Wednesday, 9 April 2008
Seanad Eireann Debate
I welcome the Minister of State, Deputy Jimmy Devins. I put this motion on the Order Paper as a result of the huge concern throughout the country about the difficulties parents are experiencing in accessing assessments for their children, getting inpatient beds where they are required and the huge difficulties schools and school principals have in accessing the support services they believe are required for children in their care. The motion aims to highlight the need to implement fully the EPSEN Act of 2004 as a matter of urgency and as advised by the National Council for Special Education. The council advised the Minister to bring the timetable for implementation forward as it considered it inappropriate that children should have to wait until the implementation date contained in the Act.
The motion highlights the need for the Government to address the shortage of psychologists and the huge difficulties encountered by schools and parents in obtaining assessments, the long waiting lists for speech and language therapies and other therapies which parents know their children need and, in some cases, have been advised by assessments that they need, and the difficulty many parents encounter when trying to obtain an appropriate education for their children. In the absence of these services parents must resort to the courts, as was graphically seen recently. Fine Gael also put down this motion as a result of the failure of the Government to fund an adequate number of mental health initiatives, its failure to ring-fence the funding for mental health, the stripping of assets from mental health facilities and the diversion of funding, as is evident at Beaumont Hospital where the site for a unit that was meant to replace facilities in St. Ita’s has now been taken for a co-located hospital. This is a disgraceful abandonment of a commitment to people suffering from mental health difficulties.
There is a failure to provide adequate services in child and adolescent psychiatry throughout the country. Evidence of this is the closed list in Kill, County Kildare. Families in that area can no longer access the service because the list is effectively closed and is not taking referrals. Other child and family services throughout the country have waiting lists of one to three years. What are parents supposed to do with children who have mental health difficulties and who need help now, not in three years? Everybody is aware of the value of early intervention in such cases. This is the 11th year of Fianna Fáil-led Government, a Government that inherited a surplus in the public finances and a strong economy, yet these are the statistics and the experience of children with special needs.
This country has experienced huge economic growth. The Celtic tiger roared loudly, but the roar was not even a whimper when it came to caring for children with special educational needs or those in need of psychiatric services. Why has this not been a priority area, as is evident from the detailed report, The Lie of the Land, launched some time ago and the waiting lists I have mentioned? Every Member of the House is aware of cases of children with special needs being unable to access an appropriate education, receive a diagnosis or obtain vital services such as speech and language therapy. If one does not get a diagnosis for one’s child, how can one know what the child needs or the range of services that would benefit the child? If one cannot get a diagnosis, it is difficult to access the services appropriate to the child.
What is the Government’s response to the motion? I condemn the long amendment it has put forward. It is full of words which try to paint everything in the garden rosy. I would be far more impressed if the Government had acknowledged the waiting lists and the difficulties, as opposed to complete denial in the face of the reality of poor services, and sought the support of the Opposition in trying to find a way forward and having a debate that examines the barriers that exist, the reasons the money is not being effectively spent in this area and why services are still not available to children. We know the number of children involved so we should surely be able to deal with their needs in a country such as this, given the type of economy we have had over the last 11 years. I will be saddened and disappointed if the Green Party accepts the Government amendment. Only 11 months ago that party was committed to this issue and critical of the Government’s appalling record, a record that has not changed or improved in the time the Green Party has been in Government.
The amendment is an insult to families of special needs children. It is an insult to Bridget Keane and John Butler and their son Mark. Mark has Down's syndrome and in their local newspaper his parents spoke of how the lack of speech therapy is hampering his development. Ms Keane said that with proper help and intervention Mark could reach his full potential but that very little help was available. Mr. John Lindsay, the chief executive of Down's syndrome Ireland, went even further when he said: “The provision of this service by the State has reached crisis point”. Mr. Lindsay is on the front-line working with children with Down's syndrome and their parents. He is aware of the situation. I accept the amendment’s statement that there is increased funding. However, there is still huge difficulty because people cannot access the services they need. Why is this happening? Why did the Ó Cuanacháin family in Arklow, County Wicklow, have no choice but to take the Minister for Education and Science and the State to the High Court to try to obtain an appropriate education for their autistic son, Seán?
This amendment is an insult to every family waiting for a psychological assessment for their children and who have had to endure broken promises and unfulfilled commitments by the Minister with regard to increasing the number of educational psychologists. Some of the wording in the amendment is ridiculous. I ask any member of the Government to find a principal from any school in the country who will agree with what is said in the amendment, that schools are happy with the level of resources they have been given, are happy to assess the child’s educational needs themselves and that there is no need for an educational psychologist in many cases.
Senator Frances Fitzgerald: It is the most extraordinary wording I have seen in an amendment and is so far from the truth that it beggars belief. The Minister promised to increase the number of national educational psychologists by 31 to 158 but only 11 have been delivered. The programme for Government pledges to increase the number of psychologists to 200 by the end of 2009 but given the lack of educational psychologists graduating, the slow recruitment process and the lack of resources it seems extremely unlikely that this will be reached.
I have quoted some individual stories and that is just the tip of the iceberg, as everyone in this House knows. Even if one were not moved by the individual stories, there is no doubt the economic arguments would make sense. The report of the National Council for Special Education, NCSE, the Minister’s own organisation, makes this point that early intervention makes economic sense. If one does not intervene and help children with special needs at an early enough stage they go on to have increased difficulties, employment is more difficult for them, it is more difficult for them to pass exams and access third level education, life becomes much more burdensome and difficult and some will become more dependent on the State. It makes economic sense as well as everything else to put these services in place.
The Minister has been slow to implement the Education for Persons with Special Educational Needs Act 2004 as advised by the NCSE. We all appreciate that massive change in special needs education cannot be introduced overnight. However, the Act compelled the NCSE to draw up an implementation plan to guide the Minister and assist her in enacting the new provisions. Why has the Minister been slow to introduce the implementation plan? Page 150 of the NCSE’s report to the Minister warns:
On the same page of the report, in section 6.12, it states that, “The council’s view is that these provisions cannot wait until the end of the five-year implementation phase.” Yet on the amendment we see no reference to this. We see an acceptance of the implementation date in the Bill and no recognition of what the council said to the Minister. In this report we see in black and white the Minister’s expert group specifically set up to advise on special education stating categorically that many provisions need urgent attention, yet the Government amendment does not address that. This is a serious situation for families and children. Some 30 separate actions should have been implemented. Perhaps the Minister of State would respond, because the Minister did not respond in the Dáil.
I want to address briefly the question of inpatient and outpatient services for children, which is Deputy Devins’s particular responsibility. A Vision for Change recommended 100 inpatient beds for children and adolescents in five units. Although these beds were promised by the end of 2007, it appears most of them will not be delivered until 2009. As I have said, mental health continues to be the Cinderella of our public health service. Why? Why are so many children being admitted to adult psychiatric wards? Between December 2006 and December 2007, 200 children were admitted to adult psychiatric wards. What are we doing admitting young children to adult psychiatric wards?
Senator Frances Fitzgerald: I look forward to hearing what the Minister of State has to say tonight on implementing A Vision for Change and providing more beds and units for children in need of in-patient care. In 2006, 3,000 children and adolescents waited an average of 15 months for a psychiatric assessment. The waiting list was longer in 2007 and the money for the implementation of A Vision for Change was slashed. This cannot be tolerated. What reassurance can the Minister of State give Members that this situation will change?
The Irish Psychiatric Association presented a very detailed report some time ago analysing all this. Mr. Declan Coogan, a spokesperson for the Irish Association of Social Workers was quoted in The Irish Times about children who were in urgent need of proper intervention but were unable to access support. One example was an eight year old boy with serious emotional and behavioural problems at home and school. He had been on a waiting list for two years. His behaviour had become so problematic he had reduced hours at school and his family, understandably, was under considerable stress. What do we offer these families? Where is the funding to implement A Vision for Change? Where are the urgently needed inpatient beds particularly in the area of child and adolescent psychiatry? In the amendment the Minister of State mentions 1,050 posts. Will these be affected by the cutbacks the Health Service Executive is meeting to discuss today? Where are those posts? Has the recruitment process begun? I have been able to touch on only some of the issues of concern to us in this area. I look forward to hearing what the Minister of State has to say in response.
Senator Fidelma Healy Eames: I intend to share my time with Senator Donohoe. I thank the Minister of State, Deputy Devins, for being in the House. Informally he told me he loves his job. We can make this a great country for people with disabilities if we work together and listen to people with disabilities because they best know their needs. This is not a great country for people with disabilities. I will touch on education and employment in particular. To be given a fair chance or a level playing field people with disabilities need appropriate, timely intervention and various forms of assistance. Special educational needs exist on a continuum from mild to severe and similar adaptations need to happen in the workplace to make disabled people more employable.
