The amendment proposes to provide examples of personal social services for the purposes of Part 2 of the Bill. I understand from the Department of Health and Children that some personal social services, such as residential care, are covered in existing health legislation. Any further expansion of the scope of such provisions by defining "personal social services" would be more appropriately dealt with in the existing legislation. It is not, therefore, proposed to accept the amendment.
Disability Bill 2004: Report Stage (Resumed).
That is exactly what the Minister of State said.
We are in the same Government.
I move amendment No. 40:
In page 10, between lines 23 and 24, to insert the following:
"‘needs officer' shall be construed in accordance withsection 7 and section 10. Each subsequent reference to ‘assessment officer’ and ‘liaison officer’ in this Act shall be construed as references to ‘needs officer’;”.
I move amendment No. 46:
In page 11, line 27, after "request" to insert "without undue delay".
Amendment No. 46 is very important in the context of the significance of delays in the provision of services to people with disabilities. We cannot allow circumstances to continue to exist in which families must wait for services. People are directly affected. The whole ethos of the legislation must be looked at very seriously.
On the broader issue of the Bill, I would like the Minister to take on board a number of points, especially in regard to the amendments. This will be our last opportunity to present changes to the legislation. I would like to see a clear and unequivocal right to an assessment of need that would not be resource dependent. I would also like the services identified in the assessment of needs for an individual to be provided within a reasonable and agreed time frame. In addition, I seek that the Bill would provide for the protection of disability specific resources and that the provisions regarding sectoral plans would take account of the wider needs of people with disabilities. Each Department concerned with relevant services should also provide a sectoral plan. The Bill should impose a statutory duty on all Departments and public bodies to include people with disabilities in their plans and services with appropriate monitoring and accountability. I wished to return briefly to those issues.
Regarding amendment No. 46, if the Minister were to accept the amendment it would add teeth to the legislation and would give it strength.
I support the amendment. It is important to include a time scale as it would provide a sense of urgency. Adding a time scale to the subsection would strengthen it and it would not change things unduly.
I am unaccustomed to retorting to a Second Stage speech on Report Stage. I do not know how Deputy McGrath got away with that. The sectoral plans were a matter of discussion. A number of strategic Departments will be involved in sectoral plans. The Department of Education and Science will have a separate one. It would be ludicrous if my Department had a sectoral plan. It would not be particularly worthwhile in this context, except in regard to my employment sector, which comes under the remit of the Department of Finance.
Section 9(5) requires the Health Service Executive to commence an assessment within three months of the date of application and to complete it without undue delay. If the National Council for Special Education is to comply with the request — section 8(3) obliges it to do so — the council must act within these time frames. I am concerned that if I were to accept amendment No. 46 which appears to give reasonable leeway to the council the time frame given to it might become a factor for delay. The section as published requires compliance without qualification and it is the preference of the Minister to maintain that situation. I see where the Deputy is coming from, but sometimes in legislation if we tie ourselves into a time frame it can cause a delay as opposed to where one does not have a specific instruction. The spirit of what the Deputy advocates in the context of the legislation is reflected in the sections to which I referred.
Amendments Nos. 51, 51a, 53, 54, 55, 58 and 59 are related to amendment No. 49. Amendment No. 52 is an alternative to amendment No. 51a. Amendment No. 56 is an alternative to No. 55. These amendments will be discussed together by agreement.
I move amendment No. 49:
In page 12, lines 3 to 8, to delete all words from and including "considered" in line 3 down to and including "provision" in line 8 and substitute the following:
"listed in order of importance, which are considered appropriate by the person or persons referred to insubsection (2) to meet the needs of the applicant and the period of time required by the person or persons for the provision of each of those services and the order of such provision, giving preference to services which are most needed by the applicant”.
Grouping the amendments in this way makes it easier for us to follow them and makes life much easier. There is a concern that when the service statement is drawn up, services are not compiled in order of priority of need. The liaison officer then has to find out what can be provided. The amendment is similar to the wording in the Bill except that it would provide for the services to be listed in order of importance. It is preferable that the service most urgently required would be granted as soon as possible. That makes sense and it does not affect the general thrust of the Bill. The service statement is important. I am asking that this statement would list the services required in order of importance. That is the only difference this amendment would make, which is reasonable. Otherwise a person might get a service they may not need as urgently. The Minister should consider this provision, which is important and will not make a major change to the legislation.
Other Deputies who are well able to speak on them have tabled amendments Nos. 51 to 56, inclusive, and amendments Nos. 58 and 59. I will come in later on them.
The grouping includes amendments Nos. 51 to 56, inclusive. Amendment No. 51 is straightforward and offers a more concrete wording by the substitution of "shall" for "may". This will ensure that the matter is not open to discretion, and that it shall happen. The Minister will make provision for what is sought in amendment No. 51 and I shall withdraw amendment No. 52 on that basis. I wish to clarify whether it will apply to all other areas where that kind of terminology is used. I assume that if it is done in one section it will be done in all others.
That is not clear.
It is not even a technical amendment. It relates to the language and the attitude involved. I appreciate the Minister taking that on board and changing the terminology for how consultations would be notified rather than the present wording that virtually commands people to appear before an assessment officer.
I support my colleagues' amendments, especially amendment No. 49 with which we are dealing. I also wish to speak on the two amendments I have co-sponsored, Nos. 55 and 59. Deputy Stanton has already outlined the reason for the amendments. We are seeking to incorporate the principle of a continuous review and the prioritisation of service provision because that is what the various groups sought so that, at the very least, the services most urgently required would be first delivered as the Bill does not guarantee as of right that people's needs will be addressed. The amendments fall short of enshrining the principle of progression in regard to needs that are not met. In the confines of what is being presented to us, we are trying to put in place a mechanism that will allow for prioritisation. My preference is for an unqualified right to an assessment of need. This will not happen, as outlined by the Minister of State in his response to this subject on Second and Committee Stages.
Amendments Nos. 55 and 59, which I have tabled, propose to delete the clauses in section 8(1)(b) and (c) which would permit an assessment officer not to inform a person with a disability of the purpose of an assessment interview and not to ensure that the person with a disability is given adequate information relating to the process and the results of the assessment. The rationale for this according to the Minister of State is that the provision of such information may, in some cases, be prejudicial to the applicant’s mental health, well-being or emotional condition or inappropriate having regard to the age of the applicant or the nature of his or her disability.
The rationale behind the provisions is indicative of the Government's patronising medical approach to people with disability. This contrasts with the rights-based approach which the Opposition, the DLCG, the Human Rights Commission and many others who made submissions are advocating. The clauses we seek to delete are offensive and retrograde in the extreme. We cannot continue to regard people with disabilities as dependants to be protected and cared for. They are equal citizens; hence the selection of the title of the document, Equal Citizens, for which people had great hope. People with disabilities have the right to be informed of matters that concern them directly.
I accept the way information on the assessment is imparted may need to be customised to make it accessible, but it is fundamentally wrong to argue that any Health Service Executive employee should have discretionary power to withhold information concerning a person with a disability from that person because the employee is of the opinion that the person cannot take it. These provisions are a throwback to the bad old times and run counter to the principle of informed consent. They should be removed.
The Government's amendment No. 51a refers to procedures for interviews. Deputy Lynch has withdrawn her amendment, which reflects the language issue to which she adverted. The change in the language of the subsections is so the assessment officer will meet the applicant rather than ask the applicant to attend for interview. People would be happy with that.
Amendment No. 53 proposes a further variation to the text by requiring that the assessment officer would attend before the applicant. It is considered that this proposal is primarily concerned with the location of the meeting and that details of this nature are not really appropriate to legislation. It would not be appropriate, therefore, to accept the amendment.
Having listened with interest to the Deputies raising a number of points relating to the participation and involvement of the applicant in the assessment process, I noted that this is an important topic. We are all obliged to get the balance right. The detailed provisions in section 8(7) and (8) seek to do that and were prepared in light of proposals made in the consultation process and on the advice of the Department of Health and Children.
Amendment No. 49 would require assessment reports to contain a prioritised list of services. The principle in the Bill is that the report would set out all required services and indicate in itself the order for their provision, together with the optimum timescale for their delivery. I do not know if the amendment would improve any arrangements for assessment and service delivery.
Amendment No. 51 would require an assessment officer to carry out an interview in all cases. It is desirable that some discretion regarding procedures remain with the assessment officer so individual circumstances in each case can be considered. I am not disposed to accepting this amendment.
Amendment No. 54 proposes to require the applicant to comply with any reasonable requirement of the assessment officer for information. This amendment is not necessary because, under section 8(8)(a), as it stands, the assessment officer is only empowered to seek information that he or she may reasonably request.
Amendments Nos. 55 and 59 cover procedures for assessment interviews. The amendments would remove a provision designed to cater for the assessment of a small number of individuals. The provision allows the assessment officer discretion in deciding if the applicant should be told the purpose of the assessment interview or about other information related to the assessment. This takes account of circumstances where particular sensitivity may be required, for example, in the case of someone with a severe intellectual disability or the case of a child where potentially disturbing information or a potentially disturbing information prognosis falls to be given. It is inappropriate to state, as Deputy Ó Snodaigh does, that we are removing a right because there are particular circumstances in which certain information would not be in the best interest of the person being assessed. We could remove the discretion to exercise sensitivity but the Deputy will appreciate that it is often very important. The assessment is an individual matter and tying the assessment officer in knots would represent a retrograde step.
Amendment No. 56 would require the assessment officer to form a reasonable opinion of whether the giving of any information to a person with a disability would be prejudicial to the individual's well-being. I am concerned that the interpretation of what is reasonable may vary widely. The Deputy has not provided a definition or otherwise provided a yardstick to measure what is reasonable. By contrast, the provision as it stands is grounded on a verifiable reality of opinion. In the circumstances, I am not disposed to accept the amendment.
On Committee Stage, section 8(8)(c)(i) was amended to require that note be taken of the views of the applicant in the assessment process. Amendment No. 58 envisages an additional requirement that a written note be taken of these views. I am satisfied that the text of the provision as drafted envisages a written record of the views of the applicant on his or her needs and preferences regarding services. Accordingly, I do not propose to accept the amendment.
On amendment No. 49, there is no link between the assessment report prepared without regard to the cost of or the capacity to provide any service identified as being appropriate to meet the needs of the person and the subsequent service statement specifying the health services or education to be provided. As it stands people may never receive certain services outlined in their assessment report. The alternative would be for the assessment report to list services required in order of importance and timeframes for accommodating needs. It should be feasible to work out what would be possible over a period and make provision for an annual review. The Minister spoke about services being listed or provided in order of importance but there seems to be no reference to this in the Bill. I do not know what difference it would make except to give priority to certain services that would be required urgently.
