Mark Daly (Fianna Fail)
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The first matter is from Senator McCarthy, whom I believe has a number of guests in the Gallery with him from An Saol Foundation, which is the topic of his Commencement matter this afternoon. I welcome Pádraig Schäler, who is in the Distinguished Visitors' Gallery, as he should be, along with Mary Davie, Patricia O'Byrne and Reinhard Schäler from An Saol Foundation. They are most welcome as guests of Senator McCarthy.

I welcome the Minister of State, Deputy Niamh Smyth, to Seanad Éireann, for what I believe is her first Commencement matter with us.

Aubrey McCarthy (Independent)
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I thank the Minister of State for attending. I rise this afternoon to highlight a critical issue that requires immediate attention, namely, the urgent need for the Government to make a clear and committed statement regarding the funding for An Saol Foundation. I specifically refer to the need for capital funding to advance the Teach An Saol project in Ballymun and to fully implement the 12 recommendations made in the HSE's 2023 report. The An Saol Foundation was set up by Reinhard Schäler and Patricia O'Byrne for their son, Pádraig, who was a 22-year-old student cycling while on holiday in Cape Cod 13 years ago when he unfortunately had an accident and acquired severe brain injuries. Individuals like Pádraig are among the most vulnerable in our healthcare system. They often live with profound and complex requirements and impairments. They require ongoing specialised rehabilitation. The An Saol Foundation offers not just care, but a vision and a belief that those with catastrophic brain injuries can continue to live with dignity, autonomy and connection when the right supports are in place. I visited the foundation in Santry a couple of weeks ago and was fascinated by the families and the people who were there on the ground providing care. It is a fantastic set-up.

Teach An Saol, the capital project at the centre of this issue, would be a purpose-built centre in Ballymun offering residential, day care and community facilities. It is fully in line with international best practice and grounded in years of research, clinical experience and direct engagement with the families who use An Saol's services. It reflects a model of care that is person centred, community based and outcomes driven. That can be seen even in the current An Saol project. It is exactly what our health policy claims to support.

In 2023, as I have already mentioned, the HSE conducted a thorough review of An Saol's work and made 12 clear recommendations. These including reorganising An Saol as a core part of the neurorehabilitation pathway, providing sustainable operational funding and progressing the capital development of the An Saol project in Ballymun. More than a year later, we have had no clear statement from the Department outlining when these recommendations will be implemented. We must not allow this inaction to continue. I ask the Minister of State to confirm whether the Department will provide the necessary capital funding to progress Teach An Saol. The project speaks to the very core of what our healthcare system should be. It is not reactive but proactive. It is not only clinical; it is also compassionate. We often speak about inclusion, dignity and equal access to care in this House. An Saol embodies all of that. The values we have spoken about need to be backed up with action from ourselves and that action must be resourced. I urge the Minister of State to act and not only to fund this project, but to implement the core recommendations, to stand with those living with severe acquired brain injuries such as Pádraig and to support families such as Reinhard, Patricia and Pádraig's aunt, Marie, who are here today.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I thank the Senator for his question and warmly welcome the family who are here today to keep the campaign going for what is a very good cause. The An Saol Foundation does really great work. I thank Senator McCarthy for raising this very important issue and for offering me the opportunity to respond on behalf of the Minister for Children, Disability and Equality, Deputy Foley. Unfortunately, she is in the Dáil Chamber as we speak and could not be here. I am here on her behalf.

In budget 2025, €27 million was allocated for capital projects for disability services. I realise that the crux of the Senator's question is the capital spend. This represents an increase of €4 million on 2024. Under the transfer of functions agreement and in line with the national development plan, this is due to grow to €29.2 million in 2026. This is a significant achievement and reflects the Government's strong commitment to supporting people with disabilities, as set out in the 2025 programme for Government. It also signals our determination to realise the full ambition of the UN Convention on the Rights of Persons with Disabilities. Investment alone is not enough, but it is the foundation for progress. The disability action plan has ambitious three-year targets for increasing residential placement capacity, accelerating the rate of decongregation, and providing new day service places. While meeting these targets will be dependent on increasing staffing complements within services, providing the necessary capital infrastructure will be of importance also. Independent living and housing will be a major feature of the next national disability strategy. It must be noted that continued cross-Government engagement will be a critical component of the success of this campaign. A senior and dedicated lead within the HSE has been appointed to lead the development of a multi-annual infrastructural strategy for the disability sector and to ensure that there is a strategic, directed growth in investment and the delivery of capital projects.

