Update on Disability Issues: Minister of State at the Department of Justice and Equality

The purpose of today's meeting is to meet with the Minister of State at the Department of Justice and Equality, Deputy Finian McGrath, who has special responsibility for disabilities, to discuss progress on, among other issues, the Disability (Miscellaneous Provisions) Bill 2016, the Optional Protocol to the UN Convention on the Rights of Persons with Disabilities, the Assisted Decision-Making (Capacity) Act 2015 and the provisions not yet commenced and the implementation of the National Disability Inclusion Strategy 2017-2021. I welcome the Minister of State and his officials. We were a little unsure that we would have the Minister of State here today but he is in good fettle. I wish him the best. Unfortunately, a number of the committee's members are unable to attend the meeting this morning. We have received apologies from Deputies Mick Wallace and Clare Daly and Senator Frances Black, so our number is somewhat depleted as a consequence.

Before we begin, I will give the caution on privilege. Members, including the Minister of State, should be aware that under the salient rulings of the Chair members should not comment on, criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable.

I invite the Minister of State to make his opening statement.

I thank you, Chairman, and the members of the committee for the warm welcome. It is great to be here. It is great to get out of Beaumont Hospital and be back in business. I welcome this opportunity to update members of the committee on the important work being undertaken in the Department of Justice and Equality to support the recent ratification of the UN Convention on the Rights of Persons with Disabilities. Specifically, I will update the committee on progress regarding the Disability (Miscellaneous Provisions) Bill, the Optional Protocol to the UN Convention on the Rights of People with Disabilities, the Assisted Decision-Making (Capacity)Act 2015 and the implementation of the National Disability Inclusion Strategy 2017-2021.

The week before last, I was delighted to attend the UN conference of the states parties to the Convention on Rights of Persons with Disabilities, CRPD, and to speak of Ireland’s progress in ratifying and implementing the convention. The ratification of the convention has been a deeply held commitment of mine since I was appointed Minister of State with responsibility for disability issues a little more than two years ago. Indeed, as an Independent Alliance Minister of State I insisted on it being highlighted among the highest priorities when negotiating the programme for Government. In other words, I was directly involved in inserting it in the programme for Government. It was a key issue for me in supporting the Government.

The convention came into force for Ireland on 19 April 2018. This marked a key moment not only for people living with a disability but also for their families, friends and support networks and for Irish society generally. Ireland’s ratification means that all European Union member states have now ratified the CRPD, making the EU the first region to ratify the convention. Ratification was the first action listed in Ireland’s national disability inclusion strategy. The strategy takes a whole-of-Government approach to improving the lives of people with disabilities and contains 114 measurable and time-specific actions under eight themes that relate to the areas of education, employment, provision of public services, health, transport, personal safety and autonomy. The strategy and the robust monitoring framework supported by the National Disability Authority, NDA, leaves us well placed to respond to the requirements of the convention. I commend and thank the NDA on its magnificent and supportive work on the disability issue.

I am a firm believer in placing a strong focus on ability rather than disability. Key actions in our national strategy include the implementation of a comprehensive employment strategy for persons with disabilities, including an increase of the public service employment target from 3% to 6%, the arrangement of special public service recruitment competitions and the opening up of alternative recruitment channels. Ireland has strong equality legislation which prevents discrimination on the basis of disability. However, people with disabilities are still only half as likely to be in employment as others of working age. I take that very seriously. This is why the comprehensive employment strategy sets out a ten-year approach to ensuring people who are able to and want to work are supported and enabled to do so. The strategy includes commitments such as special public service competitions and the opening up of alternative recruitment channels as well as the provision of a NDA-assisted employer helpline to provide expert guidance and peer support to employers. There is a great deal of work taking place under the radar in the broader society with regard to employment, with small companies and businesses taking on people with disabilities. In addition, some Departments are doing a magnificent job. I accept that we still have a long way to go but a quiet revolution is taking place regarding the employment of people with disabilities. These are concrete examples of how Ireland will fulfil its obligations under the CRPD.

In line with the convention’s guiding principles of respect for inherent dignity, individual autonomy - including the freedom to make one’s own choices, and independence of persons, the disability inclusion strategy contained a commitment to establish a task force on personalised budgets to make recommendations on potential models of personalised budgets to give people with disabilities more control in accessing health funded personal social services. When establishing the task force in September 2016, I was eager for it to proceed along the lines of my thinking and beliefs regarding people with a disability - that we must allow them to say how they wish to lead their own lives.

I am pleased this vision was demonstrated in the recommendations of the report of the task force, which I hope to publish very soon. I brought a memorandum to the Cabinet on Tuesday morning. I thank Mr. Christy Lynch and the task force for their magnificent work on the report. It will be a core element in responding to some of the fundamental principles of the convention. I refer to our respecting dignity, autonomy, independence and the freedom to make one's own choices.

The convention rebalances the right of people with disabilities to make decisions for themselves, rather than having decisions made for them. With ratification now in place for Ireland, I can now focus on using the convention to better equip and resource people with disabilities to improve their quality of life. The ratification of the UN convention is an important support for me as a Minister of State.

Ratifying the convention signals a commitment to ongoing improvement in the provision of disability services. In keeping with this principle, I recognise totally that there is always more to be done, including ratification of the optional protocol. I will respond to this in more detail later.

There has been some commentary on ratification of the optional protocol, which is not being ratified at this time but will be ratified as soon as possible following the completion of Ireland's first reporting cycle. This will provide an opportunity to identify areas for improvement and any actions needed for a high level of compliance. While I accept there was a commitment given, in the 2015 roadmap, to ratify the optional protocol at the same time as the convention, my current focus has been on ratifying the convention in the first instance. That was the first step.

As I have outlined, the convention and the optional protocol cover a broad range of commitments, some of which require substantive cultural change. Indeed, an analysis of the some 14 complaints brought under the optional protocol since 2010, indicates a range of areas on which we are actively working hard to address, such as deprivation of liberty and the right of deaf persons to participate in jury duty.

Work is continuing on the final reforms needed for Ireland's compliance with the convention's requirements. Just because one does not see this in the newspapers every single day does not mean the work is not being done. A phased approach is seen as the most practical and realistic way of moving ahead. Furthermore, while we have already made significant progress in terms of legislative change, including to the law on decision-making capacity, there still remains some legislation to be enacted.

The disability Bill was published in 2016 and is currently awaiting Committee Stage in Dáil Éireann. This is something Deputy Ó Caoláin has raised with me regularly. The Government has given approval for the Bill to receive priority within the Office of the Parliamentary Counsel, and work is under way to progress the Bill for enactment by the end of the year. I hope it will be sooner. When I say that, I mean it.

The Bill addresses a range of issues to facilitate the highest possible level of compliance with the convention such as an amendment of the Juries Act 1976 and the Electoral Act 1992 to facilitate greater participation of persons with disabilities in jury service and political life; improving the standard of reasonable accommodation to be provided by commercial bodies whose activities are regulated for quality of service; bringing civilian staff of the Garda Síochána back within the terms of Part 5 of the Disability Act to promote and support the recruitment and employment of persons with disabilities. This will allow the public sector employment quota to apply to civilian staff, which is an important part of any employment strategy.

There is a range of mostly technical amendments that are to be brought forward on Committee Stage. It was originally intended to introduce deprivation of liberty provisions as amendments at this stage. However, due to the complexity and far-reaching implications of the proposals and in response to feedback from many in the disability sector, the Government decided it was better to deal with the issues separately. The deprivation-of-liberty provisions will now feature in a standalone Bill to be sponsored by the Minister for Health, Deputy Simon Harris, and me.

The central problem to be addressed by the new provisions is that existing legislation does not provide a procedure for admitting persons without capacity to relevant facilities in which they will be under continuous supervision and control and will not be free to leave.

Existing legislation does not provide procedural safeguards to ensure individuals are not unlawfully deprived of their liberty. The draft legislative proposals that I published for public consultation last December are designed to address this gap by providing safeguards for older people, persons with a disability and some categories of people with mental illness to ensure they are not unlawfully deprived of their liberty in certain residential facilities. The consultation was an important part of the debate. We wanted to ensure everyone was consulted, including those with disabilities, senior citizens and those in the mental health sector.

The development of these deprivation-of-liberty legislative provisions is a highly complex undertaking. In addition to satisfying the requirements of the CRPD, the provisions must also align with our obligations under the European Convention on Human Rights and existing legislation, such as the Assisted Decision-Making (Capacity) Act and the Mental Health Act. I am continuing to progress this legislation as a matter of priority. The target date for finalisation of the heads is the autumn.

The Assisted Decision-Making (Capacity) Act needs to be fully commenced. Three million euro in funding has been allocated in 2018 for the establishment of the Decision Support Service.

A question that people often ask me about the convention is on resources, and rightly so. I fully agree that to support people effectively in accessing their rights, the proper allocation of resources is a key consideration. That is an important part of my strategy on providing services for people with disabilities.

We, as politicians, need to be mindful of any changes in policy and resourcing that can significantly impact on everyday circumstances. I am very much aware of this, and many members of this committee are very supportive in this regard. When the matter arises in the Dáil, as it does regularly, the committee members are very supportive of the concept of implementation. It is all very well to be talking about rights but they have to be backed up by resources. In fairness to the committee, every member has an amazing track record on disability services.

