Tánaiste Micheál Martin recently said he wanted his new administration to be “a defining government in respect of disability”.
The Fianna Fáil leader, who is set to become taoiseach this week, said the aim was to “provide services for people with disabilities in a seamless way”. However, there are many issues to be addressed in the sector – both in relation to the provision of services, the recruitment and retention of staff and overall funding.
A HSE report last week set out in stark terms the current difficulties. It said: “There are very significant challenges in relation to improving access to specialist disability services: Over 13,500 children and families are awaiting access to children’s disability services and assessment of need; many children and adults are not able to access respite, or sufficient levels of respite, to meet their needs; people with disabilities are concerned that the right supports are not available; families of adults with disabilities are concerned that services and supports will not be available when they can no longer maintain their caring role; and many service providers are facing sustainability challenges.”
The report noted that while “specialist disability services are meeting the needs of many people with disabilities and their families, we know we must do better”.
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The issue of the sustainability for some service providers is brought into focus by the warning from some that the absence of additional funding could force them to delay making payments to the Revenue Commissioners and impact on services they can provide. There is deep unhappiness among some that they were turned down for additional funding in the final weeks of last year.
The exchequer budget this year for specialist disability services is €3.2 billion – an increase of €330 million or 11 per cent on last year’s. There is also an additional €18 million available in once-off funding. More than €39 million has been provided for new measures this year including about €16 million for residential services and €9 million for children.
The HSE national service plan for this year, however, warns that disability services will likely need more resources. “Despite this very welcome investment the cost of running our existing services at current levels (estimated out-turn 2024 circa €3,084m) over the next 12 months will be a significant challenge in the context of the total funding available to specialist disability services in 2025,” it says. “Therefore, our disability services will likely require additional funding support.”
The HSE said it was “not intended to cut services in 2025″. But it will seek to minimise the level of financial deficit by focusing on, for example, improving financial controls, particularly around staffing.
The HSE said in general it would seek to maintain current service levels while growing these “in areas where this has been specifically funded, particularly in support of our key priorities around residential, respite, day services and children’s services”.
The HSE also said improving productivity would be essential if was to maintain current service levels while reducing the use of agency personnel. “This means that we need to improve the efficiency and effectiveness of our care and other processes so that we can safely provide more care for patients via the same or less staffing hours. This must be done without reducing quality for patients or over-burdening our staff.”
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