Disability Services: Motion [Private Members]

Deputy Pauline Tully

I move:

That Dáil Éireann:

notes that:

— the Disability Capacity Review to 2032 - A Review of Social Care Demand and Capacity Requirements to 2032, which was published in July 2021, to establish the level of additional funding that would be required to address unmet need and demographic change in disability services found that additional funding of between €750 million and €1,350 million would be required by 2032, for disability services to address demographic change and the considerable levels of unmet need;

— the Action Plan for Disability Services 2024-2026 was published in December 2023, consisting of 68 actions to address identified deficits and drive reform in specialist community-based disability services;

— 93 Children's Disability Network Teams (CDNT) have been established, whose role it is to carry out assessments under the Disability Act 2005 and deliver therapeutic supports;

— the Roadmap for Service Improvement 2023-2026 - Disability Services for Children and Young People, was published in October 2023, which contains 60 actions to achieve quality, accessible, equitable and timely services for children with complex needs, as a result of being disabled; and

— the State signed the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in 2007 and ratified the Convention in 2018, which asserts that Disabled Persons' Organisations (DPO) must be prioritised in consultations, monitoring and implementation of the Convention;

further notes, with extreme concern, that:

— the Action Plan for Disability Services 2024-2026 states that the monies allocated to disability services over the last number of budgets has not been sufficient;

— the latest Health Service Executive (HSE) Children's Disability Staff Census and Workforce Review found there was 817 staff vacancies across the CDNTs;

— Section 39 staff still do not enjoy pay-parity with Section 38 and HSE staff;

— the average duration of the Assessment of Needs process, as of Q2 2024, was 23.72 months, and this compares to 19.06 months in Q2 2020;

— 487 disabled people have been facilitated to move out of congregated settings to community living since 2020, while 174 disabled people were admitted to a congregated setting and 462 have passed away in a congregated setting during this period;

— 1,233 people under the age of 65 remain in nursing homes;

— 1,965 disabled people live with family carers over the age of 70 and have no pathway to access planned residential supports;

— waiting lists for residential funding are increasing year on year;

— Budget 2025 only provides funding for 70 new residential places;

— disabled people are at greater risk of poverty and deprivation;

— the employment rate of disabled people in Ireland at 32 per cent is the lowest in the European Union (EU) and the disability employment gap at 44 per cent is the highest;

— the Government has failed to increase the rate of the Wage Subsidy Scheme in three years, despite increases in the National Minimum Wage; and

— DPO/Disabled Persons Representative Organisations (DPRO) are not adequately funded to enable them to effectively engage in research and advocacy on behalf of the disability community;

observes that:

— five Sinn Féin private members' motions debated on 8th March, 2022, 29th March, 2022, 11th October, 2022, 17th October, 2023 and 5th March, 2024, in relation to disability, have called for the ratification of the Optional Protocol of the UNCRPD; and

— a memo was brought to the Cabinet on the 8th October, 2024, to seek approval to ratify the Optional Protocol of the UNCRPD, 17 years after the State signed up to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD); and

calls on the Government to:

— set the date for the ratification of the Optional Protocol of the UNCRPD and amend the Disability Act 2005, and deliver rights-based access to services and support for people;

— acknowledge its failure to truly recognise the additional cost of disability in Budget 2025, and rectify this mistake in the upcoming Social Welfare Miscellaneous Bill 2024, to ensure core disability-related social welfare schemes are increased by €20;

— allocate an additional €10 million to the Wage Subsidy Scheme for workers with disabilities;

— establish a "Community Care Access Fund", to speed up access to mental health and disability diagnosis and interventions;

— create more spaces in adult day services, appropriate respite and intensive home support packages for disabled children;

— end the practice of placing people under 65 in nursing homes by making greater provision for disabled people to live in appropriate accommodation, by investing in de-congregation, and provide housing and housing supports in the community;

— prioritise the development of a planned pathway to residential supports for disabled people; and

— put in place a DPO/DPRO Training and Development Fund and also a Disability Inclusion Fund for all local authorities, to support their specific disability inclusion requirements in line with the UNCRPD and Public Sector Equality and Human Rights Duty.

The disability capacity review was published in July 2021. Its remit was to establish the level of additional funding that would be required to address unmet need and demographic change in disability services by 2032. It found that additional funding of between €750 million and €1.3 billion would be required to address those issues by 2032. The Action Plan for Disability Services 2024-2026 was published in December 2023 and included proposals to start addressing identifiable defects. It incorporated proposed additional capacity to help bridge the gaps identified in the capacity review by 2026. Among the proposals in the plan were 600 new posts in children's disability network teams, CDNTs, 900 new residential places, moving 500 people out of congregated settings and 260 people under the age of 65 out of nursing homes, 800,000 additional personal assistance hours and 110,000 additional home support hours.

Those are laudable proposals that are very much needed to fill the gaps identified in the disability capacity review. However, looking at the recent budget announcement in respect of disability services and the level of funding committed to, I am unable to square the circle. The Ministers announced additional funding of €336 million for disability services in the recent budget. Each year, DPROs and disability organisations have requested that this funding announcement be made in a much more transparent way and they have done so again this year. The Ministers did not set out that €290 million of this funding was for existing levels of service while only a paltry €42 million was for the development of new measures and only an additional €4 million is provided for capital projects.

The action plan proposed the delivery of an additional 600 new posts for CDNTs on top of those posts that are already funded although unfilled. The reality is that, regardless of how many posts are funded, recruitment and retention within CDNTs is extremely difficult. For the third year in a row, the vacancy rate in CDNTs has risen. According to the staff census, there were 524 vacancies in 2021, 707 in 2022 and 817 in the latest report, which is from 2023. It is not down to funding. It is down to a lack of planning and consultation in advance of moving to the CDNT model. The promised planning, policies and structures were not put in place. This resulted in many experienced staff leaving disability services, resulting in a chaotic and challenging work environment for the remaining staff. Proper workforce planning should have been implemented well in advance of the introduction of the CDNTs. In the aftermath of their messy implementation, this should have been a priority. Sinn Féin has called for a workforce plan through six different motions in this Government's term.

This has had an absolutely devastating effect on the children and families who are suffering because of the lack of support and services within the community. I will refer to one young lad who is aged 16 and whose name is Kyle. On the day the Minister announced his budget in 2024, Kyle was put into an induced coma at Beaumont following an incident in his family home. His parents, who provide full-time care, were forced to call gardaí, who had to handcuff this 16-year-old, non-verbal, autistic boy and put him in an ambulance so that he could receive treatment, having had one of his many recent violent outbursts in his home. His parents, Linda and Robbie, both work but their entire lives are centred around providing care to Kyle. They have fought for supports and services for Kyle's entire life. He has significant high support needs. He is still under sedation in Beaumont Hospital. He was placed in an induced coma because of a state of distress and aggression requiring sedation. His mam says that, despite pleas since 2017, when Kyle's school hours were reduced, and multiple requests for adequate support services, they have been left in crisis. Crucially, Kyle's rights have not been met. His parents are at their wits' end. They cannot manage the situation any more without the required supports. They cannot care for him and they feel he is being let down by the State. He is not being allowed to be the person he could have been because he did not get the support and early intervention he required. If that had happened, he could be at home with them and able to live a life. Now, they have to seek a residential placement for him, which is going to be in County Roscommon, miles away from his home in Dublin, where he has lived his whole life.

Kyle is only one of many in this situation. We will be facing many more if young children do not get the vital intervention they need right now to help them to live at home with their families and to go to school to get education or training and go on to work. It is not fair. It is a clear denial of human rights.

Deputy David Cullinane

This is one of dozens of debates on disabilities we have had in this Dáil term. My party, Sinn Féin, has brought forward five separate motions on the issue of disabilities. On the Government's record, this is a government that put in place a capacity review. It was a ten-year review that set out how much funding was needed, what capacity was needed in terms of, for example, staff and resources for decongregation and what supports were needed for children and adults in all of the different areas of disability services. The disability capacity review has never been properly funded. We then had an action plan for disability services. Of course, we welcome it when plans are put in place but the problem is that the plans are not delivered on. We have just had a budget that many disability organisations and people with disabilities tell us does not make enough funding available even to deliver the plan the Government has in place, which we know is inadequate in itself.

The most difficult meetings I have had over the long years I have been a Member of the Oireachtas and a councillor are those relating to children with disabilities and to access to services in particular. When we raised issues in respect of assessments of need today, the Taoiseach made the point that, while these assessments are important, what is more important is that children get access to services. I agree with that. We want children to get access to services but we know that an assessment of need is important for a child as a gateway into some services, particularly in schools, where there is competition for scarce resources. Even if we accept the Taoiseach's logic that we need to provide the services for children first, which I do, I talk to parents all of the time who have to battle with the State to get access to basic services for their children. While they are waiting for an assessment of need, some children will get services and some will not. The word parents often use when telling me about the service their children get is "patchy". They might get some element of what they need. In very rare circumstances, they may get all of it. However, they may get none of it. The family then has to pay for services privately. That is really traumatic for them when they are trying to get access to the best services for their children.

We have the same situation in adult disability services. I was dealing with a lady regarding her child. This person is in his 40s. He is an adult but she describes him as a child. He lives in Lismore, County Waterford. He accesses day services in Waterford city because there are no day services in Dungarvan. She has to drop him off at a drop-off point outside Dungarvan in Kilmacthomas. She has to drive to Kilmacthomas every day, which is a long drive from Lismore, to drop him off very early in the morning to get into the day service. He then has to get support and a bus to get back again. She gets no support whatsoever. The first problem is that the transport is not there and she has to do the driving. The second problem is that day services do not exist in Dungarvan. That is a problem not just for her, but for many children with profound disabilities in west Waterford. It is the same right across the State.

I dealt with another couple I met a number of weeks ago. They are in their 80s. They have a child - they again call him a child - who is in his 50s who has a severe intellectual disability. They are worried about what will happen to him when they pass away.

They are worried because they had to fight tooth and nail to get whatever services their adult child has received right through his childhood and adult life. They told me that everything was a battle. They are worried because of the lack of independent living opportunities that exist. We need to do much more. The reason we have capacity reviews and so-called action plans is, as I understand it, that we look at the identified need, then we provide the resources and then we provide the services, but that is not people's lived reality or experience. It certainly is not the lived reality of people with disabilities or the parents either. It seems to be a constant battle. There are other issues with payments to people with disabilities, empowering them to live independent lives, which we need to do. I have had several meetings with my party leader and Deputy Tully on this over the past number of weeks. I want to see the next Government and every political party really step up to the plate and deliver a manifesto and election commitments that are real, deliverable, which will actually make a difference for people with disabilities and which will once and for all put the rights of people with disabilities front and centre in any programme for Government.

