Getting There: Transport and Access to Social Services Contents

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Getting There Transport and Access to Social Services

A Citizens Information Board Social Policy Report

Acknowledgements

The Citizens Information Board gratefully acknowledges the assistance of those who contributed to the preparation of this report, in particular, the Citizens Information Services, the Citizens Information Phone Service and the Disability Advocacy Services around the country that provided the feedback and the case evidence. Useful comments on specific issues raised in the report were provided by personnel in the Irish Wheelchair Association, Disability Federation of Ireland and the Rural Transport Programme (Pobal). Information was also provided on various aspects of the report by officials from the HSE Community Welfare Service, the Department of Transport, the National Disability Authority and the Department of Social and Family Affairs.

A Citizens Information Board Social Policy Report 1 Preface

The basic theme of the Citizens Information Board’s (CIB) Strategic Plan 2009–2012 is putting the citizen at the centre of how services are delivered. One of the Board’s strategic priorities is to be a pivotal intermediary between citizens and public services. A core element of the Board’s strategy is learning from client experiences to produce objective, fact-based evidence in order to help public sector bodies understand emerging service needs and issues with regard to rights and entitlements within their remits. Issues relating to the link between transport availability and access to social services have emerged as significant for users of CIB-supported services and this report outlines and discusses these issues.

This report will help to bridge the gap between the experiences of service users in respect of transport and access to social services and public policy in this area.

December 2009

2 Getting There: Transport and Access to Social Services Contents

1. Background 5 1.1 Introduction 5 1.2 Context of Report 6 1.3 Methodology 6 1.4 Outline of Report 7

2. Key Factors Identified 8 2.1 Introduction 8 2.2 Demographic Considerations 8 2.3 The Link between Transport and Access to Services 8 2.4 Different Models of Transport Services 9 2.5 Local Public Transport 9 2.6 Public Transport in Rural Areas 9 2.7 Car Ownership 10 2.8 Transport and Social Inclusion 10 2.9 People with Disabilities 11 2.10 Transport Accessibility 11 2.11 Cost of Disability 11

3. Developing an Inclusive Transport System – Current Policy Context and Programmes 13 3.1 Introduction 13 3.2 ‘Transport for All’ Concept 13 3.3 Department of Transport Sectoral Plan 13 3.4 An Accessible Public Transport System 14 3.5 Integrated Rural Transport: International Best Practice 16 3.6 Rural Transport Programme 17 3.7 Community and Voluntary Transport Services 19

A Citizens Information Board Social Policy Report 3 4. Current Transport and Mobility Support Schemes 20 4.1 Introduction 20 4.2 Free Travel Scheme 20 4.3 Mobility Allowance 21 4.4 Motorised Transport Grant 21 4.5 Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994 22 4.6 Ambulance Services 23 4.7 Supplementary Welfare Allowance (SWA) Scheme 24 4.8 Parking for People with Disabilities 25

5. Transport and Mobility Supports – Issues Identified by Service Users 26 5.1 Introduction 26 5.2 Difficulties in Availing of Free Travel 26 5.3 Travel to and from Hospitals 27 5.4 Accessibility of Public Transport 30 5.5 Transport and Mobility Support Schemes 30 5.6 Transport and the Cost of Disability 33 5.7 Transport and Employment of People with Disabilities 33 5.8 Parking Permits for People with Disabilities 34 5.9 Information 34

6. Addressing the Issues 35 6.1 Introduction 35 6.2 Need for a More Integrated Approach 35 6.3 The Central Role of Transport in Accessing Services 36 6.4 Implementing the ‘Transport for All’ Concept 37 6.5 Existing Transport Schemes and Supports 37 6.6 Voluntary Sector Initiatives 38 6.7 Travel Information and People with Disabilities 39 6.8 Parking Permits for People with Disabilities 39 6.9 Conclusion 39

