I am delighted to be here for this debate and to hear the views of the House. I welcome the opportunity this debate provides me to emphasise this Government's commitment to providing a high quality service for all people with a disability. I was honoured to be appointed by the Taoiseach to the position of Minister of State at four Departments and with responsibility for disability and mental health.
In that context, I have responsibility for the oversight of the Government's national disability strategy, including the six departmental sectoral plans, and the co-ordination of the implementation of the Disability Act 2005 and the Education for Persons with Special Educational Needs Act 2004.
In January 2008, the Government announced the establishment of the Office for Disability and Mental Health to support me as Minister of State with responsibility for disability and mental health in exercising my responsibilities across the Departments of Health and Children, Education and Science, Enterprise, Trade and Employment and Justice, Equality and Law Reform. The new office brings together responsibility for a range of different policy areas and State services which directly impact on the lives of people with a disability and people with mental health issues. The office aims to bring about improvements in the manner in which services respond to the needs of people with disabilities and mental health issues by working to develop person-centred services focusing on the holistic needs of clients and service users and actively involving them in their own care. Substantial progress has been made in recent years in the areas of disability and mental health but much remains to be done. In particular, there is a need to improve co-ordination and communication across different Departments and agencies in the delivery of services to this client group. This will be the main focus of the new office in the coming months.
Among the key priorities for the office for disability and mental health are supporting the implementation of the health sectoral plan under the Disability Act 2005. The office will focus in particular on facilitating the delivery of integrated health and education support services for children with special needs by developing further existing mechanisms for co-operation and co-ordination between the health and education sectors at national and local level and developing an appropriate continuum of training and employment support services for people with a disability by working together with the Department of Enterprise and Employment, FÁS and the Health Service Executive. The director of the office is a member of the senior officials group on social inclusion which monitors progress on the Government's commitments on social policy, including commitments under the national disability strategy. The Government has agreed that meetings, to be held quarterly between me as Minister of State with responsibility for disability and mental health issues, the four Secretaries General of the relevant Departments and the director of the new office, will review progress in the priority areas.
The Government has provided significant additional resources in recent years to drive improvements in educational services for children with special needs. Since 2004, investment in special education has almost doubled to €900 million, enabling thousands of extra staff to be put in place. Indeed, there are now more than 9,000 teachers and almost 10,000 special needs assistants working solely with children with special needs. This compares with just a fraction of that number only a few years ago.
The level of training for teachers in a wide range of special education areas has also improved significantly. We have taken steps to reduce the need for educational assessments and to ensure children can get additional support as early as possible. All primary schools have been allocated a guaranteed number of resource teaching hours to cater for pupils with high incidence special needs such as dyslexia. As a result, most children with special needs no longer need to have an assessment before they can get extra support. These, and a range of other developments, have transformed special educational services for the better. Further improvements are also in train with the phased implementation of the Education for Persons with Special Educational Needs Act.
Given the sheer scale of the improvements to take place under the Education for Persons with Special Educational Needs Act, the legislation envisaged that the provisions of the Act would be phased in over a five-year period with full implementation by October 2010. It required the National Council for Special Education, NCSE, to prepare an implementation plan with advice for the Minister for Education and Science on the steps it believes should be taken to implement the Act within a five-year period from the establishment date of the council in October 2005. Upon receipt of this advice, the Department of Education and Science needed to consider it and consult a wide range of stakeholders before developing a final detailed plan for full implementation.
The Minister for Education and Science believes it is in the interest of children with special needs that the changes provided for in the Act are rolled out in a smooth and planned way. She has decided therefore to stick with October 2010 as the date for full implementation. Provisions that have been implemented include the establishment of the NCSE, the appointment of the members of the inaugural Special Education Appeals Board who are working to ensure appropriate structures and processes are in place once the relevant sections of the Act which would allow appeals to be undertaken are commenced, and the provision of guidance to schools on issues such as devising and implementing individual education plans.
A cross-sectoral team has been established comprising senior officials from the Department of Education and Science, the NCSE, the Department of Health and Children and the HSE. This team is working hard to co-ordinate the implementation of Part 2 of the Disability Act 2005 and the relevant sections of the Education for Persons with Special Educational Needs Act 2004 and to improve co-ordination between the two sectors. I can personally vouch, having attended some of the meetings, that they are working hard.
Investment in special education has increased significantly since the Education for Persons with Special Educational Needs Act was passed, enabling improvements in staffing and other resources to be put in place. The Act, therefore, is being implemented on the phased basis envisaged in the legislation as voted for by this House. There has been no delay. Many of its provisions have been implemented and the rest will be phased in by the October 2010 deadline.