Deputy Pádraig Mac Lochlainn

I want to take the Minister and Minister of State through the serious crisis in services for children with disabilities in Donegal. I think they are fully aware of them. More than a year ago, Special Needs Parents Network Donegal, which represents more than 900 parents of children with disabilities, published a survey about the real impact of the longest waiting lists in the entire State for physiotherapists, occupational therapists, psychologists and speech and language therapists. None of this is being provided and assessments are not being done. It is a serious crisis. A forum was established with the HSE, the parents' representatives and the public representatives in the county. It met once a month, then every three months, and now we have learned it is being stood down without any consultation with public representatives. That is outrageous. We were looking for accountability and updates on recruitment. The parents told their stories. Indeed, they passed around photographs of their children to get a human sense of who these children were and the impact on their lives. The forum was stood down.

Then there are organisations like iCare and Bluestack Special Needs Foundation that have been around for more than 20 years, with one in the north of the county and one in the south, providing services to significant numbers of children and their parents. Those organisations, until recent years, had to raise all the money themselves. There are huge fund-raising efforts that are ongoing to this day. They ask for basic core funding. They have approximately €36,000 each. They will fold unless they get appropriate funding. This has been brought to the Minister's attention but the HSE, working with the Minister, has provided no solutions. Our disability services for children are in crisis across Donegal. We had a forum established to hold the HSE and the Government to account and it has been stood down. Will the Minister please ensure it is re-established as soon as possible and that we get answers and solutions on respite care and services for children with disabilities?

Deputy Rose Conway-Walsh

I thank my colleague Deputy Pauline Tully for bringing this important motion to the House. It is a real shame that she was compelled to do so but this is what happens when we have a Government that turns its face away from citizens who need support. I acknowledge all the section 39 workers who gathered outside Mayo County Council yesterday. One after the other, Fianna Fáil and Fine Gael councillors stood up to say how absolutely disastrous the way section 39 workers are being treated with regard to pay parity was, and how that was causing problems in service delivery, recruitment and retention in County Mayo. They were obviously supported by SIPTU and Fórsa. The Minister has a responsibility to stop the forthcoming strike. These workers are being forced to go on strike and he needs to sort it because people all over Mayo, including vulnerable families, will be left with no support while these workers are forced to go on strike. It is absolutely incredible that he has reneged on the promise he made to these workers.

The Government went to great lengths to produce a disability capacity review which, since its publication in 2021, has gathered dust on the proverbial shelf. Of course, the review told us what every one of us here knows from our constituency work, which is that people with disabilities are being left behind and there is a significant level of unmet need that the Government will not address. In my constituency, I have seen the real impact of the Government's austerity on people with disabilities. For example, there is the case of the 72-year-old lady from Mayo with a spinal injury, who has to go to Clarinbridge, County Galway to get respite care, a distance of more than 200 km. I have case after case. What about Geraldine, the lone parent with four year girls? Her second eldest is 13. Niamh has autism, epilepsy and type 1 diabetes. She requires six daily injections, all administered by her mother. Geraldine applied for respite services in February. She is still on the waiting list. She looked into private homecare support but was told no nurses were available. She was advised to place an advertisement on Midwest Radio to employ her own nurse. That is the help that these people are being given when trying to look after people with disabilities. The Minister should be absolutely ashamed of himself.

Deputy Paul Donnelly

In the past few months, I received a message that the Blakestown CDNT in Dublin 15 had informed a parent that her child would not receive services for 72 months. I was so stunned at the date that I asked her if it was in writing, which she confirmed. She dropped the letter up to me. I know the Minister has that latter. Before the CDNT service, we used to have early intervention teams and school age teams. It seems that the change in name has done nothing to provide either early intervention or school supports for autistic children. In fact, it has worsened. It is important to put names to these. I have a letter here, which states that the writer is writing to me regarding their son Jaden, who is due to start primary school in September 2025, and he has epilepsy, autism and a feeding tube. The letter states that his psychologist said he will need a cognisant assessment before he starts primary school and that they sent off the assessment of need form, which needs to be completed before the parent can enrol him in primary school, to see what recommendations are given for him. It states that they have heard nothing back and enrolment starts in most schools at the end of November. They are getting worried that he will not be able to start school on time because this assessment has not been completed. They ask if there is anything I can do.

There is another case. The writer states that they have finally received their son, Luke's, service statement for his assessment of need, which was a two-year battle. The correspondence states that the report recommends that he requires supports, including psychology, speech and language therapy and occupational therapy, from his local CDNT in Blakestown. They state that the waiting list is currently in excess of 72 months, which is six years. The letter states that this is a direct result of recruitment and retention issues in Blakestown CDNT since the team was established. Luke will have completed primary school at the end of that stage, which is far too late to receive any early intervention. The writer states that as a trained neuropsychiatric and developmental disability nurse, having worked for many years in the field in Australia, it is truly devastating that our young children are not given the supports to enable them to progress and nurture their developmental needs. They state that having had the experience, they have been fortunate enough to have navigated the system thus far, but there are many parents and families who are not so fortunate. They state that the primary care team diagnosed Luke with autism spectrum disorder and discharged him in the same meeting, which is a massive diagnosis to receive, with no follow-up care. They state that his next service or intervention is in six years.

That is absolutely appalling.

Deputy Mairéad Farrell

Tá sé iontach go bhfuil sé seo curtha os comhair na Dála ag mo chomhghleacaí, an Teachta Pauline Tully, anocht. Ar ndóigh, tá sé iontach go bhfuil daoine anseo atá in ann a gcuid tuairimí a roinnt linn mar go bhfuil sé fíorthábhachtach go gcloisfear tuairimí na ndaoine seo. Ón athbhreithniú a rinneadh maidir le hinniúlacht seirbhísí do dhaoine faoi mhíchumas, tá a fhios againn go bhfuil an t-uafás maoinithe agus infheistíochta ag teastáil. Táthar ag rá go dteastaíonn idir €750 milliún agus €1.35 billiún go dtí 2032 chun dul i ngleic leis an méid atá de dhíth i dtaobh seirbhísí i gcomhair daoine agus a gcuid teaghlach. Is cuimhin liom go ndúirt grúpaí a phléann le daoine faoi mhíchumas go soiléir ag an olltoghchán deireanach nár chóir go mbeadh sé seo á phlé ag am an olltoghcháin amháin ach go gcaithfidh an Rialtas dul i ngleic leis seo i mbealach dáiríre.

Tá súil agam go bhfuil na hAirí ag éisteacht. Chuile sheachtain bheo, bíonn tuismitheoirí ag teacht isteach chuig m'oifig. Bíonn siad ag rá liom nach bhfuil a gcuid páistí in ann na seirbhísí atá ag teastáil uathu a fháil. Tá siad ar liostaí feithimh atá i bhfad rófhada agus níl siad in ann na seirbhísí atá de dhíth orthu a fháil. Chomh maith leis sin, tá a fhios againn go bhfuil fadhb ollmhór ann maidir le faoiseamh. Níl teaghlaigh ag fáil an faoiseamh atá ag teastáil uathu. Ní hamháin go gcuireann sé sin brú ar an teaghlach, an páiste nó an duine fásta a bhfuil an faoiseamh ag teastáil uathu ach ní dhéanann sé ciall ar bith go fadtéarmach. Tá a fhios againn go gcuireann sé sin tuilleadh brú ar sheirbhísí go fadtéarmach. Mar gheall air sin, caithfimid dul i ngleic leis an bhfadhb maidir le faoiseamh. Nílim ag caint faoi fhaoiseamh gach cúpla seachtain nó pé tréimhse atá ann. Caithfimid breathnú ar na seirbhísí ina iomláine taobh amuigh den fhaoiseamh sin. B'fhéidir go gcaithfimid breathnú ar chlubanna tar éis na scoile ionas gur féidir le teaghlaigh leanúint orthu ag obair agus mar sin de agus leis na páistí eile dul ar scoil. Caithfear fís éagsúil a bheith ann do na daoine agus teaghlaigh seo. Tá súil agam go n-éistfidh an Rialtas lenár rún.

Minister for Children, Equality, Disability, Integration and Youth (Deputy Roderic O'Gorman)

I am pleased to address the issues raised in the motion tabled by Deputy Tully. The Government will not oppose the motion but we will use our time to demonstrate what we have delivered in the sphere of disability over the past four years.

The motion touches on a wide range of issues, spanning the remit of several different Departments, including my own. I will provide some details of measures across other Departments highlighted in the motion, insofar as time will allow. The Minister of State, Deputy Rabbitte, will comment in more detail on progress in specialist disability services but it is important to note the overall budgetary allocation for disability services in 2025. The Government is committed to expanding supports for people with disabilities and developing a more integrated and person-centred policy approach across all public services. This commitment is reflected in the budget for disabilities services, which has increased by €1.2 billion over the past four years. In 2020 when we took office, the budget was €2.1 billion. This year, following the increase, it will be €3.2 billion. This provision recognises the very significant existing challenges in the sector, about which Deputies have spoken, but funding is also provided to build on service expansion to date in children’s services, day services, respite and residential services, personal assistance hours, and other supports to assist people to continue living independently in their own homes.

Turning to the optional protocol, which is referenced in Deputy Tully's motion, as Deputies will be aware, last Tuesday, 8 October marked a milestone for Ireland when the Government agreed to accede to the optional protocol to the UNCRPD. The ratification of the optional protocol is a key priority in the programme for Government and has been a core objective for myself and the Minister of State, Deputy Rabbitte. This decision by Government demonstrates Ireland’s commitment to the continued and progressive realisation of the rights and obligations enshrined in the convention. It also conveys an important message regarding the value the State places on advancing the rights of persons with disabilities. Accession to the optional protocol will enable people who feel that their rights under the convention have been breached to submit a communication to the UN's disability committee. The UN committee will then assess communications against the its own admissibility criteria. If admissible, the committee will then assess the merit of a communication and if a breach of rights has occurred, it will issue recommendations to the State for remedies. The protocol acts as an important accountability mechanism for the State and as such, strengthens Ireland's commitment to upholding the rights of persons with disabilities and highlights the value that we, as a Government, place on ensuring that we are held to account in adhering to our obligations under the convention. The Minister of State and I have long prioritised this particular measure and earlier this year I formed an interdepartmental group to hasten the work on ratification. The completion by the interdepartmental group of its work enabled the Government to take a decision last week to accede to the optional protocol. Following the decision, the Tánaiste and Minister for Foreign Affairs will sign an instrument of accession on behalf of the Government to be deposited with the Secretary General of the UN in the next number of weeks. The protocol will enter into force in Ireland 30 days after that document is deposited.

