Joint Committee on Social Protection, Community and Rural Development and the Islands debate -
Wednesday, 25 Oct 2023

Green Paper on Disability Reform: Department of Social Protection

An Leas-Chathaoirleach

Apologies have been received from An Cathaoirleach, Deputy Naughten.

I remind members participating in the meeting remotely that they are required to do so from within the precincts of Leinster House only.

I remind all those in attendance to make sure their mobile phones are switched off or on silent mode.

I welcome the witnesses from the Department of Social Protection. They are protected by absolute privilege in respect of the presentations they make to the committee. This means they have an absolute defence against any defamation action for anything they say at this meeting. However, they are expected not to abuse this privilege and it is my duty as Chair to ensure this privilege is not abused. Therefore, if their statements are potentially defamatory in respect of an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative they comply with any such direction. Witnesses are reminded of the long-standing parliamentary practice that they should not comment on, criticise or make charges against any person or entity by name or in such a way as to make him or her identifiable, or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity.

Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against any person or entity outside the Houses or an official either by name or in such a way as to make him or her identifiable.

The committee will consider the Green Paper on Disability Reform with officials from the Department of Social Protection. The Department is creating a straw man proposal on the restructuring of long-term disability payments under the Roadmap for Social Inclusion 2020 -2025. The Green Paper proposes a tiered income support system that would replace the flat system. Currently, everyone who qualifies for a disability payment gets the same amount of money. The proposal is to change this and to have three tiers of payments depending on a person's ability to work. The Green Paper includes proposals on reforming the following income supports: disability allowance, invalidity pension, blind pension, partial capacity benefit and domiciliary care allowance. For those watching the discussion who may wish to contribute to the consultation, the Minister has invited submissions from individuals and stakeholder organisations, especially people with disabilities, disabled persons organisations, DPOs, and disabled persons representative organisations to share their views. The closing date for submissions on this consultation is 15 December 2023. The committee is supportive of the reform of these income supports and welcomes the opportunity to discuss the Green Paper today.

I welcome to the meeting Dr. Ronán Hession, assistant secretary, working age and family policy; Dr. Sarah Waters, principal officer, illness disability and carers policy; and Dr. Devesh Singh, chief medical officer.

I invite Mr. Hession to make his opening statement.

Mr. Rónán Hession

I am not yet a “Dr.” but my two colleagues are.

I thank the committee for the opportunity to discuss the Green Paper on Disability Reform: A Public Consultation to Reform Disability Payments in Ireland. I am the assistant secretary general at the Department of Social Protection with responsibility for policy on working age income supports. I am joined by Sarah Waters, principal officer with responsibility for disability policy; and Dr. Devesh Singh, the Department’s chief medical officer.

The Minister for Social Protection published the Green Paper on Disability Reform and launched the associated public consultation on 20 September 2023. The public consultation will run until 15 December. The Green Paper is available in plain English and accessible formats. The aim of the Green Paper is twofold: to better insulate disabled people who cannot work from poverty and deprivation and to encourage a higher level of employment for people with disabilities, which will enhance their participation in society and will, in turn, reduce the risk of poverty and deprivation.

The commitment to examine a reform of long-term disability payments has been set out in several key policy documents: the Roadmap for Social Inclusion 2025-2025, the Pathways to Work Strategy 2021-2025, the Make Work Pay for People With Disabilities report, and the programme for Government. As the Green Paper points out, disabled people in Ireland face a high cost of disability, high poverty risks and low employment rates. The survey on income and living conditions, SILC, shows that the at-risk-of-poverty rates for people with disabilities is 35.2% compared with 5.8% for the wider population. The employment rate for disabled people cited in the Green Paper is 37% compared with 73% for the general working population. For comparison, the EU average is closer to 50%.

The Indecon cost of disability report found that the overall average annual cost of disability in Ireland ranged from €9,482 to €11,734. The report made a number of key recommendations, which helped to inform the approach in the Green Paper, including that the levels of disability payments and allowances should be changed to reflect the different costs of disability by severity and type of disability, the concentration of any additional supports should be targeted to those most in need and who faced the greatest additional costs of disability, and a high priority should be given to facilitating an increase in employment opportunities for individuals with disabilities.

Before I set out the substance of the Green Paper proposals, I wish to explain what we mean by "Green Paper". A Green Paper is a Government proposal on how to improve something or solve a problem. It does not claim to be the best way or the only way. Its real purpose is to encourage thinking and discussion and to prompt suggestions. It is, therefore, a useful tool in a public consultation as it provides focus and ensures everyone is working with the same information. Therefore, the features proposed in this Green Paper should not be taken as definite. They are proposals designed to help interested parties think about what might work and to encourage a focused debate around key design issues to reform disability payments in Ireland.

The first of the Green Paper’s main proposals is the introduction of a three-tiered personal support payment. In effect, this would replace the invalidity pension, disability allowance and blind pension, although it would still be possible to qualify for the payment on a contributory basis or via a means test. Broadly speaking, this mirrors the approach with the State pension, where there are parallel contributory and non-contributory streams. Rather than the current one-size-fits-all approach, under the Green Paper proposals, people with a very low capacity to work would get a higher payment rate. The proposed higher rate is the same as the State pension contributory rate, which will increase to €277.30 from January. People in the lowest tier with a moderate to high capacity to work would receive a payment at the current rate of disability allowance and be provided supports to find training and employment opportunities suited to their needs. People with a more limited capacity to work would be placed in the middle tier and their payments would be halfway between tiers 1 and 3. They would be offered appropriate employment supports and services. I highlight what the Minister has emphasised regarding this tiered payment structure: nobody will see his or her payments reduced and nobody will lose his or her payment, nor will secondary benefits be affected.

The second aspect of the Green Paper is the introduction of new in-work supports. The current system of disregards would be replaced by a working age payment model. This would create a greater link between welfare payments and employment earnings to ensure a person experienced an increase in income where he or she took on additional work, subject to a threshold.

The third aspect of the Green Paper involves addressing inconsistencies and anomalies within the system. The paper proposes standardising the eligibility and age criteria of the new contributory and non-contributory personal support payment. It is also proposed to raise the qualifying age for disability allowance to 18 years to bring it into line with the other disability payments, and to extend the payment of domiciliary care allowance to 18 years of age, with the associated carer’s support grant.

A key consideration when we were preparing the Green Paper was to ensure any proposals were in line with the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD. While every Department must respect the spirit of the UNCRPD, there are two articles of particular focus for our Department, those being Article 27 on work and employment and Article 28 on an adequate standard of living and social protection.

Article 27 of the UNCRPD recognises the rights of disabled people to work on an equal basis to others. The Green Paper seeks to target employment supports in a way that is appropriate to a person’s capacity. Some 26,000 disabled people are working and availing of the Department's income or employment supports. We know that many more would like to pursue their employment ambitions, subject to their capacity to do so. We would like to do more to help them.

Article 28 of the UNCRPD recognises the rights of disabled people to an adequate standard of living and social protection. The tiered payment structure attempts to address this right to an adequate standard of living by ensuring those with the greatest incapacity receive a higher weekly payment, which will help to insulate them from poverty.

Article 4.3 of the UNCRPD commits state parties to consult closely with and actively involve disabled people through their representative organisations in the development and implementation of legislation and policies. The Department has consulted disabled persons' organisations, DPOs, in the planning of the consultation process and we are holding a number of consultation events so that disabled people, DPOs and disability groups can all engage with and give feedback on the proposals. The first of these events was held in Dublin last week.

I wish to address some points that have been raised in the early stages of this consultation and that, in our view, do not accurately represent what is being proposed. First, the Green Paper does not propose cutting people off from their payments. The Minister has been emphatic in stating that nobody will have his or her payment reduced or removed on account of the Green Paper proposals. The Government’s objective is to increase people’s payments or to provide more employment supports for those who can and want to work. The intention is to offer people more, but in a targeted way. We know that, without targeting, we would be spreading limited resources thinly, which the cost of disability report specifically advised against.

Second, comparisons have been drawn between the Green Paper proposals and the previous reforms undertaken in the UK. The UK system involved an approach of functional assessments to establish payment eligibility, with the prospect of people losing their payments. There has been widescale criticism of that model, with several reports pointing out deep failures in the approach taken and its delivery. We are not proposing the UK system. In the Green Paper approach, the assessments will help to inform decisions about payment increases and the targeting of employment supports. Again, I should emphasise the Minister’s clear commitment that nobody would see his or her payment reduced or removed. However, if people feel that tiering is not the right way to target payments and supports, we are genuinely open to alternative and better ways.

I should also address concerns about the assessments. We have already done assessments for 220,000 of our customers. The assessments are not new. We have been doing tiered assessments for partial capacity benefit for more than ten years. The approach is not based on the medical model nor the UK functional model but on an holistic approach, termed the “biopsychosocial model”. My colleague, Dr. Singh, will expand on this point if it is of interest to the joint committee.

Third, I wish to be clear that the Green Paper is not a cost-cutting measure. Based on a conservative estimate, the Green Paper proposals, if introduced, would increase spending by more than €130 million per year.

We would welcome engagement on the Green Paper proposals and we look forward to open discussions. In particular, we are keen to hear ideas about what might work better. As the Minister has pointed out, the easiest thing for her to do would be to ignore reform. These payments have not been reformed in years or even decades. However, the current approach is leading to poorer outcomes for disabled people. We do not wish to cause anxiety or stress for our customers on disability payments by initiating these conversations, but we hope that the end point will be an improved system that works better for them.

An Leas-Chathaoirleach

I thank Mr. Hession. This is the third straw an proposal that has been brought to our committee. I find it a useful way to frame my own thinking as it gives me something to respond to. I thank the Department for that level of engagement.

I will now invite members to contribute. I remind any member participating remotely to use the "raise hand" function in Microsoft Teams and to cancel it when speaking. The first member indicating is Deputy Donnelly.

Deputy Paul Donnelly

I thank the witnesses for their report, which I have read through. I have a couple of quick questions but one thing that has been really bothering me in recent years is the word "customers" creeping in with reference to services that we provide. I find it objectionable. We should be using the word "citizens" instead. The Department is not a business and the service users are not customers of the State; they are citizens of the State who have an entitlement to services. I just wanted to make that point before asking some questions.

