Mark Daly (Fianna Fail)
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The Minister of State, Deputy Higgins, is most welcome to Seanad Éireann.

Eileen Lynch (Fine Gael)
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I thank the Minister of State so much for being with us to discuss this important issue. It is one that affects many families countrywide, namely, the lack of a clear plan for provision of accommodation for those with intellectual disabilities. Many families, parents, siblings and guardians provide care at home for loved ones with intellectual disabilities. This is saving the State millions in service costs ever year, but the question that has been asked for quite some time is what happens when the carer can no longer care. These people have been failed by successive governments due to lack of planning for something that is entirely foreseeable. I appreciate we cannot come up with a solution overnight but recently I met a group called Before We Die. The Minister of State has met them, as have an Tánaiste and an Taoiseach, and the Minister of State is aware of their recent survey, their report and their eight demands. This group represents concerned parents and caregivers all over the country who do not know how or where their children will be cared for when they can no longer care for them.

There are currently over 110,000 people with intellectual disabilities. Almost 30,000 of them are aged 15 and over and live in the family home. Based on CSO figures, 2,314 carers are over 70 and at least 500 of them are over 80. Almost 300 of those are based in my county of Cork. According to a survey carried out by Before We Die dealing with the families they represent and the members of their organisation, 78% of families have no formal housing plan, 20% are progressing informal conversations about housing and only 2% have a formal written housing plan in place. We need a cross-departmental approach to ensure a functioning housing plan is in place for those with disabilities. A record of those seeking accommodation provision needs to be created and I am aware that is something the Minister of State is working on but the vast majority of families are unaware they need to ensure their child is on the housing list in order that they can be provided for and that those in the Department are fully aware of the need and the level of need they are dealing with.Simple issues like how long it can take to get a HMD form 1 filled out can delay applications.

I acknowledge that we have seen progress recently in the joined-up approach and initiative that has been taken by Cork County Council and Cork City Council in relation to providing social housing for those with intellectual disabilities. One fairly basic thing they have done is appoint a dedicated liaison officer for social housing in each council for those with intellectual disabilities. This is something that needs to be rolled out in local authorities across the country.

This is not an easy problem to solve and we need a multifaceted approach. In the very short term and in the upcoming budget, we need to introduce an emergency funded plan for carers aged over 70. These families simply cannot wait. If we do not deal with it now, we will be dealing with it in a crisis situation where we have no choice but to provide. Ireland’s residential provisions for adults with intellectual disabilities, IDs, cost significantly more per person than comparable systems across the EU because our current model is inefficient. The cost of a new residential placement rose from 284,000 in 2019 to 332,000 in 2022, and 63% of placements were done through for-profit businesses. I accept that the Government is putting money into this but I question whether it is being put into the right places. I am not sure it is economically efficient, but it is certainly not working for caregivers and service users. It is also vital that we listen to carers and those who have the lived experience. They have to be involved in this process. We need to look at the needs of the individual. We previously had a policy of decongregation but that does not necessarily work for everyone. There are certain people with high-volume care needs who will work better on their own whereas those with a lower care need will work better in housing where they are not isolated and they have shared services, and where integration is a better option. We need to take all of those things into account. Fundamentally, though, we need a place right now.

Emer Higgins (Dublin Mid West, Fine Gael)
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I thank Senator Lynch for raising this important issue and offering me the opportunity to respond. Supporting people with disabilities and their families is a key priority for the Government. My Department, together with the HSE, is committed to improving disability services so that people can access the supports they need when they need them. This commitment is reflected in both the programme for Government and the new National Human Rights Strategy for Disabled People 2025-2030, which was co-designed with disabled people and their representative organisations. It was done that way to ensure that their voices and priorities were the heart of policy and service development. The Senator referred to how the lived experience must be taken on board, and that is exactly what has happened in terms of our strategy.

It is also reflected in the significant investment being made in disability services. The overall budget for specialist disability services has increased from €1.7 billion in 2017 to almost €3.9 billion this year, with specialist disability residential services accounting for almost 60% of the HSE's total disability budget spend. This year, €65 million has been allocated to support new developments in disability residential services. This includes €14 million to deliver approximately 199 residential responses and 152 new residential placements. Funding will also support new residents in existing placements that have become vacant and require enhancements or, in limited circumstances, placements in nursing home settings. The remaining €25 million will support residential packages for children with complex needs, enhanced supports for existing residents in decongregation transitions and the under-65s programme, which is important. These investments are helping to expand residential capacity and improve outcomes for people with disabilities across the country. As of April of this year, 9,031 specialist disability residential places were being delivered by approximately 90 service providers nationwide. Since 2020, additional funding has supported the creation of more than 1,000 new residential places for people with disabilities.