The programme for Government reaffirmed our commitment to the rights articulated within the UNCRPD, setting out a further commitment for the development of an implementation plan for the convention. This commitment will be delivered in the form of the next national disability strategy, which will provide a blueprint for the further realisation of the UNCRPD and embed a dynamic framework approach to disability policy across government. Consultation and codesign with disabled persons and their representative organisations have been at the centre of the development of this new strategy. This means there will be lasting and agile structure for whole-of-government engagement on disability issues, to problem solve issues and drive progress while always working in collaboration with stakeholders. A robust and extensive public consultation process for the strategy has concluded. There were 34 focus groups, a number of which the Minister of State and I attended. There were also 18 interviews, 500 responses to a national survey and five town hall events, both in-person and online. This is in addition to targeted and ongoing engagement with disabled persons organisations. Key to these discussions has been the role of stakeholders in the design and implementation not only of this strategy, but of national policy more broadly. We are committed to ensuring that DPOs, in particular, are supported to engage in effective advocacy. This will support the disabled community to have their voices heard effectively in the public sphere and, crucially, bolster our ability to make better policy that is reflective of their needs and lived experience.

The Government acknowledges that effective contributions to the policy making and implementation process requires adequate resources. Capacity building and funding for DPOs is being actively considered as part of the development of the strategy. The new national disability strategy will represent a paradigm shift in how disability policy is managed across government. There will be robust structures for stakeholder involvement in design and implementation but the strategy is also going to embed supports across government, at national and local level, for the collaborative design and implementation of national disability policy. At a national level, the new strategy will implement structures for co-ordination and co-operation across government under six key themes: inclusive learning and education; employment; independent living; active participation in society; well-being and health; and transport and mobility.

The Opposition motion highlights broader matters relating to income supports and the cost of disability. Supports and services for people with disability are continually reviewed by the Department of Social Protection. The Minister, Deputy Humphreys, has introduced significant changes in this year's budget, which she spoke about in the debate that just concluded. The maximum personal rate of disability payments was increased by €12 per week, with proportionate increases for qualified adults. Over the past four budgets, the personal rate for disability payments has risen by €41 per week. In 2023, almost 223,000 people with disabilities received an income support at a cost of €2.8 billion. This has increased by almost €1.66 billion and almost 61,000 recipients over the past ten years. In 2021, the Minister published a report on the cost of disability in Ireland that detailed the significant additional costs faced by individuals with disabilities over and above those faced by the general population. The programme for Government commits to using this research into the cost of disability to inform the direction of future policy. My Department is continuing to engage with the Department of Social Protection on how this is to be progressed further.

One issue of particular concern is the low employment rate among persons with a disability. This is a key focus of the new national disability strategy, which will build on the comprehensive employment strategy for people with disabilities. The wage subsidy scheme is a key employment support. It incentivises employers to hire people with disabilities by offering employers subsidies ranging from €6.30 per hour to €9.45 per hour according to the number of employees. In September of this year, the Department of Social Protection published a review of the wage subsidy scheme, which makes six key recommendations on how to improve and expand the scheme. In budget 2024, the Minister for Social Protection allocated an additional €3.7 million to implement the recommendations of this review. The revised scheme is expected to be implemented from January 2025.

Deputy Conway Walsh referred to section 38 and 39 organisations and the Government has worked hard to achieve a just outcome for workers in community and voluntary organisations delivering disability services on behalf of the State. An agreement was reached last October at the WRC resulting in funding being provided for an 8% increase in pay for workers in community and voluntary organisations funded under a section 39 agreement. Through a subsequent WRC process the Department has made a further offer of an additional 8.5% for pay for these workers. The combination of these two pay offers would represent a minimum of 16.5% in pay increases over three and a half years. Unfortunately, up to this point the second of those pay agreements has not been accepted by the unions - they have disengaged from the process. However, I remain optimistic that we can succeed in getting an agreement that properly rewards the women and men who work in section 39 and indeed section 56 organisations.

I assure the House that the Minister of State, Deputy Rabbitte, and I remain committed to the improvement of specialist disability services throughout the country. I am very much aware of how important these services are for people with disabilities, for their families and for their wider support network. The Government will continue to develop services and supports for people with disabilities. We will continue to ensure that these are aligned with the principles set out in the UN CRPD. I believe this commitment was demonstrated most recently by our decision last week to accede to the optional protocol.

An Cathaoirleach Gníomhach (Deputy Marc Ó Cathasaigh)

We have five speakers in the next Sinn Féin slot.

Deputy Johnny Mythen

I thank Deputy Pauline Tully for her Trojan work in advocating for better services and conditions for people with disabilities and for bringing the Private Members' motion to the Dáil. One of the Government mantras is "Let's make the country a great place to do business in." However, on reflection it is not a great place to be disabled in. A recent workforce survey found 817 staff vacancies currently exist across children's disability network teams. Here are some facts from my own constituency of Wexford. New Ross has an allocation of 11.05 posts to CDNTs and currently has 6.9 vacant posts. Gorey has an allocation of 12.9 and currently has 6.8 vacant posts. Wexford has an allocation of 17.94 and currently has 6.8 vacant posts. Enniscorthy has an allocation of 20.3 and currently has 19.5 vacant posts.

There are 12 CDNTs in CH 05, catering for approximately 7,000 children. Of these children, around 1,700 are waiting for an initial contact. The assessment of needs processes is taking over two years. This is totally against legal obligations of the State. The evidence is in plain view before the Minister's eyes. Surely, he must see it is time to press the alarm button. How many of the 68 deficits that were identified in disability services have been addressed in the published action plan for 2024 to 2026?

I welcome the ratification of the optional protocol in the UN Convention on the Rights of Persons with Disabilities which is so important for people with disabilities.

Section 39 workers must be given equal pay for equal work. I ask all Deputies to support this important motion.

Deputy Seán Crowe

Over 4,000 children are waiting on a stage 1 assessment for services in the CH 07 area of Tallaght, west Wicklow and north Kildare alone. Those 4,000 children waiting to be seen represents a 33% increase in the last two years in my area. The Taoiseach said today that tackling child disabilities is one of his priorities but parents and their vulnerable children in my area have seen little outward evidence of this concern. Children are being left behind in dire need of disability support services at an early age. Supports like speech and language therapy, which would give them the best chance of accessing education and leading the same lives as their peers, are not available. The pay and numbers policy is austerity by another name, austerity in an era of a €24 billion surplus. It is not only cruel; it is unbelievable and it is wrong. Hundreds of posts have been wiped out with a stroke of a pen when there is no excuse not to be doing all we can to fill these vitally needed posts. That is only one aspect of the shambles that the Government has made of the health service.

I have long campaigned for the better treatment of section 39 workers. The State was happy to outsource the vital work these workers do in our communities but then completely abandoned its responsibilities to these organisations. Is it any wonder that disability support organisations cannot keep staff or provide services when they cannot keep staff on 2009 levels of funding? It is no longer sustainable for section 39 providers to be expected to bail out the State for its inability to provide services when the Government refuses to increase supports and funding despite its boasts of huge budget surpluses. Disability groups in Walkinstown and Tallaght have ongoing difficulties in getting the State to release funds so they can maintain services for the most vulnerable. Those are far from isolated cases.

The Government likes to talk about how well the economy is performing, but for whom? It is not for the people who rely on disability services for some semblance of normality or the parents who have to shell out for private assessments and treatments because the community disability teams are chronically understaffed and need key personnel. Children with special needs should not have to wait for years to get an assessment and then wait years more to get support, but that is the reality facing many families in my constituency.

Deputy Maurice Quinlivan

It is essential for the optional protocol to the UN CRPD to be ratified. As the Minister indicated in his response, the Government agreed to do so on 8 October. While that is welcome, October is in the dying days of this Dáil. Nobody expects it to last until after Christmas. I do not have to tell people here that those who live their lives with a disability need further support, support that the Government does not deliver. We all deal with that; every single day we get people in our constituency offices.

Several times in this Chamber, I have raised the issue of Le Chéile national school in Limerick city. That school has significant needs. It is a school that caters for 186 children in an area the Pobal deprivation index has described as extremely disadvantaged. It is a school where the staff estimate that 72% of the children have an additional need, with 38% of the children having more than one need. The fantastic staff have been pleading for over two years with various Departments for additional resources to support these children but at every turn the door has been closed. This is a school with significant disability and additional needs but it cannot get the genuine supports it needs. The response I got from the Minister two weeks ago referred me back to the HSE. The school has written confirmation from the HSE that it will not fund any of the places or supports it needs. It has been pushed from the Department of Education to the HSE to the Minister's Department. The problem is these kids are not getting access to the services they need. They are sitting there in a brand-new shiny school delivered a number of years ago under the regeneration programme with no supports put in for some of the most complex needs.

In the short time remaining to me I want to mention some of the fantastic disability service providers in Limerick, including Dóchas and Headway, which do incredible work on a shoestring. They should not constantly need to seek support through fundraisers. They should be provided with adequate resources to do their important work.

Deputy Martin Browne

I also commend Deputy Tully on bringing this motion before the House. The need to deliver rights-based services and supports for people has never been more pressing due to the Government announcing €336 million in additional funding for disability services. As €290 million of that was for existing levels of service, this left just €46 million for new development measures and capital developments to be spread thinly across respite, day services, children's services and of course the 11,000 children waiting for an assessment of needs. This is despite the disability capacity review indicating a need for annual investment of €135 million over a decade. That is why our budget would provide €147.6 million to meet requirements.

In my county of Tipperary, Cashel and Clonmel CDNTs have vacancy rates of 59% and 56%, respectively, with therapy hours falling by 40% because staff had not been hired. That is what funding at this level of service gives us when the Government's actions make experienced staff leave. When section 39 staff across the sector still do not enjoy pay parity with section 38 and HSE staff, this must be addressed straightaway. We would do it differently by funding targeted recruitment and retention measures for children's disability services under a community care access fund to speed up access to mental health and disability diagnoses and interventions of €30 million for 2025.

That leads me to the need to ratify the optional protocol. The truth is that the Government has stalled on this today because it cannot deliver for people with disabilities. That is why Josh in Clonmel cannot get to the school he deserves. That is why another boy cannot access the ASD primary placement in Carrick-on-Suir and why schools are seeing funding and staffing delayed or denied. I will be writing to the Minister on all these issues. Now that he has indicated a change of heart on the optional protocol, how will he uphold those rights with such an insignificant approach to the real needs of people with disabilities?

Budget 2025 has confirmed that, sadly, with the Government's approach, nothing will change.

