7. Implementation of Part 3 & Part 5 in the Department of Health and Children and in the Health Services

7.1 Part 3: Access to Buildings and Services

The provisions of Part 3 of the Disability Act 2005 relate to access to facilities, services and information. Together with the implementation of a more co-ordinated cross departmental approach to planning and service delivery they provide a statutory basis for Government policy in relation to the mainstreaming of services for people with disabilities. This chapter sets out the measures to be taken by the Department of Health and Children, the HSE and other bodies under the aegis of the Minister for Health and Children to comply with their obligations under Part 3.

While the health of the population has improved substantially over the past 30 years, the Irish population still has higher premature mortality than many of our European neighbours. The most powerful factors affecting health status are socio-economic and lifestyle related, and it is widely acknowledged that disadvantaged and socially excluded individuals and communities, including people with disabilities, suffer from poorer health. The National Health Strategy Quality and Fairness, the National Health Promotion Strategy and the National Service Plan for the Health Service Executive 2006 take account of this.

7.1.1 Department of Health and Children

In the Department of Health and Children, the Disability Liaison Officer (DLO) acts as a point of contact for staff with disabilities, their managers and the HR section. The DLO also provides assistance and support to staff with disabilities and their line managers by the provision of necessary information, appropriate contacts, guidance, suggestions and advice and liaises where appropriate with the Employee Assistance Officer (EAO). To increase awareness of disability issues throughout the Department and to support new entrants, disability guidelines and contact details for the DLO have been placed on the Department's intranet.

To date the Department has:

  • issued a number of suggested actions for the implementation of Parts 1, 3 and 5 of the Disability Act, 2005 to each Principal Officer;
  • held two information sessions on the Disability Act, 2005 and the NDA Code of Practice on Accessibility of Public Services and Information provided by Public Bodies;
  • arranged for the nomination of an "Access Officer" and for the functions of the "Inquiry Officer" to be incorporated into the functions of the Complaints Officer within the Department of Health and Children.

In recognition of the implications of the Disability Act, 2005 for the Department of Health and Children and as recommended by the National Disability Authority, the Department's Human Resource (HR) Implementation Group established an Advisory Sub-Group in December, 2005. The Advisory Sub-Group is representative of the relevant Divisions throughout the Department and also staff with a disability.

The Advisory Sub-Group was asked to prepare a Report for the HR Group on the implementation of the Disability Act, 2005 within the Department itself and in particular Part 3, Sections 26 - 28. In carrying out its work, the Advisory Sub-Group, took into account the following documentation:

  • The Disability Act, 2005;
  • The NDA Code of Practice for Accessibility of Services;
  • The Department of Health and Children Outline Sectoral Plan under the Disability Bill, 2004; and
  • The NDA Response to Outline Sectoral Plans of Government Departments under the National Disability Act, 2005.

The Advisory Sub-Group prepared an "Awareness Audit" in Questionnaire format. The purpose of the audit was to raise awareness of Part 3 of the Disability Act, 2005; to determine the Department's current status in regard to meeting the requirements under Sections 26, 27 and 28 of the Act and to identify and make recommendations in order to fully implement the requirements of the Act and the NDA Code of Practice in the Department. The Disability Audit Questionnaire was circulated to all Divisions in the Department, together with a copy of the NDA Code of Practice on Accessibility of Public Services and Information provided by Public Bodies. The Advisory Sub-Group also asked two of its members who have disabilities to complete the questionnaire in order to provide their expert opinion on accessibility and information issues within the Department.

There was a 52% response rate to the questionnaire. The responses reflected a mixed picture of disability awareness within the Department. While there was a high level of awareness of the Disability Liaison Officer (DLO) service, there is clearly a need to raise awareness of other specific services such as evacuation procedures for people with disabilities and the use of Braille and other accessible formats.

The Advisory Sub-Group recently finalised its report and has made a number of recommendations which are being implemented within the Department.

These recommendations include, for example:

  • Provide disability awareness training for all staff, ensure that all disability issues are raised regularly as part of divisional, staff and team meetings as appropriate;
  • Identify existing staff with knowledge of sign language and facilitate others to acquire this skill. Prepare a staff handbook containing information on disability services available in the Department, such as the loop system and who to contact in relation to particular services such as sign language;
  • Making the provision of interpreter services a compulsory requirement for all conferences and consultation processes hosted by the Department;
  • Issue internal guidelines to staff on arrangements for the provision of information in all accessible formats;
  • Include the offer to accommodate special needs in all invitations to meetings with Department Officials.

