Disability Services

Background

The Central Council for the Rehabilitation of Tuberculosis REHAB was founded in 1949. In the age of pool competitions in the 1950s, REHAB established a number of facilities in Dublin, Cork and Limerick.

By the late 1950s, there were fewer TB patients, and it commenced accepting psychiatric patients.  It concentrated on re-training. The State largely relied on religious institutions to provide for persons with intellectual disabilities. REHAB succeeded in raising monies through local committees and, with EU assistance, established services throughout the country.

Certain categories of persons and children with disabilities, including intellectual disabilities, were placed in psychiatric units. Many intellectually disabled children spent long periods in psychiatric hospitals with questionable justification. Notwithstanding the progressive removal of persons with intellectual disabilities from psychiatric hospitals, the program of transfer is not yet completed.

Groups of parents sought to establish special schools for children.  In 1955 Michael’s House was established which now has 120 Community-based centres in the Dublin area.

Modern Development

When the Health Boards were established in 1970, disability services received greater attention. Initially the system continued to be somewhat incoherent. Disability rights slowly became a focus for health services. Policies sought to support persons with disabilities to have greater participation in society.

A report in the mid-1970s strongly supported participation in the community through community workshops.  By the 1990s, there had been a more significant move towards participation and integration.

The provision of residential accommodation is of less significance, and the objective is to enable persons with disabilities to live as independently as possible, preferably in their own homes and to participate in society.

Disabled Persons Maintenance Allowance has been administered by the Department of Social Protection since the late 1990s and has become part of Disability Allowance.

Disability Services

There are approximately 26,000 persons registered with the National Intellectual Disability database, and almost all of them are in receipt of services.  Most avail of multidisciplinary service.  The most common services are social work, medical services and psychiatry.

For children, the most common services relate to speech and language, social work and occupational therapy.  Almost two-thirds live at home with relatives or foster parents.

There are 29,700 persons under 66 registered with the National Physical and Sensory Disability Database Committee, of whom 83 per cent are in receipt of services.  They are most commonly technical aids or appliances, day services, personal assistance and planned respite. Only a relatively small proportion are in receipt of residential services.

HIQA has published quality standards for residential services for persons with disabilities.

Umbrella Organisations

A range of statutory and voluntary bodies supported by the government provide services to disabled persons. Voluntary organisations, both nationally and locally, have played a very significant role in the field of disabilities.  It is estimated that over 150 organisations provide services for persons with intellectual or physical disabilities.

Religious bodies have provided a range of services, including the Brothers and Daughters of Charity, St.  John of God, Sisters of Mercy, St.  Michael’s House, Stewarts Hospital and the Western Care Association in Mayo.

The National Association for Persons with an Intellectual Disability is an umbrella group of 160 affiliated organisations for various disabilities, principally intellectual disabilities.  It seeks to represent the interests of persons with intellectual disabilities and their families.

Numerous disability organisations have grown up dealing with particular groups and interests.  Most are affiliated to the Disability Federation of Ireland. The Disability Federation of Ireland has over 120 organisations associated with persons with physical and sensory disabilities and acts as an advocate in this area.

The National Federation of Voluntary Bodies providing services to persons with intellectual disability is another umbrella organisation.

Commission & Reports

The Commission on the Status of Persons with Disabilities was established in 1993.  Its 1996 report put forward the principle that services for persons with disability should be mainstream.

The Commission’s strategy involves legislative solutions, proposals for new policy initiatives and new structures for the delivery of equality services within a framework of rights, not charity. The Commission has developed a model of service which places the user of those services at the centre of the process of service delivery, from the planning stage right through to implementation.

The 1996 Strategy for Equality Report of the Commission on the Status of Persons with Disabilities indicated that approximately 360,000 were classed as having h some type of disability.  Approximately 25,000 were then in receipt of Disabled Person’s Maintenance Allowance/ Disability Allowance.

