Wednesday, 18 April 2012
Dáil Éireann Debate
1318. Deputy Derek Nolan asked the Minister for Health further to Parliamentary Question No. 552 of 13 March 2012, the number of the 42 recommendations from the Irish Human Rights Commission report arising from the operation of a residential and day-care centre for persons with a severe and profound intellectual disability that have been implemented; the recommendations that have not been implemented; the timeline for when the outstanding recommendations will be implemented; and if he will make a statement on the matter. [18728/12]
Minister of State at the Department of Health (Deputy Kathleen Lynch): As the Deputy is aware the Irish Human Rights Commission Enquiry Report into the provision of intellectual disability services by the Brothers of Charity Services to adults in the John Paul Centre, Galway was published in March 2010. From a Department of Health perspective, the Report raises important questions regarding the current arrangements for funding, accountability and standards in our disability services. It is acknowledged that, despite considerable advances in the standard of service provision in recent years, more needs to be done to improve services. A number of important current initiatives will further advance the ability of the health services to focus more fully on meeting the needs of people with disabilities. My Department’s ongoing Value for Money and Policy Review of Disability Services (VFM) is considering how well the current substantial allocation of funding for disability services is being used, and is exploring the way forward for reconfiguration of these services, and their management and operation, so as to enable them to respond more effectively to individual needs. It is expected that the Review will be completed in the first half of 2012.
The Report makes 15 specific recommendations to the Department of Health. I have set out below the current position in relation to the implementation of the recommendations below. Recommendations 1 and 2: (Gaps in existing law/ practice and ratification of UNCRPD). These recommendations were accepted. The Department of Justice and Equality has responsibility in relation to ratification of the UN Convention on the Rights of Persons with Disabilities (UNCRPD). The Department of Health is engaging with that Department in relation to ongoing work involved in preparing for ratification.
Recommendation 3: (Definition of health and personal social services). The Department of Health has completed a review of the eligibility framework which is contained in the Health Act 1970. The issue is being considered in the context of policy proposals being developed on Universal Health Insurance. The Government is now committed to implementing a comprehensive programme of health reform. It has set clear goals for the health service, namely, a universal, single tier health care system with access based on need and not income, more care delivered locally through strengthened primary care, and greater transparency and incentives regarding performance. The Government will introduce Universal Health Insurance with equal access to care for all, with no discrimination between patients on the grounds of income or insurance status.
Recommendations 4, 5, 6 and 8: (“bottom up” redesign of service agreements (quantum, quality and accountability) working group on national average costs, National Intellectual Disability Database review, individual assessments to inform service level funding — non-retrogressive measures). These recommendations have been accepted and will be informed by and progressed in the context of the forthcoming Value For Money and Policy Review of Disability Services.
Recommendation 7: (Disability Act 2005). Part 2 of the Disability Act 2005 was commenced for children under the age of 5 on 1 June 2007. It had been intended that the Disability Act would be commenced on a phased basis for the 5-18 year old cohort and then for adults, with the Disability Act and the Education for Persons with Special Education Needs (EPSEN) Act 2004 to be implemented during 2010 in respect of children between 5 and 18 years of age. In light of current fiscal constraints, it was necessary to defer further implementation of the two Acts.
Recommendations 9, 13 and 15: (Clear guidelines on the required staff-to-client ratios; clear protocols for the prevention of foreseeable risks to vulnerable persons with an intellectual disability living in institutions or residential centres through timely and appropriate intervention strategies; HIQA’s inspection and monitoring role to be immediately introduced). HIQA has prepared and published standards for residential services for the disability sector, which outline what is expected of a provider of services and what a person with a disability, his or her family, and the public, can expect to receive from such services. The standards clearly set out what a quality safe residential service for people with disabilities should be and support the delivery of person-centred care in this sector. The Government is committed to ensuring that vulnerable people with disabilities in residential services are safeguarded and protected, and that their quality of life is enhanced. With this in mind, the current Programme for Government commits to mandatory standards for this sector and inspections of services by HIQA. Discussions have begun between the Department of Health and HIQA to progress this commitment. Given the complex nature of residential service provision for people with disabilities, ranging from congregated settings to dispersed housing in the community, careful consideration is being given to designing the most appropriate regulatory model and this work is ongoing. A target date of Quarter 1 2013 has been provisionally set for the commencement of the proposed regulatory scheme.
Recommendation 10: (protocols governing HSE Reviews including reporting). The HSE has informed the Department that it has reviewed its current arrangements for holding and managing enquiries in order to ensure that all future enquiries are conducted efficiently and effectively, and without undue delay. I understand that a Serious Incident Unit has been set up within HSE for the purpose of developing and implementing policies and procedures to facilitate appropriate and proportionate responses to all serious incidents including the establishment and management of inquiries and investigations.
Recommendation 11: (the complaints mechanisms under Part 9 of the Health Act 2004 should be reviewed). The Department will raise this issue with the HSE to establish how the overall complaints system is working in relation to disability service providers.
Recommendation 14: (Department to review the Government’s 2003 Report to the CPT and the recommendations made in the Report — persons with ID in a psychiatric facility). Substantial progress has been made in relation to (a) transferring persons with an intellectual disability from psychiatric hospitals and other inappropriate placements, (b) the development of national standards, recommendations 9, 13 and 15 above refer.
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