Allowing persons with disabilities to make personal choices and exercise independent judgment on how State financial supports are used can have life-enhancing, confidence-building results.
A campaign by Inclusion Ireland and Down Syndrome Ireland in favour of personalised budgets has been supported by Minister of State Finian McGrath with the expectation that a reasonable proportion of the Health Service Executive's disability budget will be set aside for individualised and community-based supports.
It will not be easy. Over the decades, the official attitude towards individuals with disability has tended to be overbearing and paternalistic. This has manifested itself in a ‘one-size-fits-all’ approach and the provision of residential and day care services where the client has little or no say in how money allocated for their welfare is spent or the kind of services they receive.
Changing that system is certain to generate opposition from existing service providers and from those health administrators who wish to keep the financing of services as rigid and as uncomplicated as possible.
Such predictable opposition reflects a mindset in which the provider, rather than the client, is boss. It permeates many aspects of the health service. To counteract it within acute hospitals, a “money follows the patient” approach was tried. Resistance continues.
The funding of disabled people on an individual basis, so they can customise the services they require, has been successfully introduced in Britain and elsewhere. It operates here on a minuscule scale but is difficult to access. What is required is a change of attitude and greater official flexibility.
Empowering people – particularly those with disabilities – to live as independently as possibly should be the motivation behind an effective health service. Mr McGrath has endorsed a compelling campaign in support of those whose voices are rarely heard at government level.
Vested interests and bureaucracy should not be allowed to suppress this important development in personal freedom and self-expression.