The Government objects to reasonable amendments by the Opposition. It seems to be engaged in negotiations. I wonder whether we should close the Oireachtas altogether and run the country by negotiation with social partners and other groups. Why are we here in the first place? Deputies seem to have no input into legislation such as this. They are the last people to be consulted and are treated with disdain by Ministers. Where is the Minister of State, Deputy Fahey? He is responsible for taking this Bill but he is not present. He was late this morning and late on the previous occasion on which we dealt with the Bill. What is going on? We have received no explanation as to where he is. Although my amendment is important, I wonder if we are wasting our time. The Minister just reads out a piece of paper and does not even consider the amendments.
Having nearly 20 years of experience and having been involved in advocacy when this discussion was taking place, I am as competent as anybody else to deal with legislation in this House. I was very much involved in the Cabinet sub-committee review of disabilities. As a person, no more than Deputy Finian McGrath, who has a child with disability I have both a personal and political view in terms of ensuring this legislation is brought to fruition as quickly as possible. Equally, I want to ensure that the best possible job is done by Members of the House.
Often the Government can empathise with the Opposition's concerns. With complicated legislation, often legitimate concerns, such as those contained in this amendment, are reflected within the legislation as it stands. Section 8(7)(b)(iii) has the timeframe for the delivery of the service and the order of such a provision. That is encompassed in the legislation per se. The liaison officer must take account of the Department in preparing service statements and their order of importance will be directed within the legislation as it stands. What is being sought is in the legislation under section 8(7)(b)(iii).
The concerns of the Opposition are not about the competence of the Minister taking the Bill. Clearly she is a competent woman. She would not be where she is if she were not. Nobody is disputing that.
The Deputy would not be there, either.
It is a women's club.
That is it. We are going to take over the place.
Anyone could be answering because our concerns are not being taken on board. It is the same script, regardless of who reads it out. It could be me, the Clerk, the usher or anyone. The script is the script and there is no discretion and no one is prepared to listen. Sometimes, that one is not talking does not mean one is listening, and the script is the script. On this side of the House it appears that it does not matter who is in the ministerial seat on the Government side, competent or otherwise. The script is the script and we are getting nowhere. It is all right for us——
We are getting nowhere unless we can get this legislation finished and enacted and see how it works out.
——because fortunately we do not need the types of services which are supposed to be provided in this Bill. However, it is not all right for people who desperately rely on it.
I move amendment No. 51:
In page 12, line 11, to delete "may" and substitute "shall".
I move amendment No. 51a:
In page 12, line 14, to delete "attend before" and substitute "meet with".
I move amendment No. 55:
In page 12, lines 22 to 26, to delete all words from and including "unless" in line 22 down to and including "disability" in line 26.
I move amendment No. 57:
In page 12, line 28, to delete "endeavour to".
This relates to the duty of the assessment officer to facilitate communication, participation and dialogue in the assessment process. The provision requires the assessment officer to endeavour to ensure that such participation takes place. The proposed amendment would oblige the assessment officer to ensure this sort of involvement by the applicant and effectively leave the officer responsible for the communication of other people involved in the assessment process. I do not believe this is a reasonable approach. Section 10 provides for standards to apply to the assessment process and places the responsibility on the HSE to ensure that they are applied. I believe that the issues involved are adequately covered by standards to be made under section 10 and I do not propose to accept this amendment.
I move amendment No. 59:
In page 12, lines 39 to 44, to delete all words from and including "unless" in line 39 down to and including "disability" in line 44.
Amendments Nos. 61, 62 and 114 are related and will be taken together. Is that agreed? Agreed.
I move amendment No. 61:
In page 13, line 2, after "person")" to insert "has or".
This section deals with an application for assessment. It is just as well the House has been dealing with this Bill for a long time. Someone reading it for the first time would be completely confused. Certain sections of it do not gel. For example, section 9(1)(a) says:
(a) a person (“the person”) is of opinion that he or she may have a disability, or.
My amendment inserts the words "has or" so that the wording says that a person has or is of the opinion that he or she has a disability. I do not believe having a disability is a matter of opinion. One either has a disability or one does not. I do not know anyone with a disability who would either like to have one or is of the opinion that they have one. I do not know where that language comes from. It is just like the language in the phrase "shall attend before the assessment officer for interview". I cannot understand it. It is to form an opinion whether one has a disability. Surely this cannot be right. Clearly, for the majority of people in that category the issue is not one of opinion but of fact.
Previously we discussed the "trust me" element, so to speak, of this legislation. Either one is covered by the legislation or one is not. Legislation is about absolutes. Sometimes we get the absolutes wrong and we have to revisit them, but it should not be a matter of opinion, and that is what the amendment is about.
Amendment No. 62 relates to section 9(1)(b) which states “a specified person (“the person”) is of that opinion in relation to another person and the person considers that by reason of the nature of that other person’s disability or age he or she or is likely to be unable to form such an opinion”. I know what that means but this is about the language used. The amendment proposes to delete the words “form such an opinion” and substitute the phrase “make application under this section”. The subsection would still have the same effect but there would be a better use of language. We are supposed to be drafting legislation that is understandable to everyone who might read it. Surely it makes sense for the Minister of State to accept these amendments. They will not impose a charge on the Exchequer or give rise to offence. Some of the language in the Bill is quite offensive.
I support these two amendments, particularly amendment No. 62. It might be difficult at times to consider whether another person can form an opinion. Even if a person is unable to form an opinion, he or she may be unable to make an application due to physical impairment. If a person is unable to form an opinion, it is likely that he or she cannot make an application. A person may be unable to make an application because of a disability preventing him or her from physically doing so, even if that person can form an opinion.
The two amendments put forward by Deputy Lynch are useful, valid and represent an improvement on the wording in the section. I urge the Minister of State to accept them.
Section 8 deals with the parameters for applying for an assessment of need. Section 9(1)(a) provides that a person who is of opinion that he or she may have a disability may make an application for assessment. Amendments Nos. 61 and 114 seek to include a person who has a disability as well as a person who is of the opinion that they have a disability. The current text is inclusive of such persons as someone with a disability will also be of the opinion that they have a disability. I do not propose, therefore, to accept amendments Nos. 61 and 114.
In regard to amendment No. 62, section 9(1) describes two circumstances where applications for assessments may arise. One is where a person considers that he or she has a disability and where he or she may make an application. The other is where the person is unlikely to be able to form the opinion that he or she has a disability and another person applies on his or her behalf. The provision, as drafted, means that the decision on applying for an assessment rests with the applicant unless the applicant is unlikely to appreciate the need for an assessment. This is consistent with the focus on the individual's needs that underlines the approach to assessment in the Bill. I am not sure that the proposed amendment would improve the approach being taken and for these reasons I do not propose to accept amendment No. 62.
I am still at a loss having heard the Minister of State's reply. I listened carefully to what he said and I believe he is of the same opinion as me, both of us being at liberty to form opinions. If I have a disability, it is not a matter of opinion; it is a matter of fact. It should not be up to myself or someone else to form an opinion as to whether I have a disability. That is what I thought this legislation involved. The definition in this respect is restrictive but clear. Why the Minister of State is leaving this section so open in terms of this matter being down to another person's opinion is beyond me.
I am not a great expert on legislation but I would have thought it is about absolutes. Why would the Minister of State leave this matter open to opinion? Does he consider it possible for a person who does not have a disability to suddenly decide that he or she may have one? Does he believe that is how people think?
It is an opinion because one does not know for certain if one has a disability until one has an assessment.
That is the most ridiculous statement I have ever heard. The Minister of State is saying one does not know that one has a disability until someone tells one that one has a disability and yet one will have gone for an assessment. Why would one do that? Is the Minister of State indicating that a person who does not believe he or she has a disability would apply for an assessment and suddenly be informed that he or she has a disability because he or she applied for that assessment? Is he saying that it is during an assessment that such disability will come to light and that a person will suddenly discover, have had no notion beforehand, that he or she is blind, has a hearing impairment, cannot walk or is intellectually restricted?
If one is of the opinion that one may have a disability, one may make an application for an assessment. There is no mystery about it.
My point is——
If the Deputy will allow the Minister of State to conclude, I will then call her.
The idea behind this provision is to include a person who has a disability as well as a person who is of the opinion that he or she has a disability. In other words, we are providing for both.
Perhaps I am the only person who thinks like this, but one either has a disability or one does not. It is one or the other. In the case of some people because of the way this Bill is framed——
People may be of the opinion that they have a disability but they may not have one.
Can the Minister of State provide an example of that?
We are getting into a type of Question Time. The Minister of State has spoken twice on this amendment and Deputy Lynch is on her third contribution, which will be her final one.
I will conclude. I do not know of any circumstances where a normal — whatever one considers to be normal — healthy, active person would be of the opinion that he or she has a disability and has that confirmed after applying for an assessment, when up to that point the person was not certain about that. I do not know of, and it is unlikely I will ever meet, anyone in that category.
On a point of clarification, the parent of a child with late developmental issues would be covered by the Bill.
I can guarantee that the parent would know that from every early on.
I move amendment No. 62:
In page 13, lines 7 and 8, to delete "form such an opinion" and substitute "make application under this section".
I move amendment No. 62a:
In page 13, lines 18 and 19, to delete "(within the meaning of theComhairle (Amendment) Act 2005)”.
I move amendmentNo. 63:
In page 13, between lines 20 and 21, to insert the following:
"(e) a carer or family carer.”.
This is a simple amendment. It is also logical and I would not table it if it was not, although so far logic has defied the Minister of State. In this amendment, I propose that the words "a carer or family carer" be included in the descriptions of persons who may apply to the executive for an assessment or for an assessment in regard to a specific need or a particular service identified by him or her. I seek the inclusion of "a carer or family carer" as a category because the carer maybe a person other than a spouse, parent, relative, guardian, legal representative or personal advocate. While I accept that many of the 150,000 family carers who save the State an estimated €1.6 billion per year by providing over 3 million hours of work in the home each week may be covered by the provisions in section 9, there are some people who will not be covered by the four categories. If the Minister of State does not accept this amendment, section 9(1)(b) would, effectively, restrict the types of carers recognised for the purpose of this legislation. For example, people with disability who have same sex or even opposite sex long-term partners as their carers will be virtually excluded by virtue of the term “spouse” instead of “partner”. The Government will be discriminating against not only gay and lesbian people with disability but others in long-term cohabiting relationships.
This provision also discriminates against people with disability who, for whatever reason, have no family member or legal guardian to care for them and who may be cared for by another person. That is wrong and the Government should take this amendment on board and recognise the case I make.
Will the Government recognise the insult felt by carers due to the failure of the Bill to explicitly mention them, their role and contribution? The Carers Association has objected to the Bill as formulated since it gives no recognition to the role of carers as part of the service delivery change. Even at this stage, will the Minister of State consider including such a reference and giving recognition to different relationships?
I strongly support amendment No. 63 in the name of Deputy Ó Snodaigh. It is an important amendment because it deals with the carer or the family carer. This is an opportunity to pay tribute to the many carers and commend and thank them for their fantastic work. It is essential that they are respected, that their voices are heard and that they are given the maximum financial support. This is an important part of the debate.
Another important issue which has come up is children as carers in the family unit. There must be supports for children whose parents have a physical disability and who are directly involved in the day-to-day care of, and providing assistance to, their parents. There are many such children in this State who are doing an excellent job and it is up to us to ensure they are given the maximum support.