Deputy Chris Andrews

I thank Deputy Tully for bringing forward this Private Members' motion. Enable Ireland Sandymount School provides education for children with very complex needs. Many of the students are wheelchair-bound and need movement breaks. They need these breaks in a specific class, which is out of action because of a serious leak in the roof over one of the rooms. This is having a negative impact on their physical health, mental health and education. The leak also means the library cannot be used by anyone in the school. Repair works need to be done urgently. As usual, children with disabilities have been left at the back of the line. We see phone pouches and bike shelters being prioritised ahead of these children with their priorities. I ask the Minister to undertake to go down to the school in Sandymount and explain why the leak has been putting students out of some classrooms for nearly two years and why they cannot have their stretch breaks to look after their health.

I note the Taoiseach earlier announced extra funding for education across different Departments. Will the Minister give a commitment to ensure Sandymount School will have its roof fixed as a matter of urgency in order that the children will be able to get the breaks they desperately need? Giving that commitment would show them that he cares about children and people with autism.

Deputy Sean Sherlock

I support the Sinn Féin motion. Every week, we discuss important issues such as this one in debates on Private Members' motions. I have lost count of the number of motions of this nature I have spoken to at this stage. That is testament to the need to reform the way we order business in the House in the next Dáil, of which I will not be a part. It becomes a little tiresome when there are these set-piece events. The Opposition introduces Private Members' motions, we speak to the issues of the day, the Government responds and there are short speeches. It is hard not to become a little cynical about the fact that speeches are all fit for a social media clip. This is the new paradigm we are in as politicians. No real business gets done, as such.

I acknowledge the work that has been done and the genuine attempts by the Minister and Minister of State across the floor to improve things. It is easy for us in opposition to say how wrong Ministers are and that they are constantly getting things wrong. If we look at the Minister and Minister of State opposite, by any objective standards their bona fides are genuine in terms of trying to assist and work on the myriad issues regarding disability services in particular.

If I have one critique, it is that I cannot understand why we have not yet cracked the recruitment egg. It seems to me, in my very simplistic analysis of all of this, that if we had all the requisite skills employed and the requisite number of whole-time equivalents employed, whether speech therapists, occupational therapists, audiologists or any other "-ologist" we want to mention, it would go a long way towards ensuring that the lives of the people we represent, our constituents who are the very people who need these services, would be significantly enhanced if they got access to the services they so desperately need. The HSE's children disability staff census and workforce review found that there were 817 staff vacancies. I question the veracity of those figures. I have a filing cabinet full of replies to parliamentary questions from the HSE and I have noticed it bombards me with figures. I question the veracity of the methodologies it uses to assess its own figures. However, let us take it at face value that there are 817 staff vacancies across 93 CDNTs. That represents a 36% vacancy rate. If there is a 36% vacancy rate, it means there is a child or adult at the other end of those waiting lists who is not getting access to a service.

I am not here to criticise but why have we not cracked the vacancy nut, so to speak? Why are we not able to recruit? Why is more energy not deployed by Ministers and the Government to bring people from around the globe back and create the circumstances in which people are willing to come back? While we have to take into account that people want to travel and live life and the circumstances in which they are employed, whether in the Emirates or Australia, why can we not attract people to come back and work in Ireland? Why can we not recruit enough people? I just cannot figure it out.

The HSE is spending millions through recruitment agencies on trying to employ people. Why is that failing? I do not understand it. It is well known that the Minister of State, Deputy Rabbitte, has had a few altercations, if I can use that word, with the HSE on issues related to recruitment, assessments of need and so on. What is it about the HSE and its structures and culture that have been allowed to pervade Irish society in a way that ensures that when there is a programme for Government in place and a clear ministerial direction, the workflow does not work in a way in which the democratic will is recognised and respected? What prevents the vacancies that need to be filled from being filled?

I am being respectful when I say there is ministerial accountability built into the democratic process and so one can only blame the HSE for so long. At some stage, the Minister or Government of the day has a mandate to crack the whip. I fail to understand why we cannot recruit enough staff for the people for whom we all advocate. I see advocacy for the people we represent as a key role for Dáil Deputies. Why can I not get access to services for the people I advocate for when we are told the country is awash money? There is no shortage of money for capital projects and current spending. Why can we not get access to those services?

A small but significant example is the case of St. Killian's Special School. All of the Cork TDs engaged in lobbying recently, through parliamentary questions and with the Minister directly, for services in the school. The HSE very quickly found €40,000 for the provision of therapies in the school. I was absolutely delighted to hear that but the replies to parliamentary questions we received from the HSE stated the matter was a function of the Minister and the HSE had no control over it. However, the HSE, in a contradictory manner, was able to find the money for the school. It was a brilliant result for the school but it has now created exceptions for other schools. I suspect the HSE did not inform the line Minister that it was going to make this allocation. Some of the Cork TDs who were lobbying on behalf of St. Killian's found out about it a bit sooner than others.

It is my understanding that the line Ministers of the day were not informed of the allocation. There is something systemically wrong there because - I speak for Cork - Government and Opposition TDs for Cork generally try to work together. It undermined the process of advocacy. It begs the question of what will happen after December to St. Killian's and other schools and the pilot project that was supposed to be under way. Where stands that pilot project now? I understand St. Killian's was not part of the pilot project. I say all of this because I am hopeful that, given the amount of money available, subject to recruitment and vacancies that arise, services can flow for these children. That is a simple point I am trying to make.

The next few weeks will be spent out on the doors; let us call a spade a spade. Not much is going to happen until a new Government and mandate are in place. I hope any incoming Government would examine the issue of vacancies. Recruitment is the key, whether it is the housing, health or disability sector. Until such time as we have enough people to staff all of the required positions, the very people we are all standing up for here will still be minus the service they so badly need. If some energy could be put into that - it is something I would call for - the Minister would have cross-party support for it.

Deputy Holly Cairns

I thank Sinn Féin for bringing forward the motion. I want to touch on the budget because every year on budget day we go through the same farce again and again. The Government announces a high-level figure for investment in disability services. This year it claimed the figure was €336 million, only for us to find out days later that this money will largely pay for services already being provided and the actual amount allocated to expanding our threadbare supports is far lower. In reality, only €42 million for the expansion of disability services is in this year's budget. That is a €22 million decrease on last year's budget. I would like to hear an explanation from the Government to justify reducing the amount of additional funding.

The disability capacity review published in 2021 quantifies the current and future need for disability support services. One of the key issues highlighted was significant levels of unmet need for disability services and net changes in the size and age profile of the disability service population which will add to unmet need over the coming decade. The review also stated that addressing demographic changes alone would not be sufficient as the current level of unmet need is not sustainable. There is a need to spend between €550 million and €1 billion extra each year to meet the needs of the growing and ageing population between now and 2032.

This funding is needed for residential services, supported housing, adult day programmes, multidisciplinary therapy services, personal assistants and respite. The disability capacity review outlined the situation and it was up to the Government to respond quickly and sufficiently. There have been four separate budgets since the review was published and none has come close to meeting those funding targets. The last budget only allocated an extra €42 million in additional expenditure for investment in disability services. The Social Democrats provided for a total package of €660 million in additional funding for disability, with €127 million to be provided for the expansion of services, ensuring adequate funding for the huge capacity gaps that exist in services.

The disability capacity review was a stark reminder of just how far behind the rest of society disabled people have fallen in terms of basic community and residential services. Instead of ramping up investment as its report recommends, the Government decided to wind it down. The Taoiseach promised that this budget would make disabled people feel seen. Does he genuinely believe that slashing the funding allocation for additional services by that much makes people feel seen?

All the while, nearly 13,500 children are waiting for initial appointments with children's disability network teams, disabled people in Ireland face the highest unemployment rate of disabled people in Europe, poverty rates among disabled people are three times higher than in the general population and the ESRI warned the budget will push more disabled and older people into poverty. Is that what prioritising disability looks like to this Government? I often wonder what exactly is the point of a new Cabinet subcommittee if these are the kinds of ideas that it produces. Political choices are being made at that subcommittee and the Cabinet table about what to spend money on and how much, and that led to disability services becoming threadbare and dysfunctional at a time of record surpluses.

It seems the only thing that disabled people and their families are guaranteed from the State are waiting lists for assessment of need, therapies and school places. Successive Governments have repeatedly failed people with disabilities and this Government is no different. There was an opportunity in the budget for the Government to put its money where its mouth is when it comes to disability and invest in the services and supports to lift people out of poverty and tackle the structural issues at the root of social isolation and unemployment rates. Instead, we have seen another missed opportunity to make a real difference to people's lives. Failing to address the structural barriers results in disabled people being unable to access services, employment, suitable accommodation and education.

The budget failed to address the cost of disability with a weekly cost-of-disability payment, for which the Social Democrats have long advocated, instead providing a one-off payment of €400. Disability is not a one-off; it is consistent and incurs day-to-day costs which add up to between €9,000 and €13,000 a year, not including inflation and the rising cost of living. We know in some instances, the cost is a lot more than that. If this budget truly attempted to tackle poverty rates and the rate of poverty and deprivation among disabled people, it should have addressed the cost of disability with more than a one-off payment.

The next Government needs to create a pathway so that, through a combination of the disability allowance and cost-of-disability payments, people are brought above the poverty line and reach at least the minimum essential standard of living. If Fine Gael, Fianna Fáil and the Green Party will not sufficiently fund disability services at a time of record surpluses, I have no faith that they ever will.

Ireland ratified the UN Convention on the Rights of Persons with Disabilities in 2018. We were the last country in the EU to do so. Six years on, we have not ratified the optional protocol. It is poorly named. Far from being optional, it is a crucial tool for the implementation of the UNCRPD. All states that sign the convention are obliged to take steps to ensure that disabled people can exercise their human rights. When states fail to uphold these rights, the optional protocol is there to allow individuals to hold the state accountable. It empowers people with disabilities to stand up against discriminatory laws and practices by the state, which is why it is so vital to ratify the optional protocol as soon as possible.

One of the Government's excuses for not ratifying the optional protocol in previous years was delays at UN level. Ratification had been expected to follow Ireland's first periodic review under the convention. These delays were not news to me or the Ministers. The disability matters committee received briefings from the Irish Human Rights and Equality Commission, IHREC, in June 2021, which outlined the backlog in the UN and the need for the Government to bring forward its plan for ratification. The Secretary General of the Department of children acknowledged those delays at the time and stated that the Department was very open to ratifying the convention much sooner. The Secretary General outlined that the original timeframe in the UN reporting cycle would be met and ratification would be required by the middle of 2022.

It is now October 2024 and we are still waiting for ratification. How is it that it was only in August 2023 that the Minister sought external legal advice as to what work needed to be done in order for Ireland to be in compliance with the convention? It was only in March of this year that an interdepartmental group was set up.

How is it that only now, with weeks, if not days, left in this Government are we hearing that the protocol-----

Deputy Roderic O'Gorman

Will be ratified.

Deputy Holly Cairns

----- might finally be ratified-----

Deputy Roderic O'Gorman

Yes, that is correct.

