Vol. 503 No. 5
6 Mr. Broughan asked the Minister for Health and Children the steps, if any, taken or envisaged by him to fulfil the commitment made in An Action Programme for the Millennium to reduce unnecessary bureaucracy in dealing with health agencies; and if he will make a statement on the matter. [6452/99]
I understand the Deputy is referring to a section of An Action Programme for the Millennium which refers specifically to people with disabilities. As set out in the programme, the Government is committed to ensuring the needs and aspirations of people with disabilities, their families, carers and advocates are comprehensively addressed.
The health agencies with which people with disabilities would have most contact are the health boards. To ensure the smooth planning and delivery of services and to provide a clear channel of communication with the various bodies representing people with disabilities, co-ordinating committees for mental handicap services and for physical and sensory disability services have been established in each health board.
Within the mental handicap services, the regional co-ordinating committee structure has greatly assisted the planned development and management of the services. The role of the co-ordinating committees, which are representative of health boards, voluntary service providers and parents and families of persons with a mental handicap, is to agree a plan for the development of services in each region, to identify priority needs and to co-ordinate the delivery of services, including new services, as resources are made available.
The report of the Review Group on Health and Personal Social Services for People with Physical and Sensory Disabilities, Towards an Independent Future, was published in December 1996. This report recommends the establishment of co-ordinating committees for physical and sensory disability services. These committees have basically the same functions and aims with regard to the development of services in this sector as those for the mental handicap services. My Department has commenced a review of the operation of these committees which are relatively new. This review should be completed in the next month.
The other major health agency dealing with people with disabilities is the National Rehabilitation Board. As the Deputy is aware, the Department of Social, Community and Family Affairs is currently engaged in implementing the report of the establishment group of the National Disability Authority, as agreed by the Government in July last year. The report gives effect to a number of recommendations put forward by various expert groups and qualified commentators in recent years, not least the Commission on the Status of People with Disabilities. The guiding principles of the establishment group are those set out in the Commission's report, namely, equality, maximising participation and enabling independence and choice through a social model of disability.
If the Deputy is aware of any specific instances of unnecessary bureaucracy in relation to the delivery of those services, I will be pleased to have them examined if the relevant details are supplied to me.
I thank the Minister for his response which dealt with the structural arrangements in relation to the planning and delivery of services from the point of view of the service providers.
Do the co-ordinating committees exist and are they operational in all health boards? Can the Minister guarantee people with disabilities that there will be a limit on the waiting or recall times for occupational therapists and for the receipt of a disabled person's grant, for example? We must remember that people with disabilities use the health agencies in the same way as the rest of us.
Is the Minister aware of a disturbing report by the INOU about the difficulties experienced by the long-term unemployed, who want to come back into the workforce, in accessing accurate information about their medical card entitlements? Surveys have shown that people are not getting accurate information not to mention their medical cards. Guidelines were drawn up by the Department of Health and Children, but are they being followed by the chief executive officers and staff in all health boards? They affect everyone, including people with disabilities. This is a disturbing issue. While we understand there are staff shortages, we cannot understand health board staff giving out inaccurate information.
I agree there is no reason for any health board or agency to give out inaccurate information. I am not aware of it being an endemic problem. People are usually well informed of their entitlements and how to access them, particularly through the community welfare officer scheme. The reply does not fully answer the Deputy's question about the standardisation of documentation, the need to computerise our services and improve the interface between people and the health boards. Much work needs to be done in this area.
We have a devolved system of health administration in that we have given the operational responsibility for the health services to the regions. There are varying degrees of success in the administration of one programme in a health board area compared to another. That seems to indicate that best practice models are not used consistently and uniformly throughout the health system. I am not aware of any problems in the disabled person's grant scheme in the Midland Health Board, yet I have met Deputies who claim there are delays in other health boards. This is sometimes due to the personnel concerned and the fact that operational issues, such as the visit of an occupational therapist, may not be as proactive in one health board area as compared to others.
I am contemplating the need to do an audit of all forms, documents and applications. Despite the fact that all health boards implement the same schemes, they probably have different formats and levels of information on application forms. We should try to address that issue as it would reduce the confusion experienced by public representatives not to mention the public.
Deputy R. Bruton rose.
I am trying to facilitate Members who may want to reach Question No. 15.
The Minister will be aware that the biggest problem in the area of disability is inappropriate or inadequate service. Is he disposed to a personal service plan for each person with a disability and some form of independent adjudication as to the adequacy with which the services are responding to that plan? That would cut away the bureaucracy and give people a statement of their entitlement given their circumstances.
I agree that for every disabled person who requires a service one would expect the health administration to tailor the available schemes to their specific needs so far as that is possible. My Departmet's priority is to provide mental handicap services and physical handicap services to those who do not have a service. The groups on behalf of disabled persons would have as their priority the need to ensure everyone has a basic service. Subsequent to that one could begin to bring forward individual service plans. We are making progress with the provision of 600 new places between residential, respite and day care services for the mentally handicapped. We are working to a model and planning the services and developments in a less ad hoc fashion than heretofore. Having attended the NAMHI conference at the weekend, I consider that the provision of services to everybody is the top priority. The individual models suggested by the Deputy would become a priority, subject to achieving that basic policy objective.