Department

The Equality section of the Department of Justice and Equality functions include

• Implementing the new National Disability Inclusion Strategy (2017 -2021)
• Coordinating the implementation of the Comprehensive Employment Strategy for People with Disabilities (2015 – 2024)
• Engaging with the European Commission and Council of Europe on the development of disability policy and sharing of good practices
• Providing grant aid and corporate governance to the National Disability Authority
• Acting as a central point of information for queries relating to Disability Policy

National Disability Authority

The National Disability Authority, established in 2000, is the central body which seeks to coordinate and develop disability policy. It provides information and statistics for the delivery of disability services.  It monitors compliance with the obligations of public bodies in relation to the employment of persons with disabilities. Such bodies are obliged to employ at least 3 percent of their employees from categories of persons with disabilities.

The National Disability Authority Act 1999 established the National Disability Authority. It seeks to promote the rights of persons with disabilities.  Members of the Authority include persons with disabilities, representatives of families and carers.

The National Disability Authority (NDA), is the independent statutory body that provides information and advice to the Government on policy and practice relevant to the lives of persons with disabilities. We have a role to assist the Minister for Justice and Equality in the coordination of disability policy.

Our functions include research, developing and collaborating on the development of relevant statistics, assisting in the development of standards, developing codes of practice and monitoring the implementation of standards, codes and employment of persons with disabilities in the public service.

It works through its Centre for Excellence in Universal Design to promote the universal design of the built environment, products, services, information, and communication technologies so that they can be easily accessed and used by everyone, including persons with disabilities.

The Health Strategy 2001 emphasised the rights of persons with disabilities and the mainstreaming principle.

Disability Act

The Disability Act was enacted in 2005. Those who had campaigned for it sought a more rights-based Act and contemplated the possibility of civil actions being taken against the State and other authorities.

The Disability Act 2005 was criticised on the basis that it was not fundamentally rights-based.  This had been resisted  on the basis of affordability on the State’s part.

The Disability Act 2005  was phased over a number of years. It defines disability as a substantial restriction on the capacity of a person to carry on a profession, business or occupation or to participate in social or cultural life by reason of an enduring physical, sensory, mental health, or intellectual impairment.

The State launched a National Disability Strategy in 2004.  This included the following elements:

• The Disability Act 2005 and its rolling implementation.
• The Education for Persons with Special Needs Act 2004.
• An advocacy service for persons with disabilities provided for under the Citizens Information Act 2007.
• Multi-annual investment programs and priorities services.
• Six sectoral plans on disability for key government departments.

The Disability Act provides for a right to an individual assessment by an independent entity.  The assessment relates to needs and related services, which are to be encompassed in a statement.

Educational Special Needs

The Education Act provides for a right to education for persons appropriate to their abilities and needs, including those with special educational needs and disabilities.

The 2004 Act sought to ensure that persons with disabilities should have the same right to avail of appropriate education as those without.  Children are entitled to an assessment under that legislation of any special educational needs.

NCSE is an independent body which assumes responsibility for special education needs and related services.  These include coordination with other state agencies.

Advocacy for Disabled Persons

The Council for the Status of Persons with Disabilities was established in 1997.  It was later renamed the Irish Council of People with Disabilities in Ireland. The Council is a publicly funded body comprised of people with disabilities. It established a national office and regional and local networks of people with disabilities.

In 2002, Comhairle was established as the public body responsible for information, advice, and advocacy regarding access to social services. In the early 2000, Comhairle provided funding to a number of organisations to develop advocacy for people with disabilities. It also commissioned Goodbody Economic Consultants to report on how advocacy could be developed for people with disabilities.

The Goodbody Report (2004) set out a strategic approach to developing advocacy services for people with disabilities, recommending a three-stranded system. This was to involve a programme of support for community and voluntary organisations to provide advocacy services, a Personal Advocacy Service with statutory powers, and a Community Visitors Programme.

The Community Visitors Programme was to be a form of citizen advocacy, which would focus on children and adults with intellectual disabilities in institutional care. The Goodbody Report mirrored many of the advocacy recommendations previously made by the Commission.

The Citizens Information Board established an advocacy service in 2011 for persons with disabilities. Six Government Departments have published disability strategies, including

• Department of Transport,
• Department of Environment, Marine and Natural Resources,
• Department of Enterprise, Trade and Employment,
• Department of Health
• Department of Social Protection.

Certain parts of the legislation and its implementation were postponed on account of financial pressures.