I have always placed strong emphasis on securing adequate funding, with €1.76 billion allocated by the Department of Health for disability services in 2018, representing an increase of 4.4% on 2017. Furthermore, in December of 2017, I announced the securing of an additional €10 million funding for respite care. This was based on listening to families on the ground and colleagues such as the members present regarding the crisis in respite care. That funding is now being pumped into 12 additional respite houses all around the country to support the families.

It is not just about funding, however. That is the important thing I have learned in the past two years. We need to challenge attitudes and mindsets and recognise the valuable contribution that persons with disabilities have made and will continue to make to our economy and society when supported to do so. We have to change the mindset in broader society and right across all sectors of society because we still have a long way to go. We need to focus on ability rather than disability and we need our society to encourage and empower people with a disability to define themselves, and in turn to be defined, not on the basis of what they cannot do but on the many things they can do. Last Friday week, along with the Minister for Social Protection, Deputy Regina Doherty, we announcement €16 million for the Ability programme, which is totally ignored by all sectors of society, including our national media. Some 2,600 young people between 16 and 29 years saw their organisations and groups, which focus on education, training and employment, receive substantial funding for their programmes based on an independent assessment of the work they do. Many of the organisations and groups, such as the Central Remedial Clinic, CRC, have been crying out for funding. It was given. It has a positive effect on young people, many of them with ability. One should note the programme is called the Ability programme.

We need society to encourage and empower people with disability to define themselves. This country has embarked on an era of unprecedented change in services for people with disabilities in recent years, which means we are now ready to meet our obligations.

I appreciate the candour of the Minister in outlining these matters. Before I come to Deputy Jim O'Callaghan, I wish to extend a warm welcome to our visitors in the Gallery.

I welcome the Minister, his advisers and our guests. The last time the Minister was here, the UN Convention on the Rights of People with Disabilities had not been ratified so I commend him on the fact that it was done in 2018. I am sure he recognises that there is further work to be done, however. When does the Minister think the optional protocol will be ratified and fully in place?

I agree with the Deputy that there is a lot more to be done. The convention covers a broad range of commitments which require substantive cultural change. Fundamental to that are the concepts of freedom, autonomy, independence and recognising the right of people with disabilities to make decisions for themselves. In this regard, I have received a report on personalised budgets, on which I brought a memo to Cabinet last Tuesday.

The Government's approach to meeting the terms of the convention will be one of sustained and ongoing improvement. Work is continuing on the reforms needed for the optimal level of compliance with the convention's requirements. In the early implementation phase it is essential that the resources are focused on the improvement and enhancement of services and not diverted into additional areas such as servicing the optional protocol before we are fully ready. For this reason, the Government and I see a phased approach as the more practical and realistic way of moving forward. The optional protocol is not being ratified at this time but it will be ratified as soon as possible, and at the latest following the completion of Ireland's first reporting cycle which will be within two to three years' time. This will provide us with the opportunity to identify any remaining actions needed for the highest level of compliance with the convention.

I agree it is important that we concentrate on the abilities of people as opposed to their disabilities. This is particularly important in respect of employment and improving access to employment for people with disabilities, which one may also call "abilities". What can Government do to encourage people in the private sector to recognise the abilities of people with disabilities, and the usefulness they could have as employees?

An awful lot can be done and I can do a lot as Minister. I have been working under the radar with small businesses up and down the country in this area. There are fantastic examples of good practice in small business and in the private sector. I visited a project in Galway a year and a half ago where 101 people with some form of disability were employed by nine or ten small businesses. It was supported by the wage subsidy scheme, WSS. Some of the people were highly technically qualified with a physical disability but fantastic on IT matters.

The public sector also has to be involved and we need to get the 3% figure up to 6%, though I am aiming for 10%. We are doing a lot and there are 5,000 people on the WSS scheme who are working in different areas with some degree of disability. In the CRC, in my own constituency, I have met young people aged between 18 and 20 who are highly intelligent and articulate but have some form of physical disability and who are crying out for work. We are focusing on the ability programme to address their needs.

We have to follow examples of good practice, much of which comes from creative small businesses where they have open minds and are inclusive. One young man aged 28, a supportive and inclusive manager of a shop, spotted an autistic family going into a shopping centre in Drogheda. He noticed that the mother was under severe pressure and had nowhere to leave her child. He opened up a sensory room because he recognised that 15% of his market had some form of disability and wanted to provide a place for kids to be left while the parents were shopping. He did it out of good will but turned it to his advantage and now he is making a fortune, with every special school in the Louth and north Meath area visiting him to use his services. I have been in the sensory room and it is a fantastic facility.

I mentioned the 5,000 people with disabilities who are working on the WSS scheme but we have a long way to go. Unemployment among people with disabilities is unacceptably high and we need to encourage people to be more supportive. We need to change attitudes and broaden the minds of people, particularly employers.

There is a great untapped resource for the Irish economy of which we are not availing. We are nearly at full employment but there is a whole section of society where levels of unemployment are too high. The objective should be to get incentives and awareness in the private sector up to the levels in the public sector.

The Minister said the Disability Bill 2016 had gone through Second Stage in the Dáil but it has still not come to Committee Stage. Why is that and why has it not been prioritised? When will the Assisted Decision-Making (Capacity) Act 2015 be commenced?

The Government decided in January to approve the priority drafting of the stand-alone Bill on the deprivation of liberty, decoupling its provisions from the Disability Bill. The equality division is working with the Office of the Parliamentary Counsel, OPC, to progress the remaining Committee Stage amendments, which will likely result in fewer than ten heads. The amendments are mostly technical and there is some work to be done to streamline the contents so that only what is absolutely necessary for compliance with the CRPD features in the Bill. A drafter has been engaged from the OPCand work is ongoing to draft committee Stage amendments. It is envisaged that the Bill will reach Committee Stage as soon as possible. I would suggest that this will be following the summer recess.

When will the Assisted Decision-Making (Capacity) Act 2015 be commenced?

The latest on that is that the high-level steering group, comprising senior officials from the Department of Justice and Equality, the Department of Health, the Mental Health Commission, the Courts Service and the director of the decision support service, which was set up in 2016 to oversee the establishment and the commissioning of the decision support service, is continuing its work.

The director has been appointed, as members will know, and is working in a very determined way to get the necessary staff, resources, IT systems, expert panels, codes of practice and regulations in place in order that the Decision Support Service can be up and running as quickly as possible. However, there are many complex strands to this work, including the involvement of multiple organisations. The prevailing view is that the service will not become operational before 2019.

A great deal of work is going on. Even in recruiting the director and the assistant director, there was a period of approximately five or six months when the process was very difficult. We advertised the position and it was extremely difficult to get the right candidate. The answer to the question is that the service will not become operational before 2019.

I welcome the Minister of State and his officials. I thank the Minister of State for all the work he has done in the context of Ireland ratifying the CRPD. I know it was one of his main targets in the past couple of years and, despite the delay, he went and did it. He is to be commended on that. It is now in the implementation phase.

I want to ask about the A Vision for Change document and intellectual disability. Can the Minister of State outline where Ireland stands in the context of matching the targets relating to intellectual disability that were set in A Vision for Change? Intellectual disability services do not match the median norms relating to the fields of adult psychiatric or the psychiatry of old age field or those that apply to child and adolescent mental health services. This is despite the fact that those services are completely under-resourced relative to the demand. My understanding is that services for people with intellectual disabilities are the worst of in comparison with the targets in A Vision for Change. I would like an update on that.

Are we taking all the questions together?

Some of the members will ask them individually. That is their style and preference.

I thank Deputy Chambers for his comments. I am on the same page as him and many other colleagues regarding the UN Convention. It is the implementation that matters. As I have said before, I use the UNCRPD to strengthen my hand when talking to my colleagues in government, and right across every Department, about resources and implementation. I agree with the Deputy. As I strongly emphasised, there is no point in talking about it. We can sign all the conventions in the world, but we have to ensure that our people have access to services and that their rights are being actively implemented. As far as I am concerned, ratification is stage 1. Stage 2 is implementation.

We have many problems in matching the targets in A Vision for Change. I totally accept that argument. We have to ensure that all people with intellectual disabilities are brought up to their targets. Regarding my own position on supporting people with disabilities, I saw this when we came into the sector two years ago. We had a huge problem with 18 year olds with intellectual disabilities coming out of second-level institutions with no places guaranteed for them. Approximately 1,500 were coming into the system every year with no guarantee of places. Dealing with that particular issue was the first thing I did, because I saw there that there was a cohort of young people with disabilities being left out of the picture. We had to go and get an extra €31 million to provide the places. It is now June 2018 and in recent weeks every young person coming out of a second-level institution at 18 has been informed of his or her place in an adult service in September. That is a start. We have achieved that target.

Another issue which I found very important was the restoration of the old respite care grant, which is now called a carer's support grant. Some 101,000 families had that grant cut. They were left behind and the restoration of that €1,700 for them was very important. Another issue we addressed related to young people with disabilities. We now have 1,000 new special needs assistants in the education system, along with 100 new special education teachers. We have tried to bridge the gap and attack the targets in A Vision for Change to which Deputy Jack Chambers referred. We have started but, as far as I am concerned, we have a long way to go. I will do my best to reach those targets in the next six months.

