David Stanton
Question:95 Mr. Stanton asked the Minister for Health and Children the progress that has been made in developing national standards for disability services; and if he will make a statement on the matter. [7003/04]
View answerWednesday, 3 March 2004
Questions (18)
Oral answers (5 contributions)
My Department, in partnership with the National Disability Authority, is developing national standards for disability services in consultation with people with disabilities, their families, carers, service providers and other stakeholders. These standards are being designed to ensure that services are provided to an agreed level of quality and that this level is consistent on a national basis. It is proposed that the standards will initially apply to day, residential, respite, training and home support services for people with disabilities, as funded by my Department.
The project began with a call for submissions on people's views on standards and quality in services. More than 500 submissions were received. These were analysed and reviewed and assisted in the development of the first draft standards. The draft standards focus primarily on attainment by service providers of generic quality standards such as governance, human resources and management information.
My Department and the NDA agreed to a pilot project to test and evaluate the application of the assessment process of the draft standards, including the use of an audit tool. The principal aim of the pilot project was to evaluate the draft standards. This evaluation process included an internal and external assessment of the services. The pilot project was undertaken in 20 participating organisations in the final quarter of 2003 and was followed by an independent evaluation of that exercise. The pilot was useful in that it raised a number of important issues which need to be further addressed. To that end, work is progressing with a view to finalising national standards for health services for people with disabilities.
When does the Minister expect the project to be completed given the promise in the national health strategy of 2001 that it would be completed in 2003? When does he propose to extend the remit of the social services inspectorate to include residential care for people with disabilities? When funding is allocated to service providers for the provision of services to people with disabilities, what checks are in place to ensure that the service being paid for is actually provided and the State receives value for money? Does the Minister and the Government intend to fully support the National Disability Authority in its efforts to establish reasonable standards for services for people with disabilities?
What is the Minister's view of reports that the draft report, the independent evaluation to which he referred, showed that 75% of services provided to people with disabilities failed to reach the standards set by his Department and the National Disability Authority? Does he have in mind a new date by which the report will be placed on a statutory footing? When will the national standards and protocols for quality, care, patient safety and risk management be drawn up?
The Deputy has asked many questions. In terms of a timeframe, the Department works with the National Disability Authority in drawing up the standards. Various reports have emerged during the process, particularly with regard to the pilot programme. The Department is not entirely happy with the recent outcome of the sector report which indicated certain inadequacies, including in key areas. It has also been in contact with some of the service providers to obtain their analyses of the evaluation.
Once the formal evaluation has been received from the consultant, it will provide useful data and the Department will work with the National Disability Authority in progressing the next phase of developing national standards, an outcome to which we are committed. It is important, however, that we get these standards right because they will ultimately constitute the template against which disability services will be benchmarked.
Contrary to the impression which recent reports may have given, the pilot project was not designed to evaluate the quality of services provided by any particular service provider, but rather to evaluate the draft standards and the monitoring tool which would help to inform the ongoing process of developing national standards. I have been asked to stress that references to services not meeting Department standards are not accurate. The 20 services involved volunteered to take part in the project and for this reason one cannot conclude that a true representation of overall services can be gleaned from the analysis of the services selected.
With regard to the expansion of the remit of the social services inspectorate, it will take some time before it is extended to cover care of the elderly and disability services. Forthcoming disability legislation may have a role to play in this regard.
When funding is allocated to a service provider, what checks are in place to ensure that the service being paid for is delivered? These funds are transferred from the Department to the health boards to the service provider. For several months, I have been trying to find out what happened to the €50 million the Minister distributed last July but have still not received a response. What checks are in place to track the money and how and where it is spent? Does the Minister agree that we are ripping people off if services for people with disabilities, for which provision is being made, are not being provided?
This is an important point. Since 1997, approximately €643 million in additional funding has been allocated for health-funded support services for people with disabilities. Of this sum, €388 million was allocated for people with intellectual disabilities and some €230 million for people with physical and sensory disabilities. The Department checks with the health boards to ensure that these allocations are used for ring-fenced projects. However, accountability legislation has consistently caused certain difficulties to arise. For example, when a chief executive officer of a health board wants to break even at the end of a year in order to comply with this legislation, does the acute service remove additionality from primary care, continuing care and care for elderly and disabled people? We have been anxious to avoid such circumstances developing?
We also work with the service providers, particularly in the non-statutory sector, with whom we meet to ensure that funding is channelled into their services. Some of the difficulties which have arisen in recent years have been in the area of pay awards, with some of the non-statutory service providers arguing that they are not often compensated for complying with the terms of benchmarking, Sustaining Progress and various agreements concluded from time to time. In terms of the Health Services Executive and primary continuing care —the non-acute side —the new reform programme is designed to ring-fence budgets for the future to ensure budgets for disability will not be eroded or redirected to other sectors.