Nithe i dtosach suíonna - Commencement Matters

Medical Aids and Appliances

Tá fáilte romhat, a Aire-Stáit as iarthar Chorcaí.

I, too, welcome the Minister of State and thank him for coming to discuss this very important issue.

I raise an issue in CHO 3 - the mid-west - of the HSE. Recently I have encountered three cases - I am sure there are many more - in which people have received not very nice letters. They were told that as there was no funding available, they would not be given power chairs. The three cases which are very significant involve two children and one adult. The adult suffers from a rare form of dwarfism that renders him unable to walk very far. As a consequence, he needs a power chair. One of the two children suffers from a rare condition, Moyamoya, while the other suffers from rare conditions and has had to use a chair since they were a very small child. The biggest issue for the three is they have outgrown the chairs they use. All three have received a similar letter citing a lack of funding and indicating that the HSE does not know when funding will become available. I am concerned because the lack of funding is holding them back. Their families are also concerned. The parents of the two children take them out as often as they can, but because they no longer fit in their chairs it has become very difficult for them to leave their homes. In fact, one of the children now falls out of their chair because it is too small. When will funding be released? How can the lives of the two children and one adult concerned and their families return to normal? It is very important that this issue be resolved as quickly as possible.

Gabhaim buíochas leis an gCathaoirleach as ucht na fáilte, mar is gnách, agus gabhaim buíochas leis an Seanadóir freisin for raising this important issue.

The HSE provides a wide range of medical and surgical aids and appliances such as wheelchairs and walking aids free of charge for medical card holders and those participating in the long-term illness scheme. Assessment by a relevant health professional is required. The community funded schemes is the collective name for the many products, supports, supplies, appliances and aids provided through community services. There is a variety of products and services provided under the schemes. The products and services play a key role in assisting and supporting service users to maintain everyday functioning and remain in their homes and local community. Their provision also avoids the need for a hospital presentation or admission, while facilitating early discharge from hospital back into the community.

Each community healthcare organisation, CHO, operates standard processes for the allocation of funding for medical and surgical aids and appliances. At times, because the demand for resources exceeds available capacity, there may be waiting lists for some categories of items provided from the medical and surgical aids and appliances budget in a particular CHO.

CHOs undertake a range of initiatives to ensure optimum use of resources. I refer, for example, to the efficient recycling of stock items such as walking aids.

In the CHO 3 area in the mid-west, there is a waiting list in place for the purchase of 25 powered chairs. It should be noted that waiting time varies depending on the priority rating, a rating which is made by healthcare professionals based on clinical risk. Priority is given to clients with the greatest level of clinical need. In addition, work is progressing in CHO 3 on the establishment of a stock database to maximise recycling of stock items across the mid west. Under the aids and appliances project, data will be transferred onto an online system allowing clinicians to review all stock online, validate waiting lists and use recycled stock more efficiently.

At national level within the HSE, a service improvement programme has been established to improve the standard and quality of the many products and services provided as part of community funded schemes and to implement standardised national contracts for the supply and pricing of these products to ensure best value for money across all CHOs. These measures will help to ensure that there is equitable access to products and services irrespective of where the service user lives.

I thank the Minister of State. While I accept that everything is being assessed and that there is a waiting list, the lives of these three people have been impacted. The Minister of State has just said there are 25 people on the waiting list. I am not sure how many other people are affected but I have been contacted by three individuals and I am really concerned that they have no quality of life. They cannot do what they have been used to doing every day. It is my understanding that in other CHO areas people get their wheelchairs more or less straight away. It very much depends on the number of people on the list. Is there any hope that some of the funding that is not being used in other areas could be diverted on a temporary basis? It is not fair that 25 people are waiting in the CHO 3 area while there are few if any waiting in others. I know that is hearsay but the people with whom I am in contact have spoken to patients in other areas who got chairs immediately. There is a problem here and the funding must be found. That is what I am asking for today.

I thank the Senator. She makes a very fair point. I will speak to the Minister following this discussion and I will try to get a handle on the national picture. The answer I have given the Senator is very much focused on CHO 3 but the Senator makes a very valid argument that if there were better alignment between all nine CHOs and a streamlining of the available funding, that might improve the situation. Ultimately, we want to ensure that the three people to whom the Senator refers and the other people on the waiting list of 25 in the CHO 3 area are dealt with as quickly as possible. I will have a conversation with the Minister in terms of the HSE looking at this issue from a national perspective in order to try to get better alignment between the CHOs to better utilise the system. Each CHO working on its own is not going to solve the problem and better collaboration may be required. I will speak to the Minister on behalf of the Senator.

Legislative Reviews

I thank the Minister of State for making time to come to the House. Political discourse, both here and abroad, is being degraded by a variety of groups and individuals who peddle messages of division and hatred that have no place in Irish culture. Several of the candidates in the recent elections ran campaigns based on messages of hate and fear that were designed to get attention and support for themselves, irrespective of the consequences of their message to individuals, the State or society. Indeed, since the elections, we have even seen a failed candidate who considers herself wiser than others, who came from the east, following a chemtrail in the sky and bearing a message of cold racism and slur, telling children from the midlands that there is no place for them at the inn because their skin is a different colour. Thankfully, the good people of Longford sent her back from whence where she came.