There is a clinical lead on intellectual disability whose name is Dr. Philip Dodd. Has the Minister of State met him?

Can the Deputy repeat that?

Has the Minister of State met the HSE's clinical lead in area of intellectual disability?

I have met everybody at this stage. He could have been part of a delegation or team. I do not specifically remember the name of the person. That does not mean I have not met him, because I meet HSE personnel regularly. I meet people from the Department of Health, the HSE and the National Disability Authority, NDA, on a regular basis because I think it is essential to do so. When I meet these people, I identify priorities for the disability sector. I usually have four or five issues to raise every time I meet them. The important thing is that if there is somebody I should meet, I am prepared to meet anybody in that sector. If there is anybody I omitted, I would be delighted to meet him or her.

I have a concern about the area of intellectual disability. No area has matched the outcomes called for in the A Vision for Change strategy but my understanding is that, despite all mental health services being under-resourced, services for people with intellectual disabilities lag far behind the norm or the median target range of all the other areas. If there is a clinical lead on intellectual disability, which I understand there is, I think it is important that the Minister of State and the Department meet that person. At the very least, intellectual disability services should match general adult services or old age services. The teams catering to intellectual disability services in all of the allied health professions lag far behind. Comparing the data on them versus data on the other teams, I am of the view that there is not enough focus on this area. We can talk generally about budgets or increased allocations. However, unless this committee and the Joint Committee on Health hear about what targets the Minister of State is meeting within the strategic focus of the A Vision for Change document, we cannot measure anything that his Department is doing in the area of mental health. I think it is the health professionals that need to receive the focus and resources. If services for people with intellectual disabilities are lagging behind, which they are , then they need to be a focus. I ask that the Department bring greater light to the data relating to intellectual disability services and the health professions therein. I have not heard much from the Department, today or ever, about how it is matching the focus of A Vision for Change.

I take the Deputy's point. I am listening to what he says but I do not accept all his arguments. I am totally on top of my brief where people in the disability sector are concerned.

I am not saying that-----

If the Deputy is addressing mental health issues as well, I note that there is a Minister of State, Deputy Jim Daly, who is directly involved in that area. I cannot-----

Who is responsible for intellectual disabilities, the Minister of State, Deputy Finian McGrath, or his colleague?

I am responsible for intellectual disabilities.

The Minister of State is responsible.

I spend every day of my working life away from the cameras meeting people in the HSE and the Department of Health who work in the area of disability. I also meet individuals from the all of the professions that operate on the front line. Furthermore, as the Deputy is probably aware, I spend a great deal of time meeting families and the service providers. There are often queues of service providers in the corridor outside the door of my office. I do not accept that I am not listening to people directly involved in it.

I never said that.

I am very strong on that issue. Regarding the funding, even yesterday-----

It is not about funding.

-----we were talking about mental health.

It is about focusing on how we are matching the targets in A Vision for Change.

There is funding, there are resources, the Minister of State is meeting people and he is genuine in his interest, but we need to know how we are matching the targets. We know more resources are being allocated and more people are being hired. However we still have a crisis affecting many families. If we are not matching the targets that are set out in the strategic document which underpins services for people with intellectual disabilities, then we need an update on that. I understand that many Departments have responsibility in this area. Moreover, we have a Minister of State, Deputy Jim Daly, who has special responsibility for mental health. However, I assume that services relating to intellectual disability are the responsibility of the Minister of State, Deputy Finian McGrath.

Yes, absolutely. I am on the same page as the Deputy as regards targets.

I have set myself targets for disability services every single week I have been in this job.

The national disability inclusion strategy, which the committee is due to discuss later, is part of that target. The strategy lists 114 actions. We meet every couple of months to analyse what we have achieved in transport, education, service provision, etc. My answer is "Yes" but I can supply the committee with a more detailed response later after I get information on exactly where we are coming from in respect of the disability sector and the mental health issue.

It would be good if the Minister of State updated this committee or the Joint Committee on Health on where his Department is, in terms of the document entitled A Vision for Change-----

I will update the committee.

-----because people often forget that there is a strategic focus on mental health services.

My next question is on child and adolescent mental health services, CAMHS. Like the Minister of State, on a daily basis I meet people who are battling to access any type of service.

Again, there is a crisis in recruiting enough staff to work in the field of allied health professionals. Will he update the committee on CAMHS and what he is doing to improve the level of intervention that people receive as children and adolescents? The State has failed people born with mild disabilities because it has not provided them with appropriate interventions thus allowing them to develop moderate to severe long-term outcomes. I urge the State to provide the appropriate interventions to these people. What is the Department doing to match greater levels of service for those who have waited a crazy length of time for a basic assessment and for basic intervention, which would make a difference to their lives? Enhancing someone's ability is about giving him or her the appropriate intervention when differences in a child's development or inability to reach certain milestones or whatever else are noticed. There is a complete lack of wraparound services in the disability area at primary and secondary school level and that is the pain that parents must face on a daily basis.

Regarding the disability section and A Vision for Change, what is the Department doing to match the waiting times? Providing the appropriate interventions enhances a person's ability in the long term.

On identifying people with disabilities, I accept that we must ensure that when it is discovered that a child or a new baby has a disability that there are early intervention services available.

Yesterday, I took a debate in the Dáil on the problems in CAMHS. The honest answer is that we are putting more money into the services. I admit that there is a problem recruiting psychologists and clinical teams. Many of our young graduates in psychology, occupational therapy, and speech and language therapy emigrated to the UK and around the world over the past seven to nine years, especially those qualified but some of them are beginning to return, which is positive. We have an issue with staff shortages, which are leading to waiting lists.

I am pushing the issue of tackling the shortages at Cabinet level. The Estimates will be discussed over the next couple of weeks and I have support for early intervention services, the recruitment of more staff and supporting those services as one of my top five priorities but I have other priorities.

I have been asked by the Deputy's colleagues to make the issue of a lack of residential places for older people with intellectual disabilities who have elderly parents my number one priority when we discuss the Estimates. At least 400 residential places are needed in 2019 to deal with the issue.

I have listed the Deputy's concerns about access to assessments and tackling waiting lists as one of my priorities. I agree with him that we must respond to the matter.

During the debate on the Estimates, I ask the Deputy to request his party to support me when I negotiate with the Department of Public Expenditure and Reform for funding.

The Minister of State will seek an increase in funding and he is not responsible for cuts that were made to public pay eight or nine years ago. However, the State has failed so many children.

Last night, I attended a meeting of a school board. Teachers have told me that the HSE has resisted the assessment of need process because it does not want to triage people and provide services. Some children who have been assessed have had their cognitive assessments rejected after waiting two years for an intervention and they must now rely on the school system for assistance. Perhaps the Minister of State cannot update me now but I would like him to provide an answer to the committee on the cognitive assessment area. I also want him to clarify the HSE policy on these assessments. One arm of the HSE provided a particular cognitive assessment for a child with some type of intellectual disability but another arm of the HSE rejected the assessment because it did not match another assessment field. Clearly, silos are operating within the HSE and the only people who lose out are the children because they do not receive the interventions that they require.

The Minister of State has said that he wants to enhance ability. If so, then there must be early and swift intervention as soon as children are diagnosed thus avoiding people having to go down long culs-de-sac and ending up in a black hole without a service or intervention. We must shine a light on mental health services whether they relate to intellectual disability, CAMHS areas and education. Many children will lose out and will not be given the opportunities that the Minister of State has mentioned if we continue like this. It would make no difference if the Minister of State threw another €100 million at this area and hired 100 psychologists, 100 occupational therapists and 100 speech and language therapists because the clearly dysfunctional system must first be fixed. There are mismatched cognitive assessments and different services operating in complete silos. Therefore, the Government will continue to fail children with disabilities. Parents and schools are at odds and exist in the unknown in terms of this area. The system works well in some areas of the country yet it is impossible for children to get appropriate interventions in others. The solution is not just a case of Estimates and throwing money at the problem. We need to analyse how the system operates because we clearly have a problem. I have only given one example of cognitive assessments where, for example, one person that the Minister of State employs does something for a five-year old child yet when he or she is seven years of age, having waited two years, another psychologist declares that his or her unit does not use that cognitive assessment. The child must then return to his or her school, time moves on and the parents and children are worse off as a result. There have been two appointments yet the child gets no intervention. That is the reality of the current system. The solution is more than Estimates. That is why we need greater focus on this.

I agree with the Deputy's call for us to shine a light on the cognitive assessment area and the assessment of need. I assure him that a debate is taking place. The latest reports that I have had from the HSE and the Department of Health is that internal discussions are taking place and there should be a cohesive response in the next few weeks. Some parents and professionals have made me aware of the issues raised by the Deputy. I will check if anything has happened in the past day or two that I have not been told about and I will forward a more detailed response to the Deputy. I assure him that we are trying to resolve the issue. I accept that one cannot have confusion about cognitive assessments or similar issues while children suffer.

On the education issue, the Deputy can criticise us and accuse us of not doing enough. I take his point on resources but I know how important resources are and that they have a major impact. Let us compare what happens now with what happened in primary school education 20 years ago. Recently, 1,000 new special needs assistants, SNAs, were appointed, which helps children with disabilities who attend school. In addition, 100 new resource teachers have been recruited, which helps children with disabilities to attend primary school. All of that proves that the situation has improved. Twenty years ago children with a disability were not provided with supports in primary school except for a little remedial teaching.

