Executive Summary

Chapter 1 outlines the policy context for the Sectoral Plan. Health policy is guided by the principles of Equity, People-centredness, Quality and Accountability, as set out in Quality & Fairness - a Health System for You. The National Disability Strategy is the focus for Government policy in relation to people with disabilities. The Disability Act, 2005 is a central element of the National Disability Strategy and its focus on mainstreaming and social inclusion is given particular emphasis through the Sectoral Plans provided for in Part 3 of the Act. The Education for Persons with Special Educational Needs (EPSEN) Act, 2004 makes provision for the special educational needs of children and students. The provisions of the two Acts are complementary and the Health Service Executive (HSE) and the National Council for Special Education (NCSE) are the two key delivery organisations in both Acts.

An extensive consultation process involving all stakeholders was undertaken by the Department of Health & Children in the preparation of this Sectoral Plan.

Chapter 2 provides an overview of the services currently provided by the HSE, including specialist services for disabilities and specialist mental health services.

The overall goal of the HSE is to maintain and improve the health of the entire population, and subgroups of the population, and to reduce inequalities in health between population groups using a population health approach.

Chapter 3 deals with eligibility. The Department of Health & Children has commenced work on a new legislative framework to provide for clear statutory provisions on eligibility and entitlement for health and personal social services. The law governing health and personal social services for people with a disability will continue to apply in the same way as that for all other persons.

Chapter 4 focuses on resources. It is important to acknowledge the very significant expenditure on services for people with disabilities. The progress of recent years will be further enhanced by the Multi-Annual Investment Programme 2006-2009. This outlines the Government's commitment to a programme of revenue and capital expenditure, amounting in total to around €900m, on specific disability support services. The bulk of this funding, around €720m, is being spent in the health services.

Developments which will underpin progress in this area are the commitments in the new social partnership agreement, Towards 2016; the planned establishment on a statutory basis of the Health Information & Quality Authority (HIQA); the finalisation of the Strategic Review of Disabilty Services and the implementation of the recommendations of A Vision for Change, the new national policy framework for the mental health services.

Implementation of the Disability Act, the Education for Persons with Special Educational Needs (EPSEN) Act, 2004 and the Government's commitment to the further development of disability and mental health services will require substantial additional health service employees. A joint working group has been established with the HSE to monitor and address workforce needs effectively within the public health service, focussing initially on emerging needs.

Chapter 5 sets out in detail the arrangements proposed for the implementation of Part 2 of the Disability Act, 2005. Part 2 provides a statutory entitlement to -

  • an independent assessment of health and education needs,
  • a statement of the services (Service Statement) which it is proposed to provide, and
  • the right to pursue a complaint through an independent redress mechanism if there is a failure to provide these entitlements.

The arrangements for the implementation of Part 2 of the Disability Act cannot be considered in isolation from the arrangements for the EPSEN Act, 2004 as the same health service staff, mainly in the areas of disability and mental health services, will be called upon to provide assessments and services under both Acts.

It is proposed to commence Part 2 for children aged under 5 years with effect from 1st June 2007. This prioritisation reflects the importance of intervention early in life, 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 5-18 in tandem with the implementation of the EPSEN Act. The NCSE is preparing an implementation report on EPSEN which is to be completed by October 2006. The statutory requirements of Part 2 of the Disability Act will be extended to adults as soon as possible but no later than 2011.

In the meantime, however, services for adults with a disability will continue to be developed over the next number of years. The primary focus of many of the elements of the Multi-Annual Investment Programme is on meeting the identified needs of adults with disabilities. Enhancements in multi-disciplinary support services for both adults and children will also be put in place progressively over the coming years. In advance of the commencement of the Act, the HSE will be promoting the practice of assessment of individual needs and the provision of service statements for all service users, as capacity permits.

Chapter 5 also describes in detail the arrangements for the Assessment of Need, for the provision of Service Statements and for complaints and redress mechanisms. Over the next twelve months, the HSE will put Assessment Officers, Liaison Officers and Complaints Officers in place and provide appropriate training. The Department of Health and Children will prepare regulations governing the assessment of need and draw up standards for assessment, in conjunction with the interim HIQA. The Department will also appoint an Appeals Officer and establish a National Disability Advisory Committee to advise on progress in the implementation of the Act.

Chapter 6 discusses three cross-departmental and cross-sectoral issues concerning people with disabilities - housing, income support and vocational training and employment. Protocols will be agreed between the HSE and housing authorities to govern liaison concerning the housing needs of people with a disability. A protocol has been agreed with the Department of Social and Family Affairs to ensure that income supports and associated benefits do not create financial barriers to people with disabilities taking up employment. From now on, a person with a disability in receipt of Disability Allowance or Blind Pension who avails of the opportunity to take up employment will be allowed to retain his or her medical card for a maximum of three years from the date on which he or she takes up employment. Protocols will also be developed to provide a strategic framework for inter-departmental and inter-agency co-operation between the Department of Health and Children, the Department of Enterprise, Trade and Employment, the HSE and FAS.

Chapter 7 sets out the measures to be taken by the Department of Health and Children, the HSE and the 27 statutory bodies under the aegis of the Minister for Health & Children to comply with their obligations under Part 3 and Part 5 of the Disability Act, 2005.

An advisory sub-group within the Department has made a number of recommendations which are being implemented. The HSE will commence an audit of its existing public buildings, put access officers in place, review its existing procurement policies and provide guidance and protocols to service areas on ensuring that all client communications are accessible. Complaints procedures required under the Disability Act, 2005 will be integrated into the statutory complaints mechanisms which are currently being developed within the HSE.

Each of the 27 statutory bodies under the aegis of the Department of Health & Children is preparing an implementation plan in respect of its own obligations under the Disability Act. The Department of Health and Children is currently putting in place the monitoring arrangements for the health services, including the HSE and other statutory bodies, as required under Part 5.

Chapter 8 sets out the arrangements for monitoring and review of this Sectoral Plan. Existing arrangements will be enhanced by the establishment of a National Disability Advisory Committee and regular reviews of progress by the Department's Management Advisory Committee. Progress in implementing the plan will be reviewed by the Department of Health and Children one year from its publication, in mid-2007. It is expected that, following this review, further actions will be identified and specific timeframes agreed with the HSE and other bodies under the aegis of the Department.