Health and Disability Services
Disability services in Ireland are delivered in the main by the Health Service Executive (HSE), and by voluntary service providers funded by the HSE.
The National Disability Authority offers independent advice to the Department of Health and Children and the Health Service Executive on disability policy and practice, informed by NDA's programme of research in this area. The NDA is assisted in this work by its Mental Health Advisory Committee.
NDA's publications on health and disability services include topics such as:
- A guide to strategic partnership with mental health service users
- Person-centred planning
- Research on issues for people with disabilities in accessing mainstream health services
- Oral health and disability
- A mapping of disability and health services (Towards Best Practice report)
- Universal Health Insurance systems and the provision of health services for people with disabilities
Universal Health Insurance Systems and the Provision of Health Services for People with Disabilities
People with disabilities have higher level of health needs than the general population. Any deficiencies with the Universal Health Insurance system introduced in Ireland could disproportionately disadvantage people with disabilities.
Key concerns at a systems level in introducing Universal Health Insurance include the costs, vis-à-vis other models; the extent of coverage and the regulatory, licensing and risk management of the model. With regard to the impact on people with disabilities key concerns centre around equitable access to services, access to insurance and the potential for excessive supplementary or out-of-pocket payments for the individual.
In 2011, the Department of Health, the Health Service Executive and the National Disability Authority completed a Report on the Practice of Assessment of Need under Part 2 of the Disability Act which concluded a number of interdependent changes would need to take place to better the process.
In 2011, the National Disability Authority undertook a consultation exercise to help develop advice on a framework for commissioning disability services.The traditional way of funding disability services in Ireland has been through block grants to disability service providers. Commissioning is an alternative way of procuring services, where the funder specifies what services they require, and invites service providers to meet those specifications.
Assessment of Need for Disability Services
The Disability Act 2005 acknowledged there is a gap between service needs and actual service provision. Part 2 of that Act provides for independent assessment of the needs of people with disabilities. Following the assessment of need, a Service Statement is prepared detailing the services which can be provided within current resources, and the timescale for delivery of these services. The person concerned is then entitled to those services set out in the Service Statement. The aggregate shortfall between assessed needs and those set out in Service Statements are required to be published every year.
This system commenced for children under 5 from June 2007. It is intended that the independent assessment under the Disability Act 2005 of the needs of 5 to 18 year olds for health and social care services will be introduced in parallel with independent assessment of their education needs under the provisions of the Education for Persons with Special Education Needs Act 2004.