What schools offer to children with disabilities is highly problematic and a bit of a joke. I know this because I work in those schools and have done so for many years. One third of our young people with disabilities aged from 15 to 19 drop out of school compared with one quarter of the rest of the population. Why? Senator Fitzgerald has touched on some of the reasons. The National Educational Psychological Service, NEPS, is haphazard. Just 1,303 of our primary schools out of a total of 3,200 have a NEPS service. At second level 456 out of 720 schools have a NEPS service. Psychological services are not in place to provide the adequate and timely assessments for children.
Autism care is a joke. It is entirely dependent on parent action. Before St. Patrick’s Day I told the Minister for Education and Science, Deputy Hanafin, research is vital to track approaches that are successful for children with autism. Speech and occupational therapy for children with autism is entirely as a result of private funding sources. For example, Claddagh national school in Galway fund-raises to pay an occupational therapist €642 for one day’s work. Leaving children with severe behavioural and communication problems without speech and occupational therapy is criminal. The Education for Persons with Special Educational Needs Act needs €397 million to be implemented. No appeals process is operational because the Act has not been implemented.
I read the Government’s amendment. There is a great deal of legislation but none of it has been implemented. We have a real difficulty in that the assessments available by law are available only to those under the age of five. Until we embrace the principles of non-discrimination, inclusion — which means no cherry picking and exclusion of children with special needs by schools — and equal opportunity for all in education and employment across society, there will be no fair play for people with disabilities.
To achieve this in law the Government needs to ratify immediately the UN Convention on the Rights of Persons with Disabilities. The Minister of State might give the timeframe for that. We signed it last year. The 20 governments across the world which have ratified it are bound by law to give fair play to people with disabilities. Some of our EU partners such as Hungary and Spain have ratified it.
One of the main points about which I want to talk to the Minister of State is the need for the individualisation of service delivery and to move away from the old model we have been using. Service providers such as the HSE and the Brothers of Charity have become highly inefficient. The Comptroller and Auditor General’s report is highly critical of this and my understanding is that the Government is too. Having spoken to many disability groups and representatives from NUIG, which specialises in this area, it is clear that we should be aiming for a new model of service delivery which will be person centred. Those groups and representatives have asked me to ask the Minister of State if he is committed to that.
I am proposing a more flexible approach so that people with disabilities, following an assessment of their needs, would hold their own budget. This would be radical for Ireland. In the United States of America at the moment, this is called the ticket to independence, whereby a person with a disability literally shops around to meet his or her own needs. In Ireland, on the other hand, we have a totally different system. I just met representatives of Muscular Dystrophy Ireland who told me that 92 out of a total of 478 people with muscular dystrophy in this country have no physiotherapy. One fifth of those with this condition have no physiotherapy. A 17 year old with muscular dystrophy was told that there was no point in having physiotherapy because he would never walk again. What hope is that to give him and his mother? Physical stimulation is vital for this young man so his mother asked for a massage chair to stimulate her son’s muscles. The chair costs €1,700 but the HSE has refused to fund it.
Currently, the HSE is contacting every user of Invacare wheelchairs, which were distributed through the old health boards, to tell them that they are no longer covered in the event of an accident. At the same time, however, the HSE will not provide these people with another wheelchair. The executive is further disabling people with disabilities. I urge the Government to get rid of the HSE.
People with disabilities are not protected in law. At present, no assessments are available to people over five years of age in this country, so the law is no good to them. Furthermore, the HSE is completely failing people with disabilities. It is wasting our money and has proved yet again that it is ineffective. If the budget was in the hands of the 17 year old to whom I referred, does the Minister of State not think he would buy his own chair, appropriate to his own needs?
Is the Minister of State committed to a more flexible and person-centred delivery of service for people with disabilities? We must break down the monopolies in the current method of service delivery. I ask the Minister of State to answer my questions and look forward to his reply.
Senator Paschal Donohoe: I second the motion proposed by Senator Frances Fitzgerald. I find myself in an unusual position because the amendment from the Government more clearly illustrates the scale of the problem we are facing than the original motion tabled by my party. If one examines the range of measures and statements contained in the amendment, they demonstrate a level of disconnection from the reality of what is happening on the ground that is worrying.
Senator Corrigan has made some superb interventions on these issues in the past and did so again this morning in the House. She made an excellent point regarding the fact that the HSE has continued to fail to ring-fence expenditure and funding for pupils and people with special needs but the Government’s amendment would have us believe this is not happening at all. The amendment would have us believe that the needs of the most vulnerable young people in our society are being met by this Government and that the funding is in place for that. However, anybody who has dealt with constituents with such problems or with the experts that are providing care in this area will know that the Government’s amendment does not recognise the reality of what is happening in communities and families who are under enormous stress and are vulnerable when dealing with the Government in their efforts to provide care for their children with special needs.
I cannot think of any greater abdication of responsibility on the part of the Government than for families to be forced to go to the highest court in the land to secure their constitutional right to school their children.
Senator Paschal Donohoe: It is a disgrace that we have 70 families in this country who have been forced to go to the courts, 47 of whom did so to attempt to vindicate the rights of their autistic children. It is shameful that they had to go to court to secure the needs of their children. One such family lives quite near me and the desperation I see in their faces when I talk about the lengths to which they must go makes me ashamed as a politician and should make this Government ashamed of its willingness to force people to take such action.
As I was preparing for this debate, I examined the annual output statement from the Department of Education and Science for 2007. That document lays out the crucial strategic priorities the Department wants to deliver and the money it will put in place to do so. Nowhere in that 27 page document is reference made to the need for ABA schools. The people working in this area are not even mentioned, let alone recognised. I decry the amendment proposed by the Government.
I welcome the Minister of State to the House this evening. I wish to comment briefly on the points made by Senator Fitzgerald. I wish to make it clear that under no circumstances are we, on this side of the House, suggesting we do not have difficulties. We clearly have difficulties but we are making progress and believe that the multi-faceted framework that has been put in place by the Government will provide the mechanism required to address the continuing difficulties and allow us to move on and meet people’s needs. It is important to acknowledge that there will always be challenges. Indeed, there should always be challenges because we should always be questioning and trying to get better. We should always believe there is a way to get better and to improve our services.
It is disingenuous to come into the House and not acknowledge the extent of the developments and progress that have taken place over the last number of years although I acknowledge that Senator Fitzgerald made reference to the increased funding that is now available. With regard to the comments of Senator Donohoe, while I thank him for his compliment, I wish to clarify that the point I raised this morning was specifically related to the €25 million that was allocated directly for mental health services for the implementation of recommendations of A Vision for Change, not for children with special educational needs.
The amendment is quite extensive and it would not be possible for me to deal with every aspect of it in the limited time available. In that context, I will address a number of key points. I particularly welcome the incorporation of the national disability strategy into the new social partnership agreement, Towards 2016.
The national disability strategy, launched in 2004, stresses equal participation in society of people with disabilities and provides for a framework of new supports for these individuals. The strategy supports and reinforces equal participation in society of people with disabilities and comprises five elements, namely, the Disability Act 2005, the Education for Persons with Special Educational Needs Act 2004, sectoral plans published in 2006 by six Departments, the Citizen’s Information Act and a commitment to a multi-annual investment programme for disability support services of €900 million for the period 2006 to 2009.
The central components of the strategy are the Disability Act and the Education for Persons with Special Needs Act. Since the launch of the strategy in 2004 until the end of 2007, €420 million in revenue and capital funding has been allocated. The programme provides a commitment to funding certain disability-specific services during the period 2006 to 2009. It is expected that by the end of 2009 there will be 1,235 new residential places, 398 new respite places and 467 new day-care places. This is a solemn reflection of the Government’s commitment to the improvement of disability services.
I wish to briefly reflect on the underpinning theme of equal participation in society of people with disabilities. Sometimes as a society, although well-meaning, we can dwell disproportionately on what the person cannot do without an appropriate focus on what the person can do.
It is essential that we aspire and aim for equal participation and full expression of citizenship for people with disabilities. We must be ambitious regarding people with disabilities and we must insist on as high a quality of life as possible. The national disability strategy provides us with concrete opportunities to achieve this. From early childhood, supports are available to assist children in their development. I welcome the implementation of the Disability Act 2005 for children aged under five. This prioritisation reflects the importance of early intervention, which can have a significant impact on the disabling effects of a condition or impairment.
