Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697751193007.pdf (Ireland)
Further Revised Estimates Volume 2023 Select Committee on Children, Disability, Equality and Integration Opening Statement by Minister Anne Rabbitte T.D.

Wednesday 26th April 2023 I am delighted that the transfer of functions of specialist community-based disability services to the Department of Children, Equality, Disability, Integration and Youth from the Department of Health took place on 1st March.
For the first time, responsibility for coordinating and steering an all-of-Government policy to promote the equal participation in society of people with disabilities has now been brought together with policy responsibility and funding for specialist disability services in one department.
We now have a significant opportunity to pursue strategic policy development, investment and reform of disability services and I look forward to progressing this agenda with Minister O’Gorman, HSE colleagues, and all our partners in the disability sector and across Government.

I am committed to ensuring that the transfer of functions to the Department of Children, Equality, Disability, Integration and Youth is as seamless as possible, maintaining the provision of services during this time of transition.
Specialist disability services continue to be provided by the HSE and a range of other providers to children and adults in residential, day and respite settings, as well as children’s therapy services, personal assistance, home support and other community services and supports.
Consistent with a mainstream first approach and the provision of integrated service delivery, all other health and social care services ordinarily available to people with disabilities will continue to be supported and provided as before.
I aim to strengthen and improve oversight and performance management structures with the HSE and this will involve building relationships between officials in my new department with key personnel in the HSE and other partner organisations, to better understand opportunities, constraints and plans for improving performance delivery and oversight arrangements.
The Department is putting in place an Oversight Agreement with the HSE, which will reflect DCEDIY’s responsibility for funding, policy and performance oversight.

It will provide a supporting framework for the implementation of the relevant legislative provisions and governance arrangements including robust financial governance and service performance arrangements.

One of the challenges of the transfer was accessing accurate and consistent information and data related to disability service areas.
Much of this is down to current constraints in the HSE’s systems and the nature of health service delivery.

We will work with and support the HSE to improve data and build the strong evidence base critical for future reform and investment in the sector.

Building on the work undertaken in the Department of Health, the transfer will facilitate the transition from a medical model of support towards a holistic, person-centred approach that supports people with disabilities to live autonomously.
A Review of Disability Social Care Demand and Capacity Requirements to 2032 was published in July 2021 and sets out the additional capacity required in specialist disability services in light of anticipated demographic changes, and addresses the gap between available services and the level of unmet need.

The Action Plan for Disability Services was developed by an interdepartmental Working Group in order to progress action on the findings of the Disability Capacity Review.
Now that the transfer has been completed, I intend to accelerate progress in this area.

The developments planned for 2023 within the available funding will improve services for some, but the scale of need identified in the Capacity Review report will require agreement on and implementation of the Action Plan for Disability Services.
In 2023, we will continue to drive the reform of disability services through the implementation of the Transforming Lives programme, including New Directions, progressing children’s disability services, personalised budgets and the neuro-rehabilitation policies.
Advancing the Progressing Disability Services Roadmap related to Children’s Services will see a critical priority focus on access to service, staff recruitment and retention, communications and engagement with families, and addressing Assessment of Need backlogs.

The number of children still awaiting an Assessment of Need is unacceptably high.
Reducing the Assessment of Need waiting list is a key priority of mine and funding has been provided in the budget to significantly reduce the waiting times for children seeking an assessment of need.

I recognise that the recruitment and retention of staff in disability services (and across all service areas) is a significant challenge for the HSE and one that has a large bearing on the achievement of service delivery targets.
We will encourage and support the HSE to implement a series of actions to improve staff retention and recruitment performance, to increase base staffing levels in line with funding received.

The following are some of the areas I am committed to progressing in 2023:     I will continue to prioritise the delivery of therapy services to children with disabilities and their families.
In day services, additional funding in 2023 will support approximately 1,250 people with disabilities who are leaving school to transition into adult day services.

I will provide for residential placements in line with policy, to respond to the increasing need, through the programme of de-congregation and the provision of emergency placements and care.

I am continuing to provide supports to keep people in their homes for as long as possible and out of residential care.
The funding I have provided will deliver an additional 70,370 personal assistant hours to expand and enhance the supports for people to live self-directed lives in the community.

 Respite care is also a key priority in that it provides important supports for families in maintaining their caring role.
The funding provided will: establish five additional respite services and increase one service from part time to full time opening; provide 27 additional in-home respite packages to children and young adults in a full year; provide 265 day-only respite packages to 180 people in a full year.

 We aim to increase the number of those under the age of 65 moving from nursing homes to community settings.
 The HSE will continue to work with community support teams to provide safeguarding support to vulnerable adults with disabilities.

 Mindful of this government’s priority to deliver comprehensive on-site health and social supports to all special schools, I am pleased to say the HSE has commence the process of prioritising the allocation of approximately 136 additional staff such as Speech and Language Therapists, Occupational Therapists, Physiotherapists to these schools.
I am delighted to work with Minister O’Gorman to deliver progress on these commitments during 2023 for persons with disabilities and their families.