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Seanad Éireann debate -
Wednesday, 6 Apr 2022

Vol. 284 No. 6

Health (Miscellaneous Provisions) Bill 2022: Report and Final Stages

Bill received for final consideration

When is it proposed to take Final Stage?

Question proposed: "That the Bill do now pass."

I thank the Minister of State, Deputy Rabbitte, for being here again. This is actually a positive day. I know the Minister of State will interpret my remarks as I intend them to be interpreted. They concern community service and disability, in the context of which we are here today. Everything we have been doing is under the framework contained in Disability Action Plan Framework: Review of Disability Social Care Demand and Capacity Requirements to 2032. There are a couple of points I want to make. I fully support the Minister of State and will work with her every step of the way on this.

There are several anomalies concerning assessment and intervention. In many cases, the delivery of a service or intervention never takes place. It is particularly concerning when one comes from a mild intellectual disability background or platform. Those in this category are excluded, which is a worry. The action plan framework, which we should all be asked to examine and work from, refers to day-service places for school-leavers, personal assistance and home supports, respite services, including alternative respite services, and residential care in the community. Let me start with the last of those, in respect of which I wish to make an appeal to the Minister and those charged with delivery at local level. I am told those over 65 with an intellectual disability and without a bed in a residential service are being offered nursing home places only. If that is correct, an ageist and ableist policy is being developed. Those who have been in a care centre or the community are having traditional supports removed and are being put into nursing homes that do not have the ability to deliver the supports they require.

Consider the point I made at the beginning, which was on the link between assessment and intervention. The link is quite broken. Assessment and intervention are separated and there is a time delay and an anomaly. There is no continuity of experience for those who need it the most. That needs to be addressed at local level on the ground.

The priorities in the document we have, action on which will be enabled by the Bill, concern the key role of respite in supporting family carers in enhancing service. While these are wonderful, aspirational words, I have some questions. Is there a lowballing of the numbers being provided for? Are they too low? Are we missing out? Have we a full and accurate picture? Are we underestimating the number of people who require school places and respite? I do not understand the delivery mechanism.

Regarding respite care or respite services, it is stated an increase in capacity to provide an initial 12 respite houses and a further increase of nine-----

I remind the Senator that we have three minutes left. If he wants a response from the Minister of State and if anybody else wants to contribute, he should note that our consideration of the Bill is due to conclude at 1.30 p.m.

I am sorry. I have a lot more to say but I will let the Minister of State respond. It is important that she do so. I will email her my script. Gabh mo leithscéal as I did not realise the time arrangement.

Does anyone else want to contribute?

I thank the Minister of State for being here. I was not expecting her to come to the House today so I feel privileged to be able to speak to her. She told the Dáil she is not the Minister of good intentions but the Minister of action. I really appreciate that because unless all our legislation is implemented and overseen, the pieces of paper we have are absolutely pointless. I am aware that the Minister of State is a very hard worker and really cares about people with disabilities. I am a member of the Joint Committee on Disability Matters and absolutely love it and the idea of bringing about equality for people with a disability. This legislation should not become another Act that is not implemented. It needs to include all people with disabilities, give rapid access to healthcare and facilitate those with a disability in seeking employment. I would love to see the legislation not only implemented but also, in the words of the Minister of State, acted upon.

I thank the Senators for their contributions and working with me since February to ensure this Bill would come to fruition. I really appreciate the opportunity in that regard, not only because I believe the best fit for disability is in the Department responsible for equality. I thank everybody in the Department of Health, particularly Mr. Barry McGreal, who ensured this legislation would come to pass and that we would get the drafting done. I thank both Houses for allowing the consideration of the Bill.

Senator Flynn is correct that the Bill is only as good as the action taken on it. Senator Buttimer talked about the fine detail.

It is underestimated. There is no denying that in the context of respite. The whole focus has to be on having real and clear understanding and guidance to meet the needs and serve the rights of the individual. It is about informing the person and his or her family of their rights and how to access services, and being open and transparent in that regard. There is no point in the Government providing policy and Departments providing money and it going then to the HSE without following the money to see how the service is delivered to the end user, whether in a day service, respite or residential care. It is also about meeting the needs of the individuals. I am acutely aware of the importance of page 7 of the Bill. To me, it is the gospel page in terms of ensuring delivery and holding people to account in that regard.

I look forward to being within the Department of Children, Equality, Disability, Integration and Youth because I look at the matter with a rights-based lens. In this context, equality is all about the right to respite and actually the right to live as close to one's community as possible, integrated within one's family and support needs.

Yet again, I thank my drafter for making this happen from February to date. I thank both Houses for supporting the Bill. I look forward to working with Senators in future. When I come to the House from now on, my senior Minister will be the Minister, Deputy O'Gorman. I thank the Minister, Deputy Stephen Donnelly, for working with me and putting up with me for the past 18 months. I look forward to working with the Minister, Deputy O'Gorman.

Question put and agreed to.