Part 2 will be commenced in respect of children aged between five and 18 in tandem with the implementation of the EPSEN Act. The Department of Education and Science has informed us it is envisaged that all sections of the EPSEN Act will be implemented over a five-year timeframe, which commenced on 1 October 2005. I welcome that the statutory requirements of Part 2 of the Disability Act will be extended to adults as soon as possible. A commitment has been given that this will happen no later than 2011 but I urge the Minister to strive for an earlier implementation date. Such developments bring their own challenges such as the sourcing of therapists. While additional training places have been provided in recent years for speech and language therapists, physiotherapists and occupational therapists, the Government faces an ongoing challenge of attracting people to work in the field. Will the Minister of State examine this issue? If children cannot access such services, all the plans in place will be impeded before they get off the ground.
The Government introduced, and is progressing, an extensive reform programme of health services. Part of this programme includes the development of national standards for services for people with disabilities along with the development of a draft code of practice for sheltered work services. Draft standards for disability service were produced by the Department of Health and Children in association with the National Disability Authority, NDA. Following the statutory establishment of HIQA, a standards advisory group is in place. I welcome the recent issuing of draft standards for residential services for people with disabilities and I particularly welcome the planned commencement of the inspectorate. This will finally address the long-standing anomaly whereby all residential facilities for children are inspected with the exception of those facilities for children with intellectual disabilities. Incredibly, residential facilities for children with disabilities were exempted from inspection.
It is important that the introduction of standards does not become a paper-based exercise but rather that they result in meaningful improvements in quality of life for people with disabilities. This may mean all of us will face a challenge to our own mindset. Will the Minister of State encourage the development of residential options for adults with intellectual disabilities in the context of living options and ensure we follow international best practice in pursuing a framework of supported living for such adults, which would provide opportunities for people with intellectual disabilities to live as independently as possible in a safe and healthy way in their own homes? I had the enormous satisfaction of being involved in the roll-out of a pioneering supported living project. This has resulted in adults having their names on their own rent books, holding their own keys, accessing supports appropriate to their needs and determining when and if to have a cup of tea, a shower or go to bed. These are basic rights we take for granted every day. Will the Minister of State consider how many of our community group homes, albeit unintentionally, have become mini-institutions? Power shifts significantly when the residents hold the keys to the home and not the staff.
Progress has been made but many more steps must be taken before we experience the highest quality of care. The Government is fully committed to providing a high quality service to all persons with a disability and this is reflected in the establishment of the office for disability and mental health, which brings together responsibility for a range of policy areas and which will improve co-ordination. I wish the Minister of State well with this essential work. I particularly welcome the inclusion of a mental capacity Bill in this year’s legislative programme. It will enable Ireland to meet its obligations under the UN convention and it will ensure our citizens with intellectual disabilities, in particular, will have the opportunity to exercise their rights as citizens.
I welcome the increase to 209 in the number of psychologists in the NEPS. I ask the Minister of State to enhance the remit of the service and to expand its role. Will he consider commencing a campaign on the MMR vaccination? The impending measles epidemic could be significant because it may result in people unnecessarily acquiring an intellectual disability. A review should be conducted regarding the needs of those with mild intellectual disabilities, who are quite vulnerable. Rather than being person-centred, perhaps it should be person-led.
I congratulate Fine Gael on tabling the motion. I have a reasonably balanced record in the House of giving credit where it is due but Senator Corrigan’s criticism of Fine Gael for not acknowledging developments is misplaced. I said to the Fine Gael leader earlier that she was quite soft on the Government in the motion but I listened to her powerful contribution.
I would like to make a number of points, of which Senator Corrigan might take note. Apart from the Government’s amendment being bad and embarrassing, it is factually incorrect. For example, it is not true that the ESSEN Act is being implemented on a phased basis in line with the five-year timeframe envisaged. That is not happening. The legislation was passed having been supported by all Members in both Houses as the way forward. The background to it was that ordinary people found themselves going to the highest courts in the land to gain the right to education for their children. As soon as their cases reached the higher courts, the Government either crumbled or lodged an appeal to the Supreme Court. It was wrong whichever way it went and this legislation resulted.
It is simple and it means where a child is considered by school authorities as requiring special needs, they ask for an assessment. The assessment is conducted by a NEPS psychologist following which resources are put in place. At every stage, provision is made for appeals by parents, schools and a number of other bodies. Everything is belt and braces and it is superb legislation. It is so good that I travelled to teacher centres around the country and proposed to teachers that they should not worry about the legislation and they should support it because it would be a positive development. It was positive but the Government has walked away from it. The amendment is offensive because the body charged with implementing the legislation is the NCSE. Are the drafters of the amendment pleased about their reference to the council in the two and a half pages of text? There is no mention of it because it would be an embarrassment.
When the Minister for Education and Science passed the legislation, she forwarded it to the NCSE saying she wanted it implemented in a five-year timeframe. We all agreed that was reasonable, even though we all wanted it implemented the next day. The NCSE produced a superb, professional report outlining 42 actions relating to the implementation of the legislation. The report reflected the views of every group involved in special education, including parents, management, school boards, teachers and other professionals. The actions are listed in one column and there are columns relating to who is responsible for each action when it should be implemented. The next section of the report outlines the financial resources needed for each action. Everything was done and this was presented to the Government in the autumn of 2006. The programme was to begin in December 2006.
The first item was to do with research so I cannot tell whether it happened or not. The second item was to commence section 5(5) to establish a standards body. This was supposed to have happened in December 2006. To add to the irony and the offence of it, the fifth action is to appoint the members of an appeals board, which has been done. The appeals board is for people appealing against the outcomes of assessments. However, the assessments can only take place on the basis of what is determined by the standards body which has not been established. The appeals board has no work whatsoever to do.
As a psychologist, Senator Corrigan can explain to us how this works. At present, psychologists have various methods of psychological assessment. The role of the standards body is to put together the basis, formula, method and template for a psychological assessment which can then be accepted into the system within the Department by which it can determine structures, resources, needs and supports which will come from it. This has not been done. The Act has not got progressed from the first step. Extra NEPS psychologists have been appointed but they are nowhere near the numbers required. I acknowledge this has been done.
I probably know more about this Act than anybody else in the House. I do not state this from a position of arrogance. I have gone through it many times. I spoke about this in Navan, Sligo, Monaghan, Wexford, Carlow and on several occasions in Dublin. I met teachers everywhere who had grave doubts about it. I stated it is the way forward. I told them it is my utopian approach to how we should deal with special educational needs. The Government put it together and everybody welcomed it. It has not happened and it is a disgrace. It is a further disgrace that the impending amendment to the Act does not mention how it will be implemented.
This is how it is supposed to work. A school, parent, or the National Council for Special Education comes to the conclusion that a child has special educational needs. When the school confirms this, a NEPS psychologist comes in and does an assessment. This assessment can be done only on the template and reference points decided by the standards body which has not been established.
Following this, the resources for dealing with the child in the school are put together and the support levels are decided. These might be at school level or other people may be brought in. The school has to put together a directed ad hoc educational plan for the child for the year. During the course of the year it is reviewed twice. At the end of the year, if the school principal and or the class teacher feels that despite everyone’s best efforts it is not working, it goes back to the National Council for Special Education and the plan is changed or improved, resources are added or something is taken from it and perhaps the child is moved to another school. I have rushed through the description of the process.
Each step is open to appeal by parents. Parents such as those we discussed here who went to the High Court, such as the family from Wicklow or the Supreme Court, such as the family from Cork, would not have needed to do so because they would have been involved from point one. They could have made their case to the school, the National Council for Special Education or one of the appeals bodies attaching to the council. At least they would have been recognised all the way through. By the time it reached a court, a judge could state that in all reasonableness, it had gone through the system, the professionals had done their very best, everything had been done according to plan and everybody must live with it. Instead, parents are fighting and shouting.
Today, a group from a special post-primary school Dundalk was outside the gates of Leinster House. The school deals with children with mild mental handicaps, rather than use any politically correct language. They wanted their children to learn domestic science and other practical subjects. They were seeking extra hours. Where have we reached as a society? Perhaps they cannot do Latin or geometry. However, these children can learn a great deal. We can give them skills and help and support them. Parents are outside our gate 12 years into the Celtic tiger looking for a couple of extra hours of support a week.
It is not mealy-mouthed of Fine Gael to table this motion tonight. It not a lack of acknowledgement of what is happening. Fine Gael and other parties gave a great welcome to this Act. We are appalled that we have seen nothing happen with regard to its implementation since the day it was passed.
Senator Ann Ormonde: In that case, I am pleased to endorse the amendment. I listened to what other speakers stated on the motion and there is no doubt that the record of the State and successive Governments over decades in providing for children with special needs has been poor. We can all put up our hands and state that down through the years nothing has been done. It is only in the past couple of years that an effort was made and €900 million is now spent on education for students with special needs. This is almost twice as much as in 2004.
