Maman Poulet | Clucking away crookedly through media, politics and life

Disabling healthcare

October 14th, 2013 · Disability, Social Policy

The circumstances surrounding the deaths of Grainne Daly and Bernard Wright were reported last week and should be remembered for years to come. Unfortunately I fear that they may soon be forgotten.

Both had disabilities and both had families who fought hard to get clarity regarding their treatment and cause of death.

Grainne’s family had been fighting for 4 years before they finally received an apology from the HSE.  Eoin English reported extensively in the Irish Examiner on Saturday on the circumstances surrounding her death and the silence from the HSE afterwards.

Bernard Wright died in 2011 in the care of St. Michaels House, his family had moved him back there from Beaumont Hospital following a refusal to administer morphine. His family thanked St. Michaels House for their care and allowing Bernard to die with dignity.

While the culture of non-disclosure and a refusal to communicate with family members during an illness and following death was the main focus of the reports last week there was another issue which lay below the surface.

There is no national protocol regarding the treatment, communication and support of people with disabilities who are receiving treatment in acute hospital settings.  Several hospitals have individual policies, however the HSE or HIQA have no national standards on the needs and treatment of this specific group when they are seriously ill. Frequently health care providers are more concerned by consent and decision making (Capacity legislation dates back to the 19th century) rather than the basics of caring and listening to patients and those who know them and planning care and consultation. Many who are concerned with this issue believe that often the best treatment is not provided to people with disabilities because they can’t speak up or are seen as less important than other patients.

Service providers (funded by the State) who support people with disabilities in residential settings also vary in the type of communication and practical supports offered to the people they care for when they go to an acute hospital. Making sure that information is passed between providers and hospitals does not always happen. Sometimes staff will remain with people with disabilities throughout their hospital stay because of the deficiencies in acute hospital care in ensuring people are heard and cared for appropriately. I have heard that some hospitals demand that this happen due to lack of resources. But often agencies do not have enough staff to ensure someone is at the hospital with the person who has a disability during their inpatient stay.

Family members may not be able to attend either and may not be able to speak up or be heard in questioning the treatment (or lack of it) being offered.  Many organisations are developing palliative care services and policies due to deficits in mainstream services.

Talking to people with disabilities about their hospital and healthcare experiences over the past 20 years I have been struck about reports of poor care, a lack of information on conditions being given to patients, being patronised by healthcare staff, the lack of knowledge of staff of many disabilities and too many assumptions being made, low levels of support with eating and hydration whilst in hospital. For those who are able to speak up they often find themselves ignored and information given to carers and families without people’s consent.  All report that it is an extremely stressful time and frequently that is due to the issues other than the illness being treated.

We need a national focus and response on the way in which people with disabilities are supported when they are patients in acute hospitals, the care they receive from staff in those hospitals – ensuring people are trained to deliver care and not rely on families or disability organisations to provide care. And we need to talk about supporting people to have the right to both live and die with dignity.

In the UK last year MENCAP published the results of a confidential inquiry into the deaths of people with disabilities.  The inquiry showed that over 1200 people with disabilities die in acute hospitals each year because they are not getting the right care.

People with disabilities, their families and those who support them should feel safe when they are in hospital and know that they receive the best standard of care. We all should feel like that.

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Amazing Michael Lynn

August 30th, 2013 · dodgy solicitors, Michael Lynn

He once was lost – but now is found and arrested facing 33 charges seeking his extradition.

Yes that is former solicitor Michael Lynn singing. Really. He was a specialist subject of mine some years ago. It’s a long story but he has his own subject category on the blog which you can search through.

(Link to track on soundcloud for those who cannot see the player.)

If you want to hear more the Full CD can be played on a flash player here. There’s a lot of coming home tunes.

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Guest Post – Indulging the Exiles

July 23rd, 2013 · Irish Politics, Social Policy

Damian O’Broin is the director of Ask Direct, a fundraising and direct marketing agency.

Let’s get the disclosures out of the way first, shall we?

I earn my living in the charity sector, and have done for 20 years. I spend my days coming up with better ways to connect emotionally with donors in order to persuade them to make more and larger gifts to the organisations that employ my services.

I’m proud of my work, and I’m proud – and awfully privileged – to be able to support ‘charity’.

And right there we have the second thing we need to get out of the way – the definition of charity. Over the years, the term has become tainted, associated with a do-gooder, patronising, disempowering attitude. Hence the appearance of terms like non-profit, NGO and social enterprise as alternatives.

