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Dáil Éireann debate -
Thursday, 10 Feb 2022

Vol. 1017 No. 7

Health (Miscellaneous Provisions) Bill 2022: Second Stage

I move: "That the Bill be now read a Second Time."

I am pleased to have this opportunity to address the House on this Bill, which will facilitate the transfer of specialist community-based disability services from the Minister for Health to the Minister for Children, Equality, Disability, Integration and Youth. Broader disability equality policy is already the responsibility of the Minister for Children, Equality, Disability, Integration and Youth following the transfer from the Minister for Justice in late 2020. After this transfer from the Department of Health, responsibility for disability equality policy and specialist community-based disability services will be centralised in a single Department for the first time. The HSE will retain responsibility for delivering the services.

The location of disability equality policy and specialist community-based disability services in a single Department will facilitate strategic policy development, including implementation of the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD, which Ireland ratified in 2018, as well as the significant reforms envisioned under the transforming lives programme. Under the convention, and following the transfer of the equality function, the Department of Children, Equality, Disability, Integration and Youth will be the national focal point and the co-ordination mechanism for implementation of the UNCRPD. Consolidation of the disability function represents a significant opportunity to further the progressive realisation of the convention in Ireland.

Assigning overall responsibility for disability matters and key resources to a single Department will enable the Government to strengthen approaches to co-ordination and offers the potential for future improvements in service delivery, including reviews of resources, to maximise the benefits for service users. This is particularly important given many of the issues arising for people with disabilities are cross-government in nature. The centralisation of the equality, health and social care dimensions of support for people with disabilities will facilitate the transition from a medical model of support towards an holistic, rights-based approach that supports people with disabilities to live autonomously. Reflecting this change in philosophy in disability policy and service delivery will be crucial for meeting Ireland’s obligations under the UNCRPD. The transfer of these key policy responsibilities provides an opportunity to look anew and critically review how specialist community-based disability services are being delivered. It will allow us to examine how the service offering can be improved to facilitate greater flexibility, choice and control from the service user's perspective.

After the transfer of policy responsibilities takes place, the governance arrangements for the transfer are that the HSE will retain service delivery responsibility and provide a framework for close co-operation between the Departments of Health and Children, Equality, Disability, Integration and Youth. This will ensure that people with disabilities will continue to have access to integrated and mainstream health and personal social services. It will also ensure that specialist community-based disability services benefit from, and are in line with, ongoing reform efforts including under Sláintecare. As the HSE will continue to deliver the services, the transfer therefore requires it to report to two Ministers for different elements of its functions. The Bill seeks to put in place a legislative basis to enable this and includes provisions on accountability arrangements for the HSE under the Health Act 2004. This aims to ensure that both Ministers have the necessary authority in their respective areas of responsibility.

I will now outline some sections. Section 1 provides for the Short Title and commencement of the Bill.

Section 2 defines the Acts referred to in the Bill. For the most part, the Bill seeks to amend the Health Act 2004.

Section 3 amends the Health Act 2004 by inserting "specialist community-based disability services functions".

Section 4 amends the 2004 Act to provide for the Minister for Children, Equality, Disability, Integration and Youth to have the power to incur expenses in administering any functions under the Act, to such extent as may be sanctioned by the Minister for Finance, payable out of money provided by the Oireachtas.

Section 5 amends the 2004 Act to provide for the Minister for Children, Equality, Disability, Integration and Youth to have the power to request advice from the HSE in respect of specialist community-based disability services.

Section 6 amends the 2004 Act to provide for the Minister for Children, Equality, Disability, Integration and Youth to have powers in the issuing of directions regarding a health needs assessment in respect of its specialist community-based disability functions.

Section 7 amends the 2004 Act to provide for the Minister for Children, Equality, Disability, Integration and Youth to have the power to issue general and specific written directions to the executive in respect of specialist community-based disability services. The executive will be required to comply with such a direction.

Section 8 amends the 2004 Act to provide for the Minister for Children, Equality, Disability, Integration and Youth to have powers in the setting of priorities for the executive’s service plan in respect of its specialist community-based disability functions.