With regard to staff, 19,000 staff in our schools work solely with children with special needs and this includes 10,000 special needs assistants, compared with 300 in 1997. There are also more than 7,000 resource and learning support teachers compared with 2,000 in 1998. More than 1,000 other teachers support children in our special schools while hundreds more work in special classes. We have made strides.
I am not saying everything is rosy in the garden, nor would I. I come from this profession and I dealt with people with special needs. I know the problems as much as anybody else. As I see it, there are still huge defects. However, the Government is making major efforts. While it is not absolute, let us hope over the next four or five years we will reach some satisfactory level. I know Senator O’Toole will throw up his eyes as I state this but we are trying and doing our best.
Having been in the system and having spoken to teachers within the schools, I am aware they are expressing the concerns outlined by Senator O’Toole. However, they are also saying that efforts are being made to try to reach out to those with special needs and God knows, we have to do this. We owe it to those children because under the Constitution they have to be given the same rights and opportunities as other children in our society.
With regard to the assessment procedure, we have a major lack of psychologists, particularly educational psychologists which is the area I know best. I am not familiar with clinical psychologists. I will use the model of the City of Dublin VEC, which is successful in how it deals with assessing children with special needs who come into the system. It has resource teachers, remedial teachers, special needs teachers and guidance counsellors. In a way, it works very well where one psychologist deals with a region. Case studies are done and a plan is made with the child’s principal, to which Senator O’Toole made reference. This plan was always there. I used it seven or eight years ago whereby a student was assessed and a psychologist then came in.
However, we have a lack of co-ordination between the two Departments with regard to child guidance clinics. If an educational psychologist wants to refer a child to the child guidance area, it breaks down. We should examine this entire area to see how best we can improve co-ordination. We are short of psychologists. Yesterday I asked a psychologist what was wrong and how come the State was crying out for psychologists. I was told they are not going into education but into the business world where they are getting very cushy jobs doing assessments and training and earning huge salaries. Perhaps that is an area at which we need to look. Many attempts have been made to try to lure psychologists into the education system but it is very difficult. If those in Opposition were in power, they would say the same thing.
We are trying to put things right and to see how we can move forward in terms of doing the best for these children. Improvements have been made with the intervention programme for autistic children. Although all is not right, there has been a major improvement in that area.
Will the Minister of State address the issue of co-ordination between the Departments of Health and Children and Education and Science and do his best to lure psychologists into the education system to try to improve the assessment process and set up individual education plans because it all stems from them? If education plans are in place, we can work to give every opportunity to children with special educational needs to enable them to thrive.
There is a lot more to do. I am not sure we have made it yet but we have a five-year programme and I accept that over the five years, we will make it work. Will the Minister of State make every effort to honour the commitments in the Education for Persons with Special Educational Needs Act because it is a good Act which can work?
Senator Brendan Ryan: I welcome the Minister of State. The Labour Party is happy to support this motion and its call on Government to implement fully the National Council for Special Education recommendations for the implementation of the Education for Persons with Special Educational Needs Act 2004.
The proposers of the motion have outlined in great detail its background and why it is needed. I do not intend to go over that again but want to make some general points in support. The NCSE at the time of writing its implementation plan for the Act identified significant gaps between what should be as per the vision of the Act and what the reality of special educational needs in Ireland was at that time. Some of these are as follows: schools are under-resourced in terms of capacity to deliver inclusive education; there is insufficient investment in training and development at all levels; institutional and systematic support for schools in regard to inclusive education provision are inadequate; boards of management, school leadership and parents are not sufficiently involved nor are they adequately informed or trained or supported to play an effective part; not all schools are inclusive; and there are numerous soft barriers to access. I will return to that last gap later. Eleven other gaps are referred to in that report which I will not go through. However, a measure of progress in this area would be an evaluation of how well these gaps have been closed. Senator O’Toole outlined how little has been achieved and how few of these gaps have been closed.
A motion was debated by the INTO at its recent conference in which it demanded that in the implementation of the Education for Persons with Special Educational Needs Act 2004, the Department of Education and Science must ensure that appropriate in-service training is available to all teachers on a whole-school basis; substitute cover is provided on a systematic basis for all teachers engaged in planning and meetings related to the Education for Persons with Special Educational Needs Act requirements; all schools are covered by a comprehensive educational psychological service; administrative and information and communications technology facilities to schools are expanded to cater for the additional requirements under the Act; children have immediate access to the relevant health and educational professionals as identified for their needs; and an additional post of responsibility of special educational needs should be provided. This suggests to me that teachers at the frontline believe many of these gaps still exist and require immediate attention.
I acknowledge this report was presented to the Minister only in October 2006 — 18 months ago — and that everything cannot be achieved overnight but significant progress should have been made in such a period if a serious effort was being made to deliver on the requirements. Almost one third of the planned implementation time has elapsed. As I said, I look forward to the Minister of State’s response in this regard.
I wish to raise another matter. Resources allocated for the phased implementation of the Education for Persons with Special Educational Needs Act should not be at the expense of essential funding to improve the pupil-teacher ratio and other educational issues. The Minister often defends her lack of progress on the matter of the said ratios by stating that she has concentrated on special needs education. Neither of these issues is being progressed quickly enough. Both these matters must be dealt with. Adequate funding must be delivered by this Government to achieve both objectives. In this regard, the NCSE argues that the funding envelope proposed should not divert monies from mainstream education given Government’s commitment to additionality.
I turn briefly to one of the gaps referred to earlier. Not all schools are inclusive and there are numerous soft barriers to access. It is of great concern to me that many schools are refusing to enrol pupils with special needs. This cannot be allowed to continue. Many of these are in the fee-paying sector but many, including some in my constituency of Dublin North, are not. There is wholesale discrimination against children with special educational needs and it must be brought to an end. A Department audit on this matter has been carried out and that report is with the Minister. Comments attributed to the Minister in the media suggest that the report confirms the anecdotal knowledge we have picked up. I know from media reports that the Minister is not in favour of publishing the report but I believe these schools must be dealt with in some way.
Schools are using such methods as examinations and interviews to exclude special educational needs students. It is being suggested to parents of special educational needs children that their son or daughter will not fit in. There should be some sanctions against such schools but so far there is none. Some people have called for the publication of the report but I accept that publicly naming them might lead to a drift in their direction rather than having the desired opposite effect. However, I call on the Minister to put in place urgently a penalty system to deal with this matter.
The Education for Persons with Special Educational Needs Act 2004 is great legislation and, as Senator O’Toole said, was supported by all parties when it went through the Houses. However, it must be fully resourced and implemented within the planned timeline of five years or less, if possible, so it can deliver the educational outcomes children with special needs and their parents are entitled to as of right. Time has been lost and it must be made up.
Minister of State at the Department of Education and Science (Deputy Jimmy Devins): I am delighted to be here for this debate and to hear the views of the House. I welcome the opportunity this debate provides me to emphasise this Government’s commitment to providing a high quality service for all people with a disability. I was honoured to be appointed by the Taoiseach to the position of Minister of State at four Departments and with responsibility for disability and mental health.
In that context, I have responsibility for the oversight of the Government’s national disability strategy, including the six departmental sectoral plans, and the co-ordination of the implementation of the Disability Act 2005 and the Education for Persons with Special Educational Needs Act 2004.
In January 2008, the Government announced the establishment of the Office for Disability and Mental Health to support me as Minister of State with responsibility for disability and mental health in exercising my responsibilities across the Departments of Health and Children, Education and Science, Enterprise, Trade and Employment and Justice, Equality and Law Reform. The new office brings together responsibility for a range of different policy areas and State services which directly impact on the lives of people with a disability and people with mental health issues. The office aims to bring about improvements in the manner in which services respond to the needs of people with disabilities and mental health issues by working to develop person-centred services focusing on the holistic needs of clients and service users and actively involving them in their own care. Substantial progress has been made in recent years in the areas of disability and mental health but much remains to be done. In particular, there is a need to improve co-ordination and communication across different Departments and agencies in the delivery of services to this client group. This will be the main focus of the new office in the coming months.
Among the key priorities for the office for disability and mental health are supporting the implementation of the health sectoral plan under the Disability Act 2005. The office will focus in particular on facilitating the delivery of integrated health and education support services for children with special needs by developing further existing mechanisms for co-operation and co-ordination between the health and education sectors at national and local level and developing an appropriate continuum of training and employment support services for people with a disability by working together with the Department of Enterprise and Employment, FÁS and the Health Service Executive. The director of the office is a member of the senior officials group on social inclusion which monitors progress on the Government’s commitments on social policy, including commitments under the national disability strategy. The Government has agreed that meetings, to be held quarterly between me as Minister of State with responsibility for disability and mental health issues, the four Secretaries General of the relevant Departments and the director of the new office, will review progress in the priority areas.