Appendix: Social Policy Alert 40 References 41

4 Getting There: Transport and Access to Social Services 1 Background

1.1 Other functions of CIB are: Difficulties in relation to transport (i) To support, promote and and mobility feature consistently in Introduction develop greater accessibility, this feedback from CISs, CIPS and voluntary/community disability This report deals with a range co-ordination and public advocacy projects. of issues relating to current awareness of social services transport and mobility supports. Transport and mobility support It reflects the experiences of (ii) To disseminate integrated schemes play a centrally important people who encounter difficulties information in relation to such role in combating social exclusion in accessing social, community services by statutory bodies and enabling access to services. and health services because of the and voluntary bodies For many people such schemes lack of availability of appropriate are the key to accessing social transport. The report is informed (iii) To provide information on and health services and make a by Citizens Information Services the effectiveness of current significant contribution to enabling (CISs)1 and projects participating social policy and services, and them to participate in society. in the Community and Voluntary to highlight issues which are While the specific social benefits Advocacy Programme for people of concern to users of those of transport and mobility schemes with disabilities funded by the services are difficult to quantify, it is clear Citizens Information Board (CIB)2. CIB uses feedback based on the that they provide an important additional resource to many people. The report compares policies and needs and experiences of users This is particularly important for practice relating to transport and of the CISs, Citizens Information 4 those reliant on social welfare access with the actual experience of Phone Service (CIPS) and income. The public subsidisation of people seeking services. A number voluntary/community disability transport and travel enables many of case examples are provided to advocacy projects to highlight people who might otherwise be illustrate the issues identified. Some issues that are of concern to users excluded not only to access services proposals for addressing these of social services. These services appropriate to their needs but also issues are included. report queries with a social policy dimension to CIB in the form of to engage in purposeful social, educational and economic activity. The principal functions of CIB Social Policy Records. Social Policy are to support the provision Records report on situations where A key consideration in the current of independent information, a CIS or CIPS user was unable to economic climate is clearly the advice and advocacy services get a service commensurate with effective use and targeting of in relation to social services and, their needs, including the following: resources. The present situation where appropriate, to provide inadequate or inappropriate where state funding is provided for these services directly to the support services; insufficient a range of parallel and fragmented public3. The Board is required to information from statutory transport and mobility support assist and support individuals, agencies; inequities, inconsistencies initiatives frequently operating particularly those with disabilities, or anomalies in the social welfare independently of each other is in identifying their needs and system; delays in the application unlikely to be the best use of options and in accessing their process for benefits/services. In resources. There is, therefore, a entitlements to social services. 2008 over 1,700 Social Policy Records were returned to CIB. clear need to explore further how

1 Citizens Information Services (42 nationwide) provide both a face-to-face and telephone service to the public through some 254 locations nationwide. 2 Currently, the Board funds and supports the provision of advocacy services to people with disabilities by 46 voluntary/community organisations around the country. 3 The Citizens Information Board funds and resources Citizens Information Services (CISs), including the development and support of the nationwide network of Citizens Information Centres (CICs), the Citizens Information Phone Service (CIPS) and the Citizens Information website (www.citizensinformation.ie). 4 In 2008, there were 668,980 CIS users and over 130,000 CIPS users.

A Citizens Information Board Social Policy Report 5 publicly funded local transport » The challenge for statutory there has been relatively little provision can be better co-ordinated agencies of meeting the costs of overall integration of transport and integrated with other mobility transport to services in a climate supports and initiatives. Also, support schemes and with the Free of severe budgetary constraints despite significant progress in Travel Scheme. the area, the accessibility of » The emerging emphasis on public transport, both bus and sustainable transport5 rail, continues to present major 1.2 challenges due to the built The feedback from CISs and environment, the design of railway Context of Report voluntary/community disability stations and the difficulty in Feedback to the Citizens advocacy projects regularly providing fully accessible buses, Information Board from CISs and refers to people who have an coaches and bus stops on all voluntary/community disability entitlement to avail of free travel routes nationwide. advocacy projects highlights the on public transport services but fact that many people encounter who have been unable to get difficulties in accessing social and to hospital, community care or 1.3 health services because of the poor other appointments using public availability of public transport, transport. This can be due to a Methodology the continuing inaccessibility of lack of service in their area, or This report is based on: such transport in many parts of because the bus times do not the country and the inadequacy suit, or because buses or trains » Review of policy documents of current transport and mobility are not accessible for people with support schemes and subsidies. disabilities. Also, there are regional » Review of selected literature The issue of transport and access disparities in access to public on the issue of transport and to services has been getting some transport and in the availability accessibility and related good attention in recent years because of: of rural transport initiatives practice components funded under the Rural Transport » Concerns about the social Programme. Many people with » Analysis of Social Policy isolation of older people in disabilities need a transport or Records submitted to the rural areas mobility subsidy that is not being Citizens Information Board met under current provisions. » Ongoing debate about equality » Social Policy Alert6 to CISs and of access to services for people It should be noted at the outset voluntary/community advocacy with disabilities that the difficulties experienced projects for people with by people in accessing transport disabilities that are funded by » The centralisation of care for to the services necessary for the Citizens Information Board cancer patients daily living are very diverse. (see the appendix) Although such difficulties have » Commitments to address been widely acknowledged » Identification of case examples7 transport accessibility issues in over the years (including in the Towards 2016 current Partnership Agreement, » Consultation with key Towards 2016, and the National informants in the policy and Development Plan 2006–2013), service delivery fields

5 See Department of Transport (2009), Smarter Travel: A Sustainable Transport Future. www.smartertravel.ie 6 A Social Policy Alert is a tool used by the Citizens Information Board from time to time to ask Citizens Information Services (CISs) and voluntary/community organisations to pay particular attention to named categories of queries and/or cases for a period of time in order to identify any policy issues arising. 7 Case examples included in the report were identified through the Social Policy Alert and from Social Policy Records.

6 Getting There: Transport and Access to Social Services 1.4 Outline of Report The report contains six chapters. Chapter 2 identifies a number of key underlying factors that need to be taken into account when considering the question of transport policy and mobility supports and their role in combating social exclusion and providing equitable access to services. Chapter 3 describes the current policy context in Ireland with particular reference to the accessibility of public transport and the Rural Transport Programme. The existing transport/mobility support schemes are described in Chapter 4, and their rationale outlined.

