I must now deal with a postponed division relating to amendment No. 1 in the name of the Minister for Health to the motion re disability services. Yesterday on the question, "That the amendment be made", a division was claimed and that division must now be taken.
Disability Services: Motion (Resumed) [Private Members]
The following motion was moved by Deputy Pauline Tully on Tuesday, 6 October 2020:
That Dáil Éireann:
acknowledges that:
— families, carers and service providers have been stretched to incredible lengths, many to breaking point throughout the course of this pandemic;
— the personal toll and long-term impact of the withdrawal of care and supports for people with disabilities, their families and their carers is deeply worrying;
— due to Covid-19, disability services that rely on voluntary fundraising to meet operating costs have been unable to do so;
— services are suffering from chronic underfunding which has resulted in unmet need exacerbated by Covid-19;
— reopened disability day services are operating at approximately 40 per cent capacity;
— service providers submitted their funding requirements to the Health Service Executive in mid-June; and
— the Government’s allocation of €10 million in additional funding to day services and home support services for disability service users is insufficient and will not meet the urgent Covid-19 related costs for service providers, community and home support;
recognises:
— that Ireland’s ratification of the United Nations Convention on the Rights of Persons with Disabilities requires progressive implementation; and
— the innovative and committed response of disability and dementia service providers in the delivery of care and support for people with disabilities and their families throughout this pandemic; and
calls on the Government to:
— provide the funding required to fully reopen day and other essential disability services to implement all Covid-19 related protocols; and
— provide the additional funding, resources and capital investment required to guarantee sustainable capacity within disability and dementia services.
Debate resumed on amendment No. 1:
To delete all words after “Dáil Éireann” and substitute the following:
“acknowledges that:
— the Covid-19 pandemic has had significant impact on the delivery of all health funded services, and services for people with disabilities have been particularly affected;
— since the onset of Covid-19 the focus of service providers has been to mitigate its immediate impact on the disability community and the World Health Organization (WHO) anticipates that Covid-19 will be with us for a further 12-18 months;
— the implementation of Covid-19 restrictions has led to the reduction and suspension of services for both children and adults across disability services and while these restrictions have been introduced as protective measures, they have resulted in significant stress for individuals with disabilities and their families;
— the reintroduction of services is now underway, as detailed in the Health Service Executive’s (HSE) roadmap to reopening services, in line with public health guidance;
— since the outset, the HSE Community Healthcare Organisations (CHO) and disability service providers worked collaboratively with families using creative and innovative models of care to support service users where the need was greatest;
— the Government is very aware of the impact of the pandemic on people with disabilities, their families and their carers;
— children’s services, respite services and adult day services are all resuming, having been reimagined and redesigned to be delivered in line with new guidance published by the HSE;
— health and social care responses to the current public health emergency are under continuing review, including specific measures such as those to support vulnerable people; these available supports may change over time and the HSE is aware that the needs of people with a disability and their families will also change over time; and
— in line with the Government's Resilience and Recovery Framework (2020-2021): Plan for Living with Covid-19 (Plan for Living with Covid-19), the HSE regards the provision of disability services as essential to maintaining a response to people with a disability, in the same way that schools and creches are, and importantly, the Government’s intention is that disability services will remain open at each level of the Plan for Living with Covid-19, subject to public health guidance, including the prevention and management of Covid-19 related infection;
notes that:
— the HSE have consistently worked to engage with individual service providers throughout 2020 citing difficulties in service provision and sustainability due to historical financial deficits and new financial challenges, and the requirement for disability service providers to achieve a financial efficiency target of 1 per cent of their budget in 2020 has been removed;
— substantial additional funding has been allocated to the Health Estimate Vote to meet the costs associated with the implementation of the measures outlined in the National Action Plan in Response to Covid-19 (Coronavirus), and the HSE have put measures in place to address both the financial and non-financial challenges of disability service providers in dealing with Covid-19;
— investment in disability services is significant with an overall budget for disability services exceeding €2 billion in 2020;
— the financial implications of measures taken to mitigate Covid-19 infection are matters which the Department of Health will continue to keep under review in conjunction with the Department of Public Expenditure and Reform, as the situation evolves;
— children’s disability services will continue to progress in all areas, and all CHOs are putting appropriate arrangements in place to resume assessment of need and intervention therapy services in line with public health guidance; guidance documents have been circulated by the HSE to all CHOs to support clinicians in decision making regarding disability assessments in the context of Covid-19 and support the return to more normal levels of service provision for children with disabilities and their families, and funding of €7.8 million has been provided to the HSE specifically to reduce the current backlog in the assessment of need, which will help reduce waiting times both for the assessment and for any therapeutic services required;
