1 in 4 people in Northern Ireland are disabled people. Disability Action represent the views of 335 organisations working to advance change for disabled people Through our core grant funded services Disability Action have delivered information and advice to 45,000 disabled people. The services that we provide are protective and preventative and we deliver them on behalf of the Department of Health at a cost to the Department of approx. £2.88 per person. In 2022/23 we involved more than 1400 disabled people in decision making. By supporting people through our information, advice and advocacy wok we reduce health inequalities and ensure that disabled people can enjoy independent living. Our work

supports transitions from hospitals. Our work improves mental health and wellbeing.

Disability Action are aware that the budget presented here, and the proposed cuts, come from a situation not of the Department’s making. We are aware that this is a challenging time. The absence of Ministers and the political institutions and the budget constraints place organisations and individuals at great risk.

We are in the midst of a Cost of Living Emergency. 8 out 10 disabled people do not have enough money for a decent life. 8 out of 10 disabled people do not have enough support to live independently. The front-line services which Disability Action provide on behalf of the Department of Health ensure that disabled people can access their benefit entitlements and supports disabled people to live independently. These services are essential.

Disabled people are choosing between breathing, heating and eating due to the impact of the Cost of Living Emergency- for these people we are a lifeline, supporting them when they have nowhere else to turn.

Disability Action has provided information and advice to £45,000 people at a cost of £2.88 per person to the Department. This £2.88 results in extensive savings for the Department. When we support someone to leave hospital with a care package in place, we save the Department £915 per day1. Every day that Disability Action assist disabled person to remain at home rather than hospital we save Department of Health £915 per day at the cost of £2.88 per person. Retaining Disability Action Information and Advice Services makes economic sense. Ending our services will lead to escalating costs and destroy lives. Once these

services cease to exist there will be significant challenges in reinstating them.

The removal of the core grant from Disability Action will negatively impact on the effective implementation of Ministerial directives and policies. Disability Action are involved in the co-design, implementation, delivery and monitoring of key Ministerial directives and Departmental statutory duties such as the Mental Health Strategy, Accident Prevention

Strategy, the Reform of Adult Social Care and the Domestic and Sexual Abuse Strategy.

The Department of Health notified Core Grant Awardees by email on the 22nd May of the decision to end services from 30 September 2023. This communication was relayed without engagement with Disability Action. Disability Action has routinely engaged with NIO Ministers throughout the political crisis who informed us that Permanent Secretaries were to make themselves available. This has not happened.

The proposed decisions within the EQIA should be considered in the context of the letter issued by Jayne Brady Head of the Civil Service on the 22nd of May 2023 which called for meeting with political parties to re-establish the institutions. In this letter Jayne Brady referred to a governance gap. The letter outlined that only Ministers could take major policy decisions. Within the letter Jayne Brady states the following the current political situation:

“leaves the accounting officer in the invidious position of having no lawful means to ensure full compliance with the duty to remain within budget limits".

The letter from Peter May was circulated on the same day. The EQIA states that by his own admission the Permanent Secretary of the Department of Health does not have the authority to end the core grant

and to implement further decisions outlined within the EQIA. By his own admission the decisions as listed are unlawful. See paragraph 8, p.13:

“In considering the scope to make further savings, the Permanent Secretary has considered the powers in the Northern Ireland (Executive Formation) Act 2022 and the associated guidance. He has concluded that, as things stand, these decisions fall outside that framework and require Ministerial authority. However, if there is a risk of overspend, further consideration will need to be given as to whether they fall within the powers of the Permanent Secretary, or whether the likely impact on services remains that these decisions would need to be taken by a Minister.”

Section 75 statutory duties are the key means available to public authorities to address inequalities and demonstrate measurable positive impact on the lives of people experiencing inequalities. The purpose of EQIAs in general is that the Department is obliged to consider and mitigate against impacts on protected groups. These Section 75 groups are listed in the first place because they are the groups most likely to be adversely impacted. The purpose is not merely to identify disproportionate impacts but to actively mitigate against them and ideally to seek opportunities to promote equality for these groups. Over time and in practice. The EQIA identifies multiple adverse impacts but does not present mitigations. There is a recognition in the Department of Health’s Equality Impact Assessment (EQIA) of its Budget 2023-2024 that cuts to the core grant will have an adverse impact on children and disabled people.

The Department of Health makes a number of important commitments in its approved Equality Scheme to ensure compliance with its obligations under section 75 of the Northern Ireland Act 1998. These include committing the necessary available resources in terms of people, time

and money to ensure that the Section 75 statutory duties are complied with and that its equality scheme can be implemented effectively, a recognition of and commitment to the importance of consultation in all aspects of the implementation of the statutory equality duties, seeking the views of those directly affected by the policies, representative groups of section 75 categories, voluntary and community groups and such other groups with a legitimate interest in the matter and liaising with organisations representing hard to reach groups such as children and young people, and disabled people. The cessation of funding to Disability Action undermines the ability of the Department to meet the objectives outlined within the Department’s own Equality Scheme. The failure of the Department of Health to invest in disabled people is non-compliant with Section 75.

The Department has a statutory duty to target resources on the basis of objective need under Section 28E of the 1998 Act. Justice Treacy’s judgment concluded that there is a statutory provision to allocate resources on the basis of objective need. Given the disproportionate impact of the proposed decisions on disabled people who are recognised as most of risk of poverty and deprivation. The proposals do not meet the statutory requirements of Section 28E.

This DoH EQIA document does not comprehensively consider the potential impacts of its 23/24 budget proposals on older and disabled people. DoH have failed in this EQIA to consider any mitigations or alternative policies. Disability Action have met with all NI political parties and have the support of all to maintain Disability Action’s core grant at the current level.

All of this poses questions as to whether it is fit and proper that the budget cuts as proposed can proceed.

The Bengoa Report outlines a process for transformation of the Health Service in NI. This has not been progressed. Disabled people should not have to pay for the lack of progress to transform the health service, nor should they have to pay for the current political crisis. It is a travesty that the Department would target cuts to provision in this manner.

Disability Action oppose the decision by the Department to

· Reduce expenditure on community aids and adaptations for clients living in their own homes

· Restrict domiciliary care packages

This will disproportionately impact upon disabled people and older people and lead to the re-institutionalisation of disabled people severely undermining our right to independent living. The reduction in this provision will increase pressure on health services and hospital beds deepening the current health crisis.

Disability Action welcome the decision to continue to invest in the Mental Health Strategy and mental health capital projects.

Disability Action conclude that the proposed budget reductions do not meet statutory provisions as outlined within Section 75 and 28E. Disability Action recommend that proposals are reconsidered, and mitigations provided.

For further information contact Nuala Toman, Head of Policy, Information, Communications and Advocacy, Disability Action at [email protected]