The Government has provided significant additional resources in recent years to drive improvements in educational services for children with special needs. Since 2004, investment in special education has almost doubled to €900 million, enabling thousands of extra staff to be put in place. Indeed, there are now more than 9,000 teachers and almost 10,000 special needs assistants working solely with children with special needs. This compares with just a fraction of that number only a few years ago.
The level of training for teachers in a wide range of special education areas has also improved significantly. We have taken steps to reduce the need for educational assessments and to ensure children can get additional support as early as possible. All primary schools have been allocated a guaranteed number of resource teaching hours to cater for pupils with high incidence special needs such as dyslexia. As a result, most children with special needs no longer need to have an assessment before they can get extra support. These, and a range of other developments, have transformed special educational services for the better. Further improvements are also in train with the phased implementation of the Education for Persons with Special Educational Needs Act.
Given the sheer scale of the improvements to take place under the Education for Persons with Special Educational Needs Act, the legislation envisaged that the provisions of the Act would be phased in over a five-year period with full implementation by October 2010. It required the National Council for Special Education, NCSE, to prepare an implementation plan with advice for the Minister for Education and Science on the steps it believes should be taken to implement the Act within a five-year period from the establishment date of the council in October 2005. Upon receipt of this advice, the Department of Education and Science needed to consider it and consult a wide range of stakeholders before developing a final detailed plan for full implementation.
The Minister for Education and Science believes it is in the interest of children with special needs that the changes provided for in the Act are rolled out in a smooth and planned way. She has decided therefore to stick with October 2010 as the date for full implementation. Provisions that have been implemented include the establishment of the NCSE, the appointment of the members of the inaugural Special Education Appeals Board who are working to ensure appropriate structures and processes are in place once the relevant sections of the Act which would allow appeals to be undertaken are commenced, and the provision of guidance to schools on issues such as devising and implementing individual education plans.
A cross-sectoral team has been established comprising senior officials from the Department of Education and Science, the NCSE, the Department of Health and Children and the HSE. This team is working hard to co-ordinate the implementation of Part 2 of the Disability Act 2005 and the relevant sections of the Education for Persons with Special Educational Needs Act 2004 and to improve co-ordination between the two sectors. I can personally vouch, having attended some of the meetings, that they are working hard.
Investment in special education has increased significantly since the Education for Persons with Special Educational Needs Act was passed, enabling improvements in staffing and other resources to be put in place. The Act, therefore, is being implemented on the phased basis envisaged in the legislation as voted for by this House. There has been no delay. Many of its provisions have been implemented and the rest will be phased in by the October 2010 deadline.
The Private Members’ motion refers to assessments by educational psychologists. I wish to make clear to the House that the purpose of the limit on the number of assessments is to encourage schools to take responsibility for initial assessment, educational planning and remedial intervention and to avoid unnecessary referral for assessments. The National Educational Psychological Service, NEPS, in common with other psychological services internationally, relies on a staged model of assessment with the school taking responsibility for these actions in the first instance. Only where there is failure to make reasonable progress in spite of the school’s best efforts should a child be referred for individual psychological assessment.
This system allows NEPS psychologists to give early attention to urgent cases and to help indirectly many more children than could be seen individually. In this regard, NEPS has recently produced an updated set of guidelines and a resource pack for primary school teachers comprehensively outlining this graduated problem-solving model of assessment and intervention. The limit of two assessments per 100 children in a given year for schools availing of the scheme for commissioning psychological assessments, SCPA, needs to be understood in this context. It also should be remembered that most primary school pupils with special educational needs no longer need psychological assessments to access extra teaching supports. I also point out that principals can contact NEPS if they believe that exceptional circumstances warrant additional assessments for their pupils.
During the last academic year 4,400 assessments were funded under the SCPA at a cost of approximately €1.5 million. In addition, almost 5,800 assessments of individual pupils were carried out by NEPS psychologists in the same period. In total, more than 10,000 psychological assessments were paid for by the Department of Education and Science in the last school year.
I assure the House that the Government is committed to increasing the number of NEPS psychologists from the current level of 139 to 169 by the end of 2008 and to 200 by the end of next year. This will enable all schools to receive a direct service from NEPS in the 2009-10 school year rather than being served by the SCPA scheme. Extra psychologists are in the process of being appointed.
I will now outline some important elements of the Disability Act 2005. Part 2 of the Act provides people with disabilities with an entitlement to an independent assessment of their health and education needs, a statement of the services it is proposed to provide, to pursue a complaint through the HSE complaints process if necessary, and to make an appeal to the independent disability appeals officer.
Part 2 of the Act commenced for children aged under five years with effect from 1 June 2007. Children under five years were chosen as the priority for the introduction of the assessment of need process under the Disability Act because of the importance of intervention early in life. This can have a significant impact on the disabling effects of a condition or impairment. The Disability Act will be commenced for children aged 5 to 18 years in tandem with the implementation of the Education for Persons with Special Educational Needs Act 2004. It is envisaged that all sections of the Education for Persons with Special Educational Needs Act 2004 will be implemented over a five-year timeframe with the assessment process provided for in the Act due to commence in 2010. In preparation for its implementation, health related support services for children aged 5 to 18 years and adults will continue to be enhanced to enable the Health Service Executive to meet needs identified for this group. The statutory requirements of Part 2 of the Disability Act will be extended to adults as soon as possible but no later than 2011.
During 2007, the Department of Health and Children and the Health Service Executive undertook significant work in preparing for the commencement of Part 2 of the Act in respect of children under 5 years of age. Standards for the assessment of need process were developed. Regulations and a commencement order were published and the Office of the Disability Appeals Officer was established. An assessment officer post has been created in each of the 32 local health office areas. The assessment officer is responsible for the co-ordination of the assessment report. Case managers have been created in each local health office area and they have responsibility for the provision of a service statement.
The Department of Health and Children and the HSE have undertaken the first of three annual reviews of progress on the implementation of the Disability Act. This review, which was published in December 2007, has identified further targets specifically on planning for the parallel commencement of the Disability Act 2005 and the EPSEN Act 2004 for five to 18 year olds and adults. A system of complaints is now in place in the HSE to deal with complaints under the Act and, for the first time, if a service user is not satisfied with the process, the independent disability appeals officer will deal with appeals from users of the system.
Significant work is being done in co-ordinating and enhancing work across the health and education sectors. A cross-sectoral team comprising officials from the Department of Health and Children, the Department of Education and Science, the HSE and the National Council for Special Education meets on a regular basis to address issues arising on the implementation of both Acts.
I will turn to an issue raised in the motion, namely, standards in the provision of services for people with a disability. As Senators are aware, the Government introduced, and is progressing, an extensive reform programme of health services. Part of this programme includes the development of national standards for services for people with disabilities alongside the development of a draft code of practice for sheltered work services. Draft standards for disability services were produced by my Department, in conjunction with the National Disability Authority, prior to the establishment of the Health Information and Quality Authority, HIQA.
A standards advisory group has been put in place by HIQA to consider the development of service specific standards, including residential and community based services for people with disabilities in residential centres. The work of this group, which includes the statutory and non-statutory sector, is well advanced.
In regard to standards in the area of sheltered work and other adult day services, the HSE has established a national review group to carry out a comprehensive national review of all HSE-funded adult day services, including sheltered work. The review will include, as part of its work, consideration of the draft code of practice for sheltered work services and the draft national standards for disability services.
The motion also refers to the control of employment levels in the HSE. Approximately 130,000 people work full-time or part-time in our public health services. The Government’s ongoing high level of investment in health in recent years has achieved and maintained significant increases in the numbers of doctors, nurses and other health care professionals employed in the public health services. The Government has also invested heavily in the education and training of such personnel to secure a good supply of graduates to provide for the health care needs of the population into the future.
There has been a growing demand for, and investment in, therapy services over the past number of years. A particular priority has been the expansion of the supply of therapy graduates. Training places for speech and language therapists have increased by 320% since 1997, from 25 to 105; training places for occupational therapists have increased by 313% since 1997, from 29 to 120; and training places for physiotherapists have increased by 137.5%, from 64 to 152. Since 1997, there has also been growth in the number of such therapists employed in the health services. There were an additional 152% speech and language therapists; 257% more occupational therapists and 139% more physiotherapists by the end of 2007.
The budget day package for 2008 provides for the creation of an additional 1,050 new posts for the delivery of health service developments. Included in these extra posts are 710 posts for the provision of additional health services for people with a disability. This demonstrates the Government’s ongoing commitment to resourcing the health services. The employment levels approved for the HSE for 2008 of 112,560 wholetime equivalents includes these additional 1,050 posts for the budget day service developments.
