The Value for Money
& Policy Review of
Disability Services
Presentation to Inclusion Ireland Conference
15th April 2011
Bairbre Nic Aongusa, Director
Office for Disability & Mental Health
Overview
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Role of the Office for Disability & Mental Health
VFM & Policy Review – Terms of Reference
What are our policy objectives?
What service users are saying
Key themes emerging
Government programme
Implementation challenges
Office for Disability &
Mental Health
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Based in Department of Health
Health aspects of National Disability Strategy
and Health sectoral plan commitments
Cross-sectoral remit in relation to disability &
mental health  Education
 Employment
 Housing
 Children
VFM & Policy Review – Terms of
Reference
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Identify the objectives - are they still valid?
Examine current outputs and outcomes
(effectiveness)
Level and trend of costs and staffing resources
over the years (efficiency)
Scope for reducing overheads
Scope for alternative policy or organisational
approaches
Objective 1: To support every person with a disability to
enable them, to the greatest extent possible, to lead full
and independent lives, to participate in work and society
and to maximise their potential;
 Objective 2: To ensure that every person with a
disability would have access to public spaces, buildings,
transport, information, advocacy and other public
services and appropriate housing;
 Objective 3: To ensure that every person with a
disability would, consistent with their needs and abilities,
have access to appropriate health, education,
employment and training and personal social services.
 Objective 4: To support and acknowledge the role of
carers.
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Over 16,000 people with disabilities attend a day setting,
with over 90% attending segregated, group settings
 Over 9,000 people with intellectual disabilities in
residential settings, 90% in segregated, group settings
 Current needs assessment methods (for the two
databases) identify continuing demand for residential
and day places
 Little acknowledgement of role of carers
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Flexible supports to suit individual needs
 “...use local services – do ordinary things in ordinary
places”
 Families of service users want to be allowed to play their
part in supporting their family member
 Get different elements of service from different providers
 Get a budget to choose and manage their own services
 Dissatisfied with the amount of independence they have
 Dissatisfied with the amount of choice they have over
the service received from service providers
 Dissatisfied with support received from service providers
to facilitate inclusion in the mainstream life of the
community
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Key themes emerging (published 3rd
December 2010)
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More access to mainstream services;
Personal supports to facilitate inclusion
delivered separately from health and clinical
supports;
Individualised funding so that service users can
exercise choice and control;
More involvement of family and friends (natural
supports, informal supports);
Tighter governance, ensuring funding is clearly
linked to needs and outcomes.
Government for National Recovery
2011-2016 (p. 54)
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“We will reform the delivery of public services to bring
about back office savings that will protect front line
services”
“A comprehensive spending review will examine all
provision for people with disability with a view to
determining how users can get the best services.”
“As part of this Review we will move a proportion of
public spending to a personal budget model so that
people with disabilities or their families have the flexibility
to make choices that suit their needs best.”
Implementation challenges
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Standardised assessment of need to determine
individualised budgets (who? how?)
May need legislative and administrative changes
New role for existing service providers?
Role of other sectors in achieving
mainstreaming agenda – employment, housing,
income support, education, transport etc.
Challenge for HSE and health system