At times it can be very difficult to care for an adult child with an intellectual disability. It ranges from extreme stress and hardship on some families to mild stress on others. Caring for a young adult with a severe intellectual disability can be very difficult and tiring at times. It is up to us, as legislators, and to the Government, the people in power, to ensure these carers and family carers are given the maximum support. I strongly support this important amendment tabled by Deputy Ó Snodaigh because it recognises and values the carer and the family carer.
The categories of persons identified in subsection (2) are readily identifiable and would generally be regarded as having a legal standing. To include a carer or family carer who is not also a relative, guardian, legal representative or personal advocate could be problematic. It would not be clear to the HSE what responsibilities such a person was willing or entitled to take in relation to an assessment or related services. The existing provision covers the circumstances where an applicant would require a representative.
Furthermore, any consideration of including other people to act on behalf of the applicant might best be dealt with by regulation under section 21. The point made by Deputy Ó Snodaigh can be considered in that context. If a person wished to have his or her carer nominated as his or her personal advocate, it would be covered by the Bill.
What the Minister of State said is all well and good. If he took on board the point I made and changed the word "spouse" to "partner", there might be some logic to what he said. I understand there might be problems in regard to carers in paid employment who would not necessarily have any long-term tie with the person for whom they care.
The last point the Minister of State made was that the majority of people with disability would be capable of making the case that somebody should legally represent them. What happens if somebody in a long-term relationship is in a car crash which leaves him or her severely disabled and unable to communicate? Who would act as his or her legal guardian? He or she would not be able to say his or her long-term partner should make decisions for him or her. I was trying to cover such a situation in the amendment. Perhaps it might be achieved by changing the word "spouse" to "partner" in recognition of the fact that there are gay, lesbian and other couples as well as married couples who are in long-term cohabiting relationships. There are moves to give greater recognition to such relationships and this would be a step in that direction.
Elderly people who have become disabled over time are often looked after by carers who make decisions for them, bring them their meals and ensure household bills are paid. These carers take over a role which in other relationships would be that of the wife, husband, mother, father or whatever. They do not have a legal standing under this legislation. The Minister of State is correct that they can apply to become the legal representative of the person for whom they care, but would it not be easier to accept the amendment?
In regard to carers, it is important to put on record that there have been advances. For example, the budget provided for improvements in social welfare payments to people with disability and their carers. A €14 increase was provided for those in receipt of the disability allowance, increasing the maximum weekly payment to €148.80. For those not in receipt of the disability allowance who are in full-time residential care, the Government has introduced a €35 per week personal payment which starts in June, next week. It is important to acknowledge that. The respite care grant which is paid annually in June has been extended to include carers who are not in receipt of carer's allowance, carer's benefit or the domiciliary care allowance. All full-time carers are now eligible to apply provided they do not work more than ten hours a week outside the home or are not in receipt of unemployment benefit. The person for whom they care must need full-time care.
The grant is automatically paid to those in receipt of carer's allowance, carer's benefit, prescribed relative's allowance, domiciliary care allowance and constant care allowance. The application for the respite care grant should be made to the disability service manager in one's local health board area. This begins in June 2005 and the grant has been increased to €1,000.
There have been steps in the right direction and part of the purpose of this debate is to move us forward. It is important to acknowledge that some major improvements have been made. The carers and families involved appreciate that and it is important that they know that their campaigning has had some effect. We have not won but they have made an impact. I urge the Carers Association and the disability groups to continue fighting hard.
Amendments Nos. 64, 116 and 118 are related and amendment No. 117 is an alternative to amendment No. 116. Amendment No. 64 and amendments Nos. 116 to 118, inclusive, will be taken together by agreement.
I move amendment No. 64:
In page 13, line 25, to delete "may" and substitute the following:
"shall, unless an assessment has been or is being otherwise carried out,".
This is a straightforward amendment which clarifies the position because it is possible that an assessment could be carried out somewhere else or be in process somewhere else, for example, under the Health Act 2004, or the Education for Persons with Special Educational Needs Act 2004.
My amendment No. 117 states:
In page 19, line 2, after "standards" to insert "within a specified timeframe".
Time is important when dealing with disability. To paraphrase the saying that one has only one chance at life, a person with a disability must ensure that there are no delays or hiccups in life.
I received a letter from 200 parents in Waterford which is relevant to this amendment. They informed me that 4,403 people in County Waterford have disabilities and the number in Waterford city is 3,836. A total of 222 persons aged between one and 14 in the county have disabilities, which 5% of the total population in that age group. At present 273 children are on waiting lists for speech and language therapy. These are the Health Service Executive figures for 2005.
It is unacceptable that these children must wait for speech and therapy services. The longer they wait, the greater the damage to them. In my experience it is necessary to start early and sign up for services for children with disabilities. This is particularly so in the area of speech and language therapy where it is possible to work wonders. There have been major developments for children who have benefited from this early intervention. Some of those who have benefited came from well-off families who were able to pay for the services. We should not discriminate against children from disadvantaged families and ignore their plight.
Although I represent Dublin North-Central, an urban area, I wish to raise an issue mentioned by these parents. They refer to the lack of services for children in rural areas as discrimination. There is less inclusion in rural than urban areas. The centralised urban services sometimes entail social exclusion of children with disabilities and their families in rural communities. I support these parents on this point. It is bad enough to have to fight for services for their children with disabilities without having to experience the added problem of discrimination in a rural area or away from the geographical centres of services.
All Members should support these parents. Children with disabilities may not have a voice or a vote but their parents, particularly the 200 who have written to me, have a vote and a voice and that will be articulated in the Dáil where, I hope, the Minister of State and the Government will listen to it. I urge Members to support amendment No. 117.
I support these amendments which are important pressure points. As this is not a rights-based Bill, these amendments can give people some comfort. To understand what difference this Bill will make when it is passed, one must look at the individual services on which it will make an impact. I was pleased that the Minister of State accepted the point on developing areas and undertook to examine it more closely.
There are other areas which serve to highlight the problem of delays and how they affect people. For example, an interdepartmental group in 1998 concluded its deliberations on the tax exemption for people with disabilities to have a car and thereby live fuller lives. The interdepartmental group recommended a change in the restrictive criteria for the primary medical certificate. There are approximately 600 people waiting to appeal a decision of rejection for this tax exemption. The average waiting time is three years. One would need to be an amputee to qualify for this exemption. People who have had a stroke or who have multiple sclerosis can do well and gain independence if they qualify for the exemption. This is an example of how the delay in making a decision affects a group of people whose level of dependency is increased by the failure to decide. When I tabled a question to the Minister for Finance specifically on the criteria asking when it might be relaxed and if he was considering it, the bottom line was that the Minister would consider the report on an ongoing basis in the overall budgetary context having regard to the existing and prospective cost of the scheme. That is what concerns all of us because the difference lies in that being changed. There are 600 people waiting but not all will qualify. I am certain there are people who apply for this and do not get it for good reason but there are others who require it. The Minister informed me that 17% of those who appeal win their appeal. The problem is that the average wait is three years, which a stroke victim or an MS sufferer does not have. That underlines the importance of having something within a specified time frame. That may not be the absolute example but it gives an indication of the pressure point.
How will the embargo work having regard to the administration that is to be set up under the Bill? If that is to be taken into consideration and there are approved additional people in administration, will that impact negatively on the front line therapy or other services that make a direct difference to people?
On the last point Deputy, I am reluctant to intervene, but I would point out that we are going outside the terms of Report Stage. These are specific amendments and because there are so many it is important to stay within Report Stage standing orders.
She is a new Deputy.
She is performing well for a new Deputy.
Watch the Independents.
And the fact that she is a woman.
It is not anticipated that extra manpower will be required within the Health Service Executive for the administrative work. That will be done by those already involved in that activity but obviously there will be different roles so there should not be a problem in that respect.
Amendment No. 64 seeks to compel employees of the Health Service Executive to apply for an assessment of a person who appears to have a disability. Section 9(4) allows officers of the Health Service Executive to seek an assessment on behalf of a person. This provision would cover a small number of cases where people did not have a relative or guardian to act for them and were not able to act for themselves. It is appropriate that the Health Service Executive is given the discretion to consider an individual's circumstances in each case. Perhaps the Deputy would explain further what she wants in addition because I did not quite understand the point she was making.
Amendment No. 116 relates to the content of a report from a complaints officer. This would allow for an assessment to be found inadequate. However intended, the meaning of "inadequate" in the context of the Bill is not clear. The text of the Bill as published ensures that the adequacy of assessments are safeguarded by section 10 which allows for the preparation of standards to govern assessments and by the existing grounds for complaint in regard to non-conformity with such standards. This is a more suitable way to ensure assessments are adequate given the broad range of considerations that go to make up good assessment.
Amendment No. 117 would specify that a time frame for carrying out a further assessment, following a successful complaint that the assessment was not carried out in accordance with standards. In the light of what Deputy McGrath has said I am prepared to review this matter and, most likely, will bring forward an amendment in the Seanad.
Amendment No. 118 seeks to require the complaints officer to make a judgment about the adequacy of the service statement. The position is that section 15(8)(e) allows the complaints officer to rule on whether the service statement is incorrect or inaccurate based on the criteria set down in section 11(7) which relates to eligibility, practicability, available resources and other matters. These are the factors that may give rise to a discrepancy between the service statement and the independently assessed needs. Therefore, I do not propose to accept amendments Nos. 64, 116 or 118.
That comes as a huge surprise and I am deeply disappointed. In regard to amendment No. 64 I do not want a person who happens to have a disability to be assessed at different stages. The Opposition wants to ensure this is smooth seamless legislation that is not too bureaucratic. That is what that amendment is about. I would hate to think a person would be assessed two and three times when clearly one proper assessment would have been enough.
I agree with what the Minister of State had to say on amendments Nos. 116 and 118. This whole section is about the accuracy of assessments only. The section says nothing about adequacy. The difficulty at the end of the day is that whereas people may find the statement is perfectly accurate it may be completely inadequate. I did not expect the Minister of State would accept these amendments but I did expect they would be understood. It should be possible where a service statement is inadequate for the executive officer to say that area was not looked at properly and should be looked at again. I do not mean the entire statement but where elements of the statement are inadequate it should be possible to look at them. That is what these two amendments seek. I accept fully what the Minister of State has said in the case of an inaccuracy that the Bill deals with that issue perfectly. However, it does not deal with the fact that it may be inadequate. At the end of the day we will be looking at service statements that will be inadequate as opposed to inaccurate. There will be such a concentration on how these service statements are compiled that they will be perfectly accurate and that is why there will be no——
The Deputy has exceeded her two minutes.
There will be no march to the High Court or to the Supreme Court as there will be no point of law to debate. Therefore, the Bill needs to be complete with regard to certain things that could happen. The issues I am talking about in amendments Nos. 116 and 118 are inadequacies as opposed to inaccuracies.