Today, I’m going to stick with charity, because that’s the term most people use. For me, charity is simply support for a cause that you care about or believe in. That cause could be the environment, it could be finding a cure for cancer, or it could be empowering lone parents to be able to fully participate in society. There needn’t be anything derogatory about it.

That’s a lot of introduction before I even get to the main point. But I think they’re points that need to be made.

Which brings me on to the Forum on Philanthropy’s proposals around tax exiles.

The Forum has proposed that tax exiles, if they donate €15 million over a ten year period, could get an extra 62 days in Ireland.

Now, I think promoting philanthropy is a great idea. I would love it if organisations and causes that I care deeply about had more money to invest in their work.

And if we look at our wealthiest citizens, their charitable giving is disappointingly low by international standards.

So, encouraging the wealthiest in our society to give more makes sense.

But this is where we run into problems.

Focusing either exclusively or primarily on giving by the super wealthy throws up a number of serious problems.

First of all, it means that it’s the interests of the rich that get well funded. Or, to put it another way, anything that challenges or threatens wealthy people won’t get as much. So children and health get the big gifts and are supported by the charitable trusts and foundations, whereas climate change and anti-poverty work struggle for support.

The second problem is that it leads to a tendency to give special privileges to the rich. Why should donors who can afford to give lots of money get kickbacks that less well off donors don’t get?

The current tax efficient giving regime is a case in point. If you donate more than €250 a year, the charity that receives your gifts can claim back the tax you paid on it. But if you give less than €250, they can’t. (In contrast, in the UK, there is no threshold and tax can be reclaimed on all gifts, no matter what the size).

But the €250 threshold is small fry compared with the proposal to give tax exiles extra days in Ireland in return for charitable donations.

Tax benefits do matter to donors, especially high-value donors. It’s rarely the primary motivation or driver, but it is a consideration.

And the Forum on Philanthropy’s proposal would work, in the sense that it would generate additional gifts from our tax exiles. Chuck a few quid to a charity and get an extra two months in Ireland? No bother.

But efficacy can’t be the only consideration. We have to consider equity. And we have to consider ethics.

Because this is an inequitable and unethical proposal.

It says that if you’re rich enough to live as a tax exile, you can get special benefits by making donations to charity.

And it says that if you’re rich enough to live as a tax exile, you can substitute charitable donations for tax payments.

(I wonder is this the real motivation here. The privatisation of taxation and social provision. A world where the rich get to choose where their charity goes, while the poor have to cough up their taxes.)

This proposal stinks. We are selling indulgences and offering unrepentant sinners extra days in the promised land.

The charity sector is about ethics, equity, fairness, justice. It’s about making the world we live in a better place. But if we support this proposal we will bring shame on ourselves. We will allow ourselves to be used by incredibly wealthy people living in luxury abroad to avoid paying tax – at a time when our public services are being hollowed out and hundreds of thousands of our fellow citizens are out of work, living in poverty and being forced to emigrate to find work.

Let’s nail our objections to the door and make it clear that while we want to encourage philanthropy, it can’t be at the expense of fair and equitable taxation.

 

Editors Note – This is the first in a series of guest and MP pre-budget guest posts. Anyone who would like to pitch a post can of course contact me at tips @ mamanpoulet.com

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Waiting for the law

June 6th, 2013 · Disability, Equality, Irish Politics, Social Policy

While waiting for the publication of the report of the Review Group into Mobility Allowance and Motorised Transport Grant (5,000 people with disabilities are going to lose up to 20% of their income at the end of this month and few seem to care)  thoughts also are not far away from very important legislation for people with disabilities which has been delayed since 2008.  The Assisted Decision Making Bill has been promised annually and Ireland cannot ratify the UN Convention on the Rights of People with Disabilities until it is made law.

Yesterday the Government announced it’s intention to seek a referendum on abolishing the Seanad and the legislation was published for such a referendum (estimated cost €19m) to take place.

This bill was not listed on the ‘A’ list which is the list of forthcoming legislation due to be published this session.

Knowing that there is a lot of other very important legislation which has yet to be published I thought I would check the ‘A’ list and see what has been published so far this session. I am looking for full publication rather than Heads of Bill which may be before committee.  (Publishing legislation doesn’t mean it will be passed this session or even this calendar year – some of the legislation which has been published so far this session is in Second or Committee stage).