Deputy Holly Cairns

-----with days left?

Over the years, we have heard from different experts, including the UN special rapporteur, who have clearly said the optional protocol could be ratified in the morning. Disabled people should not have had to wait this long. They should not have to wait any longer for the ability to vindicate their rights and hold the State accountable for its failures. The Government still has not given us the exact date or an explanation as to why it has been left this late, basically for the next Government to ratify it.

Why are disability services and rights shoved to the bottom of the priority list again and again? It is abundantly clear that despite the rhetoric, the Government as a whole is not interested in actually delivering the services disabled people are entitled to. If the Government put the principles and demands of the UNCRPD at the core of policy, it would lead to greatly improved outcomes for disabled people, their carers and their families. Putting the UNCRPD at the heart of policy is what the Social Democrats pledge to do. This would be achieved by taking a rights-based approach, which recognises the role of disabled persons organisations. We would implement reforms in governance of and accountability for the provision of disability services. We would implement, enact and commence key legislation and strategies to promote and protect the rights, quality of life and independence of disabled people and invest in inclusion to put the disability sector on a sustainable financial footing.

My party is fully committed to improving the lives of people with disabilities. Too often, a lack of funding and lack of services mean that disabled people and their families are forced to seek charity, campaign and fight for their right just to live a dignified life. Disability services or the inadequacy of them is one of the issues I am contacted about practically daily by people across Cork South-West and beyond. Sadly, we do not have a rights-based approach to disability. We have a budget-based model. Services, supports and opportunities are decided based on Government budgets and not human rights.

Deputy Paul Murphy

I thank Sinn Féin for tabling this good motion. I have not been able to be present at this debate until now because I was at an online meeting with a range of campaigners on disability services of various sorts, including parents of children with additional needs, parents of children with scoliosis who are being badly failed by the State and disabled people themselves. What is brewing is a powerful alliance of all these groups. They are not small groups. If we consider the number of people affected, we are talking about hundreds of thousands of people being badly neglected by the State. A potentially powerful alliance is being formed by these groups to demand what they deserve, which is basic services that mean they would not be disabled by society. That is the thing. Political choices are made to disable people and they demand that the necessary provisions be put in place to ensure that stops happening.

These campaigners have won important victories. Things are still very hard. There are incredible waiting lists. More than 100,000 children are waiting for necessary interventions. They are still being utterly failed, but by coming together and campaigning important victories have been won. The scrapping of the Green Paper, which was a horrific, Tory-style proposal, was a victory for disability campaigners and organisations which came together and put enough pressure on the Government to stop it. The fact the Government says that the optional protocol will be ratified is a victory. It is a victory for all those who have been campaigning. I cannot count the number of times there have been protests outside the Dáil asking for the optional protocol to be ratified. It is an important victory.

It would be better if the State protected people's rights in the first place to ensure they are not violated. The optional protocol is just one more tool in the hands of people who have already been let down and failed by the State to pursue their rights. It is good they will have that tool and the existence of that tool will put pressure on the State not to fail people in the way they are failed, but we know that currently, 24 or 25 families per month take the State to court for the State failing to follow its own laws on people's entitlement to assessments of need. If the Government was doing its job, there would be no need for anyone to take the State to court or make an individual complaint under the optional protocol. The fact these last resorts have become so vitally important is in itself an indictment of the Government's total failure to protect the rights of disabled people.

Last Friday, I hosted a public meeting in my constituency around disability services and the lack of access to appropriate school places for children with additional needs. Despite the fact that I nominally hosted it, I could not be there because I had Covid-19. However, I spoke to people who were there. It was a packed public meeting. This is a feature. The Minister of State will be aware that this is one of the few issues on which if a public meeting is put on, big numbers of people will come. It is because of, on the one hand, the sheer number of people - hundreds of thousands - who are affected and on the other, the profound impact it has on people's lives. A common theme that emerged from the meeting was that parents felt the State was effectively trying to wait them out, trying to fob them off again and again until their children turn 18 and age out of education, at which point the State will effectively abandon them completely.

It is striking. I presume it is the case for other TDs. In respect of the individual cases that come to me, the number one issue is homelessness and people facing eviction and so on, but the number two issue is parents of children with additional needs who are facing absolute horror. They have either recently discovered the issue, are trying to get what they need and are suddenly struck with the reality that this is a battle they will have for years, or parents who have been in the situation for years already and are going through various bouts of trying to contact public representatives and trying to make something happen. I cannot count the number of individual cases I have spoken about in the Dáil of people waiting literally for years with nothing happening. I mentioned recently the case of a woman who was first referred to the local CDNT in 2018 and recently got an email saying it hopes to deal with her at the end of 2025. This is common. These are not exceptions. The reality of what is happening is that people are just being fobbed off.

The other aspect - that is the CDNT-HSE aspect - is the inability of people to find an appropriate school place for their children. We should have a special class in every school in the State, but at the moment, fewer than one third of primary schools have autism classes and only 410 of 710 post-primary schools have autism classes. In Dublin 24, there is a peculiar situation. It is around the national average at primary school level, but it collapses at post-primary level. People are coming out of primary school and do not have an appropriate place. As a result, €80 million is spent annually on bussing 20,000 pupils with disabilities out of their localities to special classes and schools. It is unacceptable. It is unworkable for the children and families in every possible way.

These waiting lists and so on are not an accident. They are long by design. It is a Government strategy of penny-pinching and privatisation by stealth, that is, to force people to go private because they cannot bear to wait any longer. Úna Keightley who campaigns on scoliosis made the point at that meeting that people say to her that if they were in her situation, they would go private. The only reason she cannot go private is that it cannot be done with a child with scoliosis, because the ICU care that is necessary after an operation cannot be paid for in this country, the child cannot be taken on a plane and it is difficult to take the child on a boat. That illustrates the point that this is the situation.

Parents of children with additional needs come to me constantly. They have very limited resources and are getting loans from their own parents, credit unions and wherever else they can in order to just get some private therapy. In many cases, they cannot even get access to private therapists despite having the money.

Ultimately, all of this comes down to political choices around resourcing. We have a record €24 billion surplus. Therefore, if we are not providing the resources to have special classes in every school, the appropriate number of therapists and CDNTs across the country and appropriate therapists on school grounds, then it is a political choice. The Minister of State will say that there is a shortage of those people. That is true, but it is a question of planning and showing an intention now by significantly increasing the number of places in colleges and so on.

We support this motion. What it proposes is the bare minimum that any Government that cares about disabled people and their families would do. A genuinely left Government would do much more. In our alternative budget, we outlined costed proposals on significant investment in the additional SNAs, special education teachers and extra clinicians that are needed to clear assessment waiting lists and to ensure that no child was left behind. We outlined how the means test for carer’s allowance could be abolished. The €20 increase in disability payments proposed in this motion would be a start, but it would not be enough to provide disabled people with the decent standard of living that should be theirs as a human right. In a country with a surplus of €24 billion, there is zero justification for anyone to be living in poverty, especially any disabled person or anyone caring for someone with a disability. In our alternative budget, we proposed to introduce a €50-per-week cost-of-disability payment for all those on disability payments on top of increasing all weekly social welfare payments to €300. The Government has its own research that shows that simply being disabled in this country comes with substantial additional costs. Much of this reverts to the privatisation of what should be public health and education services, provided free at the point of use. Disabled people and their families are routinely forced to pay for private therapies and assessments rather than these being provided for free as part of a universal national health service.

An Ceann Comhairle

Next are Deputies Canney and Verona Murphy, who are sharing time.

Deputy Seán Canney

I welcome the opportunity to contribute on this motion. I thank my colleague from the disability matters committee, Deputy Tully, for tabling it.

The Dáil has discussed disability services a great deal over the past five years, but there are still a few elements we have not got right. For example, we have young children who are waiting for assessments to diagnose what is wrong with them. If they have to wait two, three or four years for such assessments, it is wrong. This is the reality of what is happening on the ground, though.

We have refurbished a building in Tuam to house a CDNT 7 facility, but the building alone will not solve the problem. It needs to be staffed properly. This has been an issue for a long time and there does not seem to be any solution in sight. The CDNTs were to be the panacea that saved children’s disability services, but they have not. All they have done is change things around so that parents are now a bit more confused about where they supposedly have to go.

When a child shows signs of something not being right and the parents know it is not right, they try their best to get an assessment to find out what services their child needs. They battle and battle. The Minister of State knows this. She is in my constituency. Many people come to my constituency office in Tuam to find out how they can access services. It is a failure if parents have to come to a politician to try to find out where services for a child with a disability can be found. We cannot explain this other than to say it is totally wrong. There is a lack of services and assessments. Parents might get an email saying their child has been added to a list as if the process of finding a solution has started, but it has not. That is just a box-ticking exercise.

Regarding the protocol that the Cabinet agreed to introduce, I am unsure as to when the accession to it will be complete. I would like to know the details.

The budget is going through, but the cost of living with a disability has not been addressed in any way. A one-off payment is not the answer for a person with a disability. Unfortunately, having a disability is not a one-off, but continuous. We have to view the payment in the cold light of day and ask how we will provide a personalised budget for people with disabilities on top of their disability allowance payments so that they can live independently.

People with disabilities cannot get transport supports. The old supports were stopped 11 or 12 years ago. We have had report after report and review after review, but we still do not have anything to replace them. The state of the primary medical certificate is a damning indictment of the Government. People say that it is the responsibility of the Minister for Finance, but it is not. It is the Government’s responsibility. Shame on the Government that it has not sorted this out. The matter has been under review and the two reports by the Ombudsman over the past ten years have called it disgraceful. It remains a disgrace.

I listened to the debate on child protection. I heard both sides of the House talking. With all due respect to the Government, it was a charade for the sake of political popularity. Children with disabilities need to be protected and we have to realise we are not protecting them as we should in terms of giving them and their parents supports. I was taken aback by the attitude today. That debate was not about protection, but political gain.

Deputy Verona Murphy

One of the simple facts that most people understand is that failure to plan is planning to fail. Deputy Canney spoke about how often we had stood on this floor to debate this issue. In my short political career, I have stood on this floor 60 times to discuss disability issues. It is terrible that I have to tell the Government that matters are getting worse, not better. Despite the fact the Government believes it is pumping money into this area, the situation is going backwards.