Will the Deputy clarify what she is seeking in amendment No. 64?
The purpose of amendment No. 64——
That is not in order. As Deputy Lynch will be replying to the debate she will have another opportunity.
I wish to clarify one issue with the Minister of State in regard to my amendment No. 117. Did the Minister of State say he accepted the principle and the vision in the amendment and will bring it to the Seanad?
I thank the Minister of State for that and commend him. Even though there are times where we disagree in debates, it is important when people listen. I acknowledge that and thank the Minister of State.
I cannot accept Deputy Lynch's views in respect of amendments Nos. 118 and 116.
It is quite clear the complaints officer can rule on the adequacy of the service statement. I do not think it is necessary therefore to rule on the inadequacy. Ruling on the adequacy of the service statement means that whatever inadequacies are there will be taken into account. I do not propose to accept that amendment. If I can understand exactly what benefit is in amendment No. 64, I would be prepared to reconsider it.
I will try to explain it again. Where it appears to an employee of the executive that a person may have a disability or where a person is in receipt of a health service provided by the executive, or both, my amendment proposes he or she shall, unless an assessment has been or is being otherwise carried out, arrange for an application. My amendment seeks to clarify the situation, nothing else. It is not earth shattering. There may be another assessment being carried out at the time.
For instance, the case of a child and an assessment under the 2004 Act.
It will take precedence over this so there will not be two assessments.
Not two assessments, but another assessment may be carried out. This is a proposal for clarification.
I do not think it necessary. As explained on Committee Stage, if an assessment is being carried out under the Education Act, then that assessment must take into account the health situation and will cover both, to ensure there is not duplication of assessments. I honestly believe that the position the Deputy is trying to achieve is adequately covered in the small number of cases where a person may not be in a position to look for an assessment. In the opinion of the HSE its officers may seek an assessment on behalf of that person and that adequately covers the Deputy's requirements.
Amendments Nos. 65, 66 and 80 may be discussed together.
I move amendment No. 65:
In page 13, line 31, to delete "within 3 months of" and substitute "forthwith after".
This amendment proposes a time frame to ensure speedy movement rather than waiting until the last minute for something to happen. The phrase "forthwith after" would give greater substance. I know the Minister of State does not agree but I think it should happen and I suppose that is my job.
We realise that the commencement period is to be within three months but the concern is that it may go to the wire and not start until the three months is up. My amendment No. 66 puts the case that in urgent circumstances the assessment should commence immediately and should be completed without undue delay. The Bill does not give an end point. The amendment seeks to impose some pressure to ensure an immediate start. The practice might well be that if it must commence within three months it would not start until the last day, as is the case with planning permission——
Two months and 28 days.
The permission is given on the last day, the deadline. If a deadline is given, it will be kept and met in almost every eventuality. Some people have illnesses with a sudden onset and they may need help urgently.
I support Deputy Stanton's amendment No. 66 and will speak on my amendment No. 80.
The important phrase is "in the case of urgent conditions, to commence immediately, which should be completed without undue delay, within a maximum period of 3 months from commencement". We all know from experience that crises arise within the disability sector. Families face difficulties due to lack of services for their family member with a disability.
My amendment No. 80 emphasises the importance of timing in dealing with people with disabilities. I referred earlier to the delays. I hope this debate, whatever about the legislation, will end the delays and end the torment and trauma for families. We are moving in that direction. However, when one considers the figures I quoted of 273 children in Waterford waiting for speech and language therapy and 260 or 270 families in the St. Michael's House area in Dublin North, my own area, looking for priority residential care, we must ensure whatever happens as a result of legislation that the battle to combat the delay in providing the services for families of those with disabilities will be won. We are moving in that direction but I want to ensure it happens. We must concentrate on the priorities because these are serious conditions and there is undue delay.
Amendments Nos. 65 and 66 seek to impose a time frame for commencement and completion of assessments and service statements including the arrangements to apply in urgent cases. Amendment No. 80 would apply to the services outlined in the service statement to require the services to be provided without undue delay. The question of establishing time limits for the assessment process is already covered in the legislation. Section 9(5) requires the assessment to commence within three months of the application and be completed without undue delay. As I stated on Committee Stage, this will be covered by regulation.
It would be unreasonable to require that every assessment would commence forthwith, as envisaged by Deputy Lynch. Section 21 allows for the making of regulations to govern the procedures for assessment including different time frames within which assessments should be made. It is envisaged that the regulations would establish different intervals for assessments, depending on the category of disability and age of the person. Such regulations would also allow for prioritisation of the assessment of urgent cases where warranted. This is adequately covered under the provision in the regulations.
Amendment No. 80 seems to be geared to require the services in the service statement to be provided without undue delay. The service statement is a document that will set out the services that can be delivered in any individual case and the timing of such provision. The content of the service statement will be dependent on available resources, eligibility and practicality, as well as the assessment report and standards to be put in place pursuant to section 10. Once prepared, every individual will have a right to the services outlined in the service statement. I believe this is a more rigorous way to provide for the services involved and in the circumstances I do not propose to accept these amendments.
Urgent cases will be taken into account in the roll-out of the legislation, its implementation and the way in which the regulations are drafted. I am confident there will be no delay for urgent cases, in particular for young children where early intervention is vital. To simply allow for immediate requirement for assessments would be practically impossible. When one considers that in many cases a number of professional therapists must be involved in the assessment, a lead-in time before commencement is necessary.
I move amendment No. 68:
In page 14, line 7, to delete "of circumstances" and substitute the following:
"in the personal circumstances of the applicant or to the services available to meet the needs of the applicant".
This amendment again addresses services and the needs of the applicant. In discussing services and the needs of people with disabilities these are key issues for the legislation. I ask all Members to support this important amendment.
I believe the section as constructed adequately covers a change in either personal circumstances or service availability. In the practical roll-out of the legislation this situation will be covered in more detail to ensure that a change in a person's personal circumstances or the provision of more resources will automatically mean a change in the assessment process.
Amendments Nos. 69 and 70 are out of order.
I move amendment No. 71:
In page 14, line 16, to delete "may" and substitute "shall".
This amendment would create an obligation on the Health Information and Quality Authority, HIQA, to produce standards for the assessment of needs. It would give rise to a legal interpretation that HIQA would be obliged to develop standards to govern the assessment process in every detail. The intention of section 10 is that standards would be established for the main features of the assessment process. In the circumstances I do not intend to accept the amendment as it could give rise to excessive codification of the assessment process. I believe there is a clear intention to set standards for assessments. However, I do not believe the proposed amendment would add to that commitment and I do not propose to accept it.
Amendment No. 72 is out of order.
I move amendment No. 73:
In page 14, between lines 22 and 23, to insert the following:
"(2) A liaison officer shall be independent in the performance of his or her functions.".
This again relates to the role of the liaison officer. The functions of the liaison officer, which are outlined in the legislation, include taking account of the resources available to the executive, practicability etc. I would like the Minister of State to clarify how a liaison officer should go about his or her work while taking account of all these issues. There is no requirement for the liaison officer to carry out his or her functions in an independent manner as provided for in respect of assessment officers and clearly this is because of the constraints on the liaison officer. Even allowing for the constraints on the liaison officer as specified in the Bill, the liaison officer should be able to perform his or her functions without other pressure.
While I may not agree, I accept that he or she must take into account the resources available and what is practicable, which is contained in the legislation. Having said that, the liaison officer should have a free hand and should be able to go about his or her functions in an independent manner without anybody in the Health Service Executive putting pressure on him or her to come up with a service statement that may not be the best that is possible for the person with the disability in the time allowed. We should give the liaison officer a certain amount of independence under the constraints of the legislation.
The Minister of State may say this provision is not essential, and maybe that is correct, but it is important to clarify how liaison officers are to reconcile what is available to the Health Service Executive with the services required. Will they be given a budget at the start of the year outlining what is available and be required to work within that budget or will they need to fight for each case as it arises? I ask the Minister of State to share his thoughts on how this will work as it impacts on the independence or otherwise of the liaison officer.
I support the amendment and I hope the Minister of State accepts it. A major problem with the legislation is that it will be known as the resource-dependent Disability Act, because it is so dependent on resources. Regardless of who makes the assessment it should be independent and whatever appeals system or liaison exists should not only be independent but be seen to be so. A common perception among disability organisations, shared on this side of the House, is that it is far from independent but is totally dependent on resources being available. It would be wrong if an assessment officer, a liaison officer or whoever is responsible for deciding the needs of a person were not independent. The need to be seen to be independent goes across the board of those involved in the process. As the Bill is so resource dependent, it appears that any assessment would be made for the purposes of saving resources rather than looking after the real needs of disabled people.
The Bill provides that the assessment officer will be independent, with responsibility for delivering an independent assessment of need for individuals. In addition, the assessment will be undertaken without regard to the cost of the service envisaged or the capacity of the executive to provide those services. The independence of this officer is essential to the process and is a response to a key concern of the disability interest groups, as I said this morning. It is equally essential that a liaison officer should be part of the executive involved in managing the needs of people with disabilities within the practical constraints applying from time to time. This is in keeping with the role of the liaison officer, which is to prepare a deliverable service statement.
The liaison officer will have a knowledge and understanding of service issues and the demands on them as well as of related resource implications and the capacity of the executive to respond in individual cases. In the light of the role envisaged for the officer in the Bill, it would be inappropriate to assign him or her the statutory independence proposed in this amendment. There will be no constraints on the liaison officer in doing his job within the HSE except the normal ones of resources, which I have outlined. He will be allowed, within the resource provisions, to make available the best service statement.
Regarding what Deputy Cowley has described as a resource-dependent Bill, also the main point of his last contribution, I put it to him that he has been an Independent Deputy here for two years. I have never yet seen him stand up in this House and say, since he is prepared to provide all kinds of services to all kinds of people, how he proposes to raise the money to pay for them.
Deputy Cowley has two minutes.
I can think of very many ways. We could start with the voting debacle. How much has e-voting now cost?
Some €60 million.
It has cost between €60 million and €80 million.
The Dublin Port tunnel is €200 million over budget.
There are the Dublin Port tunnel and Punchestown developments.
I do not know where to stop — the bypass. There are many different ways that the money could be raised without even having to increase anyone's taxes, since so much is wasted. The bottom line is that so much money is wasted in the system that those essential services for disabled people do not exist. It is extremely demoralising for disabled people or for anyone dealing with them in the services to have to beg for every penny or little service that they get, things to which they are absolutely entitled and that should be there to put disabled people on the same level as the able-bodied. That is what this Disability Bill is about. The Government went to great trouble to get a forum together of disabled people and those associated with them to propose what they thought the best way forward, but it turned its back on the forum completely by refusing to take on board its very valuable recommendations.
This Bill is totally and utterly dependent on resources. If one had everything that this Government has wasted, one could certainly have a great many very important changes in society essential to disabled people. The Minister of State is disingenuous when he says the money is not available. I certainly know where it would come from, and I would start with the Government and what it has wasted.