Consistent with the Government’s investment is the need for the HSE to manage within the budget allocated by Government and to deliver on its priorities. The recruitment pause put in place in September 2007 was initiated as part of the HSE financial break-even plan to facilitate the delivery of services on budget in accordance with the provisions of the 2007 national service plan. This pause meant that the recruitment of staff to approved posts was delayed. The HSE put in place a derogation process to deal with the filling of essential posts to protect front-line services and close to 900 posts were approved under this process. This temporary pause in recruitment ended on 31 December 2007. New arrangements introduced in January 2008 by the HSE are aimed at ensuring that health services are delivered in accordance with the provisions of the 2008 national service plan and within the funding provided by Government.
The motion also raises the ratification of the UN Convention on the Rights of Persons with Disabilities. Ireland was in the first group of countries to sign, subject to ratification, the UN Convention on the Rights of Persons with Disabilities when it opened for signature on 30 March 2007. A high-level, cross-departmental implementation group was established in 2007 to advise on any changes to the Government’s national disability strategy that may be required to enable the State ratify the convention. This group has developed a work programme to address matters that need to be aligned with the UN convention in order that ratification may take place. It is the Government’s intention that the convention will be ratified by Ireland as soon as possible, taking into account the need to ensure that all necessary requirements under the convention are being met.
One of the key areas of reform required is in regard to the law on legal capacity of vulnerable adults. The Government’s legislative programme contains a commitment to bring forward a mental capacity Bill. That Bill is an important element of the programme of work on the convention. I am glad to report that the scheme of the Bill, which is being prepared by the Department of Justice, Equality and Law Reform, is at an advanced stage of development.
As part of the 2005 budget, the Government announced a multi-annual investment programme in services for people with a disability, which will provide €900 million from 2006 to 2009. The Disability Act is underpinned by this multi-annual investment programme. It is building the additional capacity required to put in place the framework set out in the Disability Act. As part of the multi-annual investment programme under the disability strategy, the Government provided the HSE with an additional €75 million in both 2006 and 2007. This funding included moneys to provide new and enhanced services for people with disabilities. The Government is also honouring its promise on the multi-annual investment programme for people with disabilities, with a further €50 million investment, which was announced in the budget for the current year.
I have some information on the health and personal social services this huge investment is providing, which I would like to share with the House. Currently, 8,800 people with a disability receive care in residential places with more people living in group homes within their communities than in residential centres. Some 7,200 residential places provide respite care for people with a disability. Some 30,000 people with a disability attend day services. The Health Service Executive provides 3 million hours of personal assistance or home supports for people with a physical disability.
The national intellectual disability database annual report for 2007 states that 97% of the people registered with it are in receipt of a service. The report says that there has been significant growth in the level of provision of services to people with an intellectual disability which reflects the success of the Government’s investment programme.
The social partnership agreement, Towards 2016, outlines our vision for people with disabilities. The Government will work with the social partners to achieve continued improvements in the quality of life of people with disabilities. The establishment of the Office for Disability and Mental Health is another step in that process.
The Government’s decision to establish the Office for Disability and Mental Health reflects its commitment to developing a more coherent and integrated response to the needs of people with disabilities and mental health issues. It recognises that clients and service users need to be at the centre of service delivery and that we may need to examine the way in which services are currently delivered to ensure that is the case. To effectively achieve this requires an interdepartmental, cross-agency response.
My designation as a Minister of State with responsibility for disabilities and mental health and the establishment of an Office for Disability and Mental Health to support me will facilitate cross-agency and interdepartmental working and enable this Government to deliver real benefits to clients and service users into the future.
I want to hone in on just two issues because this is such a vast area. The first concerns people with intellectual disability and the other is concerned with the services for people with muscular dystrophy. We were all at the presentation today. I share with Senator Corrigan a very serious concern about people who have intellectual disabilities and totally respect their right to enjoy a good quality of life. I listened to her, intently, when she spoke about people being able to choose when they should shower or eat and drink.
John, a person I know, has moderate intellectual disability, with autism. He lived with his family until he was six, and then had to take up full-time residential placement in Dublin after his father died. This was a very traumatic event for the family, and so he ended up in residential care. In Dublin he had a series of placements in large residential settings and secure units. His life story contains vivid descriptions of years of severe challenging behaviour, which were John’s only way to communicate the stress of being disconnected from his family and community. It was a community that he loved and valued and he now lived a life that was meaningless and unsatisfying, without any activity.
Very high levels of medication, seclusion, living in a noisy crowded challenging behavioural unit away from home are among John’s memories of large residential settings. Despite massive allocations of resources this model is the daily reality for many people. The Minister of State, in his speech said there were 8,800 of these people in residential settings. I am reliably told that almost 50% of Irish people with intellectual disability still live in such large residential settings. In England, Wales and Scotland the equivalent figure is zero.
In a review of 118 UK research publications between 1980 and 1996, Hatton and Emerson found that large residential settings showed considerably poorer outcomes in user and parent satisfaction, the material and social environment, privacy, choice and personal possessions, use of community facilities and the development of skills. This led to the dissatisfaction we spoke about earlier and levels of challenging behaviour, use of medication, participation in domestic activities and the support staff. Yet the costs of community living is only 12% higher than the expenditure on people in large residential settings.
To return to John, he is an artist. He has a superb memory for dates, places and the names of plants. In the last ten years he has come into contact with a community based service, which believes in the contribution people with disabilities can make. He now works on an urban farm and is connected with a local community. He lives the life of his choosing. John is one of the lucky ones. Will the Minister of State say how long the Government is to mismanage resources by ploughing enormous amounts of money into human warehouses? That is very strong language, but I truly am convinced about that. When will the potential of the many people, such as John, who continue to live in these expensive human warehouses, be realised? Perhaps the Minister of State will please come back to me on that.
As regards muscular dystrophy, we heard heart-rending presentations from parents of children who suffer from this condition. They said, in effect, that they were watching their children die, which to me was a very dramatic statement. The Minister of State has quoted some very fine statistics. I dislike statistics, but——
Senator Nicky McFadden: ——I have other statistics before me outlining the number of people suffering from muscular dystrophy who do not have access to physiotherapists and occupational therapists. There are 97 members who have no physiotherapy when required. Some 240 receive it intermittently and need it more regularly. There are 20 members who cannot access an occupational therapist at all and 42 are waiting to receive equipment. I am told that waiting for equipment is futile. If someone needs a wheelchair or a breathing machine, he or she needs it now. When one’s life is limited and the end is dismal, the equipment is required now. That was brought home to us very poignantly today, and it was heart-rending to listen to those parents.
Another point they made was that they need an investment of €2 million for research. They are involved with the Hammersmith Hospital, London, and the Minister of State met them in February. They acknowledged how supportive he has been to them and asked us as public representatives and Members of the Oireachtas to highlight the need to get the funding for this research. They emphasised there was no need to invent the wheel, or do the same research in Ireland. They are welcome in the UK and are part of the research programme there. Perhaps we could fund this research and help to prolong the lives of these patients. It is concerned with injecting their feet to make their muscles grow, so that they can achieve some quality of life.
Senator Dan Boyle: In looking at this Private Members’ motion I have to ask whether the situation as regards people with special educational needs is what it should be. I am certain the answer is “No”, and I do not regard that as acceptable. Neither do I believe the progress being made in this area is sufficient, or happening fast enough. In supporting a motion such as this, I must ask myself if I am able to bring about any faster the necessary improvements that are needed. Again, the answer is “No”.
In this regard, there are certain points we must acknowledge. First, the legislation must be admitted as an achievement. Of the three relevant Acts passed during the term of the last Dáil and Seanad, namely, the Disability Act, the Citizens Information Act and the Education for Persons with Special Educational Needs Act, the latter is the most important and best drafted. Everyone who considers the wider debate will accept that the Disability Act is not what it could be. It is subject to review and needs to be greatly improved.
There is wider political debate on the correctness of the decisions made, not only recently but previously, in respect of the dismantling of the National Rehabilitation Board, for which I worked for a short period. I refer to merging part of the board with FÁS and part with Comhairle. We need to revisit whether this is the best way to provide particular services for those with disabilities, especially meeting employment needs, of which education comprises an important part.
The Education for Persons with Special Educational Needs Act is fine legislation. The political dissent that exists in respect of it was articulated most clearly by Senator O’Toole. His connection with education in general and the teachers’ unions in particular affords him particular insight into this matter. The clarity provided in the Minister of State’s speech, to the effect that all the provisions of the legislation will be implemented by October 2010, gives me some hope that the movement that needs to be made in this area will be made. The date is still two and a half years away and many of us in this Chamber and beyond would like a step-by-step approach between now and then to ensure that the resources are rolled out properly.
