People with Disabilities in Ireland
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Jervis Street
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Telephone: 01 87 21 74 4
Fax: 01 87 21 77 1
Email: info@pwdi.ie
Dr Maureen Gaffney, chair of the National Economic and Social Forum (NESF) on the importance of the NESF’s most recent report, ‘Improving the Delivery of Quality Public Services’.
The focus of this, our most recent NESF report – Improving the Delivery of Quality Public Services, is on putting the citizen at the very centre of public services reform.
This is a major report with many practical proposals to enhance the delivery of our public services in which we invest e39 billion per annum.
What the Report Aimed to do
Most of us, as we progress through the life-cycle, will turn to the public services to meet a whole range of needs. This is particularly true at crucial transition points – when a special needs child starts school, when a troubled teenager drops out of school, when an elderly parent living independently has an accident. These are crucial transitions because they can become turning points. The person and their family urgently need a range of services and supports – medical, educational, community. If those services are delivered in the right quantity, the right quality, in the right mix, and at the right time, the person can go on to live a healthy and productive life. If not, they can flounder, deteriorate, and ultimately may require much more expensive and complex interventions.
The starting point for the report was to recommend how public services can be reformed in a way that allows them to respond to people’s needs, particularly at those life-cycle transition points. Public services have a central role to play in promoting a more equitable and responsive society and thus underpin our future social and economic development.
The Contextual Setting
There have been significant improvements in public services here over the last decade, arising from reforms under the public service modernisation programme and successive partnership agreements. The intention of our report is to build upon and enrich this process. Notwithstanding these improvements, there are still significant shortcomings, particularly in dealing with more complex social problems, as well as new and emerging challenges that need to be met. These derive from ongoing pressures resulting from our high economic growth, population growth, demographic and social changes, inward migration and greater cultural diversity. As is the case in many other countries, there are
rising public expectations for more choice, higher quality standards and value for money.
A central issue is how to move from our present system, which often tries to fit complex individual needs into a ‘one-size-fits-all’ approach, towards an approach where services are ‘wrapped around’ people’s needs and circumstances. A main finding from our research – supported by the many submissions we received from the public - is that there is often a wide gap between what service providers believe they are providing and the services that users need to receive. Submissions from the public and the focus groups referred to on-going problems with needless bureaucracy and lack of coordination between services. This included people facing differing eligibility requirements, staff specialisations and fragmentation of service delivery. Examples given were the lack of timely early service interventions for children and young people requiring educational, psychological and other therapeutic services. For homeless young people, deficiencies identified included a lack of service integration, early intervention, advocacy and ongoing support mechanisms. For older people living alone, the need for more accessible public transportation services, along with improved health and social care services, including specialist outpatient services, health screening services, respite care, home help and recreational services were highlighted.
Very often, to try to get their needs met, a family member has to become an advocate and a broker, trying to explain the need, trying to get one agency to communicate with another and trying to decipher eligibility requirements. A central recommendation of the report is that the public services themselves must assume that role for the person in need. Thus, when an elderly person becomes frail or disabled, there should be one lead agency that they or their family can approach. That agency would then assume responsibility to the person; would arrange a full needs assessment and crucially, would advocate and broker the required services from sister agencies on that person’s behalf.
Such desired outcomes will of course require a radical culture change in the public services.
Conclusions
A main lesson across countries is that public sector reform is continuous and that governments must continue to adapt and modernise the services to meet the complex needs and higher expectations of the people that use them. The recommendations made in the report are practical and can be implemented for services identified within the ‘Lifecycle Framework’ outlined in ‘Towards 2016’. We believe they will enrich the ongoing public service reform programme and lead to the kind of public services that
we all want and deserve.
Dr. Maureen Gaffney is a well-known psychologist, broadcaster and writer. Since 1993 she has chaired the National Economic and Social Forum (NESF), which advises the Government on policies in relation to equality and social inclusion.
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