7.1.2 Health Service Executive

Work to facilitate social inclusion is already underway in the HSE through improving access to mainstream and targeted health services and addressing inequalities in health between social groups. In conjunction with these programmes the HSE aims to enhance the participation and involvement of socially excluded groups, including people with disabilities, and local communities in the planning, design, delivery, monitoring and evaluation of health services. Services are provided across a continuum, from prevention services at home and in the community through to high quality hospital and residential care services when required and are provided in partnership with service users, their families and carers and a range of statutory, non-statutory voluntary and community groups.

In implementing these provisions, the HSE will also seek to build on existing work which is already underway. For example, the Irish Health Service Accreditation Scheme is the national initiative to promote quality in the acute hospital setting. It is a voluntary scheme, which originally involved the Major Academic Teaching Hospitals (MATHs) in Ireland and which has now been rolled out to other acute hospitals. The scheme involves both self-assessment and independent, external assessment against categories of standards. These standards have been developed in consultation with health service personnel and apply across the entire organisation. These categories are:

  • Care / Service Standards;
  • Environment Management Standards;
  • Human Resource Management Standards;
  • Information Management Standards;
  • Leadership and Partnerships Standards.

The International Society for Quality in Healthcare (ISQH) has internationally validated the Irish Health System Acute Care Accreditation Standards.

With the introduction of accreditation in the Major Academic Teaching Hospitals (MATHs), the advent of the Irish Accrediting Body and the roll-out of this process to other hospitals, the Irish Health System Accreditation Scheme offers a reasonable framework to advance quality across hospitals. Although the pursuit of accreditation does not, in itself, guarantee quality of service, the framework it provides will facilitate collaboration and a consistent approach to involving patients and the public in planning and managing services.

In the area of health promotion, specific initiatives such as responding to the health promotion needs of people with hearing impairment, the assessment and delivery of health promotion training for personnel working with people with disabilities will be used to further advance the delivery of integrated services.

The estates departments of the HSE are committed to ensuring, as far as possible, that all public buildings in their remit are accessible to people with disabilities. These departments have been charged with responsibility for the ongoing upgrade of access to existing buildings, including compliance with Part M of the building regulations during alterations, planned maintenance and minor capital works.

Section 25 - Access to Public Buildings

The HSE will commence an audit of its existing public buildings with regard to their accessibility to persons with disabilities in 2006, taking into account the requirements of the Disability Act 2005, Part M of the Building Regulations and other relevant codes of practice and guidance documents.

Under the guidance of the Estates Directorate, a planned programme of remedial works will be agreed, to be implemented over the period covered by the National Development Plan 2007 to 2013.

Accessibility appraisal will be formally integrated into Lease & Acquisition procedures within the HSE.

Section 26 Access to Services and Appointment of Access Officers

The HSE will have Access Officers in place by the end of 2006. An appropriate training programme for Access Officers will be developed and delivered to ensure consistency across the health system.

An audit of services will also be undertaken to establish how integrated service provision is and to identify and put in place a plan of action designed to ensure accessibility in the context of the Disability Act 2005. Planning for the audit will commence in late 2006.The HSE will ensure the provision of the appropriate expertise through its relevant functions to advise about the means of ensuring service accessibility.

The HSE will build on work currently ongoing in relation to Disability Awareness Training, with a view to putting in place a planned and co-ordinated approach to the delivery of such training across the health system.

Section 27 Accessibility of Services Supplied to a Public Body

The HSE will review its existing procurement policies, practices and procedures with a view to ensuring that they are in compliance with the provisions of the Act. This will be completed by the end of 2006.

Section 28 Access to Information

The HSE National Communications Unit will provide guidance and protocols to service areas on ensuring that all client communications are accessible.

The HSE will request all services to review their communications at local, regional and national level with a view to ensuring that, as far as practicable, the contents are accessible to persons with visual or hearing impairments and those with intellectual disabilities. This will include:

  • The identification, where appropriate, of mechanisms to ensure that oral, electronic or written communication to persons with visual or hearing impairments are provided in a format that is accessible to the individual concerned;
  • Putting in place mechanisms to provide, where practicable, information published by services relevant to persons with intellectual disability in clear language that is easily understood.

HSE National Communications are in the process of developing a policy of ensuring all printed and electronic information for the public uses simple clear language, and is tested for those with basic literacy skills. Guidelines for writing effective health information materials have been developed as part of the National Health Promotion Information Project and are available throughout the services and to the public.

As a provider of services for people with disabilities, the HSE intends to lead the way in internet and information accessibility. The HSE website (www.hse.ie) is currently under development and, when complete, will meet the highest standards of accessibility for all users, regardless of physical, intellectual or technological ability (W3C-AAA). This will allow the detailed health service and health information contained on the website to be accessible to those using a range of assistive technologies and tools.