The Government set up 93 CDNTs around the country, but there are 817 vacancies. I will cite a letter that was sent to a family – constituents of mine – in New Ross. I will not go through it all, only the pertinent parts. According to it, children’s disability services have undergone significant reform and restructuring nationally with the implementation of the progressing disability services programme and the launching of children’s disability network teams in south-east community healthcare in September 2021. This letter is less than six months old. According to it, the core objective of this change was to ensure that children with complex interdisciplinary needs and their families would receive an appropriate family-centred service, but this transition has been faced with many challenges across south-east community healthcare, including but not limited to recruitment and retention of staff, the implementation of a new model of service, and the delivery of pre-existing waiting lists for services. The letter states that the approved staffing for the New Ross children’s disability network was 9.5 clinical posts and 1.55 administrative-management posts and that, as of now, only 3.7 clinical posts are filled, with 5.8 vacant. It also states that there are 274 children registered and that the vacant clinical posts on the team are across the disciplines of occupational therapy, speech and language therapy, nursing and dietetics.

Now, that is going backwards. As I have said previously, what is the point of having teams that are not fully staffed? We would be better having full teams in the centre of the county and providing the transport to get them there, because this is just the same as CAMHS. It is a non-service. If a child does not receive early intervention, we are stacking up these problems for the future. I have said before that the CDNT is a complete failure. We are four years in since 2021 and things have not improved. They have got worse. Reviews have been done with parents and service users and recommendations have been made, none of which have been implemented. Throwing good money after bad policy does not work but it is certainly a trait of this Government.

I move on from child services to actual adult employment services. It is very disappointing for the section 39 organisations that employ adults under the disability programme. Kilcannon Garden Centre, Enniscorthy, County Wexford, made significant pre-budget representations through a series of political representatives, both in government and outside. It asked that the wage subsidy scheme for community service programmes be increased. It has 17 employees with intellectual disability employed in Kilcannon Garden Centre alone. There have been no provisions made to increase the wage subsidy scheme. This is a garden centre but it also has a restaurant and cafe element to it. All cafes, private and none, are under severe pressure not least because the Government has not reduced the VAT rate. The protest today was by the for-profit sector. This is a section 39. It is a failure to plan when 17 people with intellectual disabilities may soon find themselves out of a job. That is absolutely despicable. The lack of consideration for these people and their families is beyond reproach. When I started and ran for election first, all I heard from the disability sector was that it does not see politicians from one end of the year to the other and for five years in between elections. What do we get the Minister doing last week? The Cabinet agreed to implement the UN protocol for people with disabilities. The Minister of State knows, and I know that this House is full of talk of an election. It is more false hope. Maybe we will not go ahead with an election, and if there is any reason I hope we will not, it is so that the Government will implement the UN protocol. It takes a series of weeks, and I will be reminding it every step of the way if an election is called, that it is all just wolf whistling, or whatever the hell they call it, to garner votes. The Government has had since 2008 to do it. It was ratified by this House in 2018, and the week before a purported election it decides it will implement it. For the 13.5% of people with disabilities, I very much hope this is carried out.

Deputy Michael Healy-Rae

I sincerely thank Deputy Tully and Sinn Féin for bringing this important motion tonight. I thank the Minister of State for being here, but I put on the record that I think it disrespectful to the party and the Deputy who has worked diligently to bring this forward. I mean no disrespect to the Minister of State, and I know there are probably other pressing matters for a senior Minister, but when there is a debate of importance like this the Minister for Health should be here. I really believe that.

Over the past decade, the cost of providing disability services has increased dramatically. However, the funding needed to cover these costs has not kept pace. Several key factors have contributed to these rising costs, such as the lack of planned residential supports, complex needs, insurance costs, unplanned care for children, changing need of older adults, pay restoration and increments. Meeting compliance costs has also become more expensive without necessary funding being provided to cover these costs. New policy initiatives have been introduced without the additional required funding.

Additional factors that have worsened this crisis are the unmet need for respite. On that subject, my brother and I attended a meeting in a special place that is close to my heart called St. Mary of the Angels in Beaufort, County Kerry. That was a farm donated by a family a long time ago. A mother and father were farmers and they had one daughter who was a nun. At the time, they were thinking what they would do with their farm and they donated it. It was called St. Mary of the Angels, and it is a special place. I always call it a centre of excellence. It was a place for young people who had intellectual or physical disabilities. They had every facility. It is located on a farm and there are landscaped walks. It is a beautiful place. Local people from Killorglin, Beaufort and Glencar all work in that excellent facility - a centre of excellence. What are we as politicians doing? In effect, we are closing it down by stealth.

Deputy Anne Rabbitte

I disagree.

Deputy Michael Healy-Rae

We are. People might deny it, but from 2011, policymakers decided to decongregate settings like that.

Deputy Anne Rabbitte

That was two years ago.

Deputy Michael Healy-Rae

We have always said that one shoe does not fit all sizes. I believe there are cases of those who I call special people, whether they have intellectual or physical disabilities. Special people are located there. They take them out of there or put people who should be going in there into what in many instances are what I call small prisons. By that I mean a house is bought, rented or leased by the HSE to put one or two persons into. I have seen this at first hand. There is a big fence put around this small location. The windows are changed, and the place is completely changed inside and it is so wrong, because you are telling that one person they have to stay inside there in that small prison. I do not think it is right. I do not think it is good for them. Now, if they can be, I am all for a person being integrated into the community and being in a place where there are services and assistance so somebody can help them go for a walk, or to mass or bingo or whatever they want to go to. It is great. However, sometimes we have people whose disability, whatever it is, might be too profound. They are not able to integrate and be part of a community. They need to be in a special place. In our example, St. Mary of the Angels is that special place. What has now happened is that it is in effect being closed by stealth and I do not want to see that happen.

Another thing that hit me hard at the meeting we were at recently was a lady of 82 who told us that she had better access to respite 30 years ago for her special person, her child, than she has today. If the Minister of State could take one thing on board from this, it is that it is wrong that an elderly lady like that had better access 30 years ago.

Deputy Danny Healy-Rae

I thank Sinn Féin for this important motion. I want to add a bit to what Michael has said about St. Mary of the Angels. I was amazed to see the Minister of State shake her head when we said this place is being closed down. It is being closed down by stealth. I will ask her one question. If someone applies today to go in there for long-term care, is there a bed for them? There is not.

Deputy Michael Healy-Rae

You are correct.

Deputy Danny Healy-Rae

There is not one extra new person being taken in there for the past eight or nine years.

Deputy Anne Rabbitte

That is not true, there was one-----

Deputy Danny Healy-Rae

There was one, and she knows the battle I had to do. Imagine one for all of Kerry. This is a vital place. It needs to be remodelled or added to. I am sorry. We need to build separate residential units on the campus. There are no respite places in Kerry for elderly parents who may have an elderly son or daughter.

The only place I was offered for that very special person about whom I was concerned when her father died and her mother could not care for her, was in County Meath, up against the Six Counties. Her mother would only see her maybe once a year. That is all she would be able to afford to go to see her. The Minister must deal with that because we need to have respite places for elderly parents. We do not have them in Kerry. That is the gospel truth.

There are other issues such as the disabled person's grant. That is such a good grant operated by Kerry County Council. The Minister of State must recognise how building costs and labour costs have gone up over the past two to three years. Everyone is talking about it. To build a normal house has increased from €250,000 to €450,000. The situation is replicated when someone applies for a level-access shower. I believe our local authority is as good or better than many local authorities. It operates the grant system for disabled people, people who get strokes, people who fall and different things happen to them so that they need a level-access bathroom. We always got a grant of about €6,000 or €6,500 to deal with improving the bathroom in order to make it accessible for people with disabilities. However, €6,500 is no longer enough, given how building costs have gone up. We need to deal with that.

People whose children are diagnosed with autism have an awful problem. It is a heavy cross for a couple to bear. In recent days I met a family with three autistic children. They have different problems. It is taking too long to get assessments. It is important to be seen in time in order that the children can develop to overcome this problem. They are not seen nor dealt with in time. It is taking two or two and a half years. God almighty, imagine the burden and the cost for a family with three children to be able to manage. We are not seeing to those people. Wherever the people are who are supposed to assess them, they are not being assessed.

We also need to look at what is causing autism because I believe this condition is increasing and we need to know what is causing it to increase. I believe there are more children than ever with this problem. More work needs to be done to establish why this problem is increasing so much. We need to look at the root cause of it because this is an awful problem for parents to find out that their young boy or girl is autistic. We need to help these people a lot more than we are.

Deputy Thomas Pringle

I welcome the opportunity to speak on this motion regarding disability services. I thank the Sinn Féin party for tabling it. According to the most recent census, 22% of our population are living with a disability. Despite this, disabled people are too often left behind and not given adequate access to the services they need. I support this motion, particularly its call on the Government to set a date for the ratification of the optional protocol of the United Nations Convention on the Rights of Persons with Disabilities. I support its call for the Government to acknowledge its failure to recognise the additional cost of disability in budget 2025. There is an urgent need for the full ratification of the optional protocol of the UNCRPD. The fact that this and the amendments to the EPSEN Act have been left unaddressed for nearly two decades as an absolute disgrace.

It is one of the clearest indicators of the lack of care and understanding this Government has for disabled people, along with the Government's refusal to acknowledge the true cost of disability. There are significant additional costs faced by disabled people which are currently not met by existing programmes or by social welfare payments. Households with disabilities incur significant extra costs and are most at risk of poverty. A once-off payment does not recognise that the costs linked to disability are not temporary or once off either.

According to Social Justice Ireland, people with a disability are three times more likely to be at risk of poverty and twice as likely to experience deprivation. If we want to make this society more equitable and accessible for people with disabilities then we need to ensure that people are not at a financial disadvantage and that people are being adequately supported by the State. During the budget debate I called for a permanent cost of disability payment of at least €50 a week. I reiterate that call today. I also reiterate my call for purpose-built housing for people with disabilities. It is important that those with disabilities are supported in applying for public housing and that purpose-built housing is available to anyone who needs it. Many people with disabilities do not apply for public housing as they believe that public housing would not be suitable for their needs. Unfortunately, they are right. However, because people do not apply, local authorities do not realise the extent of the need for purpose-built housing and therefore do not provide the funding needed to ensure that those housing units are built. Indeed, many disabled people deal with and work through the HSE and believe the HSE will provide for their needs but it does not. The HSE does not talk to the local authorities about providing housing and that is a real problem. That is why it is vitally important that disabled people themselves and their families make a point of ensuring they are actually on the housing list because they cannot rely on the HSE to do anything for them.

I call on all those in need of purpose-built housing to apply for public housing in order that local authorities can get a better idea of what is needed. I call on the Government to adopt a better and more direct way of assessing the need for purpose-built housing. There should be a fairer, simpler and more accessible way for people to apply for that housing. Many council applications for public housing are long and inaccessible. I urge local authorities to ensure there are no barriers for people applying for any type of public housing by ensuring that the process is accessible, that there are supports and that information is available for those applying.

