Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

That is great. I thank the Acting Chairperson. I also thank Senator Clonan for the opportunity to be here for Committee Stage of the Bill. If it was simple, it would have been done many years ago. Is that not the case? We would not be sitting here today. It is important to say that I will not be opposing the Bill by any manner of means. That is the first point.

I want to talk to the Senator and the colleagues who have supported him about how this small Bill is a big chance to make a difference. There is a legitimate public policy aim behind the proposed statutory duty to provide disability-related services at or before the point when a person ideally requires them. The Department shares the aim of the Senators and their intent that all persons in need of health services from the State would receive them without delay. Achievement of that goal is inevitably frustrated by the fact that the State has limited resources, many competing obligations and, most importantly in this instance, the presence of a highly competitive labour market. Staffing issues are not being caused by the lack of financial resources. Over the years, as the population grew, we did not grow our college places to meet demand. That is the resource piece I spoke to.

Children's disability network teams, CDNTs, with whatever staffing resources are available at a particular time, have responsibility for assessments of need and therapy intervention services. The amendment, by mandating services in addition to the assessments of need, could create an overwhelming demand on CDNTs.It is important to say that. It is also incumbent on the Government and various Departments to increase the number of trainees or assistant therapists coming through to be able to meet the demand.

I would also like to speak about a few of the contributors. It is important to start with the Taoiseach, who put in place the Cabinet subcommittee and included disability as part and parcel of it. I have been a Minister of State for four years and it was only my second time two weeks ago to attend a Cabinet subcommittee. I will now be attending a Cabinet subcommittee regularly at which disabilities will be front and centre and will be an agenda item for discussion every two weeks, led out by the Taoiseach. I really welcome that as it means I have a platform to address some of the frustrations I have experienced over the past number of years.

I was listening to Senator Wall. He spoke about assessment of need, CHO 7 and regional assessment hubs. They are my frustrations; there is no doubt about it. I cannot say that the hubs are all perfect by any manner or means but there was no regional assessment hub when I stood before the House this time last year. It was an agenda item which I created within the HSE to be put in. I am not a clinician; I am a politician. I do not work for the HSE. I am a Minister of State within a Department. All I have done is try to itemise, identify where we could potentially find solutions and put connectivities in place. The regional assessment hubs are by no means perfect but if there were regional assessment officers in all of them, we could possibly get through the files as they are completed on a quicker basis in order that children can get the most important piece of what we are talking about today, namely, that intervention. Our goal should be to drive down assessments. We should be driving interventions as opposed to assessments. That is where we need to get to.

On funding, it is important to say that in that space of assessments, €11.5 million was laid out, then there was another €4.5 million in this budget and another €8.5 million. Some €16 million went into that space between the PDS and the assessment of need in order for the HSE to stand up and implement the will of the Government and elected representatives to operationalise what is required for our most vulnerable citizens, that is,to give the assessments and then to ensure the interventions are met.

Senator Warfield spoke about recruitment and retention, which is a whole part of this. When we look at recruitment and retention, we have to look at them in the case of both therapists who can provide the intervention and other therapists who can provide the assessments. I chair a high-level group with all Departments on what we are doing in higher education to ensure there is expansion of spaces and more capacity, what assistant therapists might look like, whether there is a pay grade and whether it has been sorted out with the union. I am talking about trivial stuff but we are coming from a low base within disability in trying to put structure and shape to it. We are making some progress. The Senator is right, however, as is Senator Hoey in respect of section 39 organisations. We still do not have the KOSI process completed by all of our section 39 providers. There are 1,300 section 39 providers and only 200 of the KOSI forms have been completed to enable staff to get their wages and back payment paid. It is a very fair point. I hope that when the KOSI process is put in place, once and for all, the next piece of the pay and negotiation piece will be the conversation around aligning to the section 38 organisations and the HSE in order that all staff have an equal pay footing across the board.

Senator Carrigy spoke about the Disability Act. I do not disagree with him or with his committee's perspective on whether we should review it. The Disability Act is 20 years old. I will be gazing forward at the Disability Act to ensure my lens gets to it in the coming months. The Senator Carrigy is right; it has to be the same chance for all children to access assessments and interventions. I say this with the best will in the world but we can no longer have the trumping of assessments and interventions.People should not have to ring a politician or go to a Senator to ask them to write a letter so that people can access a school place. It is a broken system that needs to be shaped correctly so that it works for all, regardless of where people live and their socioeconomic environment. The system has to work equitably for all. We are all at one in both Houses when it comes to disability.

Senator McGreehan said every child deserves the same chance and the system is broken. That is absolutely true. While the transport piece does not speak completely to me and I might have some influence, it has a long way to go to meet the rights of equity of access for all.

Senator Flynn spoke very clearly about employment and equality of opportunity. That comes down to a choice-based approach. Everybody has a choice to make decisions, but if we do not have the proper accommodation, how can we expect people to participate in employment?

Senator Ward referred to this being a small Bill and matching commitment. There is no shortage to my commitment; all I need is time to do what I need to do. I do not believe there is any shortage in commitment in the Seanad. We need time to do things. If this was easy, it would have been done long ago. This is not easy, but we will work to ensure that every child can access the services they require. There is no denying that there are blockages. We need to unparcel the blockages and learn from the issues there have been with assessments of need. There have been many issues within that system. When we ask how we arrive at a stage where there are no timely interventions for assessments of need, we do not need to create a hierarchy in respect of interventions. We have to learn from what has caused the blockages.

Senator Dolan referred to just transition. Just transition includes disability and youth, two parts that were not originally included. As I said at the beginning of my contribution, I will not oppose the Bill. I do not say this is simple or easy, but we will support the Bill through the Houses.