Now we have resource hours and SNAs. We have come a long way.

I will come back to the Deputy with a more detailed response on the cognitive assessment issue.

I am aware there are ongoing discussion. Is it true that mediation is ongoing between the Department and the different health professional representative bodies regarding an agreed process. Will the Minister of State update the committee on that?

The process is ongoing and I am not aware of when the final outcome will be. However, I expect it will be soon. I was told that two weeks ago.

What is the basis of the discussions?

I am reluctant to go into the details. I do not want to upset any side involved. I will come back to the Deputy with a more detailed response from the HSE and the Department.

What are they discussing?

This meeting is to focus on justice issues.

This has to do with disability.

Yes, but we are moving into the health area.

Will the Minister of State update the committee on the basis of these discussions?

No, if the talks are going on-----

What are the talks about?

The talks are dealing with issues regarding the delivery of services for children, including cognitive assessments and assessments of needs. These discussions are ongoing. I will come back to the Deputy when I have a final response and when my information is up to date and accurate.

We understand the mediation process is sensitive but the committee should be aware of the basis of the discussions.

I responded. I said I will come back to the Deputy and the Chairman with the details of the response.

Basically, we are talking about the cognitive assessment and assessment of need. That is the basis of the discussions. The significant issue is we want to ensure the assessments of the children are accurate and they lead to the services needed.

Why did the discussions start? What was the issue?

The issue was that some people were not happy with the delivery of the services.

The committee deserves a better explanation as to what the discussions are about.

If the discussions are not concluded, how can I-----

We need to know the facts of the basis of the discussions.

I am after giving the Deputy a commitment that I will come back to him with all the facts when I have them available to me. How can I give him facts if we have not concluded the talks? These are health issues.

I support Deputy Jack Chambers on this. We would appreciate a detailed response.

I suggest the correct mechanism is for the Minister of State to come back through the clerk to the committee to ensure the information will be shared with all committee members rather than through an individual engagement. The committee is hosting this opportunity this morning.

Of course, I will come back to the committee. I recognise it is part of the disability debate. In the morning that was in it, I thought we were focussed on the justice aspect of disability.

The justice aspect is rights-based. If someone has a right to an intervention based on the UN protocol to which the Government has signed up, we can ask questions about the delivery of that right.

We are waiting years for the advanced care directives under the Assisted Decision-Making (Capacity) Act 2015 to be delivered. When will this be progressed? Health professionals are discussing it but there has been a delay in the Department in processing it. Will the Minister of State give us a specific timeline about when this will be commenced? The Government has had sufficient time to deal with complex matters we have heard about for three years. We need to know when it will be moved on.

The Assisted Decision-Making (Capacity) Act provides a statutory modern framework to support decision-making by adults with capacity difficulties. The Act was signed into law on 30 December 2015. Budget 2018 provided an allocation of €3 million for the Decision Support Service under a new subhead, D10, of the justice and equality Vote. The commencement of the provision of the Act is a matter for the Minister for Health. The work is ongoing with the Department on the necessary preparations.

How many more years does the Department need?

I will come back to the Deputy with a more detailed response from the Department and the Minister for Health. I think it will take two years.

We will have waited five years after legislation was passed for the Department to prepare the implementation of this service.

Yes, because we want to be prepared. The whole strategy was that ratification of the UN convention was an important step. The Department of Health organised a consultation process on this issue. We advertised in the newspapers and we received many submissions from senior citizens, as well as disability and mental health groups. It proved more complex than we thought. The Minister for Health and the Department are working closely on the necessary preparations.

The legislation was passed in 2015 but we are now talking about implementation in 2020. Will the Department provide detail on those complex issues?

Yes, we can provide an up-to-date roadmap on this. The NDA is working on 11 codes of practice on this issue. The work is slow because the issues are complex.

I acknowledge this does not directly come under the Minister of State's area of responsibility but that is a failure at departmental level. Legislation has been passed by the Houses but it will take five years to implement modern advance healthcare directives and assisted decision-making. If the pace of change is that slow in this area, what hope is there for everything else the Minister of State has spoken about?

I was not in this job five years ago. When I started to try to ratify the UN convention two years ago, it was a slow debate. In the end, we had to keep on pushing the issue forward. I accept the Deputy's point on frustration. However, the fact we ratified the UN convention on 19 April will, hopefully, speed up the process. If it were not ratified, we would be in a weak position.

There are issues in wider society about the rights of senior citizens, those in nursing homes and residential centres and people with disabilities in nursing homes who should not be there in the first place. The solutions are complex and, at times, it can be slow to agree on them.

There is only way to do it which is to keep the head down and keep pushing.

I thank the committee for making it possible to have this omnibus review of where we are at this time. I thank the Minister of State, his officials and the NDA for being here to assist us in that regard.

It is hard to know where start as so many interesting points made been made. I have a copy of a brief submission made by Inclusion Ireland on issues such as assisted decision-making -I did not like what I heard about that - personal budgets, the working group and a number of other issues, some of which have been dealt with. I ask the committee to provide the Minister of State with a copy of the submission for consideration.

I welcome the representatives of Inclusion Ireland who are in the Public Gallery and who also yesterday attended a meeting of the Joint Committee on Health as part of the Oireachtas disabilities group. I thank the Chairman for the leadership he provided to that group as its vice-chairman. This group comprises four organisations: the Disability Federation of Ireland, DFI, Inclusion Ireland, the Federation of Voluntary Bodies and Not for Profit Association. It has called for a five-year multi-annual investment in the disabilities sector. As mentioned by Deputy Jack Chambers, rights should drive what happens in every Department. This sector cuts across a range of Departments. The group has called for north of €200 million per annum for the disabilities sector, not to solve all the problems but to ensure a decent kick-start following ratification of the convention earlier this year on 19 April, which the Minister of State said earlier "will help, hopefully". I do not take a lot of comfort from "will help, hopefully". I understand that Ireland via the Houses of the Oireachtas has given its solemn commitment to implementation of the convention throughout our system, in education, housing, transport, communications, health, social protection and so on.

In fairness to the Minister of State he was strong in his opening remarks about the chronic unemployment rate among people with disabilities, which is damning. We experienced similar unemployment levels in this sector ten years ago when Ireland was sucking people in from other parts of the world to fill employment gaps. What new initiatives are planned to ensure the comprehensive employment strategy works? This strategy is almost three years in existence. On 2 October this year, three of its ten years will have elapsed. What initiatives are in place to drive it? The Minister of State will rightly point to the increase from 3% to 6% in the number of people with disabilities in the public sector. It we can leverage activation and employment it will be a game changer.

I welcome the recent initiative proposed at the joint meeting of the Joint Committees on Employment Affairs and Social Protection, Health and Education and Skills to look in the round at the interlocking issues between Departments. We heard testimony during that hearing for approximately one and a half hours from six people with disabilities, all of whom said they were "lucky" to get a start. Strategies and governance are not about luck; they are about making something happen. For every person with a disability who was lucky, there are thousands who were not.

There is an ongoing crisis in respite care. To put it mildly, doing something about respite provision would be modest and it does not speak to the spirit of the UN convention. Yesterday, Deputy Ó Caoláin, Senator Conway and I listened to the story of a woman who has been up to her neck caring for a child for the past 35 years and who said: "I want my life back." We focus on the rights of people with disabilities but there are other people whose rights and basic dignity are being infringed by being locked into caring roles. There is a great deal at stake in the implementation of the convention. The Minister of State is well aware of the issues. I have perhaps worn him out talking about personal assistant supports to enable people to get out and about. What will be provided for in the budget on respite care will be sold to us as substantive. However, the circumstances are chronic for the people who are stuck but there has not been a substantive response post-19 April.

I welcome the Ability programme. The CRC has two schools in Dublin and there are many other special schools in the country. However, there is no career guidance in these schools because they are regarded as primary schools. These schools should be provided with funding to enable them to provide career guidance and thus marshal people and get them thinking about progression. This issue could be taken up by the Department of Education and Skills. Under the Ability programme, these schools are currently addressing issues such as human rights awareness and understanding. It is an excellent initiative.

The Minister of State referenced the additional funding being invested in disability services every year. What annoys me and others is that we are never shown the balance sheet. We hear constantly that more money is being invested, which nobody denies, but we are never told how the need for funding is changing. We are never told if need is increasing or decreasing. We all know it is increasing. Thankfully, babies are being born that would not have survived ten years ago. Thirty years ago a child with Down's syndrome lived to only 30 or 35 years of age. That was the expectation of their parents from day one. Nowadays, these people are living into their 50s and 60s, although some have other issues. We are pumping out the flooded house but water is still coming in. If is important that across government people are as honest as they can be and admit that while additional funding is being provided they are hard pressed to keep up with the accelerating need.

I thank the Minister of State for mentioning the 1,200 young people who are in nursing homes. There are also 2,500 people in congregated settings, with up to 170 people still trying to exit these settings every year. This process was supposed to be concluded this year. At the same time, there are people who are younger than most people in this room going into nursing homes for 30, 40 and 50 years. Honesty is vital.