 

Agriculture Food and the Marine
1 Forestry Bill Published 24/4/13
Children and Youth Affairs
2 Child and Family Support Agency Bill Not Published
3 Children First Bill Not Published
Communications Energy and Natural Resources
4 Minerals Development Bill Published 16/5/13
Environment Community and Local Government
5 Electoral (Amendment) Bill Not Published
6 Housing (Amendment) Bill Published 25/4/13
7 Local Government Bill Not Published
Finance
8 Betting (Amendment) Bill Not Published
Health
9 Health (Amendment) Bill Not Published
10 Medical Practitioners Act 2007 (Amendment) (Medical Indemnity Insurance) Bill Not Published
11 Protection of Maternal Life Bill Heads Published
Jobs, Enterprise and Innovation
12 Consumer and Competition Bill Not Published
13 County Enterprise Boards (Dissolution) Bill Not Published
14 Employment Permits Bill Published 5/6/2013
15 Friendly Societies and Industrial and Provident Societies (Miscellaneous Provisions) Bill Not Published
16 Workplace Relations Bill Not Published
Justice and Equality
17 Assisted Decision-making (Capacity) Bill Not Published
18 Criminal Justice (Forensic Evidence and DNA Database System) Bill Not Published
19 Fines (Amendment) Bill Not Published
20 Irish Human Rights and Equality Commission Bill Not Published
Public Expenditure and Reform
21 Freedom of Information (Amendment) Bill Not Published
22 Houses of the Oireachtas (Inquiries, Privilege and Procedures) Bill Published 15/5/13
23 Protected Disclosure in the Public Interest Bill Not Published
24 Public Service Management (Recruitment and Appointments) Act 2004 (Amendment) Bill Published 29/5/13
Social Protection
25 Social Welfare and Pensions Bill Published 22/5/13
Transport Tourism and Sport
26 Merchant Shipping (Registration of Ships) Bill Not Published
27 Road Traffic Bill Not Published

 

It is not the presence of the Seanad or having too many politicians which is delaying the passage of legislation in Ireland. Indeed one might note that the Seanad has not enough work to do because of the scarcity of legislation. Bills could be brought to the Seanad to commence their legislative journey and speed up the process.

Government ministers and their departments simply are not performing and publishing and leading legislation through the Oireachtas.  It’s not the troika’s fault either.

There are 7 weeks left before the end of the summer session – how many of these bills will see the light of sun?

 

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Largest ever EU survey reports on LGBT discrimination

May 17th, 2013 · Equality, European Union, Homophobia, LGBT

Results from Europe’s biggest ever survey on LGBT discrimination and hate crime are released today.

Over 93,000 people responded to the EU LGBT survey conducted by the EU Fundamental Rights Agency.  The  Agency (FRA) provides evidence-based advice to EU and national decision makers so as to inform debates, policies and laws on fundamental rights.

The survey covered experiences in daily living, discrimination, violence and harassment and rights awareness.  It is a huge amount of data and it provides very important information on the experiences of LGBT people across Europe.

Results indicated that half of all respondents indicated that they had been discriminated against or harassed because of their sexual orientation in the previous year. 60% of respondents said they would not report incidents because they felt that nothing would be done. 2 out of 3 LGBT respondents were hiding or disguising being LGBT at school.

Across all areas of the survey transgender respondents recorded higher levels of actual and perceived violence, discrimination and harassment.

The results are available broken down across the 27 member states (plus Croatia.)

Some Irish statistics of note

  • 57% of Irish respondents said that they avoided holding their same-sex partner’s hand in public because of a fear of being assaulted or threatened.
  • 31% of Irish respondents indicated that they had been  physically/sexually attacked or threatened with violence at home or elsewhere  in the past 5 years. (EU figure was 26%)
  • 74% of Irish Respondents knew there was legislation preventing discrimination in employment on the basis of sexual orientation.

The majority of respondents across the EU favoured increased visibility of LGBT issues and identity in schools, education and information for public officials on LGBT issues, recognition of same sex relationships and other targeted actions as having a positive impact on tackling discrimination and harassment.

The FRA have developed evidence based advice to member states and the European Commission (who asked for the study to be undertaken).

Included in the advice, which is summarised here, is a call for recognising and protecting victims of hate crime . This is something which the State and An Garda Siochana do not currently undertake.  There is no hate crime legislation or data gathering not only for crimes against LGBT’s but also for crimes on the basis of ethnicity and race and disability.

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