Would new entrants or claimants get different payments or what way would that work? Throughout the document there are references to existing claimants but there is no reference to new ones. Will there be any difference for new people applying for any of the payments?

My second question relates to consultation. The Department has only started a consultation process but I have already received a number of emails, as have other Senators and Deputies I am sure, from people who are really concerned. Those concerns are based on the British model and I welcome the fact our guests have said the system will not be based on that model. I am interested to hear what kind of feedback the Department has received from its initial consultations.

Mr. Rónán Hession

On the Deputy's first point about customers and citizens, about 90% of our customers are citizens but about 10% are not. There are many people in the social insurance system, for example, who have entitlements but who are not Irish citizens, including people from the UK, from other European countries and from outside of Europe all together. That is why we use the word "customers". The vocabulary has moved on. Historically, we would have used the term "claimants" but we felt it was not the right word because it implied a certain power dynamic. The term "customer" is used in many areas now. I take the Deputy's point but the word is not meant to imply a commercial relationship but to reflect the fact that the people who come to our offices and with whom we deal are entitled to a good quality service from us and are not coming to us in a supplicating way. We are trying to capture that but it is probably just a failure of modern vocabulary that we do not have a better term. It is important to point out that citizenship is not necessarily aligned with the people we serve.

On the question of new versus existing, the Green Paper says that if its recommendations were to be adopted, new people applying to the system would come in under the new regime and over time there would be a transition of the existing customer base of 220,000 people. The paper says five years but it might take a bit longer than that. The idea would be that it would be on a go forward for new claims basis and then a transition of existing customers over time. Of course, if people wanted to transition sooner than that, we would facilitate that. There is a higher payment rate so that is something we would accommodate.

In terms of the concerns, we have received around 120 submissions so far, a lot of them from individuals. We have done a lot of consultation on this. The consultation we did on the cost of disability report was one of the biggest consultations ever done with disabled people in Ireland. We have done consultations recently on the wage subsidy scheme and the reasonable accommodation fund and what we found is that the organisations tend to come in later because they have to engage with their members and they have to go through a process. The early responses tend to be from individuals.

There are lots of concerns coming through, not just in the submissions but also through letters to the Department and the Minister. One of the things we are trying to achieve in the consultation process is to clarify for people what is involved here. For example, some people have been in touch with the Department thinking this was a budget announcement and that it was coming in now. We are trying to clarify this for people. That is why the Minister has tried to be very clear about people not losing payments or seeing a reduction in their payments. While these are very sensitive issues and very sensitive conversations, we do not want people approaching this from a position of needless anxiety. We want to consult and get people's views. We are doing our best to communicate as clearly as possible that this is for discussion, that we are open to other ideas and that the intention here is not to bring in changes to the detriment of people. We deal with disabled people all of the time and we understand the sensitivity of these issues. We know that people may be coming to this process with frustrations caused by other parts of the State system and that affects how they engage. Often we are not starting a fresh conversation and we understand that. We are doing our best to communicate so that people can engage from a position of giving their ideas and their feedback rather than from a position of anxiety. That is certainly not what we want.

An Leas-Chathaoirleach

Deputy Donnelly, are you happy with that? Have you any further questions?

Deputy Paul Donnelly

That is fine, thanks.

An Leas-Chathaoirleach

In that case I will move to the next member offering, Deputy Ó Cuív.

Deputy Éamon Ó Cuív

I agree with the principle of what we are trying to achieve here. When partial capacity was introduced back in the budget of 2011, the thinking at the time was that it would extend the disability allowance and that we would move forward from where we were. I agree with the basic or big principles, but of course, like everything else, the detail is what really counts at the end of the day. That is what the argument is likely to be about.

Mr. Hession talked about a unitary system encompassing disability, invalidity, the blind pension and so on. We have discussed at this committee previously the differences in the medical qualification criteria for disability and invalidity payments. We would be in favour of making invalidity like disability. If a person has been a blocklayer all of their life and only has a primary education, there is no point in saying they could have got a job as a nuclear scientist. The measure in the context of disability, which is whether a person is capable of doing the work for which he or she has education and training, within reason, is a better measure. Is it intended under the new system to unify it and use one set of criteria? If so, which criteria will be used?

I have read the documentation submitted to the committee but I have not read the whole Green Paper. There are references in some places to the severity of a disability and the cost of disability and then there is talk about the ability to work. Is a person's eligibility for the extra payments proposed to be based around an ability to work or the cost of his or her disability? A person could have a very high-cost disability but still have a good ability to work, for example. Is it based on the severity of the disability? My memory of partial capacity was that the severity of the disability was the primary focus, not the person's ability to work per se. To a certain extent, a person's ability to work depends on what he or she is qualified to do, where he or she can do it from and so on.

My next question relates to something that jumped out at me, as it were, from the paper. Mr. Hession quoted a figure of between €9,482 and €11,734, contained in an Indecon report, as being the cost of disability. If that is the cost of disability that falls on the person with the disability, and I presume that is extra costs above costs incurred by people who do not have a disability, it amounts to between €182 and €225 per week. At the moment the Department is only paying €220 per week, so clearly it is not paying people with a severe disability anything. I presume that in the Indecon report, some of those costs are not directly borne by the person with the disability but would include pay for care assistants and so on.

The paper work we got was not exactly clear on that. I saw some commentary in the media saying that we need to give another €200 a week but some of these, I understood, were not direct costs on the person but costs on the State that need to be provided through supports and so on. I ask the Department officials to clarify this issue because it has a huge bearing on what we are thinking about.

My next issue is something I favour but it must be handled very sensitively. Currently, a person on domiciliary care allowance transfers to a disability allowance as long as the disability is still of such a nature that the person is unlikely to get work. The allowance is transferred when a person is 16 years of age and it is proposed to raise the age to 18 years. This proposal was made many times before and caused a lot of angst. In favour of the proposal, and I am personally in favour of it but we need to handle this very carefully, is giving somebody at 16 years of age that kind of money for themselves. You would not give it to anybody else, disabled or non-disabled. Parents have come to me to say that they did not agree with paying the allowance to the recipient as opposed to the parent at 16 or 17 years of age. The counter argument is that the disability allowance is far in excess money wise of the domiciliary care allowance and, therefore, people have contacted me to ask for us to leave the arrangement as it is because irrespective of who gets the money there will be more money going into the household this way. Has thought been given to how to do that migration and whether there should be a higher level of domiciliary care allowance for the 16 and 17-year-old as part of this transition? I ask because in principle I am in favour of the first but I can see the practical consequences of the second, particularly for low-income families.

Finally, I have long had the belief, both in theory and in practice, from my experience of life, dealing with people and having employed people and so on, about the requirement to be available for and actively seeking work. I think that the requirement to not be working is vital for jobseeker's allowance. However, I have always been of the view regarding actively seeking work that there is a small cohort of people, anybody that you have to force by law to be actively seeking work, you would not employ anyway and most employers would not want them. There is the old saying you can bring the horse to water but you cannot make the horse drink. In terms of people who do not want to work, and there are very few of them, some people for different reasons are incompatible of holding down a job. If the requirement was changed it would stop unnecessary migration. Arising from that, I would be very interested in knowing, and I think we have asked for this before, the number of refusals. I think the Leas-Chathaoirleach asked for the figure specifically, if I remember right. I would like to know the number of refusals in the last three years, year-by-year, of applications for disability allowance on medical grounds only. That data would give us some feel of this migration issue. We have all come across people who run into trouble over the ability to work clause and attending courses, and maybe have a personality issue that makes that difficult. The only way out is to tell them to go and apply for this disability allowance even though they might not have a very significant visible disability in a classical medical sense. It would be useful if this committee had these figures on the refusal of disability allowance, particularly disability allowance, which means the person had not worked before but even for invalidity on medical grounds I ask that because we must look at why there are so many applications being refused, if that is correct that there are a lot of applications being refused. Overall, this would be a step forward. It would be great if people with disability, that inhibits mobility and so on which means more care and more costs, were to get more money. I do agree that it is not quite so simple as to say everybody gets it.

An Leas-Chathaoirleach

A number of questions have been asked and Mr. Hession might want to delegate some to his colleagues.

Mr. Rónán Hession

I noted the questions. I conferred with my colleagues but if I miss anything I ask the Deputy to please let me know. I will speak to the last point initially and Dr. Singh will give a more detailed picture of the medical grounds where people are not successful.

The intention is to unify the definition. As Deputy Ó Cuív will know, and he has mentioned this before, there are different definitions for invalidity and disability. We have not crafted a proposed new definition except to say the following. Let us say a person, for example, is on tier 3 and is considering some form of employment or training. It would involve looking at a wider range of what is available and not merely at his or her previous occupation. So this does have elements of the invalidity pension, which is slightly wider. I think we will probably need to craft something that more reflects how the tiered system works because there are different employment dimensions but it is not intended to mirror the jobseeker conditionality. The tier 3 test is probably closer to what we have for jobseeker's transition for lone parents.

Deputy Éamon Ó Cuív

Which is?

Mr. Rónán Hession

We contact them. The engagement is not purely reactive from our point of view. The options that are given to them are normally arranged. For example, we did a pilot project in the north east recently in partnership with one family, and it was done with NGOS in two other countries, namely, Finland and Greece. We asked what do lone parents need using digital activation. In other words, we loaned tablets and laptops and gave people wraparound supports that ranged from CV preparation, skills training, ways to tackle literacy issues to things like home budgeting and stress management. We do look for some level of engagement. It is not entirely passive from our point of view but it has not got the sort of jobseeker aspect of genuinely seeking work handing over. It is just more engaged and more wrapped around the person.

Deputy Éamon Ó Cuív

If a person for one reason or another does not engage, what then?

Mr. Rónán Hession

The provision is not intended to be a premise for removing someone from payment. It is up to each person but we want to make sure that it goes beyond simply saying we are here if you need us.