The Minister of State spoke about awareness in the community and among employers. My sense is that there is not enough leadership at the top. He is working night and day, might and mane to ensure there is focus on getting critical Bills enacted and securing additional funding for disability services.

I am left with a question. The Government as an entity does not get it. I refer to cultural change. The Minister of State spoke of the man in Drogheda who saw something, responded to it and his instinct was right. We see that around the place. I do not, however, see that instinct in our Government. More money must be into the disability sector.

Between 40 and 50 polling stations were not accessible to people with disabilities during the recent referendum. That is just one example, which requires an amendment to the Electoral Acts. I would be happy if we were implementing some of the Acts in place. It was like pulling teeth to introduce the change to allow blind people to vote. This was a basic measure but it is only guaranteed for referenda. It was resisted tooth and nail by a Department for many years before Mr. Robbie Sinnott pulled it out of their heads. He did it doggedly and was threatened that the State would go after him.

The attitude that we cannot do this, because it would cost money remains. This is not a criticism of the Minister of State but he sits at the Cabinet table. We will not, in fairness, be dependent only on him to do this work; we will work on it as well. This will be the third budget of this Administration and it has to demonstrate improvement in a range of areas in people's lives such as transport housing, education, employment, communications, and income supports. It cannot just be about specialist disability services, although God knows there are problems there. We will walk past the window of this budget the day after and people with disabilities will have to see that an effort was made in and there was thoughtfulness across a range of Departments. That is moving away from the tight text of the presentation of the Minister of State but it is connected. Was 19 April a game changer for the Government and the Oireachtas? There is challenge for all of us to see that reflected in the budget in early October. I refer also to assisted decision-making, deprivation of liberty, the Disability (Miscellaneous Provisions) Bill, and so on, being done and dusted by the end of this year. There is an issue with timelines.

Turning to the National Disability Inclusion Strategy 2017-2021 published in mid-July 2017, states, "Progress the Disability (Miscellaneous Provisions) Bill so as to enactment to address outstanding obstacles to ratification". The Department of Justice and Equality timeline was 2017. In the middle of July, with five and half months to go to the end of 2017, there was a commitment that it would be done by then. It bothers me that commitments are made close to when they are due. Time passes and they are still swinging in the wind. There are issues there. I thank the Minister of State for the work he does but the Government needs to reinvigorate he significance of 19 April.

Go raibh maith agat. Senator Dolan has a compendium of different issues and questions. Will the Minister of State, Deputy McGrath, take-----

I will take the whole lot together. I thank the Senator for all his work. The Oireachtas disability group is a valuable tool and Deputy Ó Caoláin is the vice-chairman. It is important we have multiple voices. On the Senator's initial points I have not seen the Inclusion Ireland document yet but I meet the organisation regularly and work closely with it. I am on the issue and I will have a look at that to see if there is something in it later, when I get an opportunity.

Turning to the budget issue, I spoke last Monday morning at the DFI conference where I met many of its members. I will also meet the DFI and the Senator in the next couple of weeks on the issue of the budget and the multi-annual funding. I support it but the Senator is correct that funding has to be provided by every Department. We have to ensure everybody in different Departments gets the issue of disability and that it is not just the Minister of State with special responsibility for disabilities talking about the €1.7 billion in funding for the social care policy plan in 2018. It has to involve transport, young people in nursing homes and decongregation etc. I get that and it is my job to make sure my Cabinet colleagues get it as well.

There has been progress on the mindset and cultural change. I notice that regularly when I speak at Cabinet level on disability issues. I try to bring in everybody involved, whether it is the Ministers for Transport, Tourism and Sport, Health, Education and Skills or Employment Affairs and Social Protection. I accept the criticism regarding balance that we have a hell of a long way to go to change the broader mindset both in government and in society but that is part of my agenda. The important aspect is to understand that the broader Dáil and society, and committees like this, have played a leading role. When I was in opposition and when it came to civil rights, human rights and equality issues, I always found the Oireachtas committees pushed out the boat and set the broader agenda. That is important to me in as Minister of State with special responsibility for disabilities. I would love €200 million in the budget this year and-----

No bother to the Minister of State.

-----I will appreciate any help. Last year, I went in looking for an extra €100 million and I ended up with €92 million. Some people would say that is not bad going in negotiations. That was in respect of the social care plan. Senator Dolan is correct, however, and Deputy Jack Chambers mentioned this as well. We can talk about resources but we have to make sure that the resources are delivered to the person with the disability. That is an issue and I will put up my hands and accept that.

The Senator also talked about employment issues. The NDA works closely with the HSE to strategically forecast funding needs. The comprehensive employment strategy for people with disabilities, for the first three years - the foundation stage - features collaboration with different employers and the implementation of make work pay actions and Departments are working together to set up a national programme to support employment. There is a broader view on the issue of work.

The Senator also touched on personal assistants, and that is something I have learned about from a recent meeting with the DFI. We can put €10 million into respite care, which is an issue that has to be solved, and we can put €31 million into school leavers but a substantial section of the disability community feels we need to increase personal assistant hours to enable people to live independent lives in line with the UN convention. I accept that argument and it is on my shopping list for the Estimates debate.

Another issue the Senator touched on was that of value for money. That is something we have to see from the viewpoint of a person with a disability. Parents regularly come to me saying they have heard that the funding for their daughter in an adult service is between €80,000 and €150,000 a year and they do not feel they are getting value for money. That has to be listened to, that is my job and that is one of the reasons we looked at a personalised budget. It will be given as an option and I do not say will work for everybody - but it is an option. I know from my own experience and from talking to people with disabilities that usually between 8% and 12% of the population are interested in that. They have to have value for money.

I will address the issue of people with a disability living longer. There is a huge increase in the population. People with health issues are living longer due to new medicines and so on. I remember being told 25 years ago that when a person has a daughter with a disability, God knows how long she will live. It might be into her 30s. Going around the country now I meet adults with intellectual disabilities in their 50s and 60s, which is great.

As the Chairman knows, I have been to his county. When we are talking about congregated settings, the examples in Monaghan are fantastic. They are smaller houses in which four or five people live with support staff funded by the State. It is very progressive. We have learned from that. Do we have more a lot more to do? Absolutely. There are more than 2,500 people in congregated settings. My job is to try to get them out. We are trying to provide funding to get another 170 out this year. We need to ensure that is progressed. As a Minister of State, one has competing needs. Different issues come at one. If I thought for a second that I could deal with all those issues in 2019 with the €200 million, I would absolutely do so. The Chairman can take it that I will be pushing for the maximum resources for my colleagues both in the Department of Health and in the Department of Justice and Equality in the negotiations.

The other question Senator Nolan posed is very important. The budget absolutely has to be cross-departmental in nature. If one is talking about equality, that has to be ensured. I agree with that principle but we have to ensure that every single Department understands it. We have made progress. We have managed to change the mindset. One of the reasons we included a Minister of State with responsibility for disabilities in the programme for Government was to start the change of mindset of Government, of the Cabinet and across society more broadly. I agree that we have to have cross-budgetary action in respect of budget 2019. We have to ensure that people with disabilities are not left behind in the broader debate. I know there are competing interests. From talking to him, I know that the Minister, Deputy Harris, is under pressure in the context of hospital issues, staff issues, accident and emergency departments, beds, etc. We also have the issue of housing. There are competing needs in the budget. My job is to try to push for the maximum supports for all people with disabilities. I give a commitment to the committee that I will do my best on these issues.

Does Senator Dolan wish to add anything?

I will be brief. First, I will give the Minister of State a break. I will probably not be at his meeting with the DFI. The Minister of State is saying that progress is being made and that there is cultural change at the level of the Cabinet and the Government. The question is whether progress is happening faster than the demographic change that is working against us. That is the real nub of this issue. Of course, progress is being made when one looks at it micro issue by micro issue. On that €200 million or more which will be the minimum going in, if that amount or something like it is not allocated, we will not make the progress required. That is the issue. Government has crises in health and housing. It is very concerned about what is or is not happening in Northern Ireland and in the context of Brexit. If one looks back five years, the Government had other priorities. Disability is always spoken about as a critical issue but it never breaks into the first division of priorities. That is the problem. It is always on the edge. Can it not break into the first division now? I have named four issues for Government. I will add a fifth. I do not hear Ministers - and I am not talking about the Minister of State - name-dropping disability, mental health or the UN Convention on the Rights of Persons with Disabilities. Has the latter been ratified? Do the Ministers understand what it means? That is the nub of the cultural change.

The Minister of State mentioned a figure of 170 people, which is all very well. I am not going to rub it in. He and I know that is modest in terms of what needs to be done. Some of that problem will be solved by people dying in the residences and institutions in which they are living. Sadly, that is a fact. Can we please stop adding to it by putting people into nursing homes? There will be people put into nursing homes this year. There are issues like that. The Minister of State has to start draining the thing.

I will leave it at that. I thank the Minister of State. I have a suggestion for the Cathaoirleach. I do not know the way to do this but there needs to be some way for this committee or the Cathaoirleach, with some of the other committees, to bring this discussion beyond justice in some way. It has to be embedded across other committees and other Departments. That is a conundrum don Chathaoirleach féin.

We note the Senator's prompting and absolutely agree.

I thank Deputy Ó Laoghaire for his comments. I take his point with regard to Senator Dolan's comment about which committee is responsible. As far as I am concerned, disability and inclusion are contemplated as part of the broader issue of equality. That is a very relevant aspect.

