Services for the disabled have little accountability
A lack of formal regulation has led to scattered, uneven services for people with disabilities and ‘independent republics’, writes PAUL CULLEN,Health Correspondent
Services for people with disabilities are unevenly distributed around the country and vary greatly in quality, according to a report published today.
In most cases, there has been a lack of focus on outcomes and little accountability in terms of the quality of service delivered, says a report by the National Economic and Social Council.
“There has been little formal regulation in the sector, with a lack of mandatory standards, and no external oversight or inspections, so that the services have been free to develop as ‘independent republics’, providing care as they see fit.”
The report points out that the sector is about to undergo a major transition next year when the Health Information and Quality Authority starts regulating residential services for people with disabilities. However, there remain uncertainties as to how this will impact on the sector and how quality can be achieved at a time of limited resources.
“While there is a move towards greater levels of formal regulation, the disability sector remains largely self-regulatory, varying from services that are demonstrating excellence, to ones where little is known about the quality of their service.”
Hitherto, disability services have not been aligned with Government policy, the report says. Since most of the services originated in local needs and through voluntary efforts, they are not distributed evenly around the country. They also vary widely in terms of what they provide and the quality of their services.
According to the main author of the report, Dr Jeanne Moore, the capacity within the disability to “monitor, reflect, problem-solve and share learning” has not been developed and therefore its ability to self-regulate is “at best patchy, ie good in some areas but absent in others”.
Dr Moore warns that now is a time of potentially seismic change for disability services and this will present considerable challenges for service users and providers, policy-makers, funders and regulators.
“There is a need for a re-balancing of the regulatory system so that it includes formal regulations and inspections to safeguard vulnerable people, but also builds on and strengthens the active search for continuous improvement demonstrated by many service providers.”
The report, Quality and Standards in Human Services in Ireland: Disability Services, is the seventh of eight reports prepared by the council on standards in Irish public services.
About 6 per cent of the population, or 50,000 people with physical, sensory and intellectual disabilities, use a variety of services, costing the State €1.2 billion a year. Although funded by the State, most are run by voluntary providers and community organisations. Some 4,000 people with disabilities live in residential care.