More broadly, the programme for Government commits to investing in residential and independent living options for both adults and children while reducing waiting times for specialist disability services. In support of these commitments, the Ministers, Deputies Browne and Foley, and I have been working with the HSE, local authorities and other partners to improve access to independent living supports and take a more planned approach to the delivery of residential services. There will be an update of this work shortly.A key objective of this is ensuring people with disabilities can access suitable housing and the supports they need to live independently in their communities, as the Senator has asked.

While housing policy is led by the Department of Housing, Local Government and Heritage, my Department funds the disability supports that enable people to live in their communities, including community living and specialist residential services. Working together through the national housing strategy for disabled people, we will strengthen co-ordination between local authorities, the HSE and service providers to better understand the need and to be able to put together better plans for future housing and residential supports.

The Senator referenced Cork County and City Council and the appointment of a new dedicated liaison officer. I met two of the women involved in that campaign only last week and I commend them. I want to let the Senator know that this is something we and the HSE are also doing. New housing co-ordination and residential placement planning and review teams are being established and new housing co-ordinators are being recruited within the HSE. These new roles will be filled by people whose jobs will be helping to support families in this situation and to help increase delivery of appropriate homes.

This work is informing the housing delivery action plans and local disability housing targets. It is also helping to ensure future investment reflects identified need. Alongside increasing capacity, we are focused on ensuring residential services are planned and delivered in a more strategic and sustainable way. That is where many of these new roles will also come in, because they will help us put that more strategic focus on ensuring we are planning ahead for the families the Senator has mentioned.

Looking ahead, my Department is updating the disability capacity review and developing a new policy framework for specialist residential services to help ensure future supports continue to meet the changing needs of people with disabilities. These initiatives will support a more planned approach to service development, thereby ensuring people can access the right supports in the right place and at the right time.

Eileen Lynch (Fine Gael)
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I thank the Minister of State for such a comprehensive reply. I welcome that there is a lot of positive news as regards investment, and I am delighted to see there is progress being made. As I said, it is maybe not as fast as we would like. I commend the Minister of State; I know the volume of work she has been doing on this, particularly when she has been in this particular ministerial role for such a short period. I know she is doing a lot of work on this issue.

I am concerned about the €40 million to deliver 199 residential responses, and 152 new residential placements. This year, there were 250 residential placements but 72 of those only went to planned placements; the rest went to emergency crisis situations whereby a carer became incapacitated or passed away. When that forward planning is not there, somebody who has been on a list is going to be superseded by somebody who is in dire need because their carer is no longer with them or no longer has any form of capacity. That is something that should be highlighted.

I very much welcome the Minister of State's news regarding co-ordination with local authorities and the HSE. Does she have an update relating to the recruitment of the HSE housing co-ordinators and the residential placement planning and review teams? This is very good news, and hopefully it is something that will have a big impact on this area.

Emer Higgins (Dublin Mid West, Fine Gael)
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To be clear, we are absolutely focused on making sure there is progress in this area, but we know there are huge challenges. We need to work through those challenges to improve access to disability services but also in being able to expand residential capacity and strengthen the supports that enable people to live independent and fulfilling lives.

The Senator mentioned the figure regarding planned placements, and she is correct. However, she might not be aware that this is the first time ever we have had planned placements as a target. This is something we have introduced this year that we want to build on next year. It is a figure we want to see moving in the right direction, because it is absolutely needed. As I mentioned, we had a significant increase in the disability budget for this year, which shows Government's commitment to making a real difference to the lives of people with disabilities and to the lives of their families as well.

My Department will continue to work across Government, which was one of the Senator's asks in her opening remarks. We will work cross-government with the Department of housing and local government, the HSE and other partners, including local authorities, to respond to what we know is growing demand and to ensure that residential services are planned and are delivered in a way that will become a way that best meets the needs of people with disabilities.The Minister, Deputy Foley, the Taoiseach, Tánaiste and I have all met the Before We Die group that the Senator mentioned. There is commitment at the highest political level on this issue. The group has done amazing work. I met its members only last week with the Tánaiste to go through the results of its surveys and its requests. I will continue to work with it to deliver improvements in this area.

We need to get to a point where there is a more planned and sustainable approach to this issue. I am determined to do that. I will continue to work with the Senator, her colleagues and advocacy groups.

Mark Daly (Fianna Fail)
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I thank the Minister of State for being here.