Deputy Éamon Ó Cuív

My specific point was there is an interface between jobseeker's allowance and disability allowance which is reaching a point where it will be our mark now as there will be three levels of disability allowance. At the lowest level of disability allowance, tier 3, there is an interface and a no-man's land for those who are not going to pass the test of being disabled yet, on the other hand, to a point are not in a position to engage with employment. At the moment these people are penalised because they are effectively thrown off or their jobseeker's allowance is reduced.

It is important, when we look at disability allowance qualification and so on, that we get this interface right because it is the interface that causes us all the grief. My own personal view is that it is a Victorian proposal that a person must be available for work and actively seeking work, that it is a legal requirement and if a person does not do that then he or she is out of the payment, which is the law. I want this matter teased out because otherwise one gets unnecessary migration and push people towards disability allowance, or applying for it at least, because there is no other way out of their dilemma.

Mr. Rónán Hession

At any sort of point between schemes, there will always be a judgment call about people. There are people who have very complex issues, for example, psychological issues, and they may have addiction issues. We find that there are people who present who do not have just one condition or environmental or societal issues going on for them. Our system is not algorithmic in the sense that we see somebody like that and say that they are not looking for work and, as a result, we are going to reduce their payment. We take account of where the person is at and we do try and give appropriate-----

Deputy Éamon Ó Cuív

The law does not.

Mr. Rónán Hession

The deciding officer has to make an interpretation of the law. We try to do it taking account of where the person is at. If a person has complex needs and for whatever reason does not meet the terms of an illness scheme or a disability scheme, for example, some people are on the supplementary welfare allowance as a result of their being sick and not entitled to benefits. They do not meet the qualification criteria for illness benefit. They also do not meet the qualification for disability allowance, but they need support. The system has to work with where people are at; we cannot just apply hard lines and say that someone does not fit entirely into a particular box. What the tiered approach allows us to do is that when we are talking about employment support for people like that, as I said earlier, we have about 26,000 people who are on either disability payments or other employment supports and who are working and availing of those supports. Some of those supports are underused, such as the reasonable accommodation fund or even the wage subsidy scheme. We would like to do more in that space. We have had success in the Ability programme and also through community employment. Deputy Ó Cuív has a background in the supported employment space. There is scope rather than it being just a binary conversation around employment. There are other ways in which people can train or get experience but the conversation is not starting from a point of assessing baseline eligibility where the ultimate aim is to try to say that someone is just not doing enough as far as we are concerned and that their payment will be affected as a result. That is not the perspective and that has not been the experience with lone parents over the past ten years since that came in. It is a way of making sure there will be assigned people within our teams to work with people who have the capacity to work and who want to work. We are getting good responses.

We had an early engagement process that we rolled out to about 16,000 people between the ages of 18 and 25 who are on disability payments. About 10% want to take that further with us. They want to work with case officers on training, which is a very good result. We are learning as we go with that. Even with lone parents, we are ten years doing it and we are still trying things out. For people with disabilities, we will also have to pilot different approaches. We may have to collaborate with NGOs and other people who have experience in this area. The intention is to build that sort of model for people who might be considered hard to employ or unemployable - it is not a phrase I like to use - who do not meet the thresholds for current disability payments. We deal with those people early and we try to support them and take account of where they are at. They are not a cohort in respect of which people go in with very black and white tests for them. Sometimes it involves working across other State agencies as well. There could be issues with homelessness, addiction, etc.

I might just touch on some of the other questions but if I did not hit the mark on that one Deputy Ó Cuív might let me know. The Deputy makes a very good point. It is one I wrestle with in the context of what the higher tier is measuring. It is kind of using a proxy for things, which is that if we have a higher restriction a person is not definitely but is more likely to have a higher cost of disability and less likely to have capacity to work. Those things combined in policy terms make the case for a higher payment. I accept what the Deputy says, that there can be people who have a very high level of restriction but have a very high capacity to work or perhaps their cost of disability might be lower because their needs are met through other supports. The tiering has kind of used a proxy approach so the language in the Green Paper is really trying to say that when you look across the three tiers, our imperfect judgment is that the people in the top tier are going to have more difficulty supplementing their income from work.

Deputy Éamon Ó Cuív

This is what worries me. It seems very focused. It is great if people with disabilities want to work. I was involved with the partial capacity aspect. I was really enthusiastic about it because it allowed people with the capability, qualifications and whatever else to go and work. I was not saying to them that to really have a bit of comfort in their life they have to go to work because if a person has a disability his or her comfort in life should not be measured on his or her ability to work. Such a person should get enough from the State to live in reasonable comfort without being able to work or choosing to work. Even on the basis of Mr. Hession's figures, the best European example shows that 30% of people in receipt of disability payments work. This means that 70% are not working and have to live off the basic income. It was a concern to me that this is very much a case of whether we can help them work. I want to have everybody work, but I see that as a bonus not as something people have to do if they want comfort. There seems to be a bit of an emphasis on work, work, work.

Mr. Rónán Hession

Just on that-----

Deputy Éamon Ó Cuív

I am talking about facilitating rather than pushing.

Mr. Rónán Hession

If you are on a disability payment, the disability pension is slightly higher. Some 155,000 people are on €220, which is the same as other core social welfare payments. That is really at the point where we are saying, "We are trying to give you a social welfare payment recognising that you cannot work". That is the way the current system operates. The disability allowance is based on restricted capacity that will prevent a person from working for at least a year. To get an invalidity pension a person cannot work for a year and he or she is unlikely to be able to work for another year. We recognise that a person cannot work. This is a social welfare level payment that we can provide from the budget we have. What the Green Paper is saying is that not everyone on that payment has the same capacity to engage in employment and supplement their income. We want to recognise that. The assessment we are doing here is not a wider disability assessment. It is purely for the purposes of trying to assess whether there is a basis on which we can target a higher payment. Among those 220,000 people, there are some who will have significant difficulty in supplementing their basic social welfare payment. Many people are calling for a cost-of-disability payment of the order of €20 to €30 a week. We say the people in the top tier will be getting an extra €45 a week in recognition of the more limited capacity or options in terms of supplementing their basic social welfare payment. For those in the lower tier, in recognition that they have some capacity and we would help them realise that in so far as they can or in so far as they are able. That is really the idea.

The tiering is not intended to be a cost-of-disability payment. What the cost of disability report makes clear – there is a lot of granular detail by condition and severity in the report – is that it is very difficult to make generalised judgments about the cost of disability. It also says that the response to the cost of disability is a mixture of different things. In some cases it is services. In other cases, it is grants or income supports. It is not just income supports. It is not just a question of saying we need to provide a payment of between €9,500 and €11,500 to cover the cost of disability. For example, for many people, the highest cost is that relating to their medicines and therapies.

This is supposed to be a whole-of-government response. The health system has to bring that response. For some people, it is the accessibility of public transport. We have a Department that is responsible for that. However, there is an element that is about income supports. Part of what the Green Paper is trying to do is accept that and say that from our Department's point of view, and to address the element that is relevant to income supports, here is an approach we think is worth discussion. That is really what we are trying to do.

The Deputy asked a specific question about whether those costs were actually borne by the person. The Indecon report, and this is a really good point, does not go on to say, "Yes, but these people have medical cards." In other words, it is a very large survey and it is also an econometric analysis. It does not allow us to say at a granular level that, yes, there are these extra costs, but people have a medical card and, therefore, those costs are met.

Deputy Éamon Ó Cuív

Right

Mr. Rónán Hession

However, that is an important part. In other words, the disability report is also trying to give a sense that the cost of disability is a real thing and it is significant. It is not a marginal cost. However, there are wider inclusions perhaps being involved that probably overstate how far the analysis goes in terms of unmet costs.

On the Deputy's point about 16- to 18-year-olds, this is a really important issue. I know the Deputy has been around this space for a long time and he will know it has been raised before. We did a very detailed consultation under the Make Work Pay for People with Disabilities report where we went to workshops and engaged with disabled people and their families to try to get a view on it. What we found is that approximately half of the people we engaged with who were surveyed thought the age should move from the age of 16 to 18, approximately one quarter said that it should not and one quarter were not sure. There will, therefore, be differences of view. I will say for the purpose of the consultation, and so people can form a view on it before giving us their submissions, that the intention behind it is not cost saving. It is not about saying that because, obviously, disability allowance is a higher payment than domiciliary care allowance, DCA. The issue is that all our other working-age payments are for those aged 18. It is a historical issue really that the payment age of 16 is what we inherited into the Department. It was at 16 years of age and it stayed there. However, it means that a person can be on the payment for two or three years before we can even engage with them if they are still in education. Concerns have been raised with us about 16 being the age at which a person can get €220. Some families will experience problems with that. However, there is a cost differential. The Green Paper states that we acknowledge the cost issue of money going into the household and that there is kind of a transition where people who are aged 15 or 16 will still get the payment or something like that. Again, we can draw that line wherever we like, but it is just a suggestion. The idea would be that for the next few years, we would keep the current system so that people can see the change coming for a few years. It is not going to kick in immediately. Perhaps those who are aged 14 at the moment would face a starting age of 18 for disability allowance or something like that. That is where the line is. We have an open view on that. Primarily, the principle is that we think it would be a better outcome for the people concerned and it would be more coherent as an overall approach to have it starting at the age of 18.

The Deputy mentioned the migration and what we would learn from the refusals data on medical grounds. I will ask Dr. Singh to come in on that in a second. What I would say, and we discussed it with this committee previously, is that our experience has been that when people apply for disability allowance, to bank the date of the claim, which, if they are successful, will be backdated to the date they applied, they apply as soon as they can. However, often in cases where there are refusals, we find that when we go back and say there is not enough evidence for a person's claim, the person will then go back and get additional doctors' reports or whatever is needed. They will then be successful in their claim.

Deputy Éamon Ó Cuív

I am not counting those as refusals until a person has gone through the review and appeal. How many get turned down at the end of the process? Everything else is only interim. The claim is live as long as there is no final decision. What we are looking for is the number of refusals as a final decision. I accept what Mr. Hession is saying. We all know the certification can be an issue. Some people miss the point that it is the ability to work rather than what is wrong with them that is the issue. What we are looking for is data on final refusals.

Mr. Rónán Hession

I will ask my colleague to comment.

Dr. Devesh Singh

I thank the Deputy very much for his question. In terms of medical assessment for disability allowance, what we see annually is approximately 48% to 50% being turned down. The biggest reason for that is lack of material information. We really need a comprehensive set of information, both medical and non-medical, to make a qualitative decision on those applications.

In terms of improving the quality of information we get from customers, we have attempted to revise over the years the structure and content of the application forms. Now, what we have is a composite DA1 application form. That will help to provide us with good quality information at the first part of the claim stage.

In terms of the ones that go for appeal, in a nutshell, more than one third of them are revised by the deciding officers. This is based on the information that comes in. The other two thirds are allowed by appeal officers at the end of the appeal process. We can provide the Deputy with exact data for appeal figures but that is the overall process.

Deputy Éamon Ó Cuív

This is what we are trying to find out. For every 100 applicants - it is a very simple figure - how many final decisions are refusals? It is not interim decisions, in other words, it is not the initial or review decision but when people are allowed to go to appeal, how many final decisions are refusals? If they do not appeal it, do people just accept first time that it is a final decision? What we are trying to get are terminal decisions on each application to give us some sense of how many out of 100 are claiming on medical grounds. That will give us useful information with regard to the issue I raised earlier.

Dr. Devesh Singh

Okay, we will have to come back to the Deputy. We have some data on the appeal process for 2022 but we will have to come back to the Deputy to address the specific question.

Deputy Éamon Ó Cuív

Okay, I thank Dr. Singh very much.

An Cathaoirleach

The next member indicating is Deputy Ó Laoghaire.

Deputy Donnchadh Ó Laoghaire

This is a very useful engagement because it is very useful to tease these issues out. Generally, I very much accept and believe what the Department is stating in terms of the objectives here in ensuring that the low rate of people with disabilities entering into employment is increased by the provision of supports, that no one will see a reduced payment and that the objective is not cost saving. I very much accept the bona fides. However, it is worth acknowledging that there are certain parallels with the British approach. I do not say that as an accusation or as conjecture. I accept that is coming from a different philosophy. Some people have ascribed it to the Tories, but it was actually a UK Labour Party Government that brought it in under James Purnell. The philosophy there was focused on cost saving. I do not believe, or at least I certainly hope, that is not what is intended here. However, one can understand that for people who are expressing concerns, there are certain parallels. There are medical assessments and three tiers. There are those parallels at the very least.

This is my first question. Does Mr. Hession anticipate the numbers claiming in all three categories - I think we are calling them personal support payments - being broadly equivalent to the 250,000 claiming the various payments at the minute? Does he see that being much the same or more or less in terms of overall customers, if that is the phrase we are using? Does he see any significant change or any change at all in that?

Mr. Rónán Hession

We have not projected an increase in the overall number.

There is nothing that we are doing in this Green Paper that would change the group of people who are eligible for the payment, except for the change from 16 years of age to 18 years of age. The primary changes within that group are the payment levels. In a quick exercise, we examined approximately 1,000 cases in the system. When we put them into categories 1, 2 and 3, we found that the Green Paper’s proposals, as currently posited, would incur an additional cost of in or around €130 million. The new approach would have a similar perimeter in terms of definitions. It would then be a question of where people sat in the three tiers, who would get the higher payments and, instead of spreading our employment supports across the entire cohort, how could we direct them at a particular cohort who could work with more support.

The Deputy made a valid point about-----

Deputy Donnchadh Ó Laoghaire

Before we move on, can it be said that, allowing for demographic changes, we will be looking at a broadly comparable number of people in receipt of payments in five years’ time?

Mr. Rónán Hession

That is our expectation, although if the Deputy looks back at the previous five years and as described in the Green Paper, we have seen a significant jump in numbers across all disability schemes, including carer’s payments. Some of that has had to do with demographics, including a larger population more generally. We have conducted a number of analyses of the mix. To give the committee a sense of the situation, there were 140,000 people in receipt of disability allowance in 2018, which is not all that long ago. There are now approximately 161,000. The number of people on invalidity pension has stayed stable, as has the number of people on partial capacity benefit and the blind pension. The number of people on the DCA, which is a payment to parents of children aged under 16 years, has increased significantly. I do not know if my team has a note for the figures going back over a longer period.

A number of factors are behind these increases, including demographics. Approximately half of the increased number of people in receipt of DCA are also on disability allowance. Ten or so years ago, there was a policy change whereby illness benefit was limited to two years, after which people went onto disability allowance. If we were to extrapolate the disability allowance curve under the Green Paper, we expect it would look broadly similar as under today’s rules, albeit with a higher cost.

Deputy Donnchadh Ó Laoghaire

I thank Mr. Hession.

I will not go so far as some members and say I support this, but I will approach it with an open mind. I am listening as much as I can and will be engaging with as many people as possible. Two places where the tyre hits the ground in terms of people’s concerns are assessments and what happens if they do not engage with Intreo and other work supports. I will deal with these concerns one at a time. Who would carry out the assessments prior to categorisation into the three tiers?

Mr. Rónán Hession

Dr. Singh and his team. We have medical assessors in the Department, so it would be done in-house. It would not be outsourced.

Deputy Donnchadh Ó Laoghaire

That sounds like a very significant increase in the number of medical assessments. Currently, there is a gate in and there is no categorisation into what would be tier 3, so I imagine the increased number of assessments would involve considerable recruitment. Is that fair to say? Surely, the capacity to do this does not exist currently.

Mr. Rónán Hession

I will let Dr. Singh speak to that. We will have to increase resources in that regard, but we already perform a large number of assessments. I believe that number in respect of disability payments is more than 50,000 per year and possibly 80,000 or 90,000 across all the schemes.

Dr. Devesh Singh

The Deputy’s question is reasonable because we have to be prepared for this whenever it comes into effect. Currently, we have 32 full-time permanently employed doctors in the medical assessment section. We are covering all 15 disability schemes and delivering approximately 95,000 to 100,000 assessments and opinions. The Green Paper would cover invalidity and blind pensions, for which we have a capacity to conduct more than 45,000 to 50,000 assessments. Currently, we do not engage in categorisation. If we introduce categorisation, it will require extra time, so the Deputy is right to say that we may need to increase our human resource capacity. We can anticipate and prepare for that, and I am confident that we will be able to deliver on that demand when it arises.

Deputy Donnchadh Ó Laoghaire

I thank Dr. Singh. That information is useful.

To give the witnesses the opportunity to nail it down, can they categorically say that medical assessments will not be outsourced?

Mr. Rónán Hession

That is correct.

Deputy Donnchadh Ó Laoghaire

Good. I am pleased to hear that.

My next question follows on from the witnesses’ dialogue with Deputy Ó Cuív and people in tier 3.

Actually, I had one further question on the medical assessment side of things. Would the decision of the medical assessor be binding on the deciding officer or would the deciding officer have some discretion? I ask this question because, although I hate to keep harking back to it, one of the criticisms of the British model is that the tiered system was rigid and did not take into account subtleties and nuances. Deputy Ó Cuív gave the example of someone who had been a blocklayer all his or her life and who now had some sort of physical disability, perhaps affecting his or her back. Intellectually, that person might be capable of other types of work, but for reasons of education, experience and so on, that is not a realistic option. In such situations, a medical assessor might say that the person is perfectly capable of doing clerical work in an office or whatever. Would the deciding officer be in a position to take that on board but, given the context, decide that the person should not realistically be expected to seek work? Would the officer still have that discretion?

Dr. Devesh Singh

Correct. The medical assessment and opinion are advisory. They do not have to be followed in all cases by the deciding officer. Deciding officers have the legislative right to make their own decisions. The medical assessor’s opinion is confined to the medical information. Some of the schemes have qualifying criteria that are non-medical. The deciding officer is in a position to make the call. I know from my own experience that, in general, a medical opinion is given due consideration and regard by the deciding officer, but that is not 100% the case. The deciding officer has discretion to decide otherwise.

Deputy Donnchadh Ó Laoghaire

I thank Dr. Singh.

I will revert to my initial question. Under the Green Paper, people in level 3 "will have to engage with the Intreo Public Employment Service and take up reasonable offers of places in training and employment programmes, and take up employment opportunities that are appropriate to their capacity and circumstances." If we shortened that sentence without changing the meaning, we could say that people would have to take up employment opportunities that were appropriate to their capacity and circumstances. We have to be honest, in that this is a new departure. Currently, people in receipt of disability allowance are not expected to work. That is the case, open and shut. However, it is strongly implied in the Green Paper that there is some jeopardy, however marginal, of someone losing a payment if he or she fails to take up employment opportunities. I understand that Mr. Hession and his colleagues are anxious not to give a headline to The Irish Times or another outlet and that they are being cautious in how they phrase this, but we have to acknowledge that there is some jeopardy for someone who fails to engage. Is that not fair to say? There is the possibility that someone who fails to engage could lose his or her payment.

Mr. Rónán Hession

It is important that I be clear on this. The Minister has been very clear that no one will lose his or her payment or face a reduction. I accept-----

Deputy Donnchadh Ó Laoghaire

To be fair, there is a distinction between the policy as set out tomorrow morning for current claimants, new claimants and so on and the application of the policy. Its application could have implications for somebody who fails to engage. If there is to be an expectation of work, that has to be measured. For the first time, some element of stick is being introduced in respect of people on the disability allowance. Mr. Hession has to acknowledge that it cannot be ruled out that somebody who does not engage or take up an employment opportunity could lose the disability allowance.

Mr. Rónán Hession

I would not accept that. I can see the Deputy is asking the question on the basis of the language in the Green Paper. However, while there is an expectation of engagement, we are not saying a failure to engage will result in the loss of the payment. As with the lone parent payment and the jobseeker’s transition payment for the past ten years, the language in question is used as the basis for more deliberate, proactive, structured, meaningful engagement with people on what is available to them and what they can do. That is the intention rather than saying to people that since they have ignored the options given to them on having been contacted, the next step is an escalation that will affect their payment. To be clear, that is not what we are saying. I can appreciate that people reading the text of the Green Paper cold could have this concern, and that is why the Minister has effectively overridden it with alternative interpretations to make clear that people will not have their payment reduced.

Deputy Donnchadh Ó Laoghaire

Mr. Hession is probably not in a position to address this today as it probably requires further discussion. However, the Department needs to make the position very clear. People are capable of bringing things to their logical conclusions. If there is an obligation, is there a sanction? If there is a sanction, what is that sanction? If there is none, is it the intention of the Department to be coy and make it seem as if there is? If there is none and the Department just intends to sit on people, maybe I can understand that, but the Department needs to make it a little more clear that if there is a sanction, it does not necessarily entail a cutting off but perhaps a series of meetings. That needs to be clarified. People are capable of reading the text such that they might say it sounds like they will be cut off if they do not take up a job. I realise this is not something Mr. Hession can address here and now but the Department needs to put some thought into how it is communicating the logical conclusion of the statement.

Mr. Rónán Hession

I think it is important that I, like the Minister, be unambiguous that the language does not describe a sanctioning regime or negative fallout from a lack of engagement. That is not the intention. We are seeking to get to a point where we can have a conversation about opportunities with those who have the ability to work. Our experience is that people respond to that. It is not a question of going into the room and saying we will have the nice conversation first and that if that does not work we will have to get more serious. That is not the nature of the conversation. It has not been our experience with lone parent cohorts. I am referring to what we will need to do over time. We are not there yet because everything is very much at the initiation of customers themselves. We are very much responsive and we try to make a menu of different options available to people, including training, community employment, the ability programme, employability measures and the workplace experience programme. We can make them aware of all these things.

We have found in our early engagement that when we are more proactive in talking to people about what is available to them and might suit them, and when they become comfortable with that conversation, we get a decent response. Ten percent of those we contact might sound low but having 1,600 people between 18 and 25 who were not previously engaged comprises a really positive start. We are learning as we go. Our experience is that the psychology is possibly the opposite of the psychology the Deputy is suggesting in that sometimes people engage more when it is not the Department that is talking to them. Consider the circumstances if one is dealing with somebody through WALK or Ahead or any such group around the country in respect of employment supports. Even though the Department might be funding it and even though one might be part of a programme sponsored by the Department, the fact that contact is not made by somebody whose communication has a harp on the envelope means people are more likely to engage in some cases. Therefore, the idea of reserving a sanction or escalation is unlikely to be helpful in the conversation.

The intention behind the language of the Green Paper, as part of a wider package of ideas and propositions, is to promote conversation with people with a view to successful outcomes, whatever they might be. A successful outcome might be part-time work, full-time work or a training course. Some people we have contacted through early engagement said they had never heard from the Department in all their time other than in respect of their payments. They said they had never been told about anything and that there had been no interest shown in them by the Department. We are trying to say we will be more visible to people in that category and give them options. An option might not be right for them, or right for them at that time in their lives, but it is a case of continuing to engage with the view to helping them to participate more in society. That is the intention rather than reserving some sanctions. The text should not be read as a precursor to a conversation on sanctions. People have picked up that tone in the document, affecting the tone of their reactions. I am happy to have a chance to speak about this, even though it is a very sensitive issue.

Deputy Donnchadh Ó Laoghaire

More thought needs to be given to that because there is a long distance to travel between the philosophy and high-minded discussion that happens here and the thinking in six or seven years’ time of a Department employee with clear instructions or protocol to be followed regarding somebody in an Intreo office in Wexford or Letterkenny. I am trying to pick out what comes after steps five and six. Necessarily and rightly, the Department employees are given instructions, and some of these come down to a level of precision and clarity. They cannot all come back to the higher philosophy. To some extent, they should but they will have to follow procedures and protocols. Therefore, it is a matter of figuring out where all this will all end up. I will finish on that. I am very grateful to have had the opportunity to engage. I hope I am wiser on account of it and that we will have further engagement.

Deputy Donnchadh Ó Laoghaire took the Chair at 10.49 a.m.

Senator Mark Wall

I, too, welcome our guests. A couple of weeks ago, I was chairing while a Private Members’ Bill was being considered in the Seanad. I believe Mr. Hession was present on the day with the Minister. The Minister was quite clear that nobody would lose their payment. Indeed, Mr. Hession said in the opening statement this morning that the Department does not wish to cause any anxiety or stress among its customers. To take up the point made by the previous two speakers, many feel undervalued at present and it is causing them stress. I am referring to a Green Paper that may or may not affect their disability payments. Taking the bona fides of the Minister will still cause stress among people who feel undervalued. It is very important that we have meetings like this. As I said in the Seanad on the day in question, it is important to have the maximum amount of public consultation. Mr. Hession might tell us again the levels of public consultation and engagement to date. I realise some of the engagements have not happened yet.

I have a couple of questions, the first being on the invalidity pension.

Mr. Hession mentioned in his opening statement that it can either be done on a contributory basis or via a means test. My understanding is that there is no means test for invalidity pension. How and at what level will the means test come in? If somebody is currently on an invalidity pension through their contributions, will they now be assessed by a means test as well? Will it still be on the contributory basis? I need clarification on this because I get queries on this through my office, and I am sure colleagues get the same queries from constituents.

On the disability allowance, Deputy Ó Cuív was quite clear about the assessments or the Intreos as some people call them. I have an issue with this. Who will provide "appropriate employment supports and services"? Who will the Department engage? Will it be outsourced? Deputy Ó Cuív identified a problem with this for those who may not actually be seeking work. When they go to one of those offices, it seems they are put under pressure to take up employment or to go on courses. That is my interpretation of the situation as well as what I have been told. As I said at this committee before, I have had to fill out disability allowance application forms for those people because of the stress they were put under when they went to those meetings. I would like to hear what the Department's plans are for those appropriate employment supports and services.

This is something I have long called for, so I welcome the fact the domiciliary care allowance, DCA, is being extended to 18 years of age. When people on the allowance at age 16 were coming into our offices to fill out the forms for the DA, it was stressful for many families. I take on board what Deputy Ó Cuív said regarding the amount of money, but if the payment of €330 per month is going to continue, that is something most families would accept. It is important to say that most families need the money. The period from 16 years to 18 years can be a difficult one for those who qualify.

Can we confirm that there are 32 full-time doctors working over 15 schemes in the system? This is very useful information for the committee.

Various questions have been asked about the medical assessment. What are the guidelines being considered regarding assessments? Will it be similar to a disability allowance assessment? What will the medical assessment be for a person to be classified as tier 3?

Correct me if I am wrong on this but at present people on disability allowance can earn up to €165 per week without it affecting their allowance. Obviously, that goes up to €375 with a 50% reduction on that. Is there an limit for people on tier 3 or tier 1, whichever one it is, in terms of their ability to earn additional money or will there be a cap, as there currently is for disability allowance?

Mr. Rónán Hession

I thank the Senator. I will address some of the questions. I will ask Dr. Waters to address the consultation point and Dr. Singh to address the medical assessment.

On the question of whether there will be a means test for the replacement for invalidity pension, the short answer is "No". There will be two doors into the new payment. At the moment, the two doors are invalidity pension and disability allowance. Invalidity pension is contribution-based and disability allowance is means-based. Those two doors will stay, but they will have the same sign over them, saying "Personal support payment". It will be a bit like it is for the State pension where people can qualify based on their contributions, with no means test, or alternatively people can get a means tested pension. Those people will not be subjected to a means test.

Regarding the employment services and how we deliver those, at the moment we largely do it through our Intreo service, but we also rely on the EmployAbility Services, which is a specialist disability service. Most likely we will have to expand that and rely on it. We also deliver programmes through dormant accounts funding which we may have to mainstream. Some 27 groups all around the country benefit from that. Some of the delivery might be through some of those groups outside the Department, or in collaboration with them. As I referenced earlier, we have done a project in the north east with the One Family Ireland. It will be a mix of those approaches.

On the DCA and the period between 16 years to 18 years, I had to check a point while the Senator was asking his question so I hope I have not missed it, but he can clarify if I have done so. For the 16 to 18 age group, it is proposed that there will be some sort of transition for people over the next number of years. It might kick in for children who are currently 14 but anyone who is 15, 16 or 17 years of age will continue in the current system. This is something we consulted on before. We received mixed feedback but slightly more leaning towards making the change than not making it. We want to test where people are at on that now.

On the means test for DA, when I spoke here on the straw man on pay-related benefit, I mentioned that we were looking at a working-age payment model. In the Green Paper, we have asked for people's views on whether that would work for people on disability allowance also. At the moment, €165 is the disregard. People are at €495 before they lose their payment in total. What we tend to see is that people work right up to the level of €165, then stop because they do not want to lose their payment and they are also considering their secondary benefits.

We suggested in the Green Paper the possibility of looking at the working-age model, which is similar to working family payment. Working family payment misses two categories, childless couples and single people. Those two categories would effectively be added with an appropriate threshold. To make the sums easy, let us say the threshold is €500 and a person earns €400. They keep 60% of the difference so they keep €60. It means that people, while keeping an eye on the threshold, can vary their work, and they can figure out what it will mean for them in terms of the top up payment. It overcomes some of the issues and some of the clunkiness that exists around elements like disregards and number of days worked, and so on. That is the idea. Even on the straw man discussions for pay-related benefit, the general tone of the response from people was that they thought it might be okay, but they would have to learn a bit more about. I suspect we will get similar feedback in this regard.

Deputy Marc Ó Cathasaigh resumed the Chair at 10.53 a.m.

Dr. Sarah Waters

Before we launched the consultation and the Green Paper, we had engaged with a number of disability organisations and DPO's about the consultation process and how we would make it as accessible as possible. We took a lot of the feedback on board regarding having hybrid events and allowing people whose first language is Irish Sign Language to be able to do video submissions. We have easy-to-read versions, people can do video submissions and, as Mr. Hession, said, we have received some 120 submissions already through the website. However, most organisations will not be submitting anything until closer to the closing date.

Last week we had a consultation event with stakeholders. Some 50 people representing various groups and organisations and DPO's attended in-person and online. We had a number of good discussions and workshops, with one of the workshops online. Feedback from those will be part of our deliberations and consultation.

We have more events planned for November. On 9 November, a large public consultation event will take place in Dublin Castle. Registration is now open and we already have more than 100 people signed up. The event will feature presentations from international experts, from Indecon, which did the cost of disability report, and from the Department. There will also be workshops so that people can discuss the various aspects of the report and what they feel is working and not working.

We are also holding two events. As part of the consultation process, we surveyed people to ask them which regions would suit them best and Athlone and Cork came out on top. Approximately 12 or 13 people are already registered for each of those locations. The Athlone event will be on 23 November and the Cork event will be on 14 November. Again, all the information about those events is on the gov.ie page. We are open to holding more events if people want events to be held in other places. We are also meeting some DPOs that want to have meetings with us throughout November and December.

Dr. Devesh Singh

I will clarify one thing about the medical assessment. I really want this to go out. People who have serious disabilities or medical conditions need not fear. I do not know how to emphasise that we are not trying to catch people out; we are trying to support people to address the cost of living, as in this categorisation, we expect people with more severe conditions to have higher costs. That is what we are trying to do. The medical assessments we do in the Department have evolved with time. We have looked at other models. Many jurisdictions have moved from the old-fashioned traditional medical model that believed disability to be the result of a health condition and that to alleviate the disability the health condition needed to treated and did not have any regard to the psychological, social and environmental barriers. Moving on from that model, the UK and other jurisdictions follow a functional capacity model which is a little more involved. It takes into account a range of actions someone can perform and gives descriptors to the range. The range of actions or activity is divided into five grades and gives them a numerical value. The descriptors are a description of the range a person can do. There are descriptors for all the body faculties and mobility is treated separately. There are numerical values and the medical assessor's job is to explain the action, observe what the person can do and assign a numerical value. It is a little fragmented. It is not a complete picture of the disability as a whole and how that person can function in society. We have moved from that system to a more recent one that derives fundamentally from the International Classification of Functioning, Disability and Health, ICF, from the World Health Organization, WHO. Like we have the international classification of diseases, ICD-10, we have the ICF, which not only looks at the biological condition, but also at the psychological sequelae that can arise from a primary mental health condition. It is often seen as a chronic sequelae of long-term ill-health, chronic pain and so on. It tries to take that into consideration and how that person functions and participates in society.

An Leas-Chathaoirleach

This is what is termed a bio-psycho-social assessment.

Dr. Devesh Singh

Yes, our forms are designed to capture that kind of information from customers. I keep repeating that the more information that is provided to us, the better the quality of the decision making at claim stage, so we do not have to review on appeal. That is the model we follow.

The grading of ill-health and disability is not new. We have been practising it in our partial capacity scheme. We were interested when it was introduced in 2012. I remember how uplifting it was for the medical assessors in the Department to see they can do more when the illness is more severe. They can allow people who have the capacity, interest and ambition to return to work to do so as prior to that, the rule was that those claiming an invalidity pension could not work. That was positive and this follows on from that model. Members may be surprised to see that there are a lot of people with disabilities currently in our scheme who have an ambition and intention to work at whatever level they can. It gives them social inclusion, respect and dignity. We should respect that.

Senator Paul Gavan

I thank our guests for their patience. Most of my questions have been answered at this point, but I will raise one broad point about the Green Paper. My reading of the paper is that one of its core proposals is to introduce this medical assessment for hundreds of thousands of people with disabilities. I take on board the assurances the witnesses and the Minister have given that this will not be used to cut payments. I accept those assurances, but I am concerned that putting this type of classification structure in place, effectively puts an infrastructure in place that could potentially be used by a future Minister to cut payments.

I also have a related question. Can the witnesses tell me what is the additional cost to the Department of the proposal to medically assess and classify people with disabilities?

Mr. Rónán Hession

I will ask Dr. Singh to comment on the cost, but I will comment on future decisions. Whatever comes out of the Green Paper - it may look like the Green Paper or it may be completely different - will have to be legislated for. At that point, any future changes or repurposing of it for something than other assigning payments will have to be legislated for. The matter will come through the Oireachtas at that point.

Dr. Devesh Singh

I thank the Senator for the question. We will see additional costs because, not only will the tiered payments be higher, but we will see an increase in applications, which would be natural behaviour. On the new assessments, the question is whether we have the capacity to conduct the volume of assessments. I accept that we currently may have a shortfall in the number of medical assessors but when this comes in we will be in a position to assess what additional capacity we need and I am confident it can be resourced through our current procurement.

The second query related to the projected assessments for the customers we currently have on disability allowance and invalidity pension. This will not be done immediately. We will assess the new claims and during the subsequent five years - it will be approximately that timeline - we will look retrospectively at the customers who are currently on disability allowance and invalidity pension. We will not have to assess them all. We already have a significant amount of information, especially medical information, about those customers. I can visualise cohorts of people who have serious medical conditions. We captured those codes under ICD-10, which indicates they can go onto tier 1 directly. It will be substantial work but I am confident we can do it within the timeframe.

Senator Paul Gavan

My final question relates to previous conversations the witnesses had with colleagues this morning, specifically with Deputy Ó Laoghaire. Mr. Hession acknowledged the language used in the Green Paper that states people at level 3 will have to engage. Why was that language chosen? It immediately changes the narrative relating to people with disabilities. It is not language I would have chosen. Will Mr. Hession comment on that please?

Mr. Rónán Hession

I thank the Senator. As a discussion document, the Green Paper is trying to put a new proposition for people to react to. In trying to distinguish what are the different levels of employment engagement between the three different tiers, it is trying to make the point that there is a nuanced difference between levels 2 and 3 and to get across that the level of engagement will be more proactive. There will be a higher expectation that it will lead somewhere other than someone's exclusion from work. It is trying to get that point across. I accept the point that the wording has created concern that it has a jobseeking ring to it but that is not the intention. It is really just trying to create a distinction in the context of a discussion document.

I will refer to the questions that sit behind the Green Paper. The cost of disability report states that whatever one does, one should not take a limited budget and spread it thinly. Therefore, the questions, even before one gets to the tiering, are what would be the best way to figure out how to target the money, what is the best way, from the limited resources available for employment supports, of targeting those and what would one look to say in those conversations. For tier 3, we will be saying that we have the full suite of supports here, we will contact the customer, take account of where they are at with their condition, experience, education, skills, etc., and that our expectation is that we will be able to have a constructive conversation that will lead somewhere, as opposed to engaging purely in information-sharing and it is for the customer then to decide if they want to initiate. It is trying to get that across.

It has been helpful to have this back and forth today to see how the language leads people to see that as a marker for escalation or something. It has been helpful for us to get that feedback and we accept that.

Senator Róisín Garvey

I thank the departmental officials for coming in. Overall, what I find when working with people with disabilities and engaging with them in the process of applying for disability payments is that it is tedious. The language is appalling. That might be part of the reason the Department turns down between 48% and 50% of applications. It is a convoluted process and the most capable people I know have had their applications for a disability payment turned down for one reason or another. We need to look at that from the get-go. If half of the applications are failing, it is not because half of the applicants do not deserve a payment. There is something else going on because many of them appeal and eventually get a payment through the appeals process. I will not even mention the appeals system because we would need an hour or two to get into how insulting, appalling, degrading and undermining it is for many people.

I was thinking about this issue. I know someone who is paraplegic and only has the use of their head but works full time. I know another person who has chronic back pain but can walk, cycle and move and still cannot work full time. Taking those two extreme cases, it is difficult to see how this tiered system will be able to categorise every disability into three boxes because we all know that when we try to put people into boxes the boxes do not work. I am concerned about how that system will work if we try to shove all disabilities into three different categories. This is not only about physical disabilities. There are mental disabilities, motivation and many other aspects as well. That will be a challenge.

People who apply for a disability payment must have medical records and a medical assessment. They usually have a GP report and often they will have a medical report from a consultant or specialist. I do not understand the reason for duplication and doing all that again, as the Department is saying, with 30 doctors. That seems to be a waste of money on duplication. Who is right then? I have had cases where people with disabilities applying for a payment have had consultants, who are the experts, state that the applicant has a long-term illness and will never work again but under the current system for disability, they are challenged and the applicants have to wait months to be accepted on appeal. We are now to have a three-tier model of assessments. How will the Department address that?

My concerns are based on my experience of engaging with citizens who have come to me highly stressed. The last thing people with a disability want to do is fight their individual cause. Not everybody's job is to fight the system to get the money they deserve. I am very curious about this.

I also want to know how much of this is already decided. The Department will engage in consultations. I note two will be held in Dublin, one in Athlone and one in Cork. They should be extended further because many people with disabilities struggle to travel and they can advocate best for themselves. I would not be waiting for the Department to invite people. I would like the Department to do more consultations and reach out further. Donegal, for example, is a long way from Dublin, Athlone and Cork, as is Clare. There are two wheelchair spaces on each train. If the Department wants to get this right, it must reach out to people with disabilities, engage with them closer to home and listen to what they say.

I would love to know what feedback the Department has had from disability groups and organisations. I saw a petition but people start petitions all the time so I will not even quote it. There were concerns around human rights and the UN convention on human rights and a call for people with disabilities to be recognised instead of having to be categorised in three boxes. That is the main issue.

I do not question the Department's' motivation. I am just not sure what will be achieved by this, other than an increase in costs of €130 million and a more convoluted system. It is interesting that between 48% and 50% of applications are being turned down. There is already something wrong with the system, without trying to create a three-tier system. I feel bad for people who have had to fight and have had consultant's reports turned down. Now they will have to prove they belong in one of three boxes.

Those are my main concerns. I referred to duplication and whether the Department will override a consultant who is a specialist in whatever field the person has a disability. I am curious as to how this will work.

Mr. Rónán Hession

I thank the Senator. I will cover a couple of points and then ask Dr. Waters to cover the consultation point and Dr. Singh to address medical assessment and the question around duplication.

In terms of how much is decided, the short answer is "Nothing". We have no Government decision to implement any policy. What we have here is a straw man or Green Paper, which gives one version of what a future system might look like. As the Chair noted, what we found was that this is a good way of giving people some focus. If we ask people what the system should look like, it is difficult for them and they will ask where they should begin as they have never designed a disability system. With this, we have a version that we think is worth looking at. It has pros and cons but at least now, by addition and subtraction, people can start to say that what they want is something completely different but they needed to see this in order to realise what they do not want. That is the intention.

We have a consultation period until the middle of December. We will extend that if that is what people want. Based on the feedback received, the Government will then have to consider where it goes next. Nothing is decided.

On the application process and half of the applications failing, one of the issues we touched on earlier is that in the current system people often submit applications that are incomplete. Once an application is submitted, that becomes the claim date, if the applicant is successful, to which payments are backdated. We need to think about how that process works, whether we are incentivising people to apply too early and before they are ready and to do that in a way that ensures they can get all their information together. What often happens is we get back to applicants saying we do not have enough information to make a decision.

Senator Róisín Garvey

I have had very capable people trying to apply. The process is complex and unclear. For example, I have had cases where people who have provided GP and consultant's reports had their applications turned down. There is something more than them not giving the correct information or applying too soon because very capable people I know of have applied and read all the criteria. The Department needs to look at the language it is using. For example, we had a case - I will not give the details - which took eight or nine months before it was finally won. By the time the applicant got the payment, he was experiencing huge mental health issues as a result of the delay.

He was an 18-year-old young man. When the letter came to say that it had been resolved and that he was going to get it, neither his mother or I could understand the letter. Maybe look at the language, whether is way too much information, and say do not apply to us until one has a GP or consultant's report, or something more than that. It is not just that people are applying too soon and they do not have enough information. A lot of people are very capable and understand they have to prove that they cannot work. There is something else going on there, and it is not just that they are applying too soon. I am asking the Department to look at it, that is all.

Mr. Rónán Hession

We are happy to do that. I know that we have shortened a number of our forms. We work with the National Adult Literacy Agency, NALA and other groups but obviously we have more to do there. We are happy to take that feedback.

The final thing I will say on the UNCRPD before I hand over to my colleagues is that the convention is very important across government. As I mentioned in my opening statement, there are three main articles that are specifically relevant, though the totality is relevant. Article 4 (3) is around consulting and engaging with disabled persons organisations, DPOs in particular and not just representative groups. There is Article 27, which is around adequate standards of living, and the increased payment rates under this will go some way towards delivering on that. Then there is Article 28, which is around inclusion and outcomes in employment. Some of what we are saying around the supports that have expanded and been made available are to deal with that.

On what the point of the whole thing is, as civil servants we do not comment on the merits of Government policy but the benchmark and starting point is that the cost of disability is too high. The poverty risk is too high and employment participation is too low by international standards. If we got to a place where the poverty rates were alleviated, there was better employment participation and the costs of disability are mitigated to some extent, they will be indicators that we are going in the right direction policy-wise. I might ask Dr. Waters and Dr. Singh to pick up on the other points.

Dr. Sarah Waters

I thank the Senator. I am well aware of how far away Donegal is because that is where I am from. She is right. In an ideal world, we would be able to get out to all counties but we have a very small team. This is the totality of the team dealing with this. What we did was to try and gauge where best to put the resources. As I said, we had a survey asking people what locations they would like and be able to come to. We had Sligo in there, Limerick, Kilkenny and Galway. There is also Athlone because people from Galway can reasonably get to Athlone, and Cork can take in Limerick and Kerry. I am aware there is nothing north of Galway but even at that, we have 12 or 13 people for both of those locations already. There is not a huge uptake on this, and probably less than we had thought. There is still a couple of weeks so that could increase. We have sent those invitations and all the details about the various events to more than100 disability groups and DPOs. They are aware of it, and we have asked them to please share this with their members. We really want to get as many people as possible to attend these events and give us their feedback.

We cannot really just decide that we are going to go to Letterkenny and then have nobody turn up. If there are specific places and the Senator thinks there could be a group of people who would really want to engage with us, then absolutely, we will do it but, unfortunately, we cannot get around everywhere.

Senator Róisín Garvey

I was not suggesting that the Department goes to every county. I am being anti-Dublin in saying, "There are two in Dublin. It is not fair".

Dr. Devesh Singh

I thank the Senator. I take her point about the medical assessments. First, refusal for long-term disability payments of 45% to 50% across European jurisdictions is not very unusual. I have seen it in a lot of the literature and it does not make us out of place compared to other European jurisdictions. However, I take the Senator's point strongly in that the process needs to meet people's needs at a time they are most in need of it, rather than have it drag on for months. We have looked at reasons that happens. We have tried to improve what we can from our side by improving application forms and communication. I still remember the intensive 22 recommendations regarding the domiciliary care allowance, which the Minister at the time commissioned in 2012. It was very good work.

There is also some sort of behaviour that I cannot explain. When I look at application forms at claim stage, and when I look at them at appeal trying to learn, for my own knowledge, what the reasons were for them being found ineligible at appeal, I find that there were reports, investigations, results, computed tomography, CT and magnetic resonance imaging, MRI scans dated prior to the claim assessment stage. I wonder why it was not given to us at claim stage. I do not want to be quoted on this but there is some belief out there that maybe people should hold things back until they get to appeal, and that is where they will get the best bang for one's buck, or something to that effect. There are a number of reasons. I take the Senator's points, we will look at these and see if there is anything more we can do with regard to the work of the Green Paper reforms.

Senator Róisín Garvey

Just because Ireland is not an outlier for Europe, that means all of Europe could be dealing with disability badly as well. That is highly likely too. It should be good to ask specific questions as to whether a person has any tests or CT scans done and to make sure to include them. I have looked at the application form and it is not that clear. We often get caught up in convoluted terminology and language and like I said, when that poor woman finally got it for her 18-year-old, neither me or her were sure what the hell the letter was saying. I was like, "I think you have got it, I am not sure". We get caught up in a lot of convoluted terms. It is something we should take back because people do not have time to be looking up the thesaurus to try and figure out if they got a disability allowance or not.

Dr. Singh did not answer my question on the duplication of medical stuff, so that it is kind of important.

Dr. Devesh Singh

It is an interesting question. Do we need to duplicate reports? We do not. We have to look at it again because I think we have on our application forms information to state that if one has any investigation results or specialist reports available, please submit them. That information is quite useful for us.

Another point is that we do not refute diagnoses or statements from specialists. Their job is to treat people and they specialise in that. Our role is to look at the outcome of that medical condition and to assess capacity for work. One can say there may be a difference in speciality, what we are looking at or on opinion, but we are not contradicting specialist reports.

An Leas-Chathaoirleach

For my own part, I will put a few questions. I think a lot of the ground has been covered already so I will try not to duplicate questions. For Dr. Waters, I might put a couple of specific questions first that I have received from AsIAm, particularly on the consultation process. A lot of these will be straightforward to answer, and it might put people's minds at rest with regard to engaging with the consultation process. I will read the questions I have here verbatim.

How does the Department handle personal or sensitive information disclosed by people who participate in the process? Would it be in compliance with GDPR? What data will be captured by the Department or external parties on individual submissions during the review process? Would any data that potentially identifies people be either made public or shared with people who are processing their claims, or external parties who are not directly involved in a public consultation process? Would anyone's payment be affected if they chose to send a submission or participate in the consultation process? I think the witnesses will be able to give us fairly straightforward answers but they are important.

Dr. Sarah Waters

Absolutely. We have done two recent consultations on the wage subsidy scheme and the reasonable accommodation fund. We have had submissions in from individuals. We would never, ever share any of that information anywhere else within the Department. In fact, the personal information that people have in their submissions - if they do, and they probably should not - that does not have any bearing on us. What we want, what we will be looking at and analysing are the points they have made, if they have answered the questions that are specifically within the Green Paper or if they have made a submission that is a little bit more general.

We will look at what are the parts of the system that they think are and are not working and what changes they would like to be made. If we go with a consultation report it will all be anonymous. Generally what we do, especially for disabled persons organisations and disability groups, is have a list of who has engaged with us but when it comes to individuals their personal details will never be included.

An Leas-Chathaoirleach

Essentially the Department would encourage people to make submissions if they have something to say and their data will be safeguarded.

Dr. Sarah Waters

Absolutely, yes.

An Leas-Chathaoirleach

And it will have no implication for their own claims.

Dr. Sarah Waters

Definitely not.

An Leas-Chathaoirleach

It is important for this to be stated as simply and succinctly as possible.

I have another question on the employment and education statistics we are using. Are we confident that we are comparing like with like? When we set ourselves in an OECD context I want to make sure we are speaking about the same thing.

Mr. Rónán Hession

It is not quite apples and oranges but it is Golden Delicious versus Granny Smith. There is enough comparability for it to be meaningful but there are asterisks. For example, in other jurisdictions the definition of disability can be quite different, for example in terms of age cohort or medical conditionality. There are some people in other jurisdictions, for example in the UK, who would pass the disability test here and be jobseekers in Ireland. What this means is the disability number might be higher but the number of disabled people working would be proportionately higher because the threshold is different.

An Leas-Chathaoirleach

The education statistics about people not completing third level education jumped out at me because I immediately wondered whether we have more people entering in the first place. I was wondering whether we were comparing like with like, particularly on this.

Mr. Rónán Hession

The Leas-Chathaoirleach is right to be cautious about the comparability. There is also the extent to which the statistics capture information. A person might not be on disability allowance because they failed a means test. This does not mean they do not have a disability. There could be other issues. For example, the most recent results from the census state 1.1 million people have a long-lasting condition which has lasted for longer than a year. This returned a much higher figure than the previous definition of disability, which was closer to 630,000 people. There is a demographic effect but there is also the definition-----

An Leas-Chathaoirleach

The question changed from what it was in 2016.

Mr. Rónán Hession

Yes. The question is different in various countries. Even allowing for these variations the average gives us a sense. The difference is worth paying attention to but not to the extent that we let ourselves off the hook and say we do not have a problem.

An Leas-Chathaoirleach

Essentially what Mr. Hession is saying is that the statistics are useful but a caveat should be applied.

Mr. Rónán Hession

There is an old saying about statistics that we should not use them in the way that a drunk uses a lamppost, which is for support rather than illumination. We are using them as a way to try to help us understand the problem rather than relying on them for support.

An Leas-Chathaoirleach

Mr. Hession is giving me flashbacks to my secondary school debating days when I used this precise analogy. It is that old.

I agree with Deputy Donnelly on the word "customer". Something about it does not sit right with me. I do not have a better alternative suggestion but there is something about it that grates. Deputy Ó Laoghaire pointed to the critical paragraph which mentions people being required to engage and offers of employment being appropriate to their capacity and circumstances. There is subjectivity in this. We can say the current Minister has been very strong in stating what she wants but that is this the current Minister in this economy. We are worried about a future Minister in a different economy when things could be more rigorously applied should the State finances be in more straitened circumstances. We want to clearly delineate that what we want to speak about is the opportunity to work and not the obligation to work. The reason we want to create this opportunity for work is about personal betterment but it is also an antipoverty measure. In terms of the impact on poverty, is it too early in the day to run simulating welfare, income tax childcare and health policies, SWITCH, modelling on this? Has SWITCH modelling been applied to see what the Department could expect the antipoverty impacts to be if we went with something akin to this straw man approach?

Mr. Rónán Hession

We have not done SWITCH analysis on this but we will have to do so when we get to the point of making proposals to the Government. We have not run it yet.

An Leas-Chathaoirleach

Has the Department done any preliminary work? It is plain that there will be an antipoverty effect. Has the Department done any analysis to quantify this in any way? Is it holding to get past the straw man process?

Mr. Rónán Hession

We have not done this analysis yet.

An Leas-Chathaoirleach

The other issue that jumped out at me is that it seems we are looking behind the curtain a little bit regarding what the working age payment will look like and what the Department's thinking is. We are looking to fold it into a more generalised working age payment, if I understand the Green Paper correctly. The working age payment will look something akin to the working family payment. Am I right in this assessment? I know the Department is doing work on the working age payment.

Mr. Rónán Hession

In the order of priority it is probably behind pay-related benefit in terms of the next phase of work. It will be the working family payment with two new categories for childless couples and single people. This is the idea that would be used to model it so that there would be a percentage difference to earnings. There are a couple of other tricky elements in there. At present people on the working family payment stay on the rate for a year unless they ask for it to be changed. A part-time worker's hours might go up and down all the time. We get a snapshot at a point in time. Unless people tell us their situation has changed we assume it stays that way. This is to the benefit of the customer - or recipient or whatever word we want to use - in the sense that if it turns out they do more hours we do not reduce the working family payment. If they do fewer hours and tell us then we will increase the working family payment. We can do this. For the working age payment to work it would need to be more real-time. We have much better information now but we must consider how real-time it would be. For pay-related benefit we will look back couple of months. We know we can do this from the pandemic unemployment payment. There are some complex scenarios, for example people who combine employment and self-employment.

An Leas-Chathaoirleach

I was going to raise the issue of self-employment. Even in terms of this proposed payment I do not see how self-employment and entrepreneurship among people with disabilities will be catered for. Similar to the working age payment we do need a real-time aspect. We need Revenue to speak to the Department of Social Protection. In the case of self-employment it would be year's end before people can report.

Mr. Rónán Hession

What we have tended to do with self-employment is look back at the previous year for which people have records. If people have work on hand, contracts and other useful information we can use this. The trickiest of all is someone in employment who is also self-employed. For example, a teacher may also give guitar lessons. Somebody might work in a warehouse and deliver food in the evenings. Where there is a mix of both it is tricky.

There are many supports. Disability allowance can be combined with some self-employment. We have the back to work enterprise allowance and the reasonable accommodation fund is available for self-employment. We do have supports. The Leas-Chathaoirleach mentioned AsIAm. This is one of the questions that AsIAm has raised with us. I should have mentioned that when we speak to people about employment opportunities self-employment is another option for people who are interested in it. We are engaging with groups and we will meet AsIAm in a couple of weeks time.

An Leas-Chathaoirleach

I would like to see flexibility and responsiveness fleshed out in a little bit more detail.

Mr. Hession and I mentioned AsIAm. The issue of autistic burnout means that people who are engaged in employment, and are due to work a certain number of hours this week, might not be up to facing that many hours next week. We do not want a situation to arise where people do not get the payments they need in a timely fashion. I would like to see this developed. How responsive and flexible could this payment be? I will not dwell on that point because I am conscious of time.

Mr. Hession mentioned that the Department ran the rule over 1,000 preliminary cases when sorting them into three categories. I assume they were randomly selected so that they would give an indicative measure of where we are likely to land. What was the percentage outcome in terms of the different years?

Mr. Rónán Hession

About of half of the people ended up on tier 3 and about 16% ended up on tier 1. We got to an estimated cost of €130 million.

An Leas-Chathaoirleach

Quite a large proportion of people currently on disability payments have the capacity to work and that is something we are trying to facilitate. That was the final piece I wanted to touch on. I found the Green Paper to be excellent in many respects but I felt there was not a great deal of detail in it about labour supports. I know Mr. Hession gave an answer to Senator Wall on some of these issues. They will have to be qualitatively different from the labour supports offered to people on jobseekers' payments because of the needs of the person and the ability of the person to interact with work, taking account of the need for responsiveness and flexibility as a person's disability interacts with his or her ability to work. If we got further down the line of developing this proposal, that is something I would need to see more of. Could Mr. Hession give me any further information on where the Department's planning is with regard to that?

Mr. Rónán Hession

It is a fair point. It is a less developed part of the Green Paper. Our starting point would be looking at the range of supports we have, for example by expanding EmployAbility or mainstreaming some of the programmes we are currently doing with the dormant accounts. We want to pilot different approaches. This is an area where we will have to step up a good bit from where we are in terms of capacity and approach.

An Leas-Chathaoirleach

It will require significant engagement with employers as well because the Department is going to have to make clear to them that they must apply an element of flexibility. If we want more people with a disability in the workplace, there is a piece of work to be done with employers to make sure they are facilitating that.

Mr. Rónán Hession

Absolutely. In many of the conversations we have been having, we have been talking about the duration with the Department and the customer. I often say that the people who determine our unemployment rate are the employers. They decide. We do not hire the people. I know there is a lot of interest. The Minister for Enterprise, Trade and Employment is very engaged in that, as is his Department. He is looking to improve outcomes there.

The shift is away from employing disabled people as a corporate social responsibility exercise to doing so as a mainstream exercise. People are being recruited into well-paid decision-making jobs that have career progression. A point I often make is that because most disabilities are acquired, for employers it is not just a recruitment issue; it is a retention issue. People who already work for you are going to acquire disabilities during their career with you. In fairness, there are lots of good examples, such as the Open Doors initiative, of employer groups initiating processes. There is a lot of appetite there. There might be a sense of risk that they want to do it the right way and are sensitive about language and what supports they can provide. There might be a concern about whether they can do it the right way and support the person. This leads to caution, so it is really about trying to get over that if we can.

An Leas-Chathaoirleach

Visibility regarding what those employment supports would look like would go a long way towards assuaging people's fears about going to the Intreo office and being told "get out and work", which is one reading of that paragraph. We want to make sure this is not the case and that we have a tailored solution.

Deputy Donnchadh Ó Laoghaire

A thought occurred to me that applies to the current regime but it would apply to the future regime as well. I have come across it twice recently. It involves somebody with a rare illness - the kind of illness where there might be 400 cases in the world. There are a variety of very rare illnesses. In both cases, I dealt with people who would probably struggle with the administration side of it. I think they found the process a bit difficult in that there was a lot of gathering of information. For a lot of conditions, you are dealing primarily with one consultant but with a rare disease, you might be dealing with six or seven, all of whom are dealing with different elements of the disease. I am not a medical expert. This is just my experience in these cases. Sometimes in those instances, the Department could be a bit more proactive. It is not appropriate in most circumstances but it is an awful lot of information. For example, an applicant might write a letter outlining the impact of this illness on him or her, or his or her child, but he or she might not necessarily have all the letters and documents he or she needs and the medical literacy to compile all that information. Would the Department consider that if it gets this letter and it mentions a number of consultants, the Department would contact the consultants itself and ask what the story is rather than the customer having to get ten detailed documents when the consultant might not know what the Department needs? It would not be appropriate to do this in the vast majority of cases but in some exceptional circumstances, it seems that the Department could be a bit more proactive with the consultants in trying to figure out what the story is and what it means for the applicant.

Dr. Devesh Singh

It is a challenging question. It is not unusual to come across an occasional situation where it is not very clear what the medical condition is. To be honest, the diagnosis is not what we award our benefits or schemes for; it is how the condition affects the person. Irrespective of the diagnosis, if there is information that somebody is affected to the degree that meets the qualifying criteria for whatever scheme is applied for, that application should be processed without undue delay.

Sometimes this arises in occupational injury benefit applications. This is the payment you get from an accidental injury at work. In these cases, there is more of a requirement to have the exact details of the injury or illness, and whether it was contracted from employment alone or outside employment. In those cases, you can have various specialists giving different views. I remember the case of someone with an allergy involving LED light. This is not a known diagnostic condition but it was affecting her. It was a challenging case but we based the award on how the person was affected in terms of headaches, ringing in the ears and lack of concentration and focus, irrespective of diagnosis. They will get to it at some stage. Does that help to address the question?

Deputy Donnchadh Ó Laoghaire

Yes, it does.

Dr. Devesh Singh

On the question of whether the Department should be proactive in contacting healthcare providers, it is difficult, particularly if you look at the volume of cases we deal with.

Deputy Donnchadh Ó Laoghaire

I did.

Dr. Devesh Singh

It is not necessary in all cases, but on occasion we do make contact. We have systems in place. For example, we have a very good system in place with the National Rehabilitation Hospital in Dún Laoghaire whereby they write directly to me rather than going through the process. Those are very due deserving cases. Something like 30 to 60 contacts are made by us to GPs and different healthcare providers.

An Leas-Chathaoirleach

As no other members are offering, I thank the witnesses for their engagement. It has been very useful for us to air some of the concerns that we have around the straw-man proposal. It is a good way for us to frame our thinking and to be able to respond in a constructive and meaningful way to what the Department is planning. I have found the engagement today to be very informative from my own point of view. That concludes the committee's business in public session for today. I propose that we go into private session to deal with other business. Is that agreed? Agreed.

The committee went into private session at 11.51 a.m. and adjourned at 12.06 p.m. until 9.30 a.m. on Wednesday, 8 November 2023.