On the comprehensive employment strategy, the Department of Justice and Equality is leading on its implementation. The strategy is basically intended to address the under-representation of people with disabilities in the labour force. The purpose of the strategy is to facilitate a concerted cross-Government effort to address the barriers and challenges and their impact on people with disabilities. As stated earlier, we have changed that figure from 3% to 6% within the public service. On the impact of the implementation issues which Deputy Ó Laoghaire raised, the implementation of the strategy is under way and is being co-ordinated and monitored by the Department of Justice and Equality. An implementation group consisting of relevant Departments and stakeholders meets regularly and is engaged in discussions with larger public sector employers such as the Public Appointments Service and the HSE to progress commitments outlined in the strategy.

Deputy Ó Laoghaire touched on the monitoring of the strategy, which is very important.

The overarching monitoring method used by the group is the traffic-light approach or the so-called red-amber-green approach. This is something we also do in the broader national disability inclusion strategy.

Importantly, we made progress on the employment of people with disabilities. Some Departments have very good records and have moved above 4%. As I mentioned earlier, there are approximately 5,000 people with some form of disability employed in small businesses in the private sector. I know from visiting third-level colleges throughout the country that there are in the region of 12,000 people with some form of disability in those colleges. This was unheard of 20 years ago. Therefore, we have moved forward and are doing certain things. As I touched on earlier, we were monitoring and assessing, every few months, every development in regard to the employment of people with disabilities.

We have to change the mindset of broader society, including in both the public and private sectors, to focus on the ability of a person with a disability. We should focus on abilities in working with people to find them employment. There are 16 Intreo officers in the 60 social protection offices throughout the country. Their full-time job is to liaise with any family or a person with a disability with a view to advising them on some form of employment. I have updated members on what we do. As I stated before, we have a long way to go and a mindset to change. It is important that we acknowledge that.

The optional protocol to the CRPD establishes two procedures to strengthen the implementation and monitoring of the convention. First, it allows individuals to bring petitions to the committee on the rights of persons with disabilities claiming breaches of their rights. The second is an inquiry procedure giving the committee authority to undertake inquiries into grave systematic violations of the convention. The convention and protocol cover a broad range of commitments, some of which require substantive cultural changes. Included are changes concerning decongregation, personalised budgets and the deprivation of liberty. As the optional protocol comes into effect 30 days after the deposit of its instruments, the State will become accountable to the committee for any breaches of the convention from that date forward. We might disagree on this but it is essential that the necessary legislation, the disability Bill we are discussing today, and the Decision Support Service be in place prior to an optional protocol. For this reason, I have opted for a phased approach as the most practical and realistic way of moving forward.

Accordingly, the optional protocol is not being ratified at this time. It will be ratified as soon as possible following completion of Ireland's first reporting cycle, which will identify any actions needed regarding compliance with the convention. The direct answer to the question is that I will ratify as soon as possible. We will ratify as soon as possible. I want to ratify. We will opt in eventually. I want to make sure everything is in place first.

I omitted to mention the reform of the wards of court system. This is also an issue.

There are two aspects on which I did not get an answer.

On the wage subsidy scheme and the optional protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.

What aspect of the wage subsidy scheme?

Has the Government any intention of expanding it further?

Yes, absolutely. With regard to social protection, I mentioned the Intreo offices. There are approximately 5,000 to 6,000 people in the scheme now. That figure might not have changed recently but the answer is "Yes". We have to ensure positive discrimination in regard to the employment issue. There are a couple of thousand people on the scheme and we need to develop it. We need to ensure more employers become directly involved. I will absolutely be pushing for this with the Minister, Deputy Regina Doherty. That comes under her remit but I work very closely with her. As I said earlier, and as Senator Dolan will tell the Deputy, there are many more qualified people now in the disability community. As a result, development is required.

What was the second question?

It was on the optional protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.

According to my briefing, that convention is the responsibility of the Minister for Justice and Equality, Deputy Flanagan. The existing legislation does not provide procedural safeguards to ensure individuals are not unlawfully deprived of their liberty. The draft legislative proposals that I published for public consultation last December are designed to address this gap by providing safeguards for older people, persons with a disability and some categories of people with a mental illness to ensure they are not unlawfully deprived of their liberty in certain residential facilities. The development of these deprivation-of-liberty legislative provisions is a highly complex undertaking. I mentioned this earlier. In addition to satisfying the requirements of the CRPD, the provisions must also align – this is probably related to the Deputy's question – with our obligations under the European Convention on Human Rights and existing legislation, such as the Assisted Decision-Making (Capacity) Act and the Mental Health Act. I am continuing to progress this legislation as a matter of priority. The direct answer to the Deputy's question is that the target date for finalisation of the heads is the autumn.

I have another series of questions. I ask the Minister of State to reflect on the optional protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. There are those who would like a narrow understanding of it, specifically focusing on incarceration in prisons and so on. A broad view needs to be taken of it. The convention should have application anywhere people are deprived of their liberty. The Minister of State would have an interest in that. I hope he will have discussions with the Minister for Justice and Equality, and that we can ratify the optional protocol as soon as possible. It is in everyone's interest.

I support Senator Dolan on the point he made about polling stations. Deputy Adams brought forward a Bill on this. No polling station should be used that is not fully accessible. We should put that on a legislative basis.

A number of points were made on respite. The Minister of State committed to expanding respite care. The matter is raised regularly in my constituency office by people seeking respite. I had a conversation recently on an issue that is broader than respite, namely, that of settings, on which there has been a fair bit of discussion. A parent to whom I spoke who has been regularly seeking more respite said the service is reasonable until the person cared for reaches the age of 18, after which there is a bit of a cliff edge. The person's son is profoundly autistic. The family have quite a challenging life. It is positive but challenging and it is very difficult for them to get respite. They recently asked a health service provider where their son would go if anything happened to them in the morning. They were shocked to discover there was no place in particular. The son would probably end up in hospital for a period until another setting was found. The family were quite shocked, upset and worried as a consequence. They are right because it indicates the lack of a long-term plan to offer support to individuals. There might be a bit of a plan up to the age of 18 but, beyond that, there is not. The family was rightly very concerned about this. It has made them concerned now and they are trying to figure out how best to put a plan in place. There might not be a great amount that they can do, which is quite worrying. That needs to be addressed.

I have more points to make and perhaps the Minister of State will take a note of them in order. I recently visited Cork Deaf Club. Much of the discussion was on the back of the recognition of Irish sign language. A number of significant issues still need to be addressed, however. One is that the driver theory test is quite challenging for those who are deaf or who have limited hearing. It is more difficult than it should be. This may not be so much the case with the practical test. There is a serious lack of teachers who can sign to an adequate standard. This needs to be addressed. I note that there is a course available.

This is more likely to be the case at primary level than at post-primary level, but it seems to be an issue. There also seems to be an issue with the quality of interpreters. There are many interpreters whose work is of a high standard, but there are also those whose work is not of an adequately high standard. Questions have been asked about the much-discussed voucher system. When will something like that be put in place to allow people to obtain interpreters for cultural and social events outside of those to which there is an entitlement because public services are being provided? Obviously, there needs to be an improvement with regard to public services as well. I ask the Minister of State and the witnesses to comment on the voucher system.

I wish to ask about the option of sending a text message to alert the emergency services. I think it may be available in Dublin in respect of ambulance services, but I am not sure. In other parts of the country, it is not the case that one can send a text message to alert the Garda and the other emergency services when people are in distress. I do not think it is possible to make an appointment with SouthDoc, which is the after-hours service in the HSE's southern area, by sending a text message. That is quite challenging.

I would like to mention an issue that was raised with me on another occasion. It has been suggested to me that it would be helpful if members of An Garda Síochána knew five or six basic signs. When communications difficulties arise in situations of distress, perhaps because somebody is not able to verbalise what he or she wants to say, it would be helpful if gardaí knew five or six basic signs. Perhaps that could be integrated into their training.

I was part of a delegation of Deputies from Cork that met the Minister of State approximately two years ago to discuss the lack of multidisciplinary supports for a special school in Cork. I regret to say that very little headway has been made in that regard since then. I wrote to the Minister of State recently to raise this matter again. If it has not yet been brought to his attention, that is reasonable. I would like the Minister of State to meet the delegation of Deputies from Cork again, ideally before the recess. Two years have passed and very little progress has been made in this regard.

I thank the Deputy. I know that, like the Chair, he is a strong advocate for people with disabilities. I agree that we need to have a broader view, as the Deputy said earlier when he spoke about the optional protocol. Of course, I will have discussions with the Minister for Justice and Equality in respect of this issue.

It is unacceptable that there are polling stations which are not accessible. If we are talking about having an inclusive democracy, we need to do something about this. I will push this issue as well.

The Deputy touched on the important broader issue of respite, about which I spoke earlier. An extra €10 million was provided for respite a few months ago to try to ensure services are provided. As he said, older parents in their 70s, 80s and 90s who are caring for their children, who are now adults with intellectual disabilities, are wondering where they will go when they pass away. I have heard about such cases in Cork and from my colleagues in the Dáil. We have to address that system. I am banging on the door as part of that. I am looking for 400 emergency residential places to deal with these situations. Last year, I managed to get emergency funding for 135 places. Having listened to what the Deputy has said today, and having listened to colleagues right across the Dáil, I have decided that 400 places are needed. That is something I have to push for.