The Private Members' motion refers to assessments by educational psychologists. I wish to make clear to the House that the purpose of the limit on the number of assessments is to encourage schools to take responsibility for initial assessment, educational planning and remedial intervention and to avoid unnecessary referral for assessments. The National Educational Psychological Service, NEPS, in common with other psychological services internationally, relies on a staged model of assessment with the school taking responsibility for these actions in the first instance. Only where there is failure to make reasonable progress in spite of the school's best efforts should a child be referred for individual psychological assessment.
This system allows NEPS psychologists to give early attention to urgent cases and to help indirectly many more children than could be seen individually. In this regard, NEPS has recently produced an updated set of guidelines and a resource pack for primary school teachers comprehensively outlining this graduated problem-solving model of assessment and intervention. The limit of two assessments per 100 children in a given year for schools availing of the scheme for commissioning psychological assessments, SCPA, needs to be understood in this context. It also should be remembered that most primary school pupils with special educational needs no longer need psychological assessments to access extra teaching supports. I also point out that principals can contact NEPS if they believe that exceptional circumstances warrant additional assessments for their pupils.
During the last academic year 4,400 assessments were funded under the SCPA at a cost of approximately €1.5 million. In addition, almost 5,800 assessments of individual pupils were carried out by NEPS psychologists in the same period. In total, more than 10,000 psychological assessments were paid for by the Department of Education and Science in the last school year.
I assure the House that the Government is committed to increasing the number of NEPS psychologists from the current level of 139 to 169 by the end of 2008 and to 200 by the end of next year. This will enable all schools to receive a direct service from NEPS in the 2009-10 school year rather than being served by the SCPA scheme. Extra psychologists are in the process of being appointed.
I will now outline some important elements of the Disability Act 2005. Part 2 of the Act provides people with disabilities with an entitlement to an independent assessment of their health and education needs, a statement of the services it is proposed to provide, to pursue a complaint through the HSE complaints process if necessary, and to make an appeal to the independent disability appeals officer.
Part 2 of the Act commenced for children aged under five years with effect from 1 June 2007. Children under five years were chosen as the priority for the introduction of the assessment of need process under the Disability Act because of the importance of intervention early in life. This can have a significant impact on the disabling effects of a condition or impairment. The Disability Act will be commenced for children aged 5 to 18 years in tandem with the implementation of the Education for Persons with Special Educational Needs Act 2004. It is envisaged that all sections of the Education for Persons with Special Educational Needs Act 2004 will be implemented over a five-year timeframe with the assessment process provided for in the Act due to commence in 2010. In preparation for its implementation, health related support services for children aged 5 to 18 years and adults will continue to be enhanced to enable the Health Service Executive to meet needs identified for this group. The statutory requirements of Part 2 of the Disability Act will be extended to adults as soon as possible but no later than 2011.
During 2007, the Department of Health and Children and the Health Service Executive undertook significant work in preparing for the commencement of Part 2 of the Act in respect of children under 5 years of age. Standards for the assessment of need process were developed. Regulations and a commencement order were published and the Office of the Disability Appeals Officer was established. An assessment officer post has been created in each of the 32 local health office areas. The assessment officer is responsible for the co-ordination of the assessment report. Case managers have been created in each local health office area and they have responsibility for the provision of a service statement.
The Department of Health and Children and the HSE have undertaken the first of three annual reviews of progress on the implementation of the Disability Act. This review, which was published in December 2007, has identified further targets specifically on planning for the parallel commencement of the Disability Act 2005 and the EPSEN Act 2004 for five to 18 year olds and adults. A system of complaints is now in place in the HSE to deal with complaints under the Act and, for the first time, if a service user is not satisfied with the process, the independent disability appeals officer will deal with appeals from users of the system.
Significant work is being done in co-ordinating and enhancing work across the health and education sectors. A cross-sectoral team comprising officials from the Department of Health and Children, the Department of Education and Science, the HSE and the National Council for Special Education meets on a regular basis to address issues arising on the implementation of both Acts.
I will turn to an issue raised in the motion, namely, standards in the provision of services for people with a disability. As Senators are aware, the Government introduced, and is progressing, an extensive reform programme of health services. Part of this programme includes the development of national standards for services for people with disabilities alongside the development of a draft code of practice for sheltered work services. Draft standards for disability services were produced by my Department, in conjunction with the National Disability Authority, prior to the establishment of the Health Information and Quality Authority, HIQA.
A standards advisory group has been put in place by HIQA to consider the development of service specific standards, including residential and community based services for people with disabilities in residential centres. The work of this group, which includes the statutory and non-statutory sector, is well advanced.
In regard to standards in the area of sheltered work and other adult day services, the HSE has established a national review group to carry out a comprehensive national review of all HSE-funded adult day services, including sheltered work. The review will include, as part of its work, consideration of the draft code of practice for sheltered work services and the draft national standards for disability services.