This amendment is focused on the practicality of the liaison officer working in the Health Service Executive. When a liaison officer is performing his or her functions, the person will have to find the services that are there. I am not sure how the liaison officer is to operate, and I asked the Minister on a few occasions yesterday evening and today how the person is to function within the Health Service Executive. Does he envisage the liaison officer being given a budget at the start of each year? Will money on which the liaison officer might draw be ring-fenced? Will the person have to fight in the executive for every crumb and service each time a service statement is being prepared?
Perhaps the Minister of State might tell us how he envisages the liaison officer providing those services and what model will be in place. That would help us all greatly. We all know that resources are never unlimited, but we wonder how that is to be done. People are worried that needs are being defined with reference to resources rather than the other way around. Resources should really be defined with reference to needs. When the liaison officer goes to the Health Service Executive seeking services, what kind of authority will he or she have to get them? That is another issue, since we all know from people working in large hospitals that there are pressures from different sections for various services. People can hold services, and sometimes patients are kept in a bed a little longer so that it is not lost to a consultant when the next patient comes in. We all know that such things go on. The liaison officer should have some form of independence or authority. What is that, and how is the liaison officer to function in the Health Service Executive? That is clear to no one.
I strongly support amendment No. 73, whereby the liaison officer would be independent in the performance of his or her functions. It is a very important and strong amendment.
On the broader question, families with members with disabilities are concerned that the resource issue arises constantly. The Minister always puts forward the Government viewpoint and especially that of the Department of Finance. However, this is a Disability Bill, and I would love to remove the fingerprints of the Minister for Finance from this legislation, allowing us to focus on people with disabilities and their rights to services. I strongly support Deputy Cowley regarding the points put forward. The funding of services is always an issue, and there always seems to be a problem. It is like those 273 young children in Waterford waiting for speech and language services. I am sure that the local whinge is that they do not have the resources, but I do not find that acceptable. That is my big problem with the resource issue. In my area, I do not find it acceptable that there are 250 in the St. Michael's House area on very serious priority waiting lists.
Those are the issues, but there never seems to be any kind of whinge or moan when money is wasted. Deputy Cowley mentioned the €60 million spent on electronic voting, but there are many other projects. I live where the new Dublin Port tunnel is about to be constructed, and they have already gone €220 million over the projected costs. A great deal of money is being wasted. The Minister for Justice, Equality and Law Reform, Deputy McDowell — Rambo himself — thinks that he is going to tackle all the gangland murders in Dublin. He is out in New York while the gangland killings are continuing. He bought a farm in north County Dublin worth about €3 million or €4 million for €30 million. I would have loved to see that extra €26 million going on services for all the people on the north side of Dublin on speech and language, residential or respite waiting lists, which could be wiped out tomorrow morning.
The resource and financial issue should be tackled head on, and we should make no apologies for supporting such a rights-based approach. We are talking about 8% of the population. When families organise rallies for next Thursday, they are not acting lightly. Yesterday I received a telephone call from Galway. The Minister of State probably knows Ronnie Hanlon, who is organising a group from Galway which is coming up for the rally on Thursday on the Bill's conclusion. Families have genuine concerns, and I know from talking to a great many back bench Deputies that many share our views but are silent because they have been put under pressure by the Whip. If they were in Opposition, they would strongly support the points that we are making regarding this legislation. We have every democratic right to put that forward, despite those who reject our entitlement to challenge the resource and funding issue. Money is always a problem regarding people with disabilities and the poor or excluded. However, that is never the case with others in society. Denis O'Brien and those with large fortunes get away scot free. Had we a fair taxation system, they would have paid at least €50 million, which would be no big deal if they make €200 million. Imagine what services could be provided with that money.
On amendment No. 73, it is important that those issues be raised. My bottom line is that I would like the liaison officer to be independent in the performance of his or her duty. The Minister of State will gather that there are several Independent Deputies in the House who are inclined to consider things objectively. For that reason, I say that a liaison officer should also be independent.
I would never question Deputy McGrath's objectivity, which is to be found in his contributions to this Bill. I agree that there are major gaps in the services provided for people with disabilities. There are waiting lists across the spectrum. Those gaps must be tackled and the resources must be found in order to provide those services. The entire thrust of the Government's policy is to provide those resources which will be underpinned by this legislation. However, there must be responsible public expenditure and good governance. We cannot have legislation that is not predicated on resources. Deputy Cowley comes into the House, utters a soundbite for publicity purposes and leaves. We hear this kind of thing week after week from the likes of Deputy Cowley. He was elected in a constituency where parish pump politics destroyed life for long enough in the past. We should be beyond that now. Deputies come in here, call for helicopters here and there and for radiotherapy services in Donegal, Mayo, Galway and Limerick. They make smart remarks about an item of legislation that is resource-dependent. That is not good enough.
The helicopters are all on the Minister of State's side of the House.
I have not been critical of any Deputy present with regard to the need for extra resources for this Bill. However, I do not have much respect for the opportunism of some Deputies.
I completely disagree with the Minister of State.
I am not sure whether the Minister is for or against the amendment because he did not address it. I have made my case and I assume that he will not accept the amendment. However, I wish to press it.
I move amendment No. 80:
In page 14, line 31, after "provided" to insert "without undue delay".
I move amendment No. 81a:
In page 15, lines 7 and 8, to delete "within a specified timeframe" and substitute "without undue delay".
Under section 11(3), the liaison officer can request the council's support in preparing a service statement, including the identification of an appropriate education service for person's with disabilities under the age of 18. Opposition Deputies asked me on Committee Stage to amend the legislation to ensure a timely response by the council to the liaison officer. I indicated that I would consider the matter and return to it on Report Stage, which I have done with this amendment.
I am not opposing the amendment as it is welcome. However, I do not understand how this aspect is different to the other amendments which sought to include the phrase "without undue delay". The response of the Minister of State on those occasions was that it would all be done by regulation. In this instance, he is doing the exact opposite by providing for it in the legislation. Will the Minister take this on board for future amendments which contain this wording?
The amendment will provide for a response from the council within a specified timeframe. I am happy to make this amendment in response to the case being made by Deputies Stanton and Lynch.
Amendment No. 83 is out of order as it involves a potential charge on the Exchequer.
I do not see how amendment No. 83 could possibly involve a charge on the Exchequer.
It involves a potential charge.
I move amendment No. 87a:
In page 15, to delete lines 27 to 35 and substitute the following:
"(e) in the case of a service to be provided by or on behalf of the Executive, the need to ensure that the provision of the service would not result in any expenditure in excess of the amount allocated to implement the approved service plan of the Executive for the relevant financial year,".
This is a technical amendment as a result of the establishment of the HSE under the Health Act 2004 to replace former health board structure. I signalled on Committee Stage that I would be bringing forward an amendment to this section on Report Stage. It was not possible to have it in time for Committee Stage because the related legal and technical issues remained to be resolved at that time.
How does the liaison officer operate under this restriction? I understand the need for it, as we know that resources are limited, but how will the officer know what resources are actually available?
The liaison officer will be subject to the service plan for the HSE, which will be handed down to the executive at regional level. Under the normal financial planning exercise, the amount of money made available for disability services will be made known to the liaison officer who will draw up a service plan in accordance with that resource provision.
Does that mean that the regional branches of the HSE will have a ring-fenced amount of finance available for disability services each year? If that is the case, when will it start?
At the beginning of each year the Minister will be obliged to state the level of resources made available for disability services. The HSE will be the direct beneficiary of that legislation but it will not be ring-fenced because changes may take place during the year. Given that I am taking a transparent approach to this Bill, the amount for the disability must be stated at the beginning of the year and the intention is that it remain within that sector.
However, it may not.
It may not.
Amendment No. 88 is out of order.
Have we discussed amendment No. 87?
It was ruled out of order because it involves a potential charge on the Exchequer.
How can a review of the future implementation of services not currently available constitute a charge? I do not address this question to the Leas-Cheann Comhairle because he clearly did not made the decision in this matter.
The Deputy must address her concerns on this point to the Bills Office or to the Ceann Comhairle.
Amendments Nos. 88a and 88b are related and may be taken together.
I move amendment No. 88a:
In page 15, line 41, to delete "without undue delay".
I brought forward an amendment on Committee Stage to ensure applicants would receive copies of their service statements without undue delay. That amendment was in response to a proposal by the National Disability Authority. During the Committee Stage debate, Deputies sought a change in the amendment so that both the preparation of the statement and its communication to the parties concerned would take place without undue delay. I am pleased to table these amendments which respond to the concerns expressed by Deputies on Committee Stage.
I support the thrust of these amendments. However, the wording is confusing. The deletion of the phrase "without undue delay" after "the service statement shall be prepared" could mean there is no rush in preparing the statement but only in regard to its provision once it is complied. By removing the first instance of the phrase "without undue delay", these amendments serve to afford more time and less urgency for the preparation of the service statement. I stand to be corrected if I am reading this incorrectly. Perhaps the Minister of State will consider including both instances of the phrase "without undue delay".
Deputy Stanton is incorrect in his interpretation. I have taken legal advice on this matter.
I support Deputy Stanton's observations on these amendments. We spent three hours in this House last Thursday dealing with urgent legislation. I assume the same people who advised the relevant Minister in regard to that matter, and whose advice was found to be incorrect, also advise the Minister of State, Deputy Fahey. I do not accept that the Government has the best legal advice. It would be entirely wrong to remove the first instance of the phrase "without undue delay" after we have collectively fought in every relevant instance over the last month to have it included. I would like to see the legal advice the Minister of State has received. I am dubious about any legal advice the Government receives because it has proved to be incorrect on many occasions.
I am prepared to withdraw the amendments if Deputies are unsatisfied. I included them at their request.
Is this how the Minister of State intends to formulate legislation? If this is the approach the Government takes, we may as well all throw our hats in the air and go the market. The Minister of State should have the conviction to argue for his amendment. Otherwise it is a pointless exercise.
We should keep this matter in perspective. It is an important issue but not the most vital we have discussed in recent weeks. Nobody asked for the first instance of the phrase "without undue delay", after "a service statement should be prepared", to be deleted. We are all pleased with the Minister of State's proposal that the phrase "without undue delay" should be included after "service provider concerned". However, both instances of the phrase "without undue delay" should be retained so that the subsection reads as follows:
A service statement shall be prepared without undue delay and a copy thereof shall be furnished to the applicant, the Executive, and, if appropriate, the chief executive officer of the Council and the head of the education service provider concerned without undue delay.
Why does the Minister of State propose to delete the first instance of the phrase "without undue delay"? This deletion is not required because the second instance of that phrase does not qualify both elements of the subsection. There are two separate aspects to this provision, the preparation and furnishing of the service statement. The subsection should stipulate that both must be done without undue delay.
That is exactly what these amendments provide.
The deletion of the first instance of the phrase "without undue delay" and the insertion of that phrase only at the end of the subsection means its import may be interpreted as applying only to the furnishing of the service statement and not also to its preparation. The retention of the first instance of the phrase, along with the inclusion of the second instance, will ensure the necessity of all necessary speed applies to both the preparation and furnishing of the statement.