Chapter 5 sets out a range of transport and access issues arising from the experience of users of CISs and other voluntary/ community organisations. Chapter 6 sets out some proposals for addressing these issues.

A Citizens Information Board Social Policy Report 7 2 Key Factors Identified

of disability increases with age. the quality of life for people with 2.1 Increased longevity is very likely reduced mobility and sensory Introduction to lead to an increase in demand impairments” (National Disability for transport and mobility Authority 2004:1). This chapter provides a brief supports. description of the main factors Provision of transport specifically relevant to the development Fitzpatrick Associates (2006), for medical appointments, of a more integrated and in their evaluation of the Rural hospitals and clinics was comprehensive transport policy Transport Initiative (now the Rural a requirement for many response to the difficulties Transport Programme), note that respondents in the study, Health experienced by some people demographic trends, in particular and Social Services for Older in accessing services necessary overall population growth and People (HeSSOP I) (Garavan et for daily living, in particular, changes in the age profile, are likely al. 2001). This report pointed out social and health services and to mean that there will be growing that a number of conditions may community care services. These numbers of people with unmet involve treatment a distance away factors include the link between transport needs unless additional from home for many people. As the availability of transport, access provisions are put in place. well as affecting access to health to services appropriate to needs and community-based services and the requirement for multiple (the primary delivery mechanism responses to meet diverse needs. 2.3 for social services), difficulties with transportation mean that The Link between people cannot access various 2.2 Transport and Access to aspects of community life – for Demographic Services example, shopping, community Considerations The National Disability Authority events and religious services. This (2004) notes that people who are can both directly and indirectly According to Census 2006, some affect a person’s health and well 40% of the Irish population live dependent on public transport cannot participate in social and being (Garavan et al. 2001). in rural areas and just over 9% Having independent transport have a disability (see 2.9 below). leisure activities on the same basis as people who are not dependent may be a key factor in combating As people live longer and with social isolation. better health, expectations around on such transport. The ability of ongoing social involvement and people generally to meet many of their needs continues to be Difficulties with public transport a related need for transport were identified by respondents will continue to increase. As influenced by their access to transport facilities; these needs in the HeSSOP I study as follows: the current trend towards crowding or the conditions of the centralisation of services include work, education, medical care, social contact, recreation, the service, negotiating the gap continues, the need for specifically between the end of the route and targeted transport and mobility access to services, utilities and shopping. Responding to the their actual destination, getting to supports for those in rural areas the bus stop or station, availability who are not car owners or who transport needs of people with poor mobility arising from of the service, getting on or off cannot drive for medical reasons the bus or train. will become even more critical in disability or frailty in old age presents significant challenges. ensuring equality of access and The need for innovative thinking in social inclusion across the life “The adequate provision of an integrated accessible public respect of links between transport cycle. People with disabilities are and health at local and national now living longer than in previous transport service is one of the significant factors that impact on levels and the development of generations and the incidence health-promoting transport policies

8 Getting There: Transport and Access to Social Services accordingly has been highlighted On the downside, these services in various studies. One alternative are more expensive. 2.6 to current transport provision Public Transport in suggested by respondents in the The level of service that Rural Areas HeSSOP I study was having services conventional transport systems provided to their own homes. Taxi provide in rural areas is patchy, and The provision of local public vouchers were also suggested can vary widely both in terms of transport in sparsely populated rural for those who cannot use public geographical coverage and service areas presents major challenges. transport. frequency. Conventional services in It requires sustained Government Ireland are also constrained by the support and public subsidies. The country’s low population density countries with the most extensive 2.4 and its highly dispersed population, and affordable rural transport which limits the commercial systems are those where long-term Different Models of viability of scheduled services and public funding has been available. Transport Services contributes to very high levels of There are operational and practical Fitzpatrick Associates (2006) note car dependence in rural areas. problems with the access to the that it is important to make a Free Travel Scheme.8 Many people distinction between conventional in rural areas and people with and non-conventional transport 2.5 impaired mobility have little chance services when addressing the Local Public Transport to make use of it. A Review of the question of how best to provide Free Schemes Operated by the more inclusive transport services. Local transport is a key factor in Department of Social and Family Conventional services operate on accessing social and health services Affairs (Quinn 2000) noted that fixed routes, with fixed departure as well as catering for the initial the value of the Free Travel Scheme and pick-up points. These can often stage in longer distance journeys varies greatly depending on the be inaccessible for people who have (that is, as a feeder service). individual’s circumstances such as difficulty getting to these points – Access to local public transport is mobility, income, general health for example, people with mobility, identified by the National Disability and lifestyle. A recently published sensory and cognitive impairments, Authority (2007) as a key issue and CSO Report (Central Statistics or people with young children. incorporates consideration of the Office 2009) shows that just over Non-conventional services, on physical environment, including half of all households in rural areas the other hand, generally provide footpaths and other aspects of reported difficulties in accessing more demand-responsive or the route to and from the first public transport compared with semi-scheduled alternatives point of use, type of vehicles, 11% of households in urban areas. which, using smaller vehicles, can interchange facilities, information One-third of rural households collect people directly from their and customer care. “Experience in expressed difficulty in accessing homes, bring them to local service Ireland and elsewhere has shown banking services and GP services centres or transport hubs, and that this is also the aspect of the compared with 15% and 11% return them home afterwards. public transport system which is respectively of urban households. Unlike conventional services, these hardest to ‘get right’. It requires The proportion of households alternative options are also more the most attention from planners reporting difficulties in accessing easily accessible to a wider range and operators as well as the most basic services fell as household of user groups because of their operating funding” (National income rose. ability to facilitate door-to-door Disability Authority 2004:16). service and passenger assistance.

