Election 2024: Disability — Comment: Two urgent issues candidates must address
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People living with disabilities or waiting for GP appointments are beginning to realise that while their problems are often hidden at home, a crisis is bubbling.
For children or adults living with disability and their families, the election is a chance to raise those problems, including access to vital therapies, with election hopefuls. Their hurdles might start at birth when a pin-prick test identifies a rare disease or later as developmental issues show for a toddler.
Then a child might want an assessment of need — this is not a HSE requirement to access services but has become seen as the entry-way. Some parents have gone to court to seek this only to find so few therapists available that it is not as effective as they hoped.
There are many examples of the pressure points. Emily Healy in Limerick has spent thousands of euro on private appointments and care for her daughter who has a rare disease. They cannot get in front of a HSE therapist regularly.
Laura Egan, co-founder of Rare Ireland, said it subsidises therapies for its members. But she pointed out that it should be "the responsibility of our health service”.
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When John Fogarty, GAA correspondent, wrote about his daughter’s challenges in getting help, he was inundated with parents sharing similar frustrations.
His local children’s disability network team recently wrote saying it can take Grace from October 2025.
He is not optimistic.
The pressures are only growing with the Economic and Social Research Institute (ESRI) saying 23% of 13-year-olds have a disability now compared to 6% in 2011/2012.
It suggested one reason is increased awareness of disability and another potentially a greater prevalence of certain conditions. Whatever the reason, those children and the adults they grow into need help.
As electioneering kicks off, the Disability Federation of Ireland has spelt out what a progressive manifesto should address.
It has asked candidates to pledge support for changes including taking a cross-departmental approach to streamline services.
A lot of money is flowing this way next year which could address some problems. The disability budget hit €3.2bn, the largest yet. An unexpected boost of €5m was announced on Friday for rare disease care bringing the annual total to €6m.
Interestingly, the Government press release mentioned Emma Fogarty who took part in a marathon with Colin Farrell to raise awareness.
So that is what is needed to get attention.
The link between high-profile advocacy and funding would not have been lost on disability advocate Leigh Gath who passed away this year.
“They must stop punishing people with disabilities because disability is not a crime,” she told this paper in 2012, never wavering from that view.
When it comes to GP services, more patients face waiting times and have lost access to same-day appointments for non-urgent calls. Families from areas as different as the north side of Cork City and the Iveragh Peninsula in Kerry have spoken to the about this in recent months.
Michael Kelleher, a GP in Lahinch said: “It is becoming a reality now in general practice across the country. It could be some days, sometimes a week or sometimes even more depending on how the demand is in the practice.”
The problem is acute for anyone moving to a new area despite doctors’ warnings on this for over 10 years.
Only one in five practices have room for new medical card patients, and one in four for new private patients, the Irish College of General Practitioners has estimated.
So why is this happening? "The population, stupid" is likely one answer.
GPs will also point back to funding cuts after the 2008 recession which put medical students off this area of study.
“Some chickens are definitely coming home to roost as some of these things could have been addressed much earlier,” Dr Kelleher said.
Changing attitudes to work have made impractical the traditional approach of a single-handed GP dashing off to answer calls at midnight from their home.
In Sinn Féin’s new health plan, it pledged a public-only employment option for GPs. This would target underserved communities where the existing practice model is not working. They would also increase training places by 60%.
Their plan, as presented by Waterford TD David Cullinane, would allow for the expansion of treatment schemes for patients.
That need to expand was made clear during the pandemic when GPs took on more vaccine campaigns and saw more people wanting care outside of hospitals.
Training places for GPs have been boosted with 350 set to graduate every year. That should start feeding in after around four years which is reassuring but also not immediate. For now a new training programme attracting GPs from abroad to rural areas has been welcomed.
So really anyone canvassing over the next few weeks should think about their solutions to these two urgent problems before pressing the doorbell.