I ask the Minister of State to outline what is being done to review and strengthen the laws on hate crime, incitement and online hate speech. This problem is not unique to the Republic of Ireland. If one looks west, across the Atlantic, one will see a President who deliberately divided a nation for his own political purposes and who dismisses any criticism as fake news. Looking east across the Irish Sea, one can also see damage and division being created by individuals for their own political ends. North of the Border, Sinn Féin and the DUP are engaged in a discourse that is driven only by party-political agendas and interests. In the Republic, there are populists motivated by the desire for attention and electoral gain who will do or say anything to further their own self-interest. All of these people have a number of things in common. Their message is one of division, setting up one group against another on the basis of nationality, gender, sexuality, colour, religion, social class, political ideology or indeed any other perceived variant of otherness. They also all have simplistic answers and superficially appealing mantras including that someone else should pay, it is someone else's fault and that they bear no responsibility and so on. The other thing that these people have in common, whether they are right wing or left wing, is that they are not concerned about the interests of the people they supposedly represent. Their primary concern is to radicalise people behind their own cause or group or to draw attention or electoral support for themselves. Those of us in the middle must stand up to these extremists. We must counter their politics of division. Otherwise, as W.B. Yeats wrote:

Things fall apart; the centre cannot hold;

Mere anarchy is loosed upon the world.

I thank Senator McFadden for raising this important issue. I also congratulate her on the presentation she has just made. It was very measured but very well researched and strong.

Safety, fairness and inclusion are at the heart of the work of the Department of Justice and Equality. The Minister and I are committed to ensuring that Ireland is a safe and secure country for everyone. This means working to find effective ways of protecting people from the effects of hate crime and hate speech and of signalling very clearly to perpetrators that hate crime and hate speech, whether they take place online or in the real world, are not tolerated or accepted here. There is already a significant body of criminal law in place to deal with hate crime and hate speech. The Prohibition of Incitement to Hatred Act 1989 includes offences of incitement to hatred on account of race, religion, nationality, ethnic or sexual orientation. In brief, it is an offence to use words, behave, publish or distribute written material, or broadcast any visual images or sounds which are threatening, abusive or insulting and are intended or, having regard to all the circumstances, are likely to stir up hatred. In addition, where any criminal offence such as assault, criminal damage or a public order offence is committed against a person because of their race, religion, colour, ethnicity or some other prejudice, it can be prosecuted through the wider criminal law and the courts can consider evidence of a hate or prejudice motive as an aggravating factor at sentencing.

Of course, the criminal law must be kept under review. We must learn from our experiences of the implementation of the law in practice and from the experiences of other countries and we must ensure that the law keeps pace with developments in society. I am very conscious of recent calls from civil society, international bodies and others for reform of the legislation in this area. With that in mind, the Department of Justice and Equality has arranged for research to be carried out on the effectiveness of hate crime laws in other jurisdictions. This work will look at how other countries have legislated to deal with offences which are motivated by prejudice or hate and how effective those laws have been in practice. Separately, the Department is undertaking a review of the Prohibition of Incitement to Hatred Act. As part of this review, the Department will shortly carry out a public consultation on the Act and the results of this consultation together with wider policy analysis and review will inform proposals for changes to the Act which will be brought before this House for debate in due course.

I thank the Minister of State. I am aware of the work that he does on this issue all of the time. I was a member of the Joint Committee on Justice and Equality in the previous Oireachtas term and know of his commitment in this area. I really welcome the fact that the Department has commissioned research, which will be invaluable. I also welcome the proposed public consultation and would urge Members of both Houses to work with that process.

Fine Gael is a party of unity, equality and opportunity.

Those are the words on the wall in the room in which our parliamentary party meets. I would like us to create a society in which everybody is engaged in democracy for the betterment of that society. I welcome the response of the Minister of State. I pledge to work with him and I encourage others to do so too.

I thank the Senator for her remarks and for the opportunity to discuss this very important matter. Hate crime means that vulnerable groups and individuals are targeted simply for who they are. The impacts of hate crime and hate speech are especially serious because they have a ripple effect that spreads far beyond the individual victim. If not dealt with, this can lead to a divided society in which entire communities feel unsafe. The serious nature of this behaviour means we must be especially careful to ensure that the legislation in place to deal with it is robust. The work being undertaken in the Department will help ensure any reform introduced is effective and reflects best practice internationally. I look forward to debating the matter with Senators when the legislation comes before the House.

Research on hate crime in other jurisdictions is likely to be completed later this year. The public consultation is due to go live very soon and I welcome the Senator's call for others to engage in it. Departmental officials will then consider the outcome of this work to determine the best approach to legislating in Ireland.

We welcome the fifth report of the European Commission against Racism and Intolerance. In its report it highlights a number of positive developments in recent years. We will work to implement its recommendations, particularly the two priority recommendations on hate crime and Traveller accommodation.

When candidates use hate speech and hate crime in their canvassing, they are engaging in lazy politics. They are being populist and scapegoating others. This type of behaviour is shameful and I am glad that it has not taken hold or been successful here.

Sitting suspended at 10.55 a.m. and resumed at 11.30 a.m.