8 Under the Free Travel Scheme, older people, people with disabilities, carers and other identified categories of people are entitled to free travel on public transport. The scheme is described in Chapter 4.

A Citizens Information Board Social Policy Report 9 Rural respondents in the HeSSOP half of the people in the sample to work can be a significant barrier I study were much more likely to drove a car. Men were more to people taking up employment, see transport as a problem than likely to drive than women and particularly low-income work. A those living in urban areas. HeSSOP increasing age was associated with study by the National Council on II (O’Hanlon et al. 2005), a more a lower probability of driving. Ageing and Older People – NCAOP recent study, shows that almost (Treacy et al. 2005) concluded that two-thirds (65%) of respondents in A recent study of the FÁS social loneliness was significantly the Greater Dublin area had used National Supported Employment linked to increasing age, lack of public transport in the previous six Programme (WRC Social and access to transport, having to travel months compared to just 20% in Economic Consultants 2008) shows greater distances to a bank or post the then Western Heath Board area. that only 27% of people with a office, poorer health and living in a disability interviewed have a full rural area. There have been definite driving licence (though it does not improvements in the provision state whether or not they have Family and friends can be a vital of non-conventional services access to a car) and that 8% have support to older people living in in recent years: for example, a provisional licence. Data provided the community, enabling them to the Rural Transport Programme for this report by a voluntary/ avail of health and social services. (discussed in Chapter 3) community disability advocacy HeSSOP II found that while 64% of and various local initiatives project showed that of the 200 or women availed of lifts from friends by voluntary/community so people who have availed of an and family, just 34% of men did so. organisations. However, employment support service, fewer People living in inter-generational such services are not yet than 10% own cars. families were more likely than commensurate with need. others to avail of lifts from family and friends. Not surprisingly, 2.8 perhaps, people living alone were 2.7 less likely than others to avail of Transport and lifts from family and friends. Car Ownership Social Inclusion According to Census 2006 (Central Lack of adequate public transport Social inclusion was a core objective Statistics Office 2007a), 28% of is one of the major factors highlighted by Fitzpatrick Associates persons with a disability live in contributing to social exclusion in (2006) in the development of rural households that do not have a rural areas (Fitzpatrick Associates public transport in Ireland. They car. This figure rises to 40% for 2006). Key groups identified suggest that this objective must be those aged 65 years and over9. The as more likely to be without kept at the forefront and that any National Disability Authority and transport are women, older broader rollout of rural transport Indecon (2004) noted that people people, people on low incomes, must be capable of meeting the with disabilities are less likely to and people with mobility, explicit needs of excluded rural drive a car – just under half of sensory or cognitive impairments groups as well as the general rural adults with disabilities drive a (Fitzpatrick and Associates 2006). transport user. A key consideration car regularly compared to three- in this regard is that rural transport quarters of people who do not Many of the poorest people in rural services, especially for people have disabilities. areas do not have a car, or cannot who do not have a car or access meet the costs of travelling long to public transport, cannot be In the HeSSOP II research distances. The costs of transport measured in economic terms alone (O’Hanlon et al. 2005) just under (Weir and McCabe 2008).

9 More detailed information on car ownership and mobility issues should be available when the results of the National Disability Survey 2006 become available – only a First Results Report has been published.

