THIS ISSUE OF Frontline has an underlying educational theme against the backdrop of national financial constraints. It was reassuring to hear the Taoiseach in the Dáil on 1 July, when he indicated that money allocated by the Oireachtas for disability services will be spent as proposed, although at a lower rate. Like other government-funded services and departments, the HSE is under great pressure to remain within their agreed allocation.
People with disabilities have lifelong needs arising from their disabilities. Evidence-based research suggests that services and professionals, in endeavouring to meet the needs of people with disabilities, do not pay sufficient attention to the needs of carers. People with disabilities may require several different services—e.g. hospital, therapists, respite, etc. In times of financial constraint, it is crucial not to weaken the fabric of an already fragile service delivery system.
The assessment of need under the disability legislation (2005) is currently being installed for children 0–5. The HSE is working in cooperation with non-statutory authorities in the roll-out process. Anecdotally, there are reports that the legislation is being triggered by parents as a way to access assessment. If so, this is an evident comment on the unevenness of spread of the Early Intervention Services nationally. There are also reports of clinical staff not being replaced, and other staff being pulled from clinical services which have their own priorities, to fill the gap. These anecdotal reports do raise the question whether this is a harbinger of worse things to come, as other pieces of the disability legislation are rolled out, such as the commencement of the EPSEN Act.
There is almost a sense of stalling in mid-air, and falling to earth, and parts scattering in all directions, with no chance of putting them back together in a recognisable whole—like Humpty Dumpty?
Reconciling person-centred services and reduced resources is a challenge. In his article, Michael Kendrick points out that many components of a person-centred programme do not of themselves require additional resources, but they do demand a significant attitudinal change, among service providers and also statutory bodies, professionals and family members. Kendrick sets out a number of principles for the individualisation of services and he questions whether congregate settings are ever truly compatible with person-centredness in the absence of choices.
Kathleen Morris’ article raises important questions about fostering relationships. For many people with intellectual disabilities loneliness is a daily reality which may not be fully understood by family or services. Companionship through the development of relationship has to be an important objective for anybody who really believes and practises Person-centredness. Sexual expression is an outcome for some relationships and for some people with intellectual disability this is an important part of their wholeness as people.
The disability legislation identifies the importance of accessing inclusion. Paul Egan, in his article on designing educational learning space, highlights a changing environment for school design. For parents who are fortunate to have children attending a school designed and built over the last five years, it is easy to detect the energy these buildings exude. The abundance of natural light, use of colour and space for the learner and the teacher are light years away from those learning environments of ten years ago and before. These new learning environments are a readily recognised outcome of government commitment to education. The challenge for government is not to panic and withdraw from its capital expenditure programme at a time of financial constraint, but to have the courage to stay focussed on continuing to build good educational infrastructure.