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Funding of Disability Services: Motion [Private Members] (Continued)

Tuesday, 4 December 2012

Dáil Éireann Debate
Vol. 785 No. 1

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(Speaker Continuing)

[Deputy Charlie McConalogue: Information on Charlie McConalogue Zoom on Charlie McConalogue] I refer to the position that obtained at the end of last year, where of the 700 people who were continuing on to further education, 57 young adults had not secured places by the end of August. These young adults were left in a position in which they had no security regarding what would be their next step. These are young adults who depend on Members at State level to ensure places are available and who will find themselves in similar positions in the future, unless Members can ensure the necessary hard steps are taken to ring-fence the funding and resources required to cater for their needs.

Acting Chairman (Deputy Joanna Tuffy): Information on Joanna Tuffy Zoom on Joanna Tuffy The Deputy's time is up.

Deputy Charlie McConalogue: Information on Charlie McConalogue Zoom on Charlie McConalogue Finally, I commend the motion to Members. I acknowledge the Minister of State's intentions are good in this area and that it is not an easy task but as a party that greatly values looking after the disabled in society, Fianna Fáil is stating she must make the hard decisions required to ring-fence the budget and ensure the resources are kept there.

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch I move amendment No. 1:

To delete all words after “Dáil Éireann” and substitute the following:

“recognises:

— this Government’s commitments to people with a disability in the programme for Government, including greater participation in employment, training and education in accordance with a revitalised national disability strategy; and

— that around €1.4 billion will be spent in 2012 on health and personal social services for people with disabilities – this is in addition to transfers to people with disabilities from the Departments of Social Protection and Education and Skills and other Government services;

notes that the Health Service Executive, HSE, national service plan for 2012 has been drawn up against the backdrop of significant funding challenges and that while the allocation for specialist disability services has been reduced by 3.7% nationally, in 2012 the level of service reduction will be less than the level of budget reduction as a result of the efficiencies that will be delivered;

acknowledges that some reductions in disability services have been unavoidable in 2012 and welcomes moves by the HSE to tailor such reductions in such a way that minimises the impact on service users and their families as much as possible; and

notes:

— that within the serious resource constraints imposed by the current budgetary and fiscal conditions, the Minister for Health is doing all possible to ensure that as much protection as possible is afforded to the disability sector and the social care area as a whole; and

— the publication of the Value for Money and Policy Review of Disability Services in July 2012, which includes recommendations to ultimately move to individualised funding for disability services so as to provide greater choice and control for people with disabilities.”

I thank the contributors thus far and note there will be many more. I welcome the opportunity to put on the record of the House the efforts that are being made to provide effective, accessible and responsive health and personal social services for people with disabilities. At the outset, I note that Members in government share the concerns of Members opposite and of the concerned parents, individuals, relatives and friends of people with disabilities who are present tonight and throughout the country. I strongly reaffirm the Government's commitment to the national disability strategy and to doing all that it possibly can to give persons with disabilities the services and support they need.

  I will begin by addressing the national disability strategy and other current developments. The growing recognition by society of the right of people with disabilities to participate in and contribute to social and economic life has underpinned the development of services in recent years. In line with the commitment in the programme for Government to publish, following wide consultation, a realistic implementation plan for the national disability strategy, I have established and am personally chairing a new national disability strategy implementation group. This group includes representatives from across the Government, as well as the County and City Managers Association. In this context, I take on board Deputy Browne's point on where people with disabilities live and on what has the greatest impact on their lives. I believe local authorities do so, which is the reason the County and City Managers Association now has a representative on the national disability strategy steering group. It also includes representatives from the National Disability Authority, a broad range of disability organisations and a number of individuals appointed in their personal capacity to bring their lived experience to the table. I was astonished to find that until I was appointed Minister of State, the group did not include people with disabilities to speak for themselves. I also convened a disability forum, under the stewardship of the National Disability Authority, to ensure the voices of people with disabilities, as well as their needs and concerns, are being heard. In addition, a number of significant developments are ongoing, which touch on all aspects of services and supports for people with disabilities. These include strategies for transferring people with disabilities from congregated residential settings into the community, putting in place a system of registration and inspection of residential centres, reconfiguring day services and supports, implementing the recommendations in the national policy and strategy for the provision of neuro-rehabilitation services, reconfiguring autism services and services for children with complex disabilities and, of course, implementing the recently published value for money policy review of specialist disability services.