I devised these amendments in response to the views expressed by Deputy Lynch and others on Committee Stage. Now I am told I have not made the correct change.
That is not what I am saying.
I will withdraw the amendments if Deputies are unsatisfied with them.
The difficulty will be overcome if the Minister of State agrees to withdraw only amendment No. 88a.
I reiterate that both the preparation of the statement and its communication to the relevant parties must take place without undue delay under the provisions of these amendments.
I move amendment No. 88b:
In page 15, line 44, to delete "concerned" and substitute "concerned without undue delay".
Amendment No. 89 is out of order.
Amendments Nos. 90 to 93, inclusive, are related and may be taken together.
I move amendment No. 90:
In page 16, line 18, to delete "may" and substitute "shall".
Amendment No. 93 was originally tabled by Deputy Stanton. This amendment will increase the degree of transparency for those with disabilities. It is a moderate and fair amendment and I see no reason that the Minister of State should not accept it. It serves to work with and make the best of the fundamentally flawed formula around the delivery of services as set out in the statement of need.
My preference, which I have already stated, is for a significantly different approach in terms of the identification and progressive delivery of disability specific services based on a recognised right to independent assessment. I regret that my amendments Nos. 126, 127, 141, 146, 148 and 155, which set out my understanding of how disability specific services should be delivered, were ruled out of order because the Ceann Comhairle believes they involve a potential charge on the Exchequer. I reiterate my objections to this Standing Order. It serves to rule out constructive amendments that aim to ensure the legislation we pass in this House is as positive as possible and facilitates progressive provisions that address, in this instance, the needs of those with disabilities. The amendments I have tabled in respect of this matter, which have been rule out of order, proposed the establishment of an independent disability support service to conduct individual needs assessments and address related issues.
I wish to speak on amendment No. 93 in my name. In my opinion it is necessary to insert an appropriate timeframe for the exchange of information between service providers and applicants.
I assume that the Minister will not accept amendment No. 91. Amendment No. 92, which is straightforward and sensible, involves providing assessments to liaison officers as well as others. I do not understand why this should be done on an either-or basis. It would not be a major deal if a liaison officer received an assessment. As it stands, the relevant subsection states:
Where a public body is furnished with a copy of an assessment report undersubsection (1), a member of staff of the body shall communicate with the applicant concerned, or where appropriate, a person referred to in section 9(2) or the liaison officer . . .
I do not understand why in the subsection the form "and the liaison officer" should not be used.
I support amendment No. 93 and I wish to provide some practical reasons regarding why it would be helpful. As a member of Kildare County Council, I was aware of frustration at the long waiting lists for disabled persons grants. People were often informed that they would require an architect to perform certain tasks which ended up costing a great deal of money. I am critical of the amount of money that is available but this is not an excuse to tell people that services would not be provided. This situation, which was expensive and frustrating, was not in the applicants' interests.
Great disparities exist in terms of the money allocated for these grants. Kildare receives the smallest allocation of €5per capita, while the largest is over €110. This has a direct bearing on the ability of local authorities to deliver services. The manner by which matters are addressed is also important. Bad situations should not be made worse. Provision of certainty that a reply on entitlement will be delivered might form an important component of this legislation.
The provisions of section 12 look beyond the health and education sectors and provide a mechanism to allow the supply of relevant information in order to facilitate access to other services. The section is a significant and practical response to the concerns of the disability sector that the Bill should foster appropriate linkages to mainstream services.
Amendments Nos. 90 to 93, inclusive, would impose more specific obligations on liaison officers and on mainstream public service providers which are contacted by a liaison officer regarding the possible provision of services to an applicant. Section 12(1) allows the liaison officer, with the consent of the person with the disability concerned, to provide information to a mainstream service provider in order to help the person receive necessary services from that body.
Amendment No. 90 would oblige liaison officers to provide information after obtaining consent from applicants. It is my view that this amendment goes beyond offering the applicant support by placing an onus on the liaison officer and the applicant to comply with the subsection. As sensitive personal information is likely to form part of the assessment report, I would not like to see any change to the subsection which would put a degree of compulsion on the applicant. For these reasons, I do not intend to accept the amendment.
Amendment No. 91 would oblige a public body to communicate immediately with an applicant. Such an obligation would be extremely onerous and unlikely to result in the worthwhile and considered response to which the applicant would be entitled. I do not, therefore, propose to accept this amendment.
Amendment No. 92 would oblige a public body to communicate with a representative of the applicant and the liaison officer. This may not be the most appropriate way to proceed because it would not be conducive to clarity on whether primary responsibility to act on behalf of the person with the disability lay with the liaison officer or with the representative. As I said after extensive debate on Committee Stage, I do not propose to accept this amendment.
Amendment No. 93 would require public bodies to communicate with the applicant or representative within a maximum of six weeks. I have sympathy with the intent of this amendment in trying to ensure prompt attention for applicants. However, as this provision applies to a range of bodies which provide a variety of services, it is not possible to be prescriptive as to the timing of the response. The response will, in general, be governed by the arrangements for service delivery pertaining to the particular service. I do not propose to accept amendments Nos. 90 to 93, inclusive.
Amendment No. 90 is important and I intend to press it. I strongly support Deputies Catherine Murphy and Ó Snodaigh on amendment No. 93.
I move amendment No. 92:
In page 16, line 27, to delete "or" and substitute "and".
I move amendment No. 93:
In page 16, between lines 30 and 31, to insert the following:
"(b) The public body shall communicate with the persons in this subsection the information regarding services that may be provided by the public body that it considers that the applicant is entitled to, as soon as practicable after receiving the assessment report, but within a maximum period of 6 weeks after receipt of the assessment report.”.
I move amendment No. 93a:
In page 16, between lines 34 and 35, to insert the following:
"13.—The Minister shall make regulations—
(a) providing for the establishment of a Disability Access Card Scheme (in this section referred to as a ‘Blue Card Scheme’) for the purpose of minimising the degree to which persons with disabilities are required to undergo repeated medical eligibility assessments,
(b) enabling the holder of a Blue Card to access cross-departmental services as may be specified in the Scheme so as to ensure a cohesive and coordinated delivery of services to persons with disabilities.”.
I am glad to bring this amendment forward and I ask the Minister of State to accept it. It is welcome in that it will not create a charge on the Exchequer but will save money. Repeated examinations are among the many difficulties with which disabled people must contend. This amendment is straightforward. I hope the Minister of State will take it on board in order to provide some semblance of fair play to disabled people. It is important for them.
The amendment will save money for the Exchequer by removing the need for repeated medical examinations. According to its provisions, a disabled person will be recognised as such and issued with a disability access card, which could be referred to as a "blue card", to ensure that he or she has automatic entitlement to available services. The services would be designated in the scheme. Disabled people would not, as happens at present, have to attend different Departments for different assessments. Repeated assessments to determine eligibility for different services can mean terrible hardship for disabled people, particularly children. If the services to be provided under the scheme can be determined, it would be a simple matter, entitlement having been established previously, to grant access on production of a blue card.
I raised this matter previously and asked the Tánaiste and Minister for Health and Children if she would consider the introduction of a disability access card. She said she understood that I was referring to the need to minimise the degree to which people with disabilities are required to undergo repeated medical eligibility assessments. The Tánaiste indicated that she would support measures to address the matter. Given her support, she will have envisaged that the Disability Bill represents an appropriate context in which to introduce an access card. It is for this reason I have moved my amendment. As disabled children do not get better, unfortunately, and disability will not disappear, it is logical to make this amendment. It would have support across the disability spectrum and send a very positive message from Government to disabled people and representative organisations that it is interested in ensuring practically that disabled persons face less hassle.
By making my amendment, the Government would acknowledge the hardship of repeated examinations and indicate its willingness to make things easier for disabled people at the stroke of a pen. Leaving the humanitarian aspect aside to consider the matter in cold, cash terms, the amendment, far from increasing costs to the Exchequer, would save money by obviating the need for repeated examinations. Those who perform assessments would no longer be required to carry out the work under the proposed scheme. The amendment would be particularly helpful to children with spina bifida and other diseases whose conditions will not improve. I hope the Minister of State will accept an amendment which has been moved in a positive spirit and which outlines provisions with which it is easy to concur. It is important for the Government to make the amendment to show that it cares.
I strongly support amendment No. 93a, which outlines important legislative provisions. I thank Deputy Cowley for moving what is, from the perspectives of the Administration and the families of people with disabilities, a sensible amendment. It is particularly important for children with disabilities and severely disabled adults. The amendment would have the effect of decreasing bureaucracy and easing the difficulties faced by families. It calls for the establishment of a disability access card scheme — to be called the “blue card scheme”— for the purpose of minimising the degree to which persons with disabilities are required to undergo repeated medical eligibility assessments.
I welcome the fact that the Tánaiste and Minister for Health and Children, Deputy Harney, has already accepted that the proposal represents common sense. Many common sense proposals come forward during debates on all forms of legislation from my Independent colleagues which I wish Ministers would acknowledge instead of making smart alec comments about helicopters and Deputies flying in and out of the Chamber. It is sensible to allow the holder of a blue card to access cross-departmental services specified in the scheme to ensure cohesive and co-ordinated delivery to persons with disabilities.
Deputy Cowley is trying to clean up bureaucracy to simplify matters for those providing services and, more importantly in light of today's debate on the Bill, to make things easier for families of people with disabilities. That is what the debate is about. I urge all Deputies to support Deputy Cowley's progressive amendment.
Cosúil leis an Teachta McGrath, tacaím leis an leasú seo ón Teachta Cowley toisc go bhfuil séá chur chun cinn, rud nár aithin mé féin nuair a bhí mé ag dul tríd an reachtaíocht. Ní fhaca mé gurbh fhéidir an rud seo a chur chun cinn cuíosach tapaidh agus nach gcosnódh sé an oiread sin airgid ar an Stát. Tá an ceart ag an Teachta nuair a deir sé go sabhálfadh sé roinnt airgid don Stát.
Deputy Cowley has moved a useful amendment which will help ease the burden placed on people by the need to undergo repeated medical eligibility assessments. For the majority of Members, such a requirement would be an irritant or something of a hassle, but for those who have major disabilities and families caring for people with disabilities, it is a strain which is disruptive of their lives and routines which have been built up over time. Any measure which seeks to make life easier for those with disabilities and their families and provides for equality with those of us who do not have to undergo continuous assessment is to be welcomed. I hope the Minister of State will take this constructive and responsible amendment on board.
As Deputy Cowley said, acceptance of amendment No. 93a would save the Exchequer money and provide for a more constructive scheme than many of those the Government has formulated which have increased rather than reduced inequality. Deputy Cowley is to be commended for moving his amendment. Rather than taking cheap shots at Deputies who are willing to formulate significant or minor measures, the Minister of State should accept the amendment. I do not see many Deputies on the Government benches contributing to the debate, nor have I seen the Minister for Justice, Equality and Law Reform, who has responsibility for this area, playing any part in deliberations on the Bill from Second Stage until now. It also says a great deal that no Member from his party has bothered to speak on any Stage of the legislation.
