heard of people in wheelchairs who have problems accessing BreastCheck and women who have problems getting a smear test.

We have a whole lot of work to do with regard to accessibility to healthcare for people. We have the big picture with the Minister of State's response, however. It is absolutely 100% welcome and proper. People deserve their autonomy. If I might make a suggestion, the staff in every single hospital and all healthcare staff should know their responsibilities under public sector duty and the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, and they should be trained. If someone has "visually impaired" written on his or her file, the staff should be able to understand that, walk up to that person and make him or her feel absolutely welcome. If someone rings up and says they cannot see a letter and to please email it to them, in 2024, with everything on our smartphones and online, surely, our hospitals can go beyond snail mail and send things via email.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator very much. She raised a very valid point. I was just thinking as to how we could correspond with people who are not in a position to receive material because of sight loss or sight issues. One in seven older people has a challenge with reading and writing. It is something I have been looking at at the moment. It is hard to believe, but there are quite a lot of people out there who are challenged and they might find some of the language hard to navigate.

I will go back to the recently published Digital for Care: A Digital Health Framework for Ireland 2024-2030. This framework acknowledges the need for a joined-up national approach to health literacy to empower everybody in Ireland with the knowledge, skills and confidence to be active partners and advocates for their own area. This involves an integrated approach across healthcare, education and in our communities to enable, encourage and educate people to make informed choices about their own health and have a voice in their own care.

The framework identifies, and this might be important, “Patients as an empowered partner” as a key principle. We acknowledge that patients can find it challenging to navigate through the health and social care system. I will bring back what the Senator said because if it is on somebody's file that he or she is not in a position to read something, having it emailed to them so that the computer can actually-----

Erin McGreehan (Fianna Fail)
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It is amazing what they can do.

Mary Butler (Waterford, Fianna Fail)
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The audio piece would make a huge difference. I thank the Senator for raising this issue. It is something we will certainly have to pursue.

Erin McGreehan (Fianna Fail)
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I thank the Minister of State.