  At a time when the Government is trying to achieve more with less funding, changing attitudes and leading by example often can be achieved without any additional funding. Some of the best practice on disability in both the public and private sectors has been as a result of a positive attitude, particularly if it comes from senior management. I see examples of this nationwide every week. The terms of reference of the national disability strategy implementation group include promoting positive attitudes towards people with disabilities and I will work with this group to develop an effective, measurable plan of action to achieve this.

  The HSE's national service plan for 2012, drawn up against the backdrop of significant funding challenges, was designed to reflect the changing priorities of the new Government and the significant programme of reform being undertaken. The allocation for disability services has been reduced by 3.7% this year. However, the level of service reduction has been less than the level of budget reduction as a result of efficiencies that have been delivered. Again, this is very much down to the service providers. While the aforementioned service providers have achieved some efficiency savings, reductions in services also have been unavoidable in day services and in residential and respite services. The necessary reduction in 2012 unfortunately mirrors that applied across all areas of the health sector. However, it is timely for me to remind Members of the highly significant levels of service provided for people with disabilities through the substantial investment of €1.4 billion by the Health Service Executive in 2012. I note this is just part of what is spent on disability. Without deviating from the script, I continually make the point that were all the money spent on disability concentrated in a single pot, there would be better outcomes.

  At present, more than 9,100 people receive care in residential places, most of whom are living in homes within their communities. Moreover, 6,300 people are receiving respite residential support, 18,600 people are attending day services and 1.64 million personal assistant and home support hours are being provided. Overall, the national intellectual disability database annual report for 2011 states that 26,831 people with intellectual disability were in receipt of services, representing 98% of the total population registered on this database and the highest number of people in receipt of services since the database was established.

  A major issue for the Government is to ensure it gets the best outcome for people with disabilities from the resources it puts into the health sector. I published the report of the value for money and policy review on disability services on 20 July last. The objective of the review was to assess how well current health and personal social services for people with disabilities meet their objectives and to recommend how these services should be delivered in the future. Many of the most fundamental changes needed to support the full participation of people with disabilities in society will be achieved through the implementation of this review. From the outset, public consultation was an important feature of the review. The review team listened carefully to what people had to say, as well as to the advice of the expert reference group on disability policy and the thoroughly researched advice provided by the National Disability Authority. As a result, the review recommends a significant restructuring of the disability services programme through migration from an approach which is predominantly organised around group-based service delivery towards a model of person-centred, individually chosen, supports and implementation of a more effective method of assessing need, allocating resources and monitoring resource use. This will represent a seismic change in how services are funded and provided and will result in shifting choice and control from professionals and administrators to where it rightfully belongs, namely, with the individual with a disability or his or her family. Work is now under way to put the necessary implementation plan in place to move forward the recommendations of the review in 2013.

  Even before the drawing up of the value for money review, major changes have been under way for disability services in recent years. There has been a definitive move from an institutional and segregated model of service delivery towards a community-based and inclusive approach that aims to support people with disabilities in community-based living with maximum independence and choice. A number of ongoing policy initiatives support this commitment. For example, in July, I jointly launched with the Minister of State, Deputy Jan O'Sullivan, the national implementation framework to support the Government's National Housing Strategy for People with a Disability 2011-2016. The development of the implementation framework underlines the successful collaborative approach involving my Department, the HSE and the Department of the Environment, Community and Local Government in addressing the housing and related support needs of people with disabilities.

  While the Government continues to support people in institutional and other residential settings, the issue of standards and appropriate services arise.


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