Tuesday, 28 June 2011
Department of Health
Services for People with Disabilities
I propose to take Questions Nos. 459 and 535 together.
The correspondence supplied by the Deputy is seeking his personal views and understanding on independent living for people with disabilities. However, the Government's central policy objective for people with disabilities is that people should be supported "to lead full and independent lives, to participate in work and society and to maximise their potential". In line with this policy, the Government's Programme for National Recovery 2011 – 2016 contains a commitment to "ensure that the quality of life for people with disabilities is enhanced and that resources allocated reach the people who need them.".
Research, both international and national, confirms that the needs of people with a disability are most appropriately met and provided in their home and community and that this provides a more sustainable model for the provision of care. The Government's commitment to people with disabilities is one whereby the focus of any supports should be based on individual need as much as possible and, while there is no "one size fits all" solution, the focus of supports should favour the individual rather than an organisation or service provider. A review of the efficiency and effectiveness of disability services funded from the Health Vote is currently underway and will be completed later this year. As part of this review an Expert Reference Group was established to review current policy in relation to disability services. Although it is important not to pre-empt any recommendation that may arise out of this process, a key theme emerging is the need for a shift in funding from organisations to individuals. This might or might not involve the transfer of actual funds to the individual. While direct payment may be considered in the future, a shorter term goal would be the transfer to the individual of choice and control over support and care decisions through the mechanism of individualised budgeting.
On 3rd December 2010 the Department published, on its website, a summary of the key proposals emerging from the review of disability policy. It proposes a re-framing of disability services towards a model of individualised supports and the main-streaming of all public services. State funding would be allocated based on an independent assessment of individual needs. Following the needs assessment, individual support plans would be drawn up and individualised budgets allocated from which the supports and services needed would be purchased.
I understand that the Health Service Executive is supporting a direct payments model for two people with a disability in the Cavan Monaghan area. In addition my Department through the Genio Trust is supporting a new innovative initiative for five individuals to manage and direct their personal assistant supports by receiving direct payments to purchase the supports they decide they need. The evaluation of this initiative will inform the implementation of the policy proposals currently being developed.
While the focus is on the shift in funding from organisations to individuals, individualised funding and direct payments are not one and the same. With direct payments the transfer involves the actual direct payment of cash to the service user. With individualised funding, the main transfer of resources to the service user is the transfer of some control over decisions. This might or might not involve the transfer of actual funds to the individual. While there may potentially be some form of direct payment in the future, the more significant change is likely to be the transfer of control and choice. Therefore it is not proposed to introduce a personal assistance act at this stage.