Noticeboard

Submissions Sought on the future of Disability Policy in Ireland

This year €1.5bn of taxpayers’ money will be spent on health services for people with a disability, a sum which represents approximately 10% of the overall €14bn health budget. Never has it been more important to ensure that the reducing amount of funding we have for public services be spent in an efficient and effective manner.

While Government has initiated a comprehensive spending review across all Department programmes to be completed pre Budget, the Disability Sector is already the subject of a detailed Value for Money and Policy Review as part of the Government’s Value for Money Reviews for the period 2009 to 2011. It is important that large scale spending programmes of this nature are subject to detailed periodic review to ensure funding for people with disabilities is spent to best effect. Any inefficiencies that may have crept into the system over the years needs to be rooted out as well as any duplication of costs.

The review itself will also assess how well current services for people with disabilities are meeting their objectives and support the future planning and development of services within the appropriate policy framework. It will allow for a greater focus to be put on unit costs and the quality of outputs for people with disabilities.

Subject to the completion of the review, the objective will be to make recommendations that will ensure that the very substantial funding provided to the sector is used to maximum benefit for persons with disability, having regard to overall resource constraints which affect all sectors at this time. It is expected that the Review will be completed by the end of this year.

Expert Reference Group on Disability Policy

As part of the overall VFM review, a separate Expert Reference Group on Disability Policy was established to look specifically at existing disability policy and whether it needs to be changed to better meet the expectations and objectives of people with disabilities. As part of this review, a public consultation process on existing disability services was undertaken which confirmed that people with disabilities and their families, more than anything else, are looking for more choice in the services they receive and more control over how they access them.

The report proposes a very significant reframing of disability services towards a model of individualised supports, underpinned by mainstreaming of all public services. On this basis, State funding would be allocated based on an independent assessment of individual needs. Following the needs assessments, individual support plans would then be drawn up and individualised budgets allocated from which the supports and services needed would be purchased.

A number of mechanisms are proposed to achieve this, including a broker system where the person has the choice and control but the broker administers the budget and commissions supports and services on their behalf, or direct payments where the person manages the budget and purchases the supports themselves.

The Group’s final report has already been the subject of internal consultation within the Department of Health and more recently it has been circulated to other Government Departments for their views. It is now being released for the public and interested parties to have their say.

Next Steps

The intention is that when the public consultation period regarding the Disability Policy Review is completed, the views expressed across Government Departments, by members of the public and interested parties will, along with the outcome of the Value for Money Review and the Disability Policy Review itself, be examined by Minister of State Kathleen Lynch and Minister James Reilly, before being put to Government for final decision.

We would urge all with an interest in improving services for people with disabilities to read the Report of the Disability Policy Review and to take this opportunity to have a say about the policy direction proposed.

Matters on Which We Would Welcome Public Comment

In considering aspects of the report on which to comment, the following key points may be helpful:

  • The vision for the proposed policy is: To realise a society where people with disabilities are supported to participate fully in economic and social life and have access to a range of quality supports and services to enhance their quality of life and well-being.
  • The two goals set out in this document are: Goal 1: Full inclusion and self-determination for people with disabilities. Goal 2: The creation of a cost-effective, responsive and accountable system which will support the full inclusion and self-determination of people with disabilities.
  • The central thrust of the proposed policy of moving to an individualised budgeting system is all about: A person-centred approach to service provision where services are planned and delivered with the active involvement of the individual, developed around his/her particular characteristics and funded on a personal basis.
  • In reading through the report, people should be mindful of the fact that: It has been Government policy under the National Disability Strategy for a number of years now that services for people with disabilities should be, wherever possible, mainstreamed with such people having access to the same services as the general population. The policy of individualised supports is a natural progression to the mainstreaming of services for people with disabilities.

The Review Group advocate a move to a more person centred approach to services for people with disabilities while this is a policy we can all support, it is accepted that it will not be without challenges both for service users and service providers. While the report sets out a way forward, further work will have to be carried out on the detail of how we move, on an incremental basis over time, from the current system of funding only service providers to one where control of funding is vested primarily in service users along with their families and/or advocates.

We are anxious, therefore, to hear from all voices in the disability area as to their views on the proposed policy. In particular, we would welcome comment on all or any of the following issues:

  • Do you agree that the current system of delivery of services for people with disabilities needs to be improved?
  • Do you agree that a move to individualised supports is the right policy to pursue?
  • Do you agree that the definition of individualised supports in the report is adequate and comprehensive?
  • How do you feel the Government’s policy of mainstreaming has worked so far?
  • Do you think a move to individualised supports will further the mainstreaming of services?
  • Do you agree that people with disabilities should have the choice to select different services from different service providers and at a time of their choosing?
  • Even if you are happy that the service currently being provided to a service user is appropriate, do you agree that the overall system of funding has to change to tie in with the need to provide more control and more choice for individuals?
  • As people with disabilities make the choice to live in ordinary independent settings which are integrated into their communities, what do you see as the impact of the reconfiguration of existing services on other service users, their families and staff delivering these services?

Finally

A reminder that submissions should be forwarded to the address below or by email to be received by Friday 4 November 2011.

Submissions should be concise, focused and limited to ten pages. They will be subject to the Freedom of Information Act 1997, as amended.

Disability Unit (Room 6.30)
Department of Health
Hawkins House
Dublin 2

Email to: neil_waldron@health.gov.ie

Tel: 01 635 4038