The motion also refers to the control of employment levels in the HSE. Approximately 130,000 people work full-time or part-time in our public health services. The Government's ongoing high level of investment in health in recent years has achieved and maintained significant increases in the numbers of doctors, nurses and other health care professionals employed in the public health services. The Government has also invested heavily in the education and training of such personnel to secure a good supply of graduates to provide for the health care needs of the population into the future.
There has been a growing demand for, and investment in, therapy services over the past number of years. A particular priority has been the expansion of the supply of therapy graduates. Training places for speech and language therapists have increased by 320% since 1997, from 25 to 105; training places for occupational therapists have increased by 313% since 1997, from 29 to 120; and training places for physiotherapists have increased by 137.5%, from 64 to 152. Since 1997, there has also been growth in the number of such therapists employed in the health services. There were an additional 152% speech and language therapists; 257% more occupational therapists and 139% more physiotherapists by the end of 2007.
The budget day package for 2008 provides for the creation of an additional 1,050 new posts for the delivery of health service developments. Included in these extra posts are 710 posts for the provision of additional health services for people with a disability. This demonstrates the Government's ongoing commitment to resourcing the health services. The employment levels approved for the HSE for 2008 of 112,560 wholetime equivalents includes these additional 1,050 posts for the budget day service developments.
Consistent with the Government's investment is the need for the HSE to manage within the budget allocated by Government and to deliver on its priorities. The recruitment pause put in place in September 2007 was initiated as part of the HSE financial break-even plan to facilitate the delivery of services on budget in accordance with the provisions of the 2007 national service plan. This pause meant that the recruitment of staff to approved posts was delayed. The HSE put in place a derogation process to deal with the filling of essential posts to protect front-line services and close to 900 posts were approved under this process. This temporary pause in recruitment ended on 31 December 2007. New arrangements introduced in January 2008 by the HSE are aimed at ensuring that health services are delivered in accordance with the provisions of the 2008 national service plan and within the funding provided by Government.
The motion also raises the ratification of the UN Convention on the Rights of Persons with Disabilities. Ireland was in the first group of countries to sign, subject to ratification, the UN Convention on the Rights of Persons with Disabilities when it opened for signature on 30 March 2007. A high-level, cross-departmental implementation group was established in 2007 to advise on any changes to the Government's national disability strategy that may be required to enable the State ratify the convention. This group has developed a work programme to address matters that need to be aligned with the UN convention in order that ratification may take place. It is the Government's intention that the convention will be ratified by Ireland as soon as possible, taking into account the need to ensure that all necessary requirements under the convention are being met.
One of the key areas of reform required is in regard to the law on legal capacity of vulnerable adults. The Government's legislative programme contains a commitment to bring forward a mental capacity Bill. That Bill is an important element of the programme of work on the convention. I am glad to report that the scheme of the Bill, which is being prepared by the Department of Justice, Equality and Law Reform, is at an advanced stage of development.
As part of the 2005 budget, the Government announced a multi-annual investment programme in services for people with a disability, which will provide €900 million from 2006 to 2009. The Disability Act is underpinned by this multi-annual investment programme. It is building the additional capacity required to put in place the framework set out in the Disability Act. As part of the multi-annual investment programme under the disability strategy, the Government provided the HSE with an additional €75 million in both 2006 and 2007. This funding included moneys to provide new and enhanced services for people with disabilities. The Government is also honouring its promise on the multi-annual investment programme for people with disabilities, with a further €50 million investment, which was announced in the budget for the current year.
I have some information on the health and personal social services this huge investment is providing, which I would like to share with the House. Currently, 8,800 people with a disability receive care in residential places with more people living in group homes within their communities than in residential centres. Some 7,200 residential places provide respite care for people with a disability. Some 30,000 people with a disability attend day services. The Health Service Executive provides 3 million hours of personal assistance or home supports for people with a physical disability.
The national intellectual disability database annual report for 2007 states that 97% of the people registered with it are in receipt of a service. The report says that there has been significant growth in the level of provision of services to people with an intellectual disability which reflects the success of the Government's investment programme.
The social partnership agreement, Towards 2016, outlines our vision for people with disabilities. The Government will work with the social partners to achieve continued improvements in the quality of life of people with disabilities. The establishment of the Office for Disability and Mental Health is another step in that process.
The Government's decision to establish the Office for Disability and Mental Health reflects its commitment to developing a more coherent and integrated response to the needs of people with disabilities and mental health issues. It recognises that clients and service users need to be at the centre of service delivery and that we may need to examine the way in which services are currently delivered to ensure that is the case. To effectively achieve this requires an interdepartmental, cross-agency response.
My designation as a Minister of State with responsibility for disabilities and mental health and the establishment of an Office for Disability and Mental Health to support me will facilitate cross-agency and interdepartmental working and enable this Government to deliver real benefits to clients and service users into the future.