People should feel they have choice and control when it comes to applying for housing or when it comes to funding that affects them directly. I echo the call of Independent Living Movement Ireland to ensure that disabled people are empowered to make their own choices and to ensure disabled people are in control of the organisations that the State funds to provide disability services. Disabled people have a right to agency and choice in their lives. However, most of the Government's disability funding goes to disability service providers through annual grants instead of directly to the disabled people. As it stands, disabled people have very little control or say in how funding is spent or on the type of supports and services they receive. This needs to change. Disabled persons organisations should be consulted on any changes to funding or services. We need to start moving away from systems that segregate and marginalise disabled people and move towards inclusive policies. We also need to move away from one-off payments that do nothing to address deep-rooted inequality. Income inequality and access to services cannot be resolved through one-off measures. The Government will continue to fail disabled people if it persists with this approach. It is vitally important that we look at the cost of disability and make sure people are not being penalised because they are disabled. At this stage, the State has the extra money to do this. For many years the State could complain that we did not have any funding, that we had not enough money to do it. However, the money is there now. All we need is the will to make it happen.

Deputy Catherine Connolly

Here we go again. Since I was elected in 2016 I do not know how many times I have talked on these budgets and on these motions. Tonight we say we have been talking for a few years. Actually we have been talking for a very long time. The disability capacity review is a good place to start. The Minister of State did one of the introductions on that, along with the senior Minister and the Minister, Deputy O'Gorman. That set out the situation. It set out the unmet need. It set out, damningly so, what happened from 2008 onwards. We talk about the crisis. That crisis created a huge crisis in all the services and they have never recovered. I see the Minister of State is nodding. I know she agrees with that. I have marked a few pages. I have read it and marked it. What is interesting about it is all the reports that went before it. It is important to say that, so when we are critical it is because there is a whole background to people with disabilities fighting on a daily basis for a framework that recognises that services must be given to them as of right, that is, a framework within a rights-based approach.

I welcome the confirmation tonight that the optional protocol will be signed, although there is a gap in relation to when precisely it will be signed. Looking at the disability capacity review in 2012, can you imagine we talked about transforming lives back in 2012? In 2014, there was a value-for-money policy review of disability services and we continued on up to 2022 and 2023, which was an interesting year because there was the Indecon report on the cost of disability, which was never implemented. There was the Joint Committee on Disability Matters, which did great work, as well as some other report within a year between 2022 and 2023. All of them begged us to deal with people with disabilities, which is more than 1 million people, depending on your definition of disability. I recall years ago in Galway we passed the Barcelona Declaration to take away the distinction - good design enables and bad design disables. It was in relation to physical infrastructure in Galway. I had the privilege of tabling that motion. It was to get away from distinctions and having a universally accessible city. It is great in theory - dishing footpaths and so on and making it accessible. We got quarterly reports for about two or three years, which are all gone by the board. When it came to businesses and support for businesses, which I support, when they took over the public space, nobody once considered the Barcelona Declaration or even looked at it to see if we were in compliance with our obligations under it. We are here tonight again with a motion from Sinn Féin, which I thank. I thank its members for the details they have set out. I welcome that the Government will not table a counter-motion. I would like to hear what it is doing now. I am not here to lambaste the Government, although I am highly critical because we seem to learn nothing and we get more and reports. We have just passed a budget with ample opportunity to put the reports into action in a way that would help the economy to thrive but we did not do that. I am standing here again speaking to this motion and asking at what stage will what we say match the reality?

I refer to a letter which I do reluctantly; I have taken the person's name off it. That family is looking for respite for a nine-year-old child. The answer came back from somebody who is a general manager with a doctorate and so on, very impressive, who told them there is no service. The response listed out the service in terms of the disability network team and so on but in respect of respite, there is no break for this family. The HSE wrote to Ability West, which told the HSE it had no respite. We know this because every time I have spoken, I have raised Ability West and the Brothers of Charity. The Brothers of Charity some years ago went to the trouble of outlining the gaps in its services. It pointed out that one of big problems was that there was no capital funding for it to build respite services, in addition to shortages of staff. There was no capital funding for them and no ability to get funding. These services to which we outsource everything rent buildings. They rent from developers in estates so all of the money is short term and short lived. The gaps highlighted in the capacity review and by Indecon are all still there. We are doing our best to tell people, "I know there are billions but I will ask the Minister of State, Deputy Rabbitte". That is what we are left saying. There is no respite for a nine-year-old. That is repeated ad nauseam in the city and county, while millions are wasted on rent. I am over time so I will stop.

Deputy Violet-Anne Wynne

I ask the Minister of State to bear with me as I try to do this very fast. Out of desperation for progress, I commend the decision of acceding to the optional protocol. I commend Clare Leader Forum and the many groups and individuals in County Clare who continue to highlight the necessity of the ratification. However, I am still nervous about the timing and need clarification. I read that the Tánaiste and Minister for Foreign Affairs must sign an instrument to be deposited with Secretary General of the UN and the protocol will enter into force on the 30th day following the date of the deposit. Has the instrument been signed? Has it been deposited? I beg that the Government does not leave it vague or cause any confusion for people with disabilities in that regard. The delay had led to issues for people with disabilities in respect of personal assistance hours. I raised a specific case before the recess and pointed to the fact that this individual has elderly parents, they have health issues and they have a complex family dynamic, which means they absolutely depend on personal assistance hours to assist them. They were approved for two additional hours and suffered social anxiety. They were extremely upset when they were told to spend more time at the day centre to fill the rest of the gaps. That is not appropriate in this case. I pass this case on again to the Minister of State to see what more can be done for this individual. This person was also told they will lose physiotherapy. This is concerning because the person has cerebral palsy. An interim measure has been put in place but there is no certainty about how long that will remain in place. It points to the cliff edge people with disabilities experience when it comes to adult services. We cannot allow this to happen as we know disability does not age out.

In respect of budget 2025, we have been promised 600,000 home support hours but 3 million HSE home care hours were lost last year due to a lack of personnel to administer them. As of 2 August, there are 2,255 whole-time equivalent CDNT positions and 1,437 vacancies. I raise the neurorehabilitation community teams. My CHO had the first team set up. It is significant that it only has a team of 5.6 instead of the minimum recommended 12 whole-time equivalents. It needs the funding. Will the Minister of State look into that?

Minister of State at the Department of Children, Equality, Disability, Integration and Youth (Deputy Anne Rabbitte)

I thank Deputy Tully for tabling this motion this evening. I welcome the advocacy groups in the Gallery. I wish I had half an hour to answer everything but I have ten minutes. I will try to keep to the script but I will answer other pieces to the issue as well. As the Minister of State with responsibility for disability, I am fully committed to the continuous advancement of rights and the alignment of services with the UN Convention on the Rights of Persons with Disabilities, as are my colleagues in government. As the Minister, Deputy O'Gorman, stated, a total of €3.2 billion has been allocated for disability services in budget 2025. Between 2020 and 2025, this Government increased the HSE’s disability services budget from €2 billion to €3.2 billion. This represents a significant increase in funding of €1.2 billion, or 58%, over the five-year period. I cannot work out how anyone can say that more money actually constitutes winding down. This investment underlines the Government’s firm commitment to expanding services to meet the needs of people with disabilities as set out in the capacity review. It also reflects increasing costs in the sector in recent years related to pay and non-pay inflation but also to the changing need of service users. It is amazing that no one talked about reform, sustainability of services or the inflationary pressures service providers are under in their contributions. The capacity review published in 2021 noted that funding in the region of €500 million to €1 billion would be needed in order to address the unmet needs and demographic pressures in the system. However, we know that costs have since increased and our estimates of need have also changed. Therefore, despite the significant increase in funding in recent years, the Government is aware that much more needs to be done.

In relation to 2025, €336 million of additional funding was secured for HSE services. This includes a significant provision of €290 million in existing level of service funding to help address the increased cost of service provision, pay cost pressures and service provider sustainability. In addition to the existing level of service, the Government will provide for the full-year cost of new services in 2024. This includes funding for service areas where we have exceeded our targets in 2024, such as residential places. Approximately 200 residential places will have been put into place in 2024. In a departure from previous years, existing level of service will also include provision for service expansion in line with demographic growth. A further €42 million is allocated for new development measures to build on the service expansion. Never before was demographic change taken into consideration. This time, it is has been. That is part of the switch from one Department to the other.

Planning is going on whereas in the past, there was none.

While I have set out the high-level allocations here, it is important to note that specific service targets will be set out in more detail in the HSE’s national service plan, which is currently being prepared.

In December 2023, alongside the Minister, Deputy O’Gorman, I launched the Action Plan for Disability Services 2024-2026. The action plan represents the first phase of the Government’s response to the capacity review. It set out ambitious targets for progressive expansion of services and sought to drive reform in how those services are planned and delivered. I am happy to report that good progress is being made with notable developments in the areas of day services places, personal assistance hours, home support hours and the funding to expand respite capacity, including the exploration of alternative respite options.

It is also important to say that older persons were paying a higher rate for home support then we were in disability. I have realigned that in this year's budget.

For other measures, progress is slower and more work needs to be done to achieve the ambition set out in the plan. This is particularly the case in areas where recruitment and retention issues are having a significant impact on residential services where housing supply constraints are an impediment to delivery. It is important to say that working with the Minister, Deputy O'Donovan, and through the Cabinet subcommittee on disability, we have secured an additional 33% capacity increase on occupational therapist, OTs, physiotherapists, speech and language therapists, and dieticians on the various programmes this year and next year, as we are bringing on more supply. We are also working with the education and training boards, ETBs, to put in place the assistant therapists.

Over the course of 2025 efforts will focus on enabling actions that can tackle these barriers and allow for further expansion of services. The action plan was always intended to be a living document which would be reviewed and updated in light of progress achieved or challenges arising that need to be addressed. In that context, it is envisaged that a review will take place in 2025, the mid-point of the plan, to inform any changes needed to the current action plan and to begin planning for the next plan for the period from 2027 onwards.

The UNCRPD calls for transition from a diagnosis-led service to a needs-based service where services and programmes for children and adults with disabilities begin at the earliest possible stage and are based on the multidisciplinary assessments of individual's needs and strengths. The progressing disability services, PDS, programme is a needs-led model of service, as opposed to diagnosis led, and a child does not require a diagnosis to access services.

On 21 May 2024, the Government announced a decision to finance an assessment of need, AON, waiting list initiative through the procurement of private assessments for long-waiting families. In the first half of the year, 1,841 AONs have been completed, which is a 28% increase on the same period last year. Funding of €10 million has been allocated in budget 2025 to assist with sustainably addressing the assessment of need backlog. The Government is committed to increasing the CDNT workforce through the implementation of the disability action plan and the roadmap for service improvement from 2023 to 2026. Despite an increasing vacancy rate, the number of whole-time equivalent, WTE, posts in CDNTs is increasing year on year, albeit in a very small way, but it is happening.