I have a long-term objective for services for people with physical or intellectual disabilities. Every state and every society should have a plan for children and adults with disabilities from the cradle to the grave. This links in with the debate we had earlier about the multi-annual approach. A plan is needed for people with disabilities. There was a row when I was looking for funding for places for 18 year olds. There is never a similar row about people in the non-disabled community. They automatically go to primary school, to secondary school and to college if they have enough points. There is no debate about it, but I need to have a discussion and a row about getting money to ensure that 18 year olds with disabilities can get adult services. That is part of this debate. We need to plan the service from the cradle to the grave.

I was in Cuba a couple of years ago. Many of the members of the committee will not agree with this, although Deputy Ó Laoghaire probably will.

The best cigars in the world.

Yes, the best cigars in the world. There are disabilities in Cuba, which is a country that has been hammered by an embargo. It has been hammered by its next-door neighbour - America - for 60 years. When I met the Cuban Minister who deals with disabilities, she brought me around. It is interesting that there were no people on trolleys in this supposedly poor country. They had a plan of the kind spoken about by Deputy Ó Laoghaire. There is a plan for every child with a disability in Cuba from the day he or she is born to the day he or she dies. I saw the services that are bring provided in a country that has a low budget. Cuba prioritises health, disability and education when it is debating these matters. It is a lesson for us all. We can learn from it. If a poor country can do it, we can do it. My objective, if I get enough time in the job, is to develop a cradle-to-grave approach to this whole issue.

I will work with the various Departments on the important issue of driving tests and theory tests for deaf people. I intervened to assist the Irish Deaf Society when it was in financial difficulty recently. Like the members of this committee, those involved in the society were very supportive when the Irish Sign Language Bill 2016 was going through these Houses. As Deputy Ó Laoghaire has indicated, now that the legislation has been passed we need to ensure services of an appropriate quality and standard are available. There should be no issues with lack of standards in services.

The Deputy made a very good point about being able to send text messages to alert the emergency services. It will have to be addressed. The inclusion of emergency communications in the proposed EU accessibility directive is being examined as part of the negotiations on the proposed directive. When that directive has been agreed and transposed, it will be put on a legislative footing in Ireland. It is important for the ongoing work on this issue to continue.

Deputy Ó Laoghaire also mentioned the use of Irish sign language by the Garda Síochána. He suggested that all gardaí should have basic training in the use of Irish Sign Language and I agree that this would be very important. I suggest that this should be done in Templemore, but I would take it a step further. Every member of the Garda Síochána should receive Irish Sign Language training at the Garda College, but this should apply to other public servants as well. They should get some level of training in the use of Irish Sign Language. I expect that people involved in the Irish Deaf Society would be glad to facilitate the training and upskilling of people in this area.

I am disappointed to hear that no progress has been made in respect of the special school in Cork. I will meet Deputy Ó Laoghaire and the other members of the delegation to discuss the issues in relation to the school in question.

I thank the Minister of State. The Minister of State has been speculating on the length of time he might have left in office. Perhaps Deputy Kevin O'Keeffe would like to shed some light on that.

Give me another two years.

You would never know.

It depends on how much progress is made.

I came in for five minutes but I have stayed for longer than I anticipated. I support the request made by my colleague, Deputy Ó Laoghaire, for the Minister of State to meet a deputation of Deputies from Cork to discuss the availability of essential services. I ask the Minister of State to agree to such a meeting.

The failure to provide for polling stations that can be accessed by people with disabilities has been mentioned. I would be careful in saying that polling stations should be shut down. I come from a rural area where polling booths were placed in private houses until quite recently. We have moved on since then. There is a limited choice of public buildings in certain parts of the country. If we are talking about upgrading access or reviewing buildings, funding needs to be provided to facilitate that. If this does not happen, people in some parts of the country will end up with no polling booths within miles and miles of them. We need to be fair to all people, for example by giving them transport or whatever.

I came to this meeting to raise a different issue. Senator Dolan referred in his concluding remarks to the need to avoid putting people in nursing homes. Yesterday, the Minister of State with responsibility for older people, Deputy Jim Daly, launched a report on the home care package, which is an alternative to the fair deal scheme for nursing homes.

Will the Department have a look at the report and see where it could feed into it and how younger adults could avail of this option? As Senator Dolan stated, the last thing we want to do is put people into nursing homes or community care houses. We want to keep them at home. There may be some parts of this report that the Department could feed into, particularly with regard to the home care package scheme for younger people.

I welcome the Deputy and I will facilitate a meeting with his colleagues from Cork. We will see if we can be supportive of parents and children in that school. We must see what is the problem or the delay. I agree with that.

The Deputy is 100% right about polling stations and accessibility is important. Even in smaller locations with polling stations, it is easy to adapt and provide resources and services. I did not realise there were still some stations in private homes.

There was until recently.

I thought there might still be some on some island communities that I have missed. There should be access and services should be provided in that respect. We will examine the home care package question. We have tried out for the past 12 months the idea of home support service hours. For example, last year there were 2.75 million home support hours. Instead of people going into respite care in those cases, the services came to the person's house. I mentioned to Senator Dolan and DFI recently the provision of personal assistant services. Last year that came to 1.5 million or 1.6 million hours. If we can increase those hours, we could provide support, particularly for young people with a disability. I do not wish to discriminate but it is particularly sad to see a young person in their 20s or 30s in a nursing home environment. The members do not have to convince me about such people as I know them, have met them and I spoke to some recently. Whatever about a senior citizen or elderly person being in a nursing home, such people are at least with their peer group. Part of the solution will be more personal assistant and home support hours. The issues of services for people of all ages will be considered in developing the new home care scheme.

We spoke earlier about funding and the mindset in Irish society. My job is to push for funding and to change the mindsets both within and outside government to ensure every person with a disability is treated with respect and dignity. I set out with three clear objectives when I took over as Minister of State. The first was to reform services, and we have started doing that. The second was to invest in services, and we have started that as well. Third and most important, is the facet fitting into the comments from Deputy O'Keeffe and Senator Dolan, which is putting the person with the disability at the centre of our services.

I will make a number of points and pose some questions before we bring this session to a close. As Senator Dolan noted, the Oireachtas disability group yesterday launched its pre-budget submission for 2019. It is the first time that an all-party or non-party group of Members of both Houses has prepared and published pre-budget proposals in the area of disabilities. The only precedent I can reference relates to mental health. A different group, which I am thankful is still functioning here, has in previous years presented such a proposition. We will forward those proposals to the Minister of State. I join the Senator in strongly urging the Minister of State's careful consideration of the points made. They were made in conjunction with four of the key organisations, including Inclusion Ireland, which is represented at the meeting, and the DFI. I thank them for their collaboration in this effort.

Senator Dolan mentioned a figure of €200 million but we are not asking the Minister of State to secure that on his own. It is across what has often been referenced as the "silos" of government. What we are hoping for and urging is that in budget 2019, not only with the portfolios under the Minister of State's aegis, but all Departments would reflect on this to ensure that the needs and rights of people with disabilities can be front and centre in all the departmental elements of the budget. As I said in closing yesterday's event, it would be an historic statement on the part of the Government if the approximately 640,000 people who have registered with a disability in the 2016 census were recognised, with their needs and rights affirmed across all Departments. I take the opportunity to strongly urge the Minister of State's careful consideration and that he could be that the champion at the Cabinet table. It is important that we see this referencing and provision across all Departments.

We are a justice and equality committee and the equality element is important, and not just in terms of justice rights. The equality element relating to people with disabilities is important. I know other members who, unfortunately, could not be with us today and who would have a very strong contribution to make in that regard. I regret that they have not been able to attend.

We can go over a number of the points made by the Minister of State, specifically relating to the optional protocol to the CRPD. In December 2016 the Minister of State sat in this room with us, indicating it was his intent and purpose to ensure the simultaneous ratification of the convention and the optional protocol. There is major disappointment that the optional protocol has been kicked down the road; there is no other way to describe it. The optional protocol will give effect to the two implementation mechanisms mentioned by the Minister of State. It is only through the adoption of the optional protocol that the mechanisms are open to exercise. I noted the Minister of State's first response to Deputy Chambers on this, which is speculation that it will happen in two or three years. Even the notion of having to wait for the first report in the cycle is not good enough. It does not allow for enforceability but it offers a means to hold to account not only Departments and agencies and it gives people hope and a path to ensuring the promise of the UN convention. That is much more than how the Minister of State described it himself.

In his opening comments, the Minister of State indicated that ratifying the convention signalled a commitment to ongoing improvement in the provision of disability services.

It has to be so much more than that. I do not doubt the Minister of State's commitment to ongoing improvements in the provision of disability services, but the ratification of the CRPD is not just people with disabilities and those who care for them and who share with them. It has to be so much more.

He referenced recognition of Irish sign language. I remember the euphoria of the deaf community in the Visitors Gallery on the confirmation of recognition of their language. Similarly the recognition of ethnicity for the Traveller community was a great day for Travellers. To see such joy in people was wonderful.