— adult day services reopened throughout August and September at 40 per cent of their pre- Covid-19 capacity and to augment this, on Monday 28th September the Minister for Health and the Minister of State with responsibility for Disability, announced that €10 million is being made available in 2020 to support the resumption of day services and enhanced home support services for disability service users and that this funding is being drawn down from the National Action Plan in Response to Covid-19 (Coronavirus);
— of this, €7.5 million will increase disability day services by one day a week for over 14,000 adults, however, capacity in day services will remain at a reduced level; the guidance developed to support the resumption of adult day services has had to take account of social distancing rules which has meant that there is a reduced number of people in each service location and the HSE is committed to maximising the support that can be provided within these restrictions; this involves a balancing of protective measures with as much available access to day services as possible, and the full year cost of continuing these services in 2021 of €30 million will be sought as part of the Estimates process;
— residential services for people with disabilities have continued throughout the pandemic and new guidance issued at the end of September in respect of visits to residential care facilities reflects the different levels of the Plan for Living with Covid-19; as with previous guidance, this emphasises that such facilities are the home environments of individuals residing there and as such the importance of maintaining family connections with loved ones from a holistic person-centred approach;
— respite is an important support mechanism for many families and short-stay residential and emergency/residential respite began to reopen from July to August as the first stage in a three-phase plan, and activity is now increasing for the next two phases – the September to November phase and then the December 2020 to February 2021 phase;
— the allocation of additional funding to disability services is only part of a range of complex barriers to the full resumption of disability services; challenges include the physical limitations of the buildings available and the continued restrictions imposed by social distancing guidance, and the HSE is building increased capacity for day services, including building refurbishment to provide extra space and access to community building and facilities;
— a key commitment in the Programme for Government is the implementation of the National Dementia Care Strategy, which aims to improve how we provide care for people living with dementia, and that in line with the Programme for Government commitment to expand the dementia advisor service on a nationwide basis, an additional 10 dementia advisors are being recruited this year with support from the Sláintecare Enhanced Community Fund;
— there has been a continued focus on meeting the needs of people living with dementia who were impacted by the suspension of day care services during the Covid-19 pandemic;
— the HSE, in collaboration with the Alzheimer Society of Ireland, has developed a range of initiatives and resources to ensure that people living with dementia stayed safe, well and connected during the crisis;
— the Government’s approach to meeting the terms of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is one of sustained and on-going improvement, and work is continuing on the reforms needed for an optimum level of compliance with the UNCRPD's requirements; and
— the Programme for Government also commits to the development of an implementation plan to coordinate implementation of the UNCRPD, and furthermore, the Programme commits to work with other parties in the Oireachtas through an Oireachtas Joint Committee to assist in monitoring and implementing the provisions of the UNCRPD, and work will commence on the development of an implementation plan shortly; and
commits to:
— a continued whole of government approach to improving access to and quality of services for people with a disability in line with the HSE’s Transforming Lives Programme and the National Disability Inclusion Strategy 2017-2021;
— preparation of Ireland’s Initial State Report to the Oireachtas Joint Committee, which is at an advanced stage of drafting and, in addition, the consultation phase on the State Report is being planned; key to this is the involvement of, and consultation with, persons with a disability on the State Report;
— the ongoing establishment of A Disability Participation and Consultation Network which will move Ireland towards meeting its obligations under the UNCRPD to consult and actively involve persons with a disability and their representative organisation, and one of the first tasks for this Network will be to partake in the consultation process on the Initial State Report;
— the full implementation of the Sustainable, Inclusive and Empowered Communities: A Five-Year Strategy to Support the Community and Voluntary Sector in Ireland 2019- 2024, which sets out a long-term vision for communities in Ireland and a general direction of travel for Government policy in relation to the community and voluntary sector for the coming years;
— strengthening the State’s relationship with the voluntary sector through meaningful participation in the new dialogue forum between the Department of Health, relevant health agencies and representation from voluntary organisations in the health and social care sector; and
— moving to a population-based planning approach to service delivery, in line with the Sláintecare vision, based on demographic and geographic considerations that reflects both the health and social care needs of those within our population, including those who require specialist disability services; this will afford the opportunity to prioritise and design the health and social care services that need to be developed for each region, so the population can get the right care, in the right place, at the right time in line with Health Information and Quality Authority standards and available resources.”
