Wednesday 20 November 2019

Mary Farrell: We can't trust shambolic HSE to run disability sector

Having witnessed first-hand the chaotic delivery of services, it's clear that change is needed fast

The controversy over the pay and perks of CEOs at firms like Rehab will no doubt add to public distrust
The controversy over the pay and perks of CEOs at firms like Rehab will no doubt add to public distrust

Mary Farrell

We are now at the end of Brain Injury Awareness week, where awareness and funds are raised for the thousands of Irish people every year who have their lives transformed by acquired brain injuries, people for whom their whole life changes in an instant. My adult son is one of these people and his injury has given me a unique and frustrating look at how services are provided in this country for people who have disabilities.

There has been much debate about charities and pay for those who are managing in that sector (all CEOs of course, not mere managers) with a sense of entitlement and importance that accompanies the title and huge salaries they are receiving. We hear of pension pots of €740,000, salaries of €240,000 (and upwards with perks) and vast sums of taxpayers money (eg €83m for Rehab) without anyone feeling the need to provide any accountability when called upon to do so – brushing off those who would question them. At the heart of this is how disability services are delivered in Ireland.

It is disturbing when we learn of the sums that various charities are receiving from Government every year to provide services and pay their staff, and yet there are people in the country who cannot get any services at all.

The Government and HSE has outsourced health and social care services to these organisations that were set up in an ad-hoc, casual, disorganised, unstructured way, and the result is chaotic delivery of services.

The disability sector and its services have evolved and grown, driven by groups or individuals lobbying for services or setting up services for a particular disability in a particular geographical area.

The Government will say that they have provided many millions for disability services in a year, and there is a perception out there that everyone is getting equal treatment and services, but that is not happening.

The Government needs to have an audit of funds and services done urgently and action to root out the waste and provide equal access to all to the appropriate services they need.

As eventually happened with children's services, the same needs to happen with the disability sector: it needs to be removed from the HSE and all services for people with disabilities brought under one separate government department with one minister responsible for it.

Is it a good idea to entrust the oversight of this enormous sector to the HSE? It cannot even get its own house in order, with healthcare shambles taking place week after week – and yet we expect the HSE to oversee this sector and deliver services to people with disabilities. . .

The Government has failed people with disabilities in this country by (a) failing to legislate for statutory rights for people with disabilities (failing to enact the Disability Act) and (b) failure to regulate the charities sector and to evaluate the services being delivered and the type and quality of same. They have failed to regulate home care provision, where vulnerable people receive support in their homes.

In the main, private home care providers deliver these services. Urgent legislation is required in this area – followed by standards and inspections.

No one has provided leadership on this matter because there are too many vested interests, and it is up to the Government to ensure that public funds are used in a manner that is equitable and fair for all. A charity regulator will not resolve this situation. The glaring need for openness and transparency has been exposed. For instance, if a charity becomes a business, allied with other business interests of the directors, then they are private contractors to the State and they should be treated as such and should not be entitled to charitable status.

There needs to be a more strategic delivery of services and equity for all people with disabilities. We well know that the rights of persons with disabilities are not enshrined in law, but Ireland is preparing to ratify the UN Convention on the Rights of Persons with Disabilities and, in order to be in compliance with this, there will have to be a lot of changes.

In Meath, there have been no services for adults with acquired brain injuries nor any kind of infrastructure for disability services. People are left totally isolated in rural areas with no services. Services that have been there up to recently have been deconstructed or, to use the HSE's euphemism, 'reconfigured', to the extent that they are now non-existent. The HSE is totally detached from the needs of people with disabilities and their families.

Sunday Independent

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