10 Getting There: Transport and Access to Social Services The transport needs of older transport system. The National 2.9 people with impaired mobility Disability Authority (2004) noted People with Disabilities and people with disabilities must that the delivery of an accessible be viewed in the context of their public transport service and the Policies aimed at meeting the general income levels relative to planning for and development of transport needs of people with the rest of the population. For the necessary infrastructure is, of disabilities have been the subject example, the at-risk-of-poverty its nature, long term. Significant of much discussion in recent years. rate for older people rose from improvements have been made to The Disability Act 2005 states that 13.6% in 2006 to 16.6% in 2007. public transport accessibility – for disability, in relation to a person, The at-risk-of-poverty rate in example Dublin Bus, DART, Luas, means a “substantial restriction 2007 for people not at work wheelchair-accessible taxis and in the capacity of the person to due to illness or disability was gradual progress by Bus Éireann. carry on a profession, business 37% compared to 16.6% for the However, there is, for example, or occupation in the State or to general population. The respective no low-floor accessible public participate in social or cultural life in figures for consistent poverty transport in some parts of the the State by reason of an enduring were 15.8% and 5.1% (Central country. physical, sensory, mental health or Statistics Office 2008b). intellectual impairment” [Section 2(1)]. This definition underlines the diversity and complexity of 2.11 disabilities that exist and the 2.10 Cost of Disability potential impact of disability on a Transport Accessibility It is recognised nationally and person’s quality of life. One of the key underlying internationally that people with principles of Transport 2111 is disabilities incur many extra The 2006 Census reports that making the transport system living costs as a result of their 393,785 (9% of the population) accessible for people with disability and that these include have disabilities. The National mobility, sensory and cognitive above-average transport costs. Disability Survey 2006 (Central impairments (see the next Statistics Office 2008a) included chapter). Public transport The National Disability Authority a broader range of disabilities accessibility issues go beyond the (National Disability Authority but also introduced a threshold needs of people with disabilities. and Indecon 2004) supports the of severity for classifying They also involve the transport introduction of a Cost of Disability someone as having a disability needs of the wider community payment. It suggests that any which resulted in an estimate who, at some stage in their lives, such payment should follow on of disability prevalence of 8.1% may have a form of mobility or from needs assessment, should be of the population (lower10 than visual impairment that makes calibrated to the degree of need, the Census rate). The survey travelling difficult if the mode of and should have as its primary questionnaires were based on the transport or the built and external purpose the equalisaton of living social model of disability which environment is not accessible. standards between people with defines disability as the outcome disabilities and the rest of society of the interaction between a Accessibility is a complex as well as encouraging participation. person with an impairment and issue that presents significant the environmental and attitudinal challenges in the provision of barriers they may face. a comprehensive and inclusive

10 This was due to a small number of persons who indicated that they had a disability in the Census not reporting a disability in the National Disability Survey (NDS) or their disability being below the threshold set in the NDS. 11 Transport 21, launched in 2005, is the Government’s current Transport Policy Ten Year Plan.

A Citizens Information Board Social Policy Report 11 The Interdepartmental Review Group on the Disabled Drivers and Disabled Passengers (Tax Concessions) Schemes (Department of Finance 2002) took the view that the future direction of that scheme would be best decided based on the findings of the Working Group on the Cost of Disability Payment12. Towards 2016 notes that, in the context of rationalising existing allowances to people with disabilities, “other issues around the cost of disability will be considered following the development of a needs assessment system provided for under Part 2 of the Disability Act 2005” (Department of the Taoiseach 2006).

12 This Working Group has not issued any report.

12 Getting There: Transport and Access to Social Services Developing an Inclusive Transport 3 System – Current Policy Context and Programmes » Determines how to provide the The Sectoral Plan refers to 3.1 service for those excluded from meeting the transport needs of: Introduction this mainstream process. “people with physical, sensory, This chapter looks at key aspects » Works continuously to find learning or cognitive difficulties of Irish transport policy that are and incorporate new ideas, (whether permanent or relevant to people with disabilities materials, technologies and temporary) and others whose and to groups with specific methods into ongoing designs access to traditionally constructed transport needs that may not so that more people can be transport vehicles, services and be adequately catered for under included in the mainstream infrastructures is limited, to a provisions to date. The policy solution in future. greater or lesser extent, on account context for the development of of age, because of accompanying transport services has been evolving The National Disability children or because they are significantly in recent years and Authority has set out a series of carrying luggage or shopping or are continues to do so as structures recommendations aimed at the otherwise impaired in their use of are put in place to implement development of the ‘Transport for the transport system” (Department Government commitments All’ concept and has also produced of Transport 2006:11). in Towards 2016, Transport 21 Recommended Accessibility and Transport Access for All: the Guidelines for Public Transport The promotion of mainstreaming Department of Transport Sectoral Operators in Ireland (National across all modes of transport that Plan under the Disability Act 2005 Disability Authority 2005a) to operate under the remit of the (drawn up in 2006). help bus and rail operators make Department of Transport is stated

their services more accessible to as an underlying principle of the passengers with disabilities. Sectoral Plan. Mainstreaming in 3.2 the transport context is defined in ‘Transport for All’ Concept the plan as meaning the adoption 3.3 of an integrated approach to The concept of ‘Transport for All’ is policy making, transport planning now generally accepted within the Department of Transport and the provision of transport EU. It has been promoted by the Sectoral Plan services for all. While this is European Council of Ministers for Transport Access for All: Sectoral to be done as extensively and Transport and has been endorsed intensively as possible with regard by the Department of Transport Plan for Accessible Transport under the Disability Act 2005 (2006) to meeting the transport needs of in Ireland. This concept is based people with mobility, sensory and on an approach (see Tyler 2002) sets out the proposals of the Department of Transport and the cognitive impairments, the plan which: notes that: agencies under its aegis in relation to the rollout of a comprehensive » Accommodates as many “it is inevitable that some people as possible in a programme of accessible transport. It outlines a series of policy people, because of the severity mainstream public transport or nature of their disabilities, will solution. This removes the objectives and targets across all modes of transport. It indicates not be able to travel on public notion that ‘special’ provision transport services (or may not needs to be made for people measures to make trains, buses, taxi and hackney services, air and be able to do so at all times). with mobility, sensory and In these cases, specialised cognitive impairments. marine transport, and parking facilities more accessible to transport services are the most people with disabilities. appropriate complementary form of transport” (Department of Transport 2006:13).