It was hoped there would be front-loading of educational funding this year in the order of €350 million in excess of the normal inflation-based rate received by the Department of Education and Science. An extra €100 million was provided but the shortfall of €250 million has made a significant difference in slowing down the rate of progress that would otherwise be achieved. The fact that there is a new leader of Fianna Fáil might offer some hope of a change in direction in this regard. One of the achievements we need to acknowledge is that when he was Minister for Health and Children, which position he did not enjoy, he instigated the idea of multi-annual funding.
Senator Dan Boyle: He gave the impression he would prefer to be elsewhere. He instigated the idea of multi-annual funding, particularly in respect of those with an intellectual disability. Deputy Cowen’s having held the health portfolio will help in shaping future Government policy in this area. We can only hope that is the case.
I agree with the sentiments of Senators on the parents of autistic children having to take court cases. I have made the same point in this Chamber. Unfortunately, all political parties in our system need to acknowledge a failing in this regard. The first court case of which I am aware to test the constitutional provision on the right to education preceded the Sinnott case. It involved a Cork mother, Marie O’Donoghue, who sought proper access to education for her autistic son Paul. This case led to the narrow judgment that our constitutional provision on education only entitles our citizens to basic primary education. As we seek to improve legislation, perhaps we need to improve the constitutional provision. Many of us in public life accept that education is not just about a basic grounding in three R’s or basic life skills and that it is a life process itself. Until we recognise that it is ongoing and should be available to all citizens to the highest possible standard, we will be running behind.
I mention the O’Donoghue case because it went all the way to the Supreme Court, as unfortunately have many subsequent cases, including the Sinnott case and the Ó Cuanacháin case, which has been in the court quite recently. The first case occurred when the then Minister for Education was a Labour Party Minister in a Fine Gael-Labour Party Government. The principle of forcing parents to go to court to access the education system reflects badly on a number of Governments in recent years and all the parties that constituted them. I hope we can bring the practice to an end fairly soon.
On the wider aspects of meeting special educational needs, I acknowledge many of the statistics quoted by the Minister of State. It is true that a certain number of respite beds are in existence and a certain number of staff have been employed. If we are to have ongoing reform of the health service, direct responsibility for, and the funding of, services for people with disabilities should probably not lie with the Health Service Executive.
I had a meeting on homelessness today and noted significant questions must be asked on whether HSE funding in this area is influenced disproportionately by decisions the executive must make on supporting the hospital-based health service. If we are to have a proper review of the health system, money directed towards social inclusion, tackling homeless and meeting special educational needs, which do not fall within the remit of Departments such as the Department of Education and Science and the Department of the Environment, Heritage and Local Government, should not be allocated by the HSE. What is happening is that the areas in question are not prioritised in the wider debate on health spending and are not being protected as a result. This results in diseconomies in terms of social policy.
I hope part of the review process that will see the full implementation of the Education for Persons with Special Educational Needs Act will address these inconsistencies. It would be unfair if the Bill were implemented fully while obstacles existed in respect of wider funding practices, thereby resulting in unnecessary funding anomalies for those who should be accessing services which we all acknowledge are not what they should be.
I am a member of a party that is part of a coalition Government and our belief is that participation in this Government will bring about the changes deemed necessary. Consequently I support the amendment and reject the Private Members’ motion. I hope there is a way for us all to consider the wider sentiments in the original motion and the Government’s amendment, which acknowledges the efforts made by it to ensure the ongoing problems regarding education for people with special needs can be dealt with and the deadline of October 2010 can be met.
Can we begin by putting matters in context? Some of the parties in Government have been in power for 11 years and, day after day on the Order of Business a number of their members speak about disability and education as if they were in Opposition. Every day they berate the Government on the lack of action and joined-up thinking on disability, health and education. The Minister of State and his colleagues should not forget that cutbacks hurt the old, poor and handicapped. This was their slogan in 1987. They have not forgotten it and I will not forget it because they have done nothing to alleviate the problem since. We have spent an inordinate amount of money and the Government amendment reads well on paper, but it is not the case in real life, as the Minister of State, Deputy Devins, and Senator Corrigan know.
The motion is important for the individual pupils and the people who are directly affected by the full implementation and roll out of the EPSEN Act, but it also has an effect on their parents, their brothers and sisters, the wider school community and the wider population in general. We are concerned here with the most vulnerable in our society. If the way we treat them is indicative of the state of our health as a nation and a State, then it reflects badly on us and on the people who we supposedly cherish. Without doubt, children with special educational needs are among the most vulnerable to ongoing marginalisation if they do not get early and appropriate educational support and provision. I say that as a teacher and one involved with disability groups in my city of Cork. We must put people at the centre of any legislative programme and any activity of ours in the future.
While the EPSEN Act is important, it is only one part of the process of the identification of learning needs and the development of education and community-based programmes of intervention to ameliorate and remediate that need. Let us look at the EPSEN Act in the overall context of the Comhairle Act 2000 and Disability Acts, the purposes of which are to serve to give effect to greater access to essential services. Unfortunately, at the coalface there are significant discrepancies about the quality and manner of service delivery. Senator Corrigan sometimes raises issues here in her professional capacity. I admire her for that because she is not shy in doing so. The same can be said of Senator McFadden, Senator Fitzgerald and myself.
However, all groups campaigning and active on disability in this country, such as Inclusion Ireland, the Disability Federation of Ireland, the National Federation of Voluntary Bodies, have spoken out against the ethos and underlying philosophy and ideology of the Acts I mentioned earlier. Disability groups and parents want rights based legislation and they have failed to get that. We have seen the consequences of that decision, most recently in the debate in the other Chamber on the lack of essential ABA places and schools for children with autism. The Acts, which were drafted in the main in response to parents taking legal action, will result in many more parents, who feel deprived, taking the long road to the High Court to get what in effect should be essential elements of primary education for their children with special
One of the failures of this Government with respect to the provision of services for special needs has been the ad hoc nature of the development of services and implementation of legislation. The Departments and the Ministers for Health and Children and Education and Science have failed to develop co-ordinated programmes to ensure that there is a seamless interchange between the meeting of medical needs and education provision. The questions of who provides occupational therapy, speech and language therapy or neurological assessment have not been resolved, and protocols have not been put in place to ensure that these questions have been answered.
The Department of Education and Science has failed in service delivery. For example, NEPS is under staffed and under resourced. It was established in 1990s with the aim to have a full complement of 200 psychologists by 2000, and it is 25% below that allocation. According to subsequent published reports, such as that of the Task Force on Autism, the figure of 200 psychologists is a gross under estimation of the overall projected need.
Society and the needs of society have changed, and the types of support required change. In the past few years all of us who have been out knocking on doors would have met an increased number of parents and families with children with autism, Asperger syndrome and other aspects of ASD spectrum. There is a significant increase in the number of children presenting themselves with emotional and behavioural difficulties. All of these and other conditions require capable education planning and programming. Government has failed to acknowledge, or factor into its forward strategies, the number of children with special educational needs who are currently attending our mainstream schools and who will be attending schools in the next five years. Improvements in educational assessment and diagnostic techniques, and a greater understanding of the neurological pathways involved in learning, mean that more children are now being classified with general and specific learning needs, and there are children with more severe and complex needs arising from organic syndromes and conditions who are surviving longer, thankfully, and now have an expectation of education. Today we were in Buswells Hotel meeting with people who have been left behind and who are being deprived of services.
We need to see precise attention to a careful development and implementation of individual education plans, which are seen as an essential and vital part of the jigsaw of special education provision. The motion is an important one because it deals with people. I agree with Senator Boyle in that on this side of the House there would be a welcome for a cross-party initiative whereby we can progress the issue, but there must be meaningful dialogue and we cannot have a situation where the HSE is used by the Minister as a shield.
We have invested billions of euro in education and health. Are we really stating in 2008 that, given all the amount of money we spent, the health service is better now than it was 11 years ago? If one listens to the Joe Duffy radio programme, to the people on the street, to the people protesting and to the ordinary citizen, the answer is a resounding “No”.
I hope Deputy Cowen comes into the House as Taoiseach and says to those in the Departments of Health and Children and Education and Science that they have had 11 years and done nothing. I hope he tells the Minister for Health and Children, Deputy Harney, to pack her bags because it is time for her to go.