The CRPD is an unfulfilled joy for people with disabilities. I cannot emphasise enough the importance of revisiting the Minister of State's decision to do this on an incremental basis. I ask him to give the programme for the ratification of the optional protocol serious consideration in the period ahead and perhaps we could talk again in the autumn on this matter. I do not want the him to dismiss my appeal out of hand and I do not expect that he will be in a position to answer my request and say: "Okay". I ask him to take a little time to consider it, to listen to the representative organisations, to reflect on the submission of the Oireachtas disability group and to give serious reconsideration to the scheduling of that.

When the committee dealt with the general scheme of the Disability (Miscellaneous Provisions) Bill, it was then called the equality and disability (miscellaneous provisions) Bill. The equality element in the Title was dropped. We have done that. I note in his opening remarks that the Minister of State stated: "The disability Bill was published in 2016 and is currently awaiting Committee Stage in Dáil Éireann". We are the committee who will perform that task and we are awaiting it. It is hugely frustrating because it also has a direct impact on the implementation of the UN convention.

There are delays with various Bills coming to the committee and there is a delay even in the decision on support service under the capacity legislation. Only a fortnight ago, the senior Minister from the Department of Justice and Equality, was before us and we cited to him the backlog in legislation. There has never been such a serious delay with progressing legislation as some of us are witnessing now, particularly those who have been here for many years. Will the Minister of State endeavour to prioritise the promised legislation and to prioritise again the assisted decision-making support service? One of his officials told us honestly during a previous engagement with officials from the Department that she did not see it happening in this calendar year. I acknowledge that is the reply the Minister of State gave, but if it is at all possible, whatever can be done before the end of the year should be done. I note that he has said 2019, as the lady official also indicated previously, make it as early as possible in the new year, if that can at all be done. The decision-making support service and the capacity legislation is a vital support for people with an intellectual incapacity.

I have a number of specific questions. The Oireachtas disability group is making a case to the Minister of State for the cost of living with a disability to be factored in. There should not be a relationship between the disability allowance, the social protection supports and people in other situations, such as unemployment assistance or whatever the case might be. People living with disabilities are living unique lives and it should be down to the real cost. As an interim measure we are urging a particular increase in budget 2019 of €20 per week to be followed in each of the subsequent years over the five-year lifespan of the submission we have made. Is an analysis of the real cost of living with a disability being undertaken? Is such an exercise under way under the aegis of the Departments of which the Minister of State has an overview?.

Are measures being taken to introduce secure medical cards for people with a disability? It is frustrating for people with a lifelong incapacity finding themselves because of whatever change without a medical card which is such a crucial comfort and support. That is simply not acceptable. If we are to believe the Minister for Health, we are moving towards an NHS-type of public health care provision, we should take medical cards away from anybody. We should move forward to include more and more cohorts. People with disabilities should not lose a medical card at any time.

What plans are there to increase the number of health professionals in the disability sector such as speech and language therapists, occupational therapists, physiotherapists? The Minister of State mentioned recruitment of up to 400 in the coming year. What proactive measures are under way to signal to displaced Irish trained therapists across the range of different areas that Ireland is hoping to recruit therapists? Are we advertising in the Irish overseas media and all the local newspapers that are sold in the United States and Britain? That is where our expats will go for information. Does the Department advertise, for example, in the Irish Voice, and The Irish Echo to notify readers that there are job opportunities in the healthcare system in Ireland in all of these specific areas?

The in loco parentis issue has not been raised. I am not going to go over what has been said but I have raised this issue repeatedly and in tandem with the Minister of State at the Department of Health, Deputy Jim Daly, I have met Department of Health officials.

I know of several settings where the in loco parentis clause almost creates an inability on the part of a parent to take even a brief break from a home environment where they are looking after a special child on a 24-7 basis. On a strict application of the in loco parentis provision, when a fully qualified, properly vetted nurse practitioner is dealing with a child's specific needs for a period of time in the day, a parent can only leave to visit next door for a coffee or to fulfil a need such as shopping, etc. Unless they can put another adult in situ they are not allowed to leave the house, though the highly qualified nurse practitioner is probably the most respected person to have in situ. If there is no willingness to look at the in loco parentis provision in its entirety, there is a huge need for a significant relaxation to allow the parent a brief respite for a half an hour or an hour to enable him or her to cope. There are real situations involving real people. I have many questions. I showed them to the clerk to the committee yesterday but they do not all come under employment, education, and transport. We believe the needs and rights of people with disabilities cut across all Departments, which is something the Minister said earlier in response to a question. I commend the Minister of State on that and I ask him to ensure that his colleagues in Cabinet also appreciate this.

I have witnessed the Eagle passenger lifter device assisting people with significant physical disabilities to get from a wheelchair into an airline seat. It has an Australian manufacturer and the process was, I understand, recently demonstrated for the Minister of State. It is not, however, available at any airport in the State. In my view, it is a requirement and the airport authorities should have it. It is long past time for people who cannot move from a wheelchair to an airline seat to have such a device, rather than being hauled by two, three or four people into a seat, which is hugely undignified. Any measure that helps affirm the dignity of every human being should be pursued. I understand that we all make a small contribution to a fund every time we book an airline flight, which is supposed to be set aside to introduce such measures so the money is there, sitting in the coffers of airline authorities, and we need somebody to drive it forward to ensure the equipment is rolled out across the airports here. It would mean a total of 11 units in Dublin, Cork, Shannon, Galway, Knock and Donegal. There would be no additional cost to the public purse. The money is there so why can we not have the service for those who need it and are entitled to it?

I will look closely at this in the context of my pre-budget submission. I have met some of the groups that are pushing this agenda. I am glad the Chairman recognises that the €200 million is not just for me and it is a broader Cabinet issue. I have made it a priority, however.

All Departments have to reflect the needs and rights of all people with disabilities. The Chairman said the UN convention was a historic statement for the 640,000 people with disabilities and he also mentioned the justice and equality dimension. I understand his concerns relating to the optional protocol and we have to ensure there is a pathway so that people can have hope. I had a choice; I could have been hanging around for another two years to get the legislation done but I decided to ratify the convention and use that to strengthen my own hand in the area. People may not have agreed with this but I felt the process was too slow.

I totally agree that the ratification of the UN convention has got to be more than just ratification. The Chairman referred to the unrestrained joy on the night the Irish Sign Language Bill 2017 was passed and we have all learned from that positive experience. We have to ensure the UN convention is a meaningful convention and is backed up by implementation and by resources.

I have worked very closely with the Chairman on other Oireachtas committees on the area of disability, as I have with Senator John Dolan. I give serious consideration to everything the justice committee tells me. Behind the scenes, I am raising the points they have made on the timeframe for ratification. I also feel strongly about the delays in the legislation. Members mentioned the issues of costs for persons with disabilities. Every time I talk about improving things for a person with a disability I refer to the high cost of services for people with disabilities. I would love to give them €20 per week more in the disability allowance and we will push for this. Over the past two years, the disability allowance has gone up by €10 a week, though I was looking for €20 more.

The security of medical cards for people with disabilities is also important. We have to build a strong, national, public health service and that is my vision. I am working with the Minister for Health on it and the domiciliary care allowance for 11,000 children was one of the first issues we worked on. We need to ensure our senior citizens, our sick and our elderly, who are among the most vulnerable people in society, have a medical card. There should be no dithering about it and nothing should change while a person has a recognised disability. I have been in talks with the spinal injuries people and I am a strong advocate in Government for medical cards for them. Many of them are working and they have many additional costs because of their disability.

I am told there are plans to get some of our speech and language and occupational therapists back from England and Scotland.

I take the point about local district Irish newspapers being sold in Birmingham, Manchester, Edinburgh which people whose parents are living in Ireland buy. I had not thought of that important means of making contact with our highly educated people whom we lost to emigration during the downturn and most of them are dying to come home. We need to push strongly for this to happen.

On the issue of in loco parentis, I have talked to the HSE, the Department of Health and have made my views known internally. I have similar views to the Chairman, because we know how difficult it is for some families with high dependency children and-or adult offspring with disabilities who cannot get a break because there are issues with using highly trained staff or nurses. We have to examine the issue in its entirety and we have to be flexible. The latest up-to-date situation is that the Department of Health is looking at the issue.

The Chairman referred to the Eagle Passenger Lifter, and I am on the same page about the undignified way people with disabilities are often treated at airports. I met personnel from the company that supplies Eagle Passenger lifters. The Chairman had a very positive constructive proposal about covering the cost because normally when one looks for a service, the first thing that is said is that it will cost us money. He pointed out that there is a budget for this service. The use of an Eagle Passenger Lifter leads to supporting the personal dignity of a person with a disability and that is in line with the UNCRPD


I thank colleagues for their views. I will give serious consideration to every idea put forward. I hope we can progress and develop services for all people with disabilities, but above all ensure that the UN convention becomes a reality for all people.

On that note, Senator Dolan and I are the survivors this morning

I have stuck with it and I am only at it for 40 years.

That is not to take away from any of our colleagues whose contributions I wish to acknowledge. On behalf of the committee I thank the Minister of State and his officials for being with us. I thank those who joined us in the Visitors Gallery. I also thank the clerk to the committee and the support staff at the top table.

The joint committee adjourned at 11.35 a.m. until 9 a.m. on Wednesday, 4 July 2018.