It is important to note that the total disabilities workforce is growing year on year. From December 2019 to August 2024, the disabilities workforce in the HSE and section 38 providers expanded from 18,273 whole-time equivalent posts to 21,055 such posts, an increase of 2,782. This represents a 15% increase in less than five years. In addition, many thousands more staff are employed by publicly-funded disability service providers in the community and voluntary sector which are funded under section 39 of the Health Act.

The provision of residential placements is a key priority for me. There are approximately 8,596 HSE-funded residential places as of August 2024. Some €106.6 million in additional funding has been provided to specialist disability residential services in budget 2025. This includes €78 million to meet the incremental cost of 2024 and new developments, and €27.9 million in new funding in respect of 2025.

The HSE is continuing its work under the under-65s programme to develop sustainable supported living solutions, providing greater independence and choice in daily life, as an alternative to nursing homes. As of May 2024, a total of 81 people have transitioned to the community since the start of the under-65s programme. A further 51 individuals are in active planning for potential discharge.

It is also important for me to say to the Deputies hat I have also secured funding which will look at that transition pathway, where Deputy Pringle hit it very well, which is by working with our local authorities and with individuals to ensure that if somebody happens to be in a nursing home, or where he or she needs his or her own independent living space, that person will be supported in independent or supported independent living and we will have that transition pathway. That was one of the items that the Disability Federation of Ireland, DFI, had spoken to me about as a collective umbrella organisation. Working with Sandra Broderick and with CHO 3 in the HSE, I managed to get some funding there for that.

Recognising the vital role of local and community participation and involvement for disabled people, the disability participation and awareness fund has been in place since 2021 and a most recent call for applications to the €3.5 million fund was issued at the end of September. Some 40 projects have been supported in that.

In May, a HSE person-centred planning resource was launched to support people with a disability who avail of adult disability services to make their own choices and decisions while planning for the future. This resources includes information on person-centred planning for adults with a disability, information for the role of families and circle of support and a e-learning module for staff with certification.

In July, I announced €23 million in capital funding for disability projects in 2024 and I have asked the HSE to develop the first ever disability-specific multi-annual capital strategy. I was particularly happy to secure additional capital funding for the disability services budget. A total of €27 million is available for capital spend next year, which is an increase on last year of 17%. This will support infrastructure development across respite, day services, children’s services and deongregation. This will also be open to section 39 organisations. Perhaps the section 39 organisations do not realise that it is there but it will be there and they will be part of the mechanism.

In August, the autism innovation strategy was published. It aims to provide the building blocks for a more inclusive society, where autistic people are understood and have equity of opportunity to participate in cultural, social and economic life and lead meaningful and fulfilled lives as valued members of the community. It will be supported by €2 million, which is available through an autism innovation strategy fund in 2025.

I am also funding two one-stop-shops which I hope will be able to expand. When Deputies talk about proper signposting and where to go, the one-stop-shop is based on the Scottish model and has come to us on recommendations from various organisations. I have taken it on board and we are funding it.

At the end of the day the capacity review looked for €1 billion to be put in. I put in €1.2 billion and I know it is still a long way short.

An Ceann Comhairle

I thank the Minister of State. To conclude, I call Deputy Buckley to speak and he is sharing with Deputies Ó Murchú and Tully.

Deputy Pat Buckley

I first thank Deputy Tully for bringing this motion forward and I am glad the Government is not opposing it. I have listened to the whole debate. The first thing that comes to mind to me is the workforce planning. Without any workforce planning, nothing happens. Even in Sinn Féin's housing strategy, we had 10% of all social housing to be specifically designed for people with disabilities. It is about going forward and doing the right thing.

The Minister of State mentioned section 38 and section 39 organisations where there is a massive disparity. My own daughter is working in a section 39 organisation where there is no problem in recruiting but the section 38 organisations are an absolute disaster. It is as simple as that. Something has to be done about that. We have 11 CDNTs in the Cork-Kerry region and they are struggling. The latest figures are of just over 600 children waiting over six months for an assessment.

Going back to what the Minister of State said about demographics and the demographic of change, I was very interested in that because we all have the constituency dashboard, which I have spoken about so many times inside here. The information is there from every census which has been done. I can go into the smallest little village or largest town in my constituency in Cork East and it will tell you how many people have autism, disabilities, the age cohort and how many there are. The information is there and we just cannot seem to plan for this.

The UNCRPD optional protocol has been and remains a massive bugbear for me. In a previous Dáil, Caoimhghín Ó Caoláin battered that drum over and over again. I fear that the optional protocol will not get passed within the term of this Dáil from the rumours which are spinning around the place outside. We will keep fighting on this side of the House anyway because it is a rights-based issue.

In the short speaking time I have left, what I am very worried about is the strain on the individuals, on their mental health and on the way they are being mistreated.

Families are broken. I can remember meeting many families a number of years ago and it was so bad that they had Alsatian cages in their kitchens so when the son or daughter kicked off they actually put them into the cage for their safety and for the child's safety. This is 2024 and we should never be approaching something like that. I just had to say that because I have seen it and I have listened to the families who have told me. The problem we have here, however, is with the assessment of needs and with how bad the disability services and the respite services are. We had a 22-bed respite service in Midleton that is now down to six beds. We are going backwards.

I had a very short window of opportunity here but I welcome that the Government is not opposing the motion. I thank the Minister of State, Deputy Rabbitte for that.

Deputy Ruairí Ó Murchú

I put it to the Minister of State, Deputy Rabbitte, that we really need to see that one-stop shop. It needs to get beyond words. We know what the huge issues are when we are talking about carers or those with disabilities and their wider families. We need to make sure there is a proper framework around them.

I welcome to the Public Gallery Alexandra Jedrzejewska from All Abilities Action Alliance Louth. I met with Ms Jedrzejewska, Ms Eimear McNally and Mr. Brian Crilly in the last while. We had an over and back on the lack of school places, particularly in secondary schools, for kids with autism. It is a huge issue. Mr. Paul Callan from Louth Disability Cycling was here earlier as Iarnród Éireann was giving him an award. He is doing absolutely spectacular work alongside Kevin O'Brien and others.

My colleagues have spoken about the fact that we need to do right by the disability capacity review and follow up on the action plan for disability. I am talking specifically about autism. We have had the Oireachtas Joint Committee on Autism report and its recommendations. We know the issues in relation to respite, which we have dealt with before. Following on from comments by Deputy Pádraig Mac Lochlainn, I must point out that we had our own Louth respite forum, which became a disability forum. However, it has fallen by the wayside with the HSE. We really need to see it in place.

I must return to the issue I brought up with the Taoiseach, which is spaces for those with autism, particularly in secondary school. The official numbers for County Louth are 75 special classes at primary school level and, while I would need detail on some of these numbers, it is 23 classes at secondary school level. Of the 18 secondary schools across County Louth, only nine have special classes. I have dealt with a number of the teachers and principals across all of the schools and their issue is that they are dealing with the National Council for Special Education, NCSE, and with the Department and the building unit. This is where it falls down. I mentioned the schools earlier. We need to see real action across the board on the school inclusion model.

Deputy Pauline Tully

I welcome everybody in the Public Gallery and the disability activists who have joined us this evening for the two-hour debate. I also thank all colleagues who spoke in favour of this motion. I feel a little bit insulted by Deputy Sean Sherlock's suggestion that some of my colleagues who made short speeches did so only for social media. I would like him to know that every one of them would have liked to have spoken for much longer on this issue if the time had been available. When we have over 30 Deputies in the party, we must try to divide out the time. It is an issue that has been raised in everyone's constituency, so every one of them could have brought up issues. I was disappointed by that comment.

I am conscious that the focus has been on many wide and varied disabilities in tonight's discussion, including on the children's disability network teams, CDNTs, and on children's additional needs. There are blind people, people who are visually impaired, people who are deaf, people who are hard of hearing, people with physical disabilities, people who are wheelchair users, people with an intellectual disability, amputees, people who are autistic, and people who have mental health issues. The need is very wide and varied. In many cases, unfortunately, those needs are not being met.

The motion is comprehensive because it reflects what is in the disability capacity review. It is reflective of the unmet need identified there and addressed in the action plan but unfortunately not funded sufficiently to address all of the actions in that action plan. I want to see that action plan actioned. I want to see those services and supports delivered for people. Disabled people have a right to live independently. They have a right to have the support to live independently in this country. There has been some reference made to residential places. The action plan committed to 900 new residential places. It committed to 500 people being moved out of congregated settings and to 260 of the under-65s being moved out of nursing homes. However, when we look at the budget announcement only 70 new residential places are being planned for the coming year, and there are no specific figures for how many of those will be going to people who are currently in congregated settings or in nursing homes.

Reference was also made to the many disabled adults who are living with aged parents and who are entitled to their own home as well. This is all around planning the accessible houses for people with a physical disability and planning to have the supports in place for the person with an intellectual disability. I come across many people with intellectual disabilities who are on the council housing lists and are often the last to be housed because the supports are not being put in by the HSE. The houses are there and they do not necessarily need any sort of accessibility adaptions made but they do need support to live independently. This is not happening, or it is not happening fast enough, and is not happening in conjunction with the local authority. That needs to be addressed. For people to live independently they need personal assistance hours and they need additional home support hours. A total of 800,000 additional personal assistance hours were committed to in the action plan as well as 110,000 home support hours, but only 20,000 additional personal assistance hours were announced this year and 40,000 additional home hours. Again, more is required to enable people to live independently. I am aware that it is not just about having the house and having the support to live in that house, one also must have the transport, the access to education, and the access to employment. It is an all-round package and it needs to be addressed.

I welcome the announcement by the Government of the intention to ratify the UN Convention on the Rights of Persons with Disabilities optional protocol. It should have been done already. The Oireachtas Joint Committee on Disability Matters has been calling for this since the committee was set up. Indeed, every organisation has been calling for it as well. There was nothing preventing its ratification, especially since the Assisted Decision-Making (Capacity) (Amendment) Act was passed in 2022. I am concerned because we are hearing talk of a general election. I do not know if the process, which has begun, continues whether or not there is an election. I would love to know exactly what the date is for the ratification of the optional protocol.

I must mention the Indecon cost-of-disability report. It confirms there is a significant additional cost associated with disability. The extra cost is a key factor in effectuating poverty among disabled people. The social welfare payment is being increased by €12 but I believe it needs to be increased by more than €12. There needs to be a cost-of-disability payment also to address the large costs faced by disabled people due, in many cases, to the lack of vital supports and services in the community.

Question put and agreed to.

An Ceann Comhairle

That motion is agreed. Congratulations to all involved.

Dáil Éireann debate - Tuesday, 15 Oct 2024

Disability Services: Motion [Private Members]

Dáil Éireann debate -
Tuesday, 15 Oct 2024