I will speak briefly about the human rights standards on which the report is based and then look at the response. Given that the committee has an indication of my remarks, I will curtail them a little.
Human rights standards which underline this type of inquiry range widely. They include the right to health and education but also the right to equality and non-discrimination, the right to an effective remedy and, at a more profound level, the right of every human being to be treated with dignity, humanity and respect. As has been indicated, we made a wide-ranging series of recommendations for the individual stakeholders. In terms of a summary outcome, this involves a reframing of how disability services are planned and delivered to respect human rights, involving Ireland in the ratification without delay of the UN Convention on the Rights of Persons with Disabilities and the need for independence, inspection and monitoring of all residential centres in the State.
At a structural level, the crucial point is that the individual should be seen as the beginning point, the centre of service provision. One should begin with the individual and work out the implications socially - the individual needs and the individual rights - rather than beginning at the top in terms of a macro approach and hoping sufficient money will be channelled downwards to allow for the individual needs. This type of individual centredness is at the heart of the Disability Act 2005, which has not been fully implemented, and the Health Act 2007.
We are conscious of the economic difficulties Ireland faces at present. No one can wave a magic wand in this area but there is a human rights dimension to how a State deals with an economic crisis. There are well-established principles of human rights law that apply at international law level. These involve, essentially and importantly, the principle of non-discrimination which is crucial in dealing with questions affecting disability. We have had some responses but the greatest concern from the commission's point of view is that despite several requests we have not yet received any substantive response from either the Department of Health and Children or the Department of Education and Skills. We have received responses from all the other stakeholders. The Brothers of Charity has undertaken to draw up a detailed action plan on the implementation of the recommendations in the report and has distributed the report to parents and staff and engaged in consultation. It has responded more widely than that but that is a short summary.
The Department of Education and Skills has indicated that it is intended to withdraw the already limited funding for educational services provided to the centre, as disclosed by the Brothers of Charity. Since the report was published less than a year ago, two community homes have closed and there are three vacancies in residential services which have not been filled from the waiting list. There are more concerns in that area.
In the area of multi-disciplinary services the Brothers of Charity is dependent on funding from the Health Service Executive. It appears that far from implementing the recommended increases in such services it is proposed to cut same. The psychiatrist who is employed directly as part of the multi-disciplinary team at the centre retired in 2010. In the meantime it has had a locum in place but no agreement from the HSE in regard to recruiting for that position. I am concerned that the psychiatry services may only be provided on a clinic basis in the future, diminishing further the multi-disciplinary service within the centre. The HSE has responded by stating it is working on a value for money and policy review to be completed this year and is expecting a report that will clarify what constitutes health and personal social services. Linked to this review, the HSE is also engaged in a costing exercise and should then be able to establish average costs for residential respite and day services. No timeline has been indicated as to when this will be completed. It is in discussion with the Department of Health and Children on the development of information and data gathering and has also engaged with HIQA on national quality standards about which I will speak in a moment.
Although the HSE does not specifically refer to funding cuts to the Brothers of Charity, it states that no additional funding was allocated to appoint new therapists to the centre in 2010. A sum of €217,500 new funding was allocated specifically to the centre. A sum of €70,000 was used to move five individuals from the campus to community-based housing and the remainder was allocated for residential services for ten adults. The commission understands that this was used to enhance existing respite services. The HSE has also agreed with the Brothers of Charity that there will be no cut in the level of respite care in 2010. A number of recommendations in the report to the HSE were left unaddressed in the response it gave to us.
HIQA has informed the commission that parts of the Health Act 2007, conferring registration and inspection functions in regard to residential facilities for persons with disabilities on the chief inspector of social services, had not been commenced and that this remains the case to date. We sought further information from HIQA in this regard and on the implementation in practice of the national quality standards.
The parent group is extremely concerned at even being able to keep the minimum of services available in the centre and is engaging with the Brothers of Charity in progressing the recommendations in the report directed at enhancing relationships at local level.
It is the firm view of the commission that the people at the heart of this inquiry must receive the support necessary to protect their dignity and worth. There is a minimum level of rights under which no person should be forced to exist, least of all those who cannot speak for themselves.