A Citizens Information Board Social Policy Report 13 A key aspect of the Sectoral Plan, appropriate, accessible toilets more accessible, better quality and also reflected in Transport 21, and lifts. passenger information. is building accessibility into new transport infrastructural projects » Features to aid people with In 2008, the Department of and the acquisition of accessible difficulties in walking, gripping, Transport conducted a Review of rolling stock and buses as a matter reaching or balancing, including the Sectoral Plan and engaged of course. In addition to the slip-resistant surfaces, handrails in extensive consultation with mainstreaming of accessibility and handholds. stakeholders in the process. A new into new projects, funding is to Sectoral Plan, Transport Access for continue to be provided to enable » Facilities to aid people with All (2008 Edition) was published in the phased adaptation or retrofit vision impairments, deafness May 2009. The new plan reflects of existing transport infrastructure or hearing loss, and other the changes that have taken place and facilities. impairments. These include since 2006 in terms of tangible the consistent use of colour improvement to public transport The Sectoral Plan notes that the contrasts, clear signing accessibility. The new plan does benefits of improved transport and lighting, non-reflective not replace the targets and other accessibility extend to all surfaces, audio and visual commitments set out in the 2006 transport users, even to the most announcements, tactile and plan but does outline a number able-bodied, and that issues audible guidance surfaces, of interim targets against which relating to transport accessibility warning systems and progress can be measured. It also go far beyond the needs of people induction loops. puts greater emphasis on joint with disabilities: working to deal with cross-cutting » Facilities to aid people with issues relating to public transport “They impact on the transport learning disabilities or mental accessibility. In particular, the needs of the entire population health problems. These include plan provides for greater joint because most people, at some clear oral and written information working between the Department point in their lives, are likely and consistent staff training in of Transport and the Department to acquire a physical or other recognising and understanding of the Environment, Heritage and impairment or be impeded the needs of individuals. Local Government in relation in some manner, that will to the built environment and make travelling difficult, if not The Sectoral Plan recognises transport infrastructure. impossible, on what one might that accessible public transport call ‘traditional’ type transport is not just about vehicles and vehicles. This is particularly infrastructure. “It also includes 3.4 the case as people advance elements such as staff training through the ageing process. It in understanding and meeting An Accessible Public is also the case that there is a passenger needs and information Transport System high correlation between age (both before and during journeys) 3.4.1 National Disability and disability” (Department of in forms and formats that can be Authority Guidelines Transport 2006:11). widely understood” (Department In 2004, to assist and support of Transport 2006:13). Aspects the Department of Transport in The Sectoral Plan identifies the of disability transport policy are achieving a high level of public following as the key elements of covered in the plan – such as transport accessibility, the accessible public transport: disability awareness training, the National Disability Authority establishment of consultative (NDA) undertook to develop and » Full unassisted access for disability user groups across the recommend transport guidelines wheelchair users (and for prams transport sectors, accessibility for improving access to bus, rail and buggies) including, where audits, integrated ticketing, and and light rail services for people

