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Minister McGrath welcomes latest HRB evidence review

27 June 2016

The review examines approaches taken to individualised budgeting for social care services for people with a disability and the related outcomes and experiences. It also examines the financial sustainability of the approaches taken.

Welcoming the publication of the report, Finian McGrath T.D., Minister of State with special responsibility for Disability said,

'The establishment of a Task Force on Personalised Budgets is another key element in the Programme for Government’s commitment to give people with disabilities more control in accessing services, together with greater independence and choice. It is imperative that the Task Force has access to good quality evidence from other jurisdictions which have already been down this road, and that we learn from what worked well in other countries and equally, what didn’t work as well. The Health Research Board has done sterling work in distilling the evidence on this complex area, and the report will provide an invaluable starting point for the Task Force, which I intend to establish very soon'.

According to Graham Love, Chief Executive at the Health Research Board,

'Evidence-informed decision making is a clear goal at the HRB.  We welcome the Minister's commitment to ensure that the evidence available is used in decision-making to improve the lives of people with a disability here in Ireland'.

This review answered two core questions.

1. What models or approaches to individualised or personalised budgeting in response to needs assessment for social care services for people with a disability are used in other jurisdictions?

2. What is the evidence on the financial sustainability of different approaches?

The six countries reviewed, which already had introduced individualised budgeting for social care services, included Australia, Canada (eight provinces), England, New Zealand, Scotland and the Netherlands. Across these countries three legislative approaches were identified. 

1. Legal frameworks enabling a brand new and ideologically driven approach, for example, Scotland

2. A consolidation of different pieces of legislation for example The Netherlands

3. An incremental process of change within broad legislative parameters, for example, New Zealand

While approaches vary, with regard to eligibility, four factors are commonly used across all countries to determine eligibility for individualised budgets. These are age, nature of the disability, severity of the disability and it's likely trajectory and long-term effects. 

In countries that introduced new legislative frameworks that focus on personalisation and self-direction, there is a shift from lists of specific services to which people are entitled to requiring that ‘eligible needs’ be met (England) or that ‘reasonable and necessary supports’ be provided (Australia).

According to Jean Long, Head of the HRB Evidence Centre, 

'Reviewing what helps or hinders the move to individualisation, the research shows lack of information and lack of legal clarity can hinder implementation. We also found that because implementation of personalised budgets is still a work in progress in many countries, there is little evidence to state whether they are financially stable or otherwise. However Australia have commenced a study on financial stability'.

You can read the full report using the link below. 



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