Tacaím go hiomlán leis an Teachta Cowley, agus tá súil agam go bhfuil an tAire sásta glacadh leis seo, cuidiú leo siúd atá thíos mar gheall ar an míchumas atá orthu agus déanamh cinnte nach mbeidh orthu dul gach bliain, nó go rialta, chun measúnacht leighis nó measúnacht eile a fháil. Is leor ceann amháin dá lán acu siúd a bhfuil míchumas orthu. Is léir don tsúil ina lán cásanna go bhfuil míchumas orthu nach mbeidh inleigheasta. I gcásanna eile, is léir do dhochtúirí agus lucht leighis nach gá dóibh dul faoi mheasúnacht, mar ní bheidh an míchumas sin á leigheas. Ní bheidh aon fheabhas ag teacht air, agus beidh siad mar sin don chuid eile dá saoil. Ba chóir dúinn bheith ag déanamh cinnte go bhfuil siad compordach agus go gcuirfear lena saoil seachas bheith ag cur as don saol ar mhaith leo a chruthú dóibh féin.
According to the Bill, people with disabilities must have a disability which is permanent or likely to be so and which must involve a substantial restriction and so on. People with disabilities who have medical cards must currently have regular assessments in order to have their cards renewed, even though we know they will not recover from their disability. The amendment provides for permanent cards for people with disabilities. The Government should examine this possibility as, apart from the bureaucracy involved, there is a certain amount of stress imposed on families and disabled people in attending repeated medical assessments. There is no need for this to happen as in most cases people will not recover from their disability as it is permanent. The Minister of State should push this matter at Government level.
I support the amendment. The Government has moved in a similar direction in the education sector where there are now special educational needs officers instead of people having to constantly repeat their case and obtain and send copies of various reports and assessments on particular children. One person has now assumed responsibility for that area. The Government has begun a trend in regard to how one aspect of persons with disabilities are treated. There is no good reason why that trend cannot be followed in regard to a much more invasive area, namely, physical assessments. The humanitarian aspect is just as important as the efficiency aspect. I believe efficiencies would be made if the amendment were accepted.
The proposal in amendment 93a is outside the scope of the current legislation. However, I agree that it is a good proposal and I assure the Deputy that the Bill would not prohibit the introduction of a card scheme such as that being suggested at some point in the future, should that become policy. I understand that an interdepartmental steering group is active in this area and that the Government would not intend to introduce additional public service cards until the group has identified a framework and standards to apply in this regard. The group will report to the Government in due course. I consider the amendment to be premature until such time as the group makes its proposals.
I am disappointed with the Minister of State. I had hoped he would accept something that could be done so simply. This could have been done at the stroke of a pen. The proposal would benefit people and ultimately save the State money. It is an important step that should be taken. We have the power to do that. The Minister of State has the power to do that. I ask him to reconsider his decision. He has the power to make life so much easier for disabled people by raising his hand. He could ensure that they would not have to undergo repeated examinations. Mothers look at their disabled children and know they will not get better, that they will never be the same as everybody else. Such people will be disabled for all their lives. Should they also have to undergo repeated medical examinations and fight tooth and nail for every single service they receive?
The Government is sending out the wrong message. This should bring home to people what the Government is all about. It shows that it is not prepared to go very far for people with disabilities. That is the tragedy of the Government and that is why it will never come to anything. It does not have enough humanity. The Government could have made a difference for disabled people in this small way. I am most disappointed.
When I left the Chamber for a few moments, the Minister of State, Deputy Fahey, made a statement on what I believe related to the fact that I have been campaigning for services — such as emergency medical helicopter services — that are not available here but that are available in every other country in Europe. I am also campaigning on other broad issues, not local, county or parish pump issues but on the national issue of cancer service provision. There is a need for radiotherapy services for people in the north west who currently must have radical mastectomies because Dublin is too far away for them to receive radiotherapy treatment. Although a unit is due to open in Galway that will not help people in parts of Donegal who are as far from Galway as they are from Dublin. While I welcome the opening of the unit in Galway, services should exist which provide equitable treatment for people. That is what I am about.
I was elected as an Independent Deputy to represent issues the Government has not addressed. It is a sad situation which brings home to me, and I am sure to the public, exactly where the Government standsvis-à-vis disabled people. The Bill should be called the “Resource Dependent Disability Bill”. No matter what the Minister of State says, that cannot be denied. Even when no resources are required for this measure and when the Government would save money, the Minister of State is still not prepared to accept the amendment. He is letting himself down. He is also letting the Government down. He should reconsider.
I strongly support Deputy Cowley. The Minister of State previously accepted the principle of one of my amendments. This is a common sense amendment regarding a blue card system. It would make sense to accept the proposal. The present system affects people with disabilities and their families, especially children with disabilities. I am disappointed that the amendment was not accepted. It is not good enough to say such a scheme could be introduced without reference to it in this legislation. The proposed scheme makes sense and there is a broad base of support for it. It would reduce bureaucracy and save money. It would also show respect and dignity to the families of people with disabilities.
Aontaím leis an Teachta McGrath aríst. Is trua nach bhfuil an tAire sásta glacadh leis an leasú faoi láthair, in ainneoin go ndúirt sé go raibh sásamh éigin ann. Níl i gceist ach céim shimplí, ach tá an tAire á rá, toisc go bhfuil coiste idir-rannógach ann faoi láthair atá ag déileáil le cártaí, nach bhfuil sé sásta bogadh ar an gceist seo. Tá muid ag déileáil leis an reachtaíocht seo le tamall maith de bhlianta, agus b'fhéidir gur thrua é nár glacadh léi roimhe seo; bheimis chun tosaigh ar an áit a bhfuil muid faoi láthair. Measaim go bhfuil gá lena leithéid de rud ionas nach mbeidh daoine ag cur as dóibh siúd le míchumas.
The Minister of State is not correct in saying that this is premature. It can be adopted. It should not be based on whether other cards are being considered by the Department or an interdepartmental group. It is a simple step which should be adopted. I do not agree with the Minister of State's logic. He accepted the logic of the proposal and agreed that it was worthwhile. Therefore, why not go the whole hog and accept the amendment?
Having listened to the debate on this amendment, I accept the sincerity of Deputy Cowley. He is sincere about anything to which he puts his mind. However, although I accept the spirit of his amendment, I am not certain I agree with the introduction of a separate medical card for people with disabilities. I am concerned that it would be regarded as segregating the disabled even further. It is clear from the Bill that service provision will be predicated not just on resources but also on one's eligibility for services. One must ask whether one will be eligible for services, limited as they are under this Bill. This is a major problem and cannot be resolved by the introduction of separate medical cards for the disabled.
I remember when there was a blue card system in place implemented by the doctor in the dispensary. It was very much about poverty and I do not want us to return to this system. We must keep the concept of the equal citizen in our minds. It represents the way forward if we are to ensure that people who happen to have a disability and who are eligible for services, limited as they are under this Bill, receive those services. We can do this by increasing the eligibility threshold for people with disabilities rather than by providing them with a separate medical card. The Minister of State should consider my suggestion seriously.
I accept fully the sincerity of Deputy Cowley and acknowledge what he is trying to do. I support his aim but am not certain his approach is the correct one.
As I stated, the proposal is not appropriate to this legislation. However, this Bill would not prohibit the introduction of a card scheme in the future. However, this is a matter for Government policy. An interdepartmental group is considering this matter and it is quite possible that it will consider the Deputy's proposal and introduce a card scheme in the appropriate way. However, it is not appropriate to do so through this Bill.
I thank Deputy Lynch for her sentiments and understand where she is coming from. Just because one has a sticker saying "Disabled" on one's car does not mean one is in a separate category. The system I propose works in the same way. It is a means of ensuring that people will not have to undergo repeated medical examinations.
Since I started talking about this scheme, I spoke to a number of people, including paediatricians, who would greatly welcome it. They feel it would be very useful because they recognise the great difficulty and hardship involved for those disabled people who must undergo repeated medical eligibility assessments, particularly children with a disability such as Down's syndrome. These repeated examinations are carried out not only at a cost to the State but also at a cost to the children's parents in that they must pay for adequate public transport to travel to the place of assessment. They also incur the cost of having to take time off work. There is also a human cost associated with having to go through this rigmarole repeatedly. They go through it only for the authorities to decide yet again that their child is indeed disabled. It is a case of the doubting Thomases of Government refusing to believe that individuals have needs and putting them through the hoops repeatedly to discover whether they should be given taxpayers' money — it is not even the Government's money — to avail of services they require such that the very best can be done for them in this society through which we are all just passing. Why must it be proven time and again that they require the services identified for them?
The Tánaiste has said my proposal is a good idea and that it would be fair. I have listened to what the Minister of State and others have said but I do not agree that my proposal could not be achieved at the stroke of a pen. It would make life so much easier for disabled people. I am sorry the Government is not taking this opportunity to establish the scheme I propose.
- Breen, James.
- Broughan, Thomas P.
- Burton, Joan.
- Connolly, Paudge.
- Costello, Joe.
- Cowley, Jerry.
- Crowe, Seán.
- Ferris, Martin.
- Gilmore, Eamon.
- Gormley, John.
- Gregory, Tony.
- Higgins, Joe.
- Higgins, Michael D.
- Howlin, Brendan.
- Lynch, Kathleen.
- McGrath, Finian.
- Moynihan-Cronin, Breeda.
- Murphy, Catherine.
- Ó Caoláin, Caoimhghín.
- Ó Snodaigh, Aengus.
- O’Sullivan, Jan.
- Pattison, Seamus.
- Penrose, Willie.
- Quinn, Ruairí.
- Ryan, Seán.
- Sargent, Trevor.
- Sherlock, Joe.
- Shortall, Róisín.
- Stagg, Emmet.
- Wall, Jack.
- Ahern, Noel.
- Andrews, Barry.
- Ardagh, Seán.
- Blaney, Niall.
- Brady, Johnny.
- Brady, Martin.
- Brennan, Seamus.
- Callanan, Joe.
- Callely, Ivor.
- Carey, Pat.
- Carty, John.
- Coughlan, Mary.
- Cowen, Brian.
- Cregan, John.
- Cullen, Martin.
- de Valera, Síle.
- Dempsey, Tony.
- Devins, Jimmy.
- Ellis, John.
- Fahey, Frank.
- Finneran, Michael.
- Fitzpatrick, Dermot.
- Fleming, Seán.
- Gallagher, Pat The Cope.
- Glennon, Jim.
- Grealish, Noel.
- Hanafin, Mary.
- Haughey, Seán.
- Hoctor, Máire.
- Jacob, Joe.
- Kelleher, Billy.
- Kirk, Seamus.
- Kitt, Tom.
- Lenihan, Brian.
- Lenihan, Conor.
- McEllistrim, Thomas.
- McGuinness, John.
- Moloney, John.
- Moynihan, Donal.
- Moynihan, Michael.
- Mulcahy, Michael.