14 Getting There: Transport and Access to Social Services with disabilities in Ireland. A Dublin Bus with designated accessible stops process of national consultation There has been a considerable (Cork to Waterford and Dublin took place with all of the key increase in recent years in the City University to Navan). It is stakeholders and a report was number of accessible low-floor envisaged that the learning from published in 2004, Towards coaches in the Dublin Bus fleet. the pilot projects will inform Best Practice in the Provision of At present, 74% of the Dublin Bus the longer-term development of Transport Services for People with fleet is accessible and accessible accessible buses nationwide. The Disabilities in Ireland (National bus stops are being installed on a service will be supported by a Disability Authority 2004). gradual basis, especially on quality booking system and helpline. bus corridors. Dublin Bus has Following this, NDA then identified two main obstacles Iarnród Éireann produced a guidelines document, to improving accessibility which In more recent years, there has Recommended Accessibility are being addressed: been considerable progress in Guidelines for Public Transport the accessibility of train stations Operators in Ireland (2005a). The » Poor condition of bus stops and and introduction of accessibility guidelines are intended to help the bus stop environment features on train carriages. New public transport operators provide accessible trains were introduced a good, comprehensive and readily » Difficulties in providing upon a number of routes in 2008 usable service for people with to-date real-time passenger and most smaller commuter trains disabilities. They cover information information are accessible. However, many provision, infrastructure and stations remain inaccessible due buildings, vehicle design, customer Dublin Bus set up a Travel to their reliance on footbridges relations, disability awareness Assistance Scheme in 2006. as the only means of crossing training and procedures for This offers practical advice and the railway track. Additionally, disruption and emergencies. In assistance to passengers intending train carriages on certain routes addition, the guidelines explain to make journeys using public continue to have poor levels the barriers to travel faced by transport. The scheme is available of accessibility for passengers. passengers with disabilities, and to anyone over the age of 18. All new stations are being outline the current Irish legal and designed to meet accessibility regulatory position. Bus Éireann requirements and Iarnród Éireann Bus Éireann now uses accessible has a detailed programme of 3.4.2 Public Transport Providers buses on its city services in Cork, action for upgrading accessiblity Public transport providers have Limerick, Galway and Waterford in existing railway stations. It also to a large extent engaged with and on some other routes. Bus produces a Guide for Passengers the challenge of developing Éireann has also initiated pilot with Disabilities, which provides accessible services and embarked projects for accessible Expressway information on facilities available on a programme of introducing coaches. These coaches are at each station, and has in place a accessible vehicles and rolling equipped with a lift to be used by mechanism for making alternative stock as well as upgrading the wheelchair users when embarking arrangements for people needing accessibility of railway stations and disembarking. A major issue to use railway stations that are and bus stops. Training in disability with the operation of the lift inaccessible. awareness and the enhancement is the need for appropriately of information provision to cater designed bus stops which Luas and DART Services for the needs of people with means significant changes to Feedback is positive in relation to different types of disability have their current design. Planning is passengers with disabilities using become strategic elements in each currently underway to make two Luas and DART services.13 of the main transport agencies. such routes operational

13 See Irish Wheelchair Association (2008), Submission to Department of Transport Review of ‘Transport Access for All’, www.iwa.ie; Department of Transport (2008), Transport Access for All (2008 Edition), www.transport.ie

A Citizens Information Board Social Policy Report 15 A particularly significant with a visual impairment or Finland, Italy, the Netherlands development is the facility on learning disability and Switzerland. The authors Luas services for wheelchair identified a number of common passengers to enter and exit » Alternative ways of denominators. All initiatives the carriages without having compensating or subsidising examined: to use a ramp or lift. Problems people with disabilities for the with accessibility in some incurred additional costs of » Embraced the very latest DART stations, related mainly transport, in the form of travel technology to platform heights, are being vouchers or taxi cards addressed on an ongoing basis. » Were people-centred and » The location and design of taxi demand-driven 3.4.3 Accessible Taxis ranks to be made accessible Taxis are widely used by people to people with disabilities » Were supported at national who cannot use other forms of including adequate space for level through policy and transport and provide a valuable, embarking and disembarking, related funding if relatively expensive, option for and shelters at taxi ranks people with mobility difficulties. » Focused strongly on integration There are currently about 1,500 » A Charter of Rights for all and did not act alone wheelchair-accessible taxis customers of taxi services nationwide (approximately » Valued indigenous knowledge 6% of the national fleet). The The Taxi Regulation Act 2003 Commission for Taxi Regulation established the Commission for A point noted by Weir and indicated in 2008 that more Taxi Regulation. The principal McCabe (2008) is that, in public money is required function of the Commission is the contrast to the approaches in to increase the numbers of development and maintenance other countries, to date there accessible taxis. of a regulatory framework for has been little collaboration the control and operation of among the providers of rural The issue of accessible taxis small public service vehicles and transport in Ireland. This has led has been the subject of much their drivers. Among the various to a lack of co-ordination and debate in recent years. For functions of the Commission some duplication of services. The example, a 2002 submission by is the promotion of disability authors conclude that “planning the National Disability Authority awareness, the implementation plays a major part in [best to the Department of the of wheelchair-accessible taxi practice] transport provision as Environment, Heritage and Local policy and addressing the needs customers are required to book in Government made a number of of people with disabilities. advance, some the night before, recommendations for qualitative some two hours in advance, improvements in taxi services but this is vital for planning and the future regulation of 3.5 timetables, routes, destination those services, including: times, and integration with other Integrated Rural Transport: transport providers such as rail” » The continued phased International Best Practice (Weir and McCabe 2008:47). It introduction of accessible The Review of Rural Transport should be noted that Pobal is vehicles Policy (Weir and McCabe 2008 for currently developing a mapping Comhar-Sustainable Development system to highlight geographic » Special arrangements to Council) looked at approaches to areas where there are gaps in address the needs of people rural transport in the UK, Sweden, transport services and project

