Dáil Éireann Debate, Thursday - 16 February 2023
94. Deputy David Cullinane asked the Minister for Health when he will publish an implementation plan for the disability capacity review; when he intends to transfer functions for specialist disability services to the Minister for Children, Equality, Disability, Integration and Youth; and if he will make a statement on the matter. [7557/23]
View answerWe kind of touched on this earlier. There are two aspects to this question. The first is about the transfer of the functions for special disability services from the Department of Health to the Department of Children, Equality, Disability, Integration and Youth - that is a mouthful - and the second relates to the resourcing of the disability capacity review. I ask the Minister of State to give an update on both those issues.
I thank the Deputy for raising this two-pronged question this morning. Hopefully, on 1 March, I will be transferred. However, we have had a number of dates in the past so if the Deputy is writing it down I would write it in pencil. I hope it will happen on 1 March. That is a piece of work that is going on at the moment.
Regarding the disability capacity review action plan implementation, the Department of Children, Equality, Disability, Integration and Youth will be doing the heavy lifting on that. We will be finalising the report. Most of the team are coming across with me from the Department of Health. The enabling works are under way with regard to finalising the disability capacity review. It is a ten-year plan but it is my ambition to launch it in phases, with the first in 2023-26. That will address the under-resourcing, the gaps and the unmet need within disabilities and particularly in disability specialist services right across the country.
The disability capacity review set out the need for €750 million of investment over ten years. The problem is that two years on, there is still no implementation plan and certainly still no funding plan. As the Minister of State will recognise, we need to support complete decongregation of people with intellectual disabilities into more appropriate facilities, which is part of the plan. We also have to ensure we have the investment needed for additional personal assistant, PA, hours and additional home care packages to serve distinct needs and support independent living. We also have a severe shortage of respite care services. Less than a third of carers for adults with intellectual disabilities can avail of respite care. There are lots of pieces to this. There are lots of elements to that disability capacity review. The overall funding ask of €750 million is significant but it is less significant over ten years. The problem is that I have not seen any funding plan or implementation plan. We cannot simply put in place capacity reviews and then not resource them and not put plans in place. Two years on, we need to see the colour of the Government's money.
The colour of the Government's money has already been shown in the previous budgets. While the disability capacity action plan has not been published, funding has been put in place. The years 2020, 2021 and 2022 saw significant investment in disability. What has been put into disability for the last two years is actually record-breaking and we have addressed the issues the Deputy raised, which needed the investment, including the respite piece and the PA piece. In the most recent budget, the PA piece was allocated ten times the funding it had received in the previous number of years. On respite, every single year since I became a Minister of State it has been my ambition, on which I have delivered, to have a respite house in every county in the country by the time I am finished. In the first year, we put €6.5 million into respite and in the second year, it was €9.5 million. This year's service plan is yet to be finalised but it will match what has gone in previously. Children's respite has been a priority of mine coming out of Covid to ensure families are supported. I am now moving on to adult respite but, at the same time, respite is not all about putting a head on a bed. It is also about looking at alternative forms of respite and PA support.
I recognise that additional funding has been made available for disability services over the last number of years.
Unfortunately, a lot of the additional funding - we had the same debate in the area of mental health - is eaten up by existing levels of service, which means that it does not provide additional capacity. I accept that additional capacity has been put in place, but it is nowhere near what is required to meet the capacity review. The only way we will make sure that is done is to have a comprehensive plan set out over a reasonable time period. The plan was meant to be a ten-year one. We are two years in, but we do not have sight of a plan or a costing model. There is also the accountability element. The advocate groups I meet tell me they do not believe the additional funding that was made available in recent years, which the Minister of State described as record-breaking, is anywhere near enough to start addressing the deficits and difficulties we have. We are still way behind where we need to be on decongregation and many other critical elements of that capacity review. I look forward to the publication of the plan. I will judge it when I see it. I hope we can see it as soon as possible.
I hope the Minister of State's functions are transferred to the Department of Children, Equality, Disability, Integration and Youth by 1 March. I think she will play a significant role there. I say that as a member of the Joint Committee on Children, Equality, Disability, Integration and Youth. There seems to be a significant issue with recruitment in this sector. I met with Down Syndrome Carlow last week. The group is waiting on occupational therapy and speech therapy services. I welcome the funding, but how can we work faster to ensure that children in need, who have a disability, will get the services they deserve?
The disability capacity action plan is needed. We know the unmet need in disability is for specialist services. Could a certain level of flexibility be shown? We know the silo issues that exist in the sense that a ping-pong game is sometimes played between CAMHS and children with autism who require services but cannot get them. We must deal with the issue across the board.
I will start with the final question and work my way back. Deputy Ó Murchú referred to a ping-pong game. The HSE has a national access policy, NAP, which promotes an integrated approach between primary care, disability and mental health. It might not be done fairly or equally across all CHOs but there are some very good CHOs that are practising that model.
In response to Deputy Murnane O'Connor, I accept there has been an unmet need in terms of the number of therapists. When I was appointed, only 3% of the overall budget was left for therapy services. Since then, every single year, with the help of the Minister, I have secured serious funding to resource therapies. The Deputy is correct that there is an issue with recruitment, but we have a progressing disability services, PDS, roadmap that we will launch fairly soon. That will show the Deputy the way forward in that regard.
I acknowledge, as should Deputy Cullinane, that a lot of money has gone into new developments in the disability area. I hope that funding will be a foundation for the disability action plan when it is published. I look forward to his feedback on it.