Section 9 amends the 2004 Act to provide for limits on the Minister for Children, Equality, Disability, Integration and Youth in the exercise of powers.

Sections 10 and 11 amend the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of appointments of executive board members. People with experience of advocacy in matters affecting recipients of services may now be selected as board members as well as those with experience in advocacy in matters affecting patients.

Section 12 amends the 2004 Act to provide for the accountability of the board to the Minister for Children, Equality, Disability, Integration and Youth in the performance of its specialist community-based disability functions. The board must inform the Minister of any matter that it considers requires his or her attention.

Sections 13 and 14 amend the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of the removal of executive board members from the board.

Section 15 amends the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of the determination of remuneration and expenses paid to executive board members.

Section 16 amends the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of the appointment of the chief executive officer of the board.

Section 17 amends the 2004 Act to provide for the CEO of the HSE to assist and provide the Accounting Officer of the Department of Children, Equality, Disability, Integration and Youth with information, including financial information and records, relating to the Accounting Officer's function in respect of the specialist community-based disability functions.

Sections 18 and 19 amend the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth regarding the terms and conditions of the employees of the executive and associated superannuation schemes.

Section 20 amends the 2004 Act to amend the definitions of "approved capital plan", "approved corporate plan" and "approved service plan" to include the Minister for Children, Equality, Disability, Integration and Youth with regard to specialist community-based disability functions.

Section 21 amends the 2004 Act regarding the obligations on the executive to prepare and submit a corporate plan to both Ministers.

Section 22 requires the laying of the corporate plan before the Oireachtas within 21 days of the plan being approved by both Ministers.

Sections 23 and 24 amend the 2004 Act to provide for consultation between both Ministers in respect of the determination of maximum net non-capital expenditure that may be incurred by the executive for a financial year.

Section 25 amends the 2004 Act regarding the obligation on the executive to prepare and submit a service plan to both Ministers for approval.

Section 26 amends the 2004 Act to provide for consultation between the Ministers prior to the amendment of an approved service plan, and prior to the approval of the amended service plan.

Section 27 amends the 2004 Act to provide the Minister for Children, Equality, Disability, Integration and Youth with the power to issue directions on the implementation of an approved service plan in respect of specialist community-based disability services, and for consultation between the Ministers prior to the issuing of directions.

Section 28 amends the 2004 Act to provide the Minister for Children, Equality, Disability, Integration and Youth with the power to make grants to the executive out of moneys provided by the Oireachtas on and from the commencement of the Act.

Section 29 amends the 2004 Act to provide the Minister for Children, Equality, Disability, Integration and Youth with the power to determine the capital funding in respect of specialist community-based disability services and for consultation between the Ministers regarding the determination of capital funding for the executive in a financial year.

Section 30 amends the 2004 Act with regard to CEO accountability relating to capital-net non-capital expenditure in respect of specialist community-based disability services function to the Minister for Children, Equality, Disability, Integration and Youth.

Section 31 amends the 2004 Act to allow for consultation with the Minister for Children, Equality, Disability, Integration and Youth about the executive’s code of governance.

Section 32 amends the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth regarding the form of, and accounting standards for, the executive’s annual financial statements.

Section 33 amends the 2004 Act and provides the Minister for Children, Equality, Disability, Integration and Youth with the power to specify the information to be included in the executive’s annual report in respect of specialist community-based disability services functions.

Section 34 amends the 2004 Act to provide that the executive may enter into service arrangements subject to directions issued by the Minister for Children, Equality, Disability, Integration and Youth.

Section 35 amends the 2004 Act to provide for directions issued by the Minister for Children, Equality, Disability, Integration and Youth to be taken into account by the executive when providing assistance for certain bodies that provide similar services to those provided by the Executive.

Section 36 amends the 2004 Act in relation to the executive’s duty to furnish information to the Minister for Children, Equality, Disability, Integration and Youth in respect of specialist community-based disability services.

Section 37 amends the 2004 Act regarding the power to require the executive to furnish information and documents to the Minister for Children, Equality, Disability, Integration and Youth in respect of specialist community-based disability services where the Minister considers it necessary in the public interest to do so for the performance their functions. The executive will furnish the information within any period that the Minister for Children, Equality, Disability, Integration and Youth may specify and, in any event, without delay.