- Nolan, M. J.
- Ó Fearghaíl, Seán.
- O’Connor, Charlie.
- O’Donnell, Liz.
- O’Donoghue, John.
- O’Donovan, Denis.
- O’Flynn, Noel.
- O’Keeffe, Batt.
- O’Malley, Fiona.
- Parlon, Tom.
- Power, Peter.
- Power, Seán.
- Roche, Dick.
- Sexton, Mae.
- Smith, Brendan.
- Smith, Michael.
- Wallace, Dan.
- Walsh, Joe.
- Wilkinson, Ollie.
- Woods, Michael.
Amendment No. 96 is related to amendment No. 95 and they may be taken together by agreement.
I move amendment No. 95:
In page 16, between lines 45 and 46, to insert the following:
"(e) identifying the services which are required but which are currently unavailable, resulting in unmet needs of the persons assessed, with a view to making those services available.”.
This amendment relates to section 13 which deals with the maintenance of records by the executive and related matters. That section states that the executive shall keep and maintain records for a number of purposes, including identifying persons to whom assessments or services are being provided, identifying those services, specifying the aggregate needs identified in assessment reports which have not been included in the service statements and planning the provision of those assessments and services to people with disabilities. I propose to add another purpose, namely, to identify "the services which are required but which are currently unavailable, resulting in unmet needs of the persons assessed, with a view to making those services available".
It is understood that the provision of the entire range of required services may be phased in to take account of available funding and professionals. Nobody would agree that this is ideal but that, as the Minister of State continues to remind us, is the reality. However, it is imperative that a record is kept of the needs that can be met immediately, those that can be met over time and those that cannot be met for the foreseeable future. The Bill should include a guarantee of increasing service provision over time to an individual and gradually reduce the gap between the assessment report and the service statement.
This amendment charges the executive with ensuring that records be maintained to identify the services which are required but which are currently unavailable. In that way, the need for those services will not be forgotten or put on the long finger and the needs of the persons concerned will be met as soon as resources are available to provide those services.
I urge the House to support my amendment No. 96, which states:
In page 17, line 3, after "provision" to insert the following:
"and an indication of the resources required to meet unmet aggregate needs".
I tabled this amendment to strengthen the section in terms of an indication of the resources required to meet the unmet needs of people with disabilities. We have had detailed discussions on the needs of people with disabilities. This amendment is progressive and sensible. Resources must be allocated to services in order to ensure that the needs of people with disabilities are met.
We can go all around the houses in debating this Bill but, ultimately, it is about providing services for people with disabilities. I stress that the services required to meet the differing needs of people with different disabilities. In the intellectual disability sector, respite, day care and residential services are needed. We mentioned the priority cases in earlier debates on the Bill. Different services are required for people with other disabilities. People with physical disabilities want to participate more in society, want accommodation that is appropriate for their needs and to be included in the mainstream of society.
It is time to end this State being a cold house for people with disabilities. For too long these people have been excluded. This amendment presents an opportunity to do something about that. It is also about ensuring efficiency and effectiveness in the provision of services. This issue has arisen in the broader debate on the Bill. We need to ensure there is efficiency and effectiveness in the provision of services for all people with disabilities. I ask all Members to support my amendment.
Tacaím le leasú Uimh. 98 a chuir an Teachta Stanton síos sa choiste.
I support these amendments, which place an onus on the Health Service Executive to identify under-resourced services for which there is a demand and to plan for the provision of those services in line with demand. That does not amount to ring-fencing resources for them but identifies the services required which are currently unavailable, resulting in unmet needs of the person assessed, with a view to making those services available.
These amendments place a specific onus on the executive to ensure that when a service is not available that does not continue to be the position but that there is a planned approach to ensure the service will be provided in the near future. My preference would be for strong ring-fencing provisions, supported by statistical analysis of needs.
I refer to the amendments I tabled, which would have the same effect as these amendments but which were ruled out of order because they were deemed to place a charge on the Exchequer. In my amendments I sought to ensure — which Deputy Stanton has also sought to ensure to a degree in the amendment he formulated — that the State would progressively take steps to bring about a full realisation of the right to services recommended to meet the needs of persons assessed. In respect of those services. the provision of which is not practicable at the time of writing of the service statements, I sought to ensure that a review of the service statement be carried out at regular intervals with a view to meeting the needs of the applicant over a reasonable period. We are reasonable in what we seek in these amendments but a restriction under Standing Orders prevents us from achieving what we seek in this regard.
Amendment No. 94 in my name was also ruled out of order. It states "Where services that are the subject of a statement issued undersection 12 have not been provided to the individual concerned within a calendar year, the service provider shall issue the individual a new statement providing an updated estimate of waiting time for the access to the service.”. That is a key requirement. It will ensure that those who have been assessed as having a need which is not met will have some inkling of when that service will be provided and their needs met, how long they will have to wait for that service and that the Health Service Executive, or whoever is the service provider, is taking their unmet need seriously. In that amendment, I went further by proposing that data on such unmet needs should be collected to establish the demand in terms of the unmet needs for each relevant service and a report should be compiled to ensure that not only the Health Service Executive, assessment officer or liaison officer notices that there is a service requirement but that statistical information and data is forwarded to the relevant Minister and Department.
In the case of this Bill, the data should be forwarded to the Minister for Finance so that he will be aware of the need to provide extra money to ensure that services, where there is a lack of funds, will be resourced in order that the failure to provide the services required does not continue to be the positionad nauseam. As other Ministers have done, the Minister of State will probably say there is no such thing as ring-fencing and that it cannot be done. The Government, in particular, the Minister for Justice, Equality and Law Reform, has said there should be no ring-fencing and that it cannot be done. There are exceptions to that assertion by Ministers that the ring-fencing of funds is impossible and is not practical. Other examples have shown it is practical and possible. Funds should be ring-fenced to ensure this legislation has teeth. This amendment would ensure not only the services are identified but that they are made available thereafter.
I will give examples of ring-fencing of funding to pre-empt what the Minister of State might say. Some 52% of the dormant accounts fund is ring-fenced for allocation to the RAPID areas and the drugs task forces. National lottery moneys are ring-fenced for specific purposes such as funding of sporting and health activities. Money from motor taxation is ring-fenced for local authorities to defray costs. The Minister for Justice, Equality and Law Reform has admitted that he agrees with the ring-fencing of money put into the court poor box. Last year I think the Minister for Finance managed to ring-fence €300 million for the horse and greyhound racing fund for the next four years. Where there is a will, there is a way in terms of ring-fencing money. I call on the Minister of State to go to the Minister for Finance when this Bill is passed to ensure moneys are ring-fenced so that the services required are made available and to ensure equality in service delivery.
While people with a disability and their families have welcomed funding commitments made in the national disability strategy and the budget for 2005, they are rightly suspicious that this is a political promise. They would prefer if the largesse were not discretionary and that it was ring-fenced to ensure the services are delivered at least at the current level but in the hope services required will continue to increase for those who have needs, are disabled, are looking to become full participants in society, have the right to independent living and wish to play an equal role to those of us who do not suffer a disability.
Section 13 obliges the Health Service Executive to maintain records on assessments and services provided under Part 2 to inform service planning. The HSE is also required to present an annual report outlining service needs, timeframes within which services will ideally be provided and the sequence of such provision.
I tabled an amendment on Committee Stage which will ensure the collection of specific information to enable the quantification of needs which are not being met by service provision. This information will enable the HSE to review the way in which resources are allocated to ensure maximum beneficial output can be achieved. Accordingly, the Bill now requires that the report to the Minister will be provided within a timeframe of six months and will also include information on the likely cost of meeting service needs. This is a substantial development providing a transparent means of future planning for service development and delivery to facilitate a progressive response to real needs. It will enable greater efficiency and management of resources to be reflected in improved service levels over time. The amendment captures the principles sought in amendments Nos. 95 and 96. Therefore, those amendments are not necessary
I am inclined to agree with the Minister of State, although I think he is talking about aggregate needs and not the individual needs of each person concerned. I will not press the amendment but I ask the Minister of State to consider a mechanism to ensure the needs of each individual are also recorded and maintained by the executive when maintaining records. I am talking about unmet needs and services in each case. My amendment does not specify the individual records of each person. The Minister of State talked about the aggregated needs and aggregating the total cost at a regional and national levels, which we welcomed on Committee Stage. However, I wish to bring it down to the individual level. It is important that is done.
In regard to my amendment No. 96 and the debate about the Health Service Executive and its role, we all agree we need the maximum beneficial output from the HSE in providing services for people with disabilities. Greater efficiency is crucial. My political and broader disability agenda is resources for services for people with disability and the unmet aggregate needs. These issues are important. When we talk about the needs of people, we refer to the need for a level of services which will assist the families of people with disabilities or those with a disability.
Amendment No. 96 is an important one which pushes to the boundaries to ensure the legislation has the maximum effect. We all agree we need the maximum beneficial output from the HSE. We acknowledge that is the ambition and the plan to deal with these services but the reality is we want to ensure people with disabilities get the maximum efficiency, the maximum level of service and are treated by the service providers with great respect and dignity at all times.
Arís, tuigim cad atáá rá ag an Aire, ach ní aontaím go hiomlán leis. Chuirfeadh an leasú leis an reachtaíocht dá nglacfaí leis. Déanann sé iarracht déileáil leis an cheist seo, mar a bhí mé féin ag iarraidh a dhéanamh sna leasuithe a rialaíodh as ord. Is é an rud bunúsach atá i gceist ná go mbeadh na seirbhísí atá de dhíth faoi láthair ar fáil roimh i bhfad. Fiú muna bhfuil an tseirbhís sin ar fáil anois, bheadh a fhios againn go mbeadh sí ar fáil taobh istigh de bhliain nó mar sin. Sin an méid atá i gceist nuair a deirtear, "identifying the services which are required but which are currently unavailable, resulting in unmet needs of the persons assessed, with a view to making those services available".
Mar a dúirt mé, bhí mé sásta dul níos faide, ach sa deireadh thiar thall, aontaím leis an méid a bhí le rá ag an gCoimisiún um Chearta Daonna nuair a dúirt sé gur ghá na hacmhainní a chinntiú i leith na ceiste seo. Faoi láthair, is féidir leis an Rialtas casadh timpeall i gceann cúpla bliain agus a rá nach bhfuil na hacmhainní aige agus go gcaithfimid gearradh siar. Sa chás sin, beidh níos mó seirbhísí ann nach mbeidh ar fáil. B'fhéidir go dtarlódh sé sin. Tá muidne ar an taobh seo den Teach ag iarraidh déanamh cinnte de amach anseo go mbeidh na seirbhísí ar fáil go leanúnach.
I am satisfied that the points made by the Deputies are covered. The unmet aggregate needs will be spelt out in detail and financial provision will be made. I am prepared to consider extending the position somewhat in response to Deputy Stanton's concerns.
I move amendment No. 96:
In page 17, line 3, after "provision" to insert the following:
"and an indication of the resources required to meet unmet aggregate needs".