- (Minister of State at the Department of Health, Deputy Anne Rabbitte).
Amendment put:
The Dáil divided: Tá, 82; Níl, 67; Staon, 0.
Tá
- Berry, Cathal.
- Brophy, Colm.
- Browne, James.
- Bruton, Richard.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Byrne, Thomas.
- Cahill, Jackie.
- Calleary, Dara.
- Cannon, Ciarán.
- Carey, Joe.
- Carroll MacNeill, Jennifer.
- Chambers, Jack.
- Collins, Niall.
- Costello, Patrick.
- Coveney, Simon.
- Cowen, Barry.
- Creed, Michael.
- Crowe, Cathal.
- Devlin, Cormac.
- Dillon, Alan.
- Donnelly, Stephen.
- Duffy, Francis Noel.
- Durkan, Bernard J.
- English, Damien.
- Farrell, Alan.
- Feighan, Frankie.
- Flaherty, Joe.
- Flanagan, Charles.
- Fleming, Sean.
- Foley, Norma.
- Grealish, Noel.
- Griffin, Brendan.
- Harris, Simon.
- Haughey, Seán.
- Heydon, Martin.
- Higgins, Emer.
- Hourigan, Neasa.
- Humphreys, Heather.
- Kehoe, Paul.
- Lahart, John.
- Lawless, James.
- Leddin, Brian.
- Lowry, Michael.
- MacSharry, Marc.
- Madigan, Josepha.
- Martin, Catherine.
- Martin, Micheál.
- Matthews, Steven.
- McAuliffe, Paul.
- McConalogue, Charlie.
- McEntee, Helen.
- McGrath, Michael.
- McHugh, Joe.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Murnane O'Connor, Jennifer.
- Murphy, Eoghan.
- Noonan, Malcolm.
- O'Brien, Darragh.
- O'Brien, Joe.
- O'Callaghan, Jim.
- O'Connor, James.
- O'Dea, Willie.
- O'Donovan, Patrick.
- O'Dowd, Fergus.
- O'Gorman, Roderic.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cathasaigh, Marc.
- Ó Cuív, Éamon.
- Rabbitte, Anne.
- Richmond, Neale.
- Ring, Michael.
- Ryan, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Smyth, Ossian.
- Stanton, David.
- Troy, Robert.
- Varadkar, Leo.
Níl
- Andrews, Chris.
- Barry, Mick.
- Boyd Barrett, Richard.
- Brady, John.
- Browne, Martin.
- Buckley, Pat.
- Cairns, Holly.
- Canney, Seán.
- Carthy, Matt.
- Clarke, Sorca.
- Collins, Joan.
- Collins, Michael.
- Conway-Walsh, Rose.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Daly, Pa.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrell, Mairéad.
- Fitzpatrick, Peter.
- Funchion, Kathleen.
- Gannon, Gary.
- Gould, Thomas.
- Guirke, Johnny.
- Harkin, Marian.
- Healy-Rae, Danny.
- Howlin, Brendan.
- Kelly, Alan.
- Kenny, Gino.
- Kenny, Martin.
- Kerrane, Claire.
- Mac Lochlainn, Pádraig.
- McDonald, Mary Lou.
- McGrath, Mattie.
- McNamara, Michael.
- Mitchell, Denise.
- Munster, Imelda.
- Murphy, Catherine.
- Murphy, Paul.
- Murphy, Verona.
- Mythen, Johnny.
- Nash, Ged.
- Naughten, Denis.
- Nolan, Carol.
- O'Callaghan, Cian.
- O'Donoghue, Richard.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Ríordáin, Aodhán.
- Ó Snodaigh, Aengus.
- Pringle, Thomas.
- Quinlivan, Maurice.
- Ryan, Patricia.
- Shanahan, Matt.
- Sherlock, Sean.
- Shortall, Róisín.
- Smith, Bríd.
- Smith, Duncan.
- Stanley, Brian.
- Tóibín, Peadar.
- Tully, Pauline.
- Ward, Mark.
- Whitmore, Jennifer.
- Wynne, Violet-Anne.
Staon
Tellers: Tá, Deputies Brendan Griffin and Jack Chambers; Níl, Deputies Denise Mitchell and Pádraig Mac Lochlainn.
Amendment declared carried.
Motion, as amended, agreed to.