The An Saol Foundation was established by the family the Cathaoirleach kindly welcomed, and it is lovely to see Pádraig and Reinhard Schäler. I thank them for being here. The HSE capital and estates section is engaging with An Saol Foundation at a local level in order to assist in progressing the latter's capital project proposal. The HSE has advised me that progress is being made on securing a site for the proposed project and an application for planning permission has been lodged. The HSE has prioritised funding for the site purchase and initial design costs, allocating almost €1.3 million through the capital allocation process. Subject to the timely receipt of all required documentation, the HSE anticipates this project will continue to progress smoothly through the necessary stages of approval and development. The HSE is working with An Saol to advise on the requirements that need to be met at each step of the process. I realise that, for those on the ground driving these projects, that process can be slow and arduous, but these types of community group and charity projects that engage with the HSE are the most fruitful of all, having a targeted approach and being the eyes and ears on the ground as to the types of service needed. While patience is required, determination always wins out. I commend the Schäler family on theirs.

The necessary stages include progressing the project through the approvals process for both the property acquisition and the capital funding. It is important to note all new capital projects are subject to the national HSE approval processes, which in turn are informed by the Government’s national infrastructure guidelines. Projects are also subject to prioritisation within available resources.

A clinical evaluation of the service provided by the An Saol Foundation was undertaken in February 2023. A review and recommendations report was subsequently published by the clinical lead for disability and the national clinical programme for people with disability, in the HSE. The review made 12 strategic recommendations to guide the development and expansion of services. The Senator referred to these. Since the publication of the report, meaningful progress has been made on many of the recommendations. The Senator will be able to say whether that progress has been meaningful when I conclude. A clinical advisory committee has now been established to support the clinical team and contribute to broader clinical governance.

The development of more objective and measurable admissions and review criteria has commenced. Regular assessments involving clients and their families have been introduced. In addition, a stakeholder working group has been set up to drive progress. An Saol has also deepened its partnerships with international academic institutions and centres of excellence while exploring collaboration opportunities with other brain injury services.

While some actions remain contingent on funding, such as expanding multidisciplinary services and formalising links with community health structures, the foundation has continued to progress implementation within existing resources. The bell means I must conclude, and the Senator may wish to respond.

Aubrey McCarthy (Independent)
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I thank the Minister of State. We have done all the heavy lifting. We have been reviewed and have the recommendations from the 2023 report, and we also have the site. That is all done and dusted. I appreciate the Minister of State's response, but we need to move further. I am disappointed we are not at the stage of the funding being in place.If one visits the Teach an Saol project, one will see that it is an essential and life-changing service for people such as Pádraig with severe acquired brain injury. That is why we cannot continue to tell families who are living through unimaginable challenges, as Patricia and Reinhard are, that there is simply no money and we must go through more HSE processes. The cost of inaction, both morally and financially, will be greater as people remain without appropriate care. I urge the Minister of State to reconsider and push this along. I encourage her to meet Reinhard and Patricia and to visit Teach an Saol. I think she will find a way forward. It is something that works on the ground and excuses will not suffice.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I again thank the Senator. I will convey his sentiments to the Minister, Deputy Foley, and encourage her to visit the site if she has not already done so. I will tell her that an invitation has been extended.

The Government remains steadfast in its commitment to improving disability services and ensuring that people with disabilities and their families receive the necessary support. By implementing strategic policies, increasing financial investment and fostering a cross-departmental approach, the Department aims to build an inclusive society where everybody has equal opportunities to thrive. Organisations such as Teach an Saol are invaluable to the disability sector. I do not say that lightly. I say it because I believe it. I see it on the ground in my own constituency. Partnerships between people who have lived experiences and the agencies and the HSE always deliver the best outcomes. As I said, it can be arduous, slow and deeply frustrating. I encourage the Senator not to lose heart and faith. Politicians in the Upper House and the Lower House will try to pursue the Departments to ensure they are proactive, progress solutions and deliver the outcomes the Senator has requested.