Section 38 amends the 2004 Act with regard to the Minister’s power to share information and documents that relate to specialist community-based disability services in specified circumstances.

Section 39 amends the 2004 Act regarding the Minister’s power to use information and documents that relate to specialist community-based disability services.

Section 40 amends section 40F of the 2004 Act to include the Minister for Children, Equality, Disability, Integration and Youth.

Section 41 amends section 40H of the 2004 Act by replacing the requirement of the board to appoint a chairperson of the audit committee from among the committee’s external members, with a provision allowing the board to appoint a chairperson from among any of the members of the committee.

Section 42 amends section 40I of the 2004 Act relating to the functions of the executive's audit committee and its obligation to provide a copy of the reports advising the CEO and the board on financial matters to the Minister for Children, Equality, Disability, Integration and Youth.

Section 42 amends the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of convening a national health consultative forum.

Section 44 amends the 2004 Act by giving the Minister for Children, Equality, Disability, Integration and Youth the power to direct the executive to establish an advisory panel for a specified purpose in respect of specialist community-based disability services.

Section 45 amends the 2004 Act to provide for consultation with the Minister for Children, Equality, Disability, Integration and Youth in respect of making regulations relating to complaints.

Sections 46 and 47 amend the 2004 Act so that the Government may make provision regarding the processes and procedures by which the functions of the Minister for Health or the Minister for Children, Equality, Disability, Integration and Youth are exercised by an order under section 6(1) of the Ministers and Secretaries (Amendment) Act 1939. Any such orders shall be laid before the Houses of the Oireachtas.

Section 48 amends the 2004 Act by deleting the word "ordinary" to allow for a quorum of seven members of the board. The transfer of functions requires the sectoral plan currently under the responsibility of the Minister for Health to be divided between him and the Minister for Children, Equality, Disability, Integration and Youth to reflect the transfer of responsibilities between the two Ministers. Sections 49 to 51, inclusive, amend the Disability Act 2005 to provide for this.

Section 52 amends section 2 of the Health Act 2007 by the insertion of the definition of "specialist community-based disability functions".

Section 53 amends section 9 of the Health Act 2007 to allow the Minister for Children, Equality, Disability, Integration and Youth to require the Health Information and Quality Authority, HIQA, to undertake an investigation in the context of specialist community-based disability services.

Sections 54 to 58, inclusive, amend relevant sections of the Health Act 2007 to extend the power to make regulations to the Minister for Children, Equality, Disability, Integration and Youth in respect of those areas which are transferring.

Section 59 provides for definitions that appear in Part 5, including "health and personal social services", "specialist community-based disability services" and "specialist community-based disability services functions".

Section 60 provides for administrative co-operation between the Minister for Health and the Minister for Children, Equality, Disability, Integration and Youth to allow them to enter into arrangements which will facilitate administrative efficiency and co-operation, the avoidance of duplication of activities by the executive and the sharing of information relevant to the employment of persons.

Section 61 provides for a review process to include an evaluation of the delivery of specialist community-based disability services and an examination of the integration of services for persons who have a disability. The review will be carried out no later than three years after the commencement of this section.

Sections 62 and 63 are quite technical sections relating to functions being deemed to have been valid in certain circumstances if, at the time of the performance or purported performance of the function, the relevant Minister believed that the function was vested in him or her by virtue of the amendments to the principal Act effected by this Bill.

Section 64 provides for the determination of disputes in connection with the amendments in this Bill and the performance of functions in this Bill.

Section 65 provides for the cessation of the functions of the Minister for Health in respect of specialist community-based disability services functions from the commencement of this section.

I know there are a lot of technical amendments here. The purpose was to allow the transfer of specialist community-based disability services to the Department of Children, Equality, Disability, Integration and Youth to take place. I believe this will be a positive step for the reasons I outlined earlier. There will, of course, be an opportunity to discuss this in more detail at Committee Stage. I look forward to all contributions.

Debate adjourned.
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