DFI / NFPBA Launch of Living in the Community: Services and Supports for People with Disabilities 2013
May 7 2013
Mansion House, Dublin, 17th April, 2013
John Dolan, Chief Executive Officer, Disability Federation of Ireland
Check against delivery
Des has already outlined to you the reasons we decided to commission this research.
I have spoken many times in this very room at our pre-budget events about our growing concerns with the constant pairing back of funding for disability services, which is impacting on both the individual and on community based services. The fact that the Value for Money Review chose not to look at community based services motivated us to progress this research. In hindsight maybe we were remiss not to have commenced this study far earlier.
We have learnt much from this study. The services and supports that are described in the research are the kinds of services that have been recommended in national and international policy (for example, recent policy reports from the HSE and the UNCRPD). They strive to be person centred, flexible, integrated into the fabric of local communities, innovative, and creative. The organisations who provide these services have taken risks time and time again to push the boundaries of what is the norm for disability services. They have had to challenge themselves to adapt to peoples with disabilities’ rising expectations for inclusion, equality, choice, participation, or the choice not to participate as people may wish.
The study shows us that these services and supports have developed very much in a vacuum, with little common understanding between the State and the community and voluntary sector on what was been developed. The approach has been piece meal. Very often new systems and procedures brought in to improve the efficiency and effectiveness of services, to make them increasingly accountable and even safer, have actually had a negative impact on these organisations’ ability to provide flexible, responsive, person centred services.
It is appalling that in 2013, in the context of the NDS, Sectoral Plans, and the UN CRPD that we know so little about community based services in Ireland. The UNCRPD signals a clear global direction on the measures needed to allow people with disabilities have the same rights as other people. If we are going to have the ability to apply this approach in Ireland we need to know what does and doesn’t work for people with disabilities on the ground. This research is a snap shot exploring the services of 15 organisations; at the same time it deepens our understanding of the challenges as well as of the rewards in implementing a community model in Ireland.
The main report at over 100 pages long, describes in detail these community based services and supports and provides us with a more nuanced understanding of a range of issues including person centred supports, the importance of connections and collaboration in providing seamless services, having a flexible approach, bridging to mainstream services, as well as strengthening of these services, through specialist knowledge and skills.
Participants in the research had a clear focus on seeking outcomes for people with disabilities as opposed to simply providing services, and it was highlighted that finding ways to ‘count’ outcomes appropriately and sensitively is the key immediate challenge – one where the voluntary sector is in a position to offer experience and leadership.
To ensure synergy and a systematic approach to the planning of good outcomes for people with disabilities, it is essential that there is ‘a common language to engage with’ across the HSE / DoH, and people with disabilities / disability organisations, as highlighted in the report. This requires a number of changes, at one level, increased information sharing across the system, improving the quality of services and supports, becoming more systematic in outcomes measurement and drawing on good practice.
The Taoiseach recently launched Healthy Ireland, and DFI greatly welcomes the direction and ambition of the policy. The community based services and supports detailed in our study are putting into practice the vision in Healthy Ireland relating to the multi-dimensional aspects of health. Healthy Ireland advocates for a whole of government approach as the broader aspects of education, employment and environment are known to affect the risk factors for health. We know that health and well-being are affected by all aspects of a person’s life. Community based services and supports are well placed to support the kinds of connections and collaboration across mainstream services, such as transport, housing, education, and employment, that promote a seamless service for an individual. In this regard the findings from our study are as relevant to the reform of our health services as it is to the reform of our local government, training and education systems.
We need to engage in the work of improving disability services and supports, in a more fluid and less compartmentalised fashion. Doing so supports the vision contained in the National Disability Strategy, and ultimately to the principles in the UNCRPD. Organisations have been eking out responsive and flexible systems of support for people with disabilities; and they have been innovative in these approaches, in particular, in the current context of austerity. At the same time, they recognise the need for continuous improvement in the quality of services and supports. It is incumbent on policy makers and planners, to not put further obstacles in their way to doing this work.
People with disabilities already live in the community; they require not only a halt to the erosion of existing community based services but the thoughtful development of the mix of different types of community based services and supports that enable people to live independently.
The researchers will bring us through more detail on the study; I would like to briefly synopsise what we have learnt from this study. We need:
· To know more about community based services already being provided in Ireland
· A clear and concise ‘disability and community’ policy direction emanating from the Department of Health across government and statuary agencies, across the community and voluntary, as well as business community
· A common language in relation to community based services
· An administrative, safety and quality structure that is underpinned by a communities approach, and that promotes and values community based services.
· Common outcomes that we can all work towards and common information management systems that will support us set targets, account for ourselves and evaluate ourselves
· And finally to learn together on how we implement a community based approach in services for people with disabilities in Ireland.