16 Getting There: Transport and Access to Social Services coverage. The mapping system RTP adopts a community-based otherwise pay towards the free is also envisaged as providing approach to redress social travel element. Funding of €11 an overview of the location of exclusion related to unmet needs million was provided from the essential services and facilities for public transport in rural areas. Department of Transport Vote for and enabling a better analysis The programme is administered the RTP in 2009.16 of travel patterns and user by Pobal on behalf of the requirements. The system is Department of Transport. The RTP currently funds a range expected to highlight greater of community transport groups co-ordination potential in The overall aim of the RTP around the country. These integrating local transport services is to encourage innovative groups have been formed either and a range of user service needs. community-based initiatives to through existing or cohesed local provide transport services in rural development organisations, or In addition to the mapping areas, with a view to addressing through the formation of new system referred to above, pilot the issue of social exclusion in groups involving NGOs, local initiatives are currently in place rural Ireland, which is caused by authorities, service users and in the North East and North West lack of access to transport. This other stakeholders. There are 36 to explore the potential for has led to the introduction of a community transport projects in improved synergies between wide range of semi-scheduled all – 34 are limited not-for-profit existing transport providers (the and fully demand-responsive companies and 2 are co-operatives. HSE, Department of Education services delivered via a number Additional projects are planned to and Science, Bus Éireann and of different service models. come on stream in the next year. Pobal). It is envisaged that the outcomes of these initiatives The Government’s continued The total number of passenger will feed into the development commitment15 to the RTP is journeys in 2007 was 998,350, and enhancement of rural reflected in its inclusion in 1.2 million in 2008 and expected transport provision. Towards 2016. The National to be around 1.5 million in Development Plan 2007–2013 2009. The number of passengers The potential of telematics14 in commits some €90 million to requiring assistance in 2008 was helping to provide better synergy the RTP over its full term. This 119,486. Table 3.1 (next page) between passengers’ needs increased funding is envisaged provides a breakdown of RTP users and transport provision is also as leading to an increase in in 2008. Percentages may vary on highlighted in the Comhar report. the frequency of existing a project-by-project basis. services, extended coverage, and additional communities accessing The RTP is based on a bottom- 3.6 rural transport. The total up approach developed during expenditure by the Department the pilot RTI phase which Rural Transport Programme of Transport on the RTP in 2008 demonstrated the effectiveness The Rural Transport Programme was in the region of €10 million. of the involvement of local (RTP) was launched in February An additional €1.5 million was communities in the provision 2007 following the Rural received from the Department of rural transport services. Transport Initiative (RTI) which of Social and Family Affairs as a The Government’s role is that was introduced in 2002. The contribution to what they would of facilitator, helping local

14 Telematics can be described as the blending of computers and telecommunications technologies in order to efficiently convey information over networks to integrate and improve the delivery of services. It refers to all types of networks that rely on a telecommunications system to transport data, including dial-up networks. 15 The McCarthy Report, 2009 (Report of the Special Group on Public Service Numbers and Expenditure Programmes) proposed the abolition of the RTP. 16 In the 2010 Estimates for the Department of Transport, provision for the RTP is being maintained at €11 million in recognition of the important role it plays in combating rural isolation, particularly for older people. In line with a commitment in the Renewed Programme for Government, a series of studies are to be undertaken to see how rural transport services, including the RTP, health related and school transport services, can be better integrated.

A Citizens Information Board Social Policy Report 17 Table 3.1: Profile of RTP Users and Journeys, 2008 Gender Age Free Travel Type of Journey Accessibility of Pass Users Transport Service Female 68% <5 1% Over 66 88% Door to Door 78% Fully Accessible 44% Male 32% School Age 21% Under 66 10% Other 22% Partially Accessible 34% 18-25 3% Companion 2% Non-Accessible 22% 26-65 17% 66 and over 58% communities to address their Health Service Executive, from summer of 2007. This scheme is transport needs through financial the County Development Board, additional to the existing Rural and administrative support while and from local development Transport Programme (RTP). communities themselves take partnerships and groups. Most also The pilot scheme, due to end in the lead in developing transport generate additional funds from July 2009, has been extended to services to fulfil these needs. their own sources. December 2009 with a view to prioritising routes that can be Some of the schemes funded Rural transport projects may also serviced from existing resources under the RTP operate their own be funded under the Rural Social and integrating these with the accessible minibuses (currently Scheme18 provided that they are main RTP. 13) but most contract with local community based, that they do private transport operators and/ not compete with the existing Fitzpatrick Associates (2006) or local voluntary organisations Rural Transport Programme (RTP) found that the RTP has generally to operate the services on their and that all other conditions been a success, providing a behalf.17 A number of schemes are fulfilled. In this context, valuable transport alternative have had difficulty providing community groups may submit for vulnerable people in rural accessible services because work projects that are compatible parts of Ireland. They identified wheelchair-accessible vehicles are with the objectives of the scheme a number of positive aspects of not always available in their areas. to their local LEADER group the programme. Firstly, it has which implements the Rural pioneered a new kind of non- In addition to funding under the Social Scheme on behalf of the conventional rural transport RTP, groups also avail of funding Department of Community, Rural service in Ireland; in particular, provided by the Department of and Gaeltacht Affairs.19 the door-to-door, semi-scheduled Social and Family Affairs arising and/or fully demand-responsive from the application of the Free Under the Evening Rural nature of the services has given Travel Scheme to the initiative. Transport Scheme operated by rural dwellers a valuable transport Some RTP groups also benefit the Department of Community, alternