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Seanad Éireann debate -
Tuesday, 11 Mar 2008

Vol. 188 No. 22

Services for People with Disabilities.

I thank the Cathaoirleach for allowing me to raise this issue on the Adjournment and the Minister of State, Deputy Smith, for his attendance. I welcome the Government's additional allocation of €50 million to disability services in budget 2008. I ask the Minister of State for an update on the projects to which this money is being allocated. In particular, I seek an assurance that this funding will be ring-fenced for disability services.

I understand several service level agreements between the Health Service Executive and disability service providers are due for renewal. At present, the obligation placed on service providers relates purely to service quantity. Will the Minister of State use his influence to ensure the new service level agreements that will shortly be entered into between the HSE and service providers will include an obligation in regard to quality of service and the implementation of guidelines for the investigation of allegations of non-accidental injury and abuse? I welcome the recently issued draft quality standards in respect of residential services for adults with intellectual disabilities. Will the Minister of State provide an assurance that any such guidelines and standards, when finalised and adopted, will form part of the service level agreements between the HSE and service providers?

Will the Minister of State provide an update on the revision of the Children First guidelines? I understand this revision commenced approximately 18 months ago and that the initial draft is awaited. The inclusion of an obligation regarding quality of service and the implementation of guidelines for the management of allegations of non-accidental injury and abuse is of particular importance given that State money will fund these services. It is essential that we learn from the past by ensuring services provided for persons with disabilities are both safe and of a quality to enable these vulnerable individuals to enjoy a good quality of life and to have the opportunity to realise their full potential and participate fully in society.

I thank Senator Corrigan for raising this issue. I am responding in the unavoidable absence of my colleague, the Minister for Health and Children, Deputy Harney. At the outset, I emphasise the Government's commitment to providing a high quality service to all people with a disability. This commitment is illustrated by the substantial investment we have made in disability services in recent years.

The national disability strategy, launched in September 2004, reinforces the equal participation in society of people with disabilities and provides for a framework of new supports for such persons. This programme, together with the enhancement of other key support services, is a key factor in building the additional capacity required to ensure services best meet identified needs. The strategy builds on a strong equality framework which is reflected in a range of equality legislation. It puts the policy of mainstreaming of public services for people with disabilities on a clear legal footing.

The main elements of the strategy are the Disability Act 2005; the Education for Persons with Special Educational Needs Act 2004; the sectoral plans published in 2006 by six Departments; the Citizens Information Act 2007; and the multi-annual investment programme for disability support services for the period 2006-2009. In launching the national disability strategy, the Taoiseach also announced the Government's commitment to a multi-annual investment package for disability-specific services over a five-year period. Since the launch of the strategy in 2004 until the end of 2007, €420 million in revenue and capital funding has been allocated to services for people with disabilities.

As the Senator is aware, €50 million was allocated in budget 2008 by the Tánaiste and Minister for Finance, Deputy Cowen, for the provision of disability services. The Health Service Executive proposes to allocate this €50 million under several headings. In regard to services for persons with intellectual disability and those with autism, by the end of 2008, 200 additional residential places will bring the total number of places to 8,462; 467 additional day care places will be provided, bringing the total number of places to 25,196; and 53 additional respite places will bring the total number of places to 4,533.

In respect of services for persons with physical or sensory disabilities, by the end of 2008, 80 additional residential places will bring the total number of places to 914 and 200,000 additional hours of personal assistance or home support will bring the total number of hours provided to 3,200,000. In addition, 140 multidisciplinary team posts are being allocated to disability services to provide assessment and ongoing intervention services to children, as provided for in the Disability Act, with a particular focus on children under five years of age. By the end of the current multi-annual investment package in 2009, it is expected that 1,235 new residential places, 398 new respite places and 467 new day care places will have been commissioned for intellectual disability services, in addition to 380 new residential places and 1,150,000 extra personal assistance or home support hours for people with physical and sensory disabilities.

It is important to ensure that all residential facilities for people with a disability are independently monitored and inspected by the Health Information and Quality Authority, HIQA, as provided for in the Health Act 2007. The HIQA has been assigned important powers to examine the nature and quality of services and to determine whether they are of the standard to which people with a disability are entitled as a right. The authority has commenced work on standards for designated residential centres for people with a disability and these will form the basis for statutory regulations and inspections. The HIQA is keen to get these standards right and is inspecting all residential services against an appropriate benchmark. I understand it is the authority's aim to finalise formal standards in 2008 and to commence formal inspections in 2009.

Service level agreements are currently being finalised. The HSE and the Department of Health and Children are in discussion on the provision of these agreements. Among their provisions will be a requirement on service providers to establish and maintain a formal policy and complaints procedure in regard to protection from abuse that is accessible to all service users, their advocates and carers.

I thank Senator Corrigan for raising this issue, as she has done on several occasions in this House. I will be glad to convey the points she raised to the Minister, Deputy Harney, and to the Minister of State at the Department of Health and Children, Deputy Devins, who has responsibility in this area.

I thank the Minister of State for one of the most comprehensive replies we have received on the Adjournment. I ask him to convey to the Minister that while I welcome the HSE's proposals for the allocation of the additional €50 million, I ask that she use her influence to ensure the money is spent on the proposed projects. I am conscious that moneys allocated in the previous year's budget for mental health services, particularly in regard to people with physical and sensory disabilities, were not used for that purpose even though specific projects were proposed and great detail was provided in respect of each of them. The funding was not assigned because the HSE had identified other priorities for which the money was required.

The projects to which the Minister of State referred are worthy and will have a significant impact. I am delighted that the new service level agreements will include the requirement that there be procedures in place for the management of allegations of abuse. When the chief executive officer of the HSE, Professor Drumm, was in Leinster House for the last HSE briefing for female Members, I was shocked by his statement that there was currently no obligation in the service level agreements in respect of either quality of service or the management of allegations of abuse. I welcome the developments in this regard to which the Minister of State referred.

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