Senator Jerry Buttimer: I have the utmost respect for her, but she has failed completely in the delivery of the health service, as did her predecessor, Deputy Martin. It is time for change. The Minister of State, Deputy Devins, is in the Department. He cannot be above in Sligo saying one thing and here in Dublin saying something else. I respect where he is coming from in that he is a good local politician, but we need leadership. We have not had leadership from Professor Drumm and Deputy Harney. I hope we get leadership from 7 May because we need it and, more importantly, the children and their parents need it.
Senator John Paul Phelan: I welcome the Minister of State, Deputy Devins, to the House and thank him for being here and staying for the duration of the debate. I find it difficult to be overly critical because Senator Corrigan and Deputy Devins are two people whom I would hold in high regard, but the amendment proposed by the Government takes some seeing to believe. In my time in the Seanad, usually Private Members’ time consists of either the Government proposing some inane motion on an obscure policy on which the Opposition must raise an amendment, or the Opposition pinpointing an area of difficulty and the Government coming up with a back-slapping amendment. I have seen back-slapping in this Chamber in my time but the nature of what is proposed in the amendment takes some beating in that regard.
I am particularly disappointed with elements of the Minister of State’s speech. One will have heard the saying that “there are lies, damned lies and statistics”. The Minister of State’s contribution was littered with statistics. Figures quoted include a 164% increase in the number of physiotherapists, a 130% increase in the number of occupational therapists and a number of other statistics in that regard. However, we heard no mention of the 3,000 out of 130,000 people who work in the HSE who do not know what their job is, what percentage of the overall workforce of the HSE this figure constitutes and what impact those resources would have on the area of special needs, disability and special education if they were provided in other areas.
I was also interested in what the Minister of State had to say about the bar on the recruitment of staff in the HSE. We are told that this bar existed until the end of last year and was lifted on 1 January. It is interesting because we are debating this motion at the same time that the top brass in the HSE is meeting in respect of further cutbacks in the health service and funding in different areas. I hope that people who need assistance, be they disabled or have special educational needs, will not be the soft target they have been in the past.
I am also interested in the reference in the Minister of State’s speech to the Education for Persons with Special Educational Needs Act where he said that the assessment process, as provided for under the Act, is due to commence in 2010. If they are to have an effect on the lives of people in this area, surely most of the other aspects of the Act are contingent on the commencement of the assessment process. We were told in 2003 or 2004 when this legislation went through the House that the assessment process would be introduced before 2010. The year now quoted is 2010. What will that mean in terms of delivery of the assessment process?
I referred to the Minister of State’s mention of the number of different specialists that are provided within the HSE. Even in the amendment, the Government gives us the statistics with regard to frontline services. There are under 30,000 people who could be described as physiotherapists, occupational therapists, social workers, nurses or doctors. Over 100,000 people are employed by the HSE, including 3,000 who do not know what they are supposed to be doing in the first place but who are not providing those essential frontline services. In terms of the actual provision of the service, the statistics are not as good as the Government would have us believe.
I remember the general election in 1987 when I was only nine years of age. It was the first time I really took an interest in politics. I remember shopping in Waterford to the tune of “Rise and follow Charlie”. I very much remember the election slogan, “Health cuts hurt the old, the sick and the handicapped”. This was probably the most cynical ploy that any political party has used in any election because as soon as the Government changed, funding for the health services was drastically cut. The reality is that in the disability sector and the mental health sector, for which the Minister of State is responsible, we are still suffering from those cutbacks in 1987.
I was disappointed by the fact that the Minister of State’s contribution did not mention mental health services. There was no mention of A Vision for Change. This is an area for which he is directly responsible. None of the Government speakers seem to have mentioned it. There can be a wait of up to three years for children and adolescents seeking psychiatric treatment. This is a disgrace in post Celtic Tiger Ireland. The usual waffle about funding is uttered. I agree with Senator Buttimer who mentioned the disgraceful situation whereby 70 cases are before the courts at present where families are trying to get suitable educational services for their children who have special educational needs. I am informed that 47 of these cases relate to autism. That is a disgrace in 2008 and is something over which the Government should hang its head in shame.
I must confess a personal interest because I was a teacher for a very brief period. I have some understanding of the education system. The appalling lack in our psychological assessment system is the fact that people cannot get access to that system. The wait for psychological assessments is disgraceful. We were told at the end of last year that there would be a projected 6% cut in the budget for NEPS. Where does this leave the Government’s pre-election promises?
I am told that one of the largest funders of psychological assessments in this country is the Society of St. Vincent de Paul, which must pay for them from its own resources. Last year, assessments for over 1,000 children were paid for by the society. This enabled them to go private because our public system does not work. In 1999, the former Minister for Education and Science, Deputy Martin, said that there would be 200 psychologists in NEPS within five years. At the moment, there are 138. The number has increased by ten since the last general election. It is nearly ten years since the then Minister gave that commitment and only 60% of students in primary education are covered by it.
I wish to say something about speech and language services and the fact that they depend on where one lives. One may get one’s assessment after a month or two or one might have to wait for over a year or two years to get such an assessment. I acknowledge the fact that funding in this area has significantly increased over that past few years but there is no commensurate improvement in the service provided to people on the ground. That is what the motion is about and is the reason I fully support it.
Senator Frances Fitzgerald: I thank my colleagues who have spoken on the motion. The Minister of State has given us a detailed account of the Government’s approach to the issue of disability and special educational needs for which I thank him. However, there is a gap between the amendment moved by the Government, the content of the Minister of State’s speech and the reality on the ground. I can see that the Government is very concerned about structures, co-ordination between Departments and the new posts it has put in place. They are very important but the reality is that on the ground, people who need to access special needs services are not getting them and waiting lists are too long.
It is imperative that this is tackled, which is why we put this motion to the House. Everybody on this side of the House and across it has daily experience of families who are trying to get their children assessed, who need special services and who are routinely told that they must wait a year, a year and a half, two years or three years. Staff in my office phoned the HSE and double checked on the waiting time for speech therapy. We were told that it was two years. We asked principals in our local schools what was the waiting time for assessment and were told that it was between one and three years. These are very long waiting times. To be the mother or father of a child between the ages of two and five who needs assessment and to be told that one must wait two or three years when one cannot afford to do anything else is devastating. That is the reason we have moved this motion and have called for more urgency in addressing this issue.
I am very concerned at some of the Minister of State’s comments. He said that many of the provisions of the Education for Persons with Special Educational Need Act have already been implemented, the rest will be phased in by October 2010 and assessments will be started in 2010. This is inaccurate and is not good enough. I can only assume that this is coming from the Minister for Education and Science. There is a degree of complacency in what has been said about the implementation of this Act. It is simply not good enough and is not accurate. There is a lot of rationalisation about what is a delay in the development of these services, about how principals can approach assessments and about the limit of two assessments per 100 children in a given year for schools availing of the scheme. It is an example of failing to acknowledge the reality of what is facing principals, teachers, parents and children. It is not good enough given the resources available in this country.
In January and February of this year 64% of children who need psychiatric care were admitted to adult psychiatric units. It is not good enough in Ireland in 2008 to provide this kind of service to our children. I hope the Minister of State, Deputy Devins, will get the funding that is needed and that the money that was taken from the mental health area will be given back to the Minister of State so that he will be able to implement A Vision for Change and change the reality that is facing families and their children who are in need of mental health services. It is simply not good enough, which is why Fine Gael tabled this motion. I commend the motion to the House and ask the Government parties to support it.
|Boyle, Dan.||Brady, Martin.|
|Butler, Larry.||Callely, Ivor.|
|Cannon, Ciaran.||Carty, John.|
|Cassidy, Donie.||Corrigan, Maria.|
|Daly, Mark.||de Búrca, Déirdre.|
|Ellis, John.||Feeney, Geraldine.|
|Glynn, Camillus.||Hanafin, John.|
|Keaveney, Cecilia.||Leyden, Terry.|
|MacSharry, Marc.||McDonald, Lisa.|
|Ó Domhnaill, Brian.||Ó Murchú, Labhrás.|
|O’Donovan, Denis.||O’Malley, Fiona.|
|O’Sullivan, Ned.||Ormonde, Ann.|
|Phelan, Kieran.||Walsh, Jim.|
|Bradford, Paul.||Burke, Paddy.|
|Buttimer, Jerry.||Coffey, Paudie.|
|Coghlan, Paul.||Donohoe, Paschal.|
|Fitzgerald, Frances.||Hannigan, Dominic.|
|Healy Eames, Fidelma.||McFadden, Nicky.|
|Mullen, Rónán.||Norris, David.|
|O’Reilly, Joe.||O’Toole, Joe.|
|Phelan, John Paul.||Regan, Eugene.|
|Ross, Shane.||Ryan, Brendan.|
|Twomey, Liam.||White, Alex.|
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