Section 29 Access to Heritage Sites

Protected Structures form part of the current healthcare estate. A similar process of auditing and remedial works will be carried out for these buildings as outlined in Section 25, bearing in mind the special significance of these structures.

Section 39 Complaints

The Health Act, 2004 requires the HSE to establish a statutory complaints system in relation to health services generally. It is proposed, therefore, that the complaints procedures required under the Disability Act 2005 will be integrated into the statutory complaints mechanisms which are currently being developed within the HSE. This will ensure that, from the point of view of the service user, one single complaints mechanism will apply for health services.

In the interim the existing complaints procedures within the HSE will apply in respect the provisions of Part 3.

Information regarding the above arrangements will be generally available to the public using the Executive's services. The Executive will endeavour to ensure that its complaints systems are as accessible and easy to use as possible, while taking account of the legislative provisions underpinning same.

In compliance with the Disability Act 2005 the HSE undertakes to work with non-statutory service providers to ensure that, where practical and appropriate, the provisions of Part 3 of the Disability Act 2005 are complied with.

Monitoring Mechanisms:

Reporting on the implementation of the provisions of Part 3 of the Disability Act 2005 will be incorporated into existing monitoring and reporting arrangements in respect of the Executive's annual service planning framework.

The HSE will, on an on-going basis, liaise and work with advocacy groups representing people with disabilities and relevant voluntary organisations to inform the implementation of this process.

7.1.3 Other Statutory Bodies Under the Aegis of the Department of Health and Children

In addition to the HSE, 27 other statutory bodies come under the aegis of the Department of Health and Children. Details of those bodies are set out in Appendix 2.

Each of these bodies is preparing an implementation plan in respect of its own obligations under the Disability Act. The main points in common are summarised here.

Section 25

The bodies concerned are undertaking accessibility audits of their premises with a view to complying, as far as practicable, with the provisions of this Section. As many of the premises occupied by these agencies are leased, this will be undertaken in consultation with the owners of the buildings.

Section 26

Access Officers are being appointed and audits of services have commenced to establish how integrated service provision is. Appropriate measures will be taken on foot of the results of those audits to ensure that the services which are provided to the general public are accessible to people with disabilities where practicable and appropriate.

These measures have commenced and will be completed during 2006.

Section 27

All bodies will ensure that the goods or services that are supplied to them are accessible to people with disabilities unless it would not be practicable or justifiable on cost grounds to do so or would result in an unreasonable delay.

In this regard all agencies will:

  • Revise existing procurement policy, procedures, practices, guidelines or templates used or developed by the public body;
  • Ensure that accessibility is a criterion to be considered in all public procurement exercises.

These measures have commenced and will be ongoing during 2006.

Section 28

All bodies will ensure, as far as practicable, that information which is provided to the public is provided in an accessible format, where so requested by persons with hearing impairments, visual impairments or persons with intellectual disabilities.

In this regard all bodies will

  • Establish procedures for processing requests for accessible formats;
  • Establish procedures for sourcing or providing accessible formats;
  • Establish what is entailed in making electronic communications accessible;
  • Review the range of information published by the body to identify which publications fall within the category concerned;
  • Establish likely demand for such information.

These measures have commenced and will be ongoing during 2006.

Section 39 Complaints

All bodies will ensure that arrangements are in place in line with the provisions of Part 3 to deal with complaints and that information regarding those arrangements is generally available to the public using their services and that the procedures in place are simple and easy to use.

Complaints mechanisms are already in place in most of the bodies concerned.

Monitoring Mechanisms

Reporting on the implementation of the provisions of Part 3 of the Disability Act 2005 will be incorporated into existing monitoring and reporting arrangements in respect of each body's annual service plan.

7.2 Part 5: Public Service Employment

7.2.1 Department of Health and Children

The Department of Health and Children is currently in the process of putting in place the monitoring arrangements for the health services, including the HSE and other statutory bodies under the aegis of the Department, as required under Part 5 of the Disability Act 2005.

The WAM (Willing, Able and Mentoring project, which is administered by the Association of Higher Education Access and Disability (AHEAD), aims to provide graduates with disabilities temporary placements with public and private sector employers. The Department is participating in the WAM Project in 2006 and has provided two placements for a period of six months each to undertake two specified projects within the Department.

7.2.2 Health Service Executive

A Sub Group of the HSE Employers' Agency (HSEEA) have developed Guidelines for the Employment of People with Disabilities which sets out best practice in the area of promoting and supporting the employment of people with disabilities.

This Group is also in the process of drafting a strategy and action plan which will present a framework for health service employers to provide a working environment where employees with disabilities are recruited, promoted and retained on the basis of their abilities and which will remove barriers to workplace participation. It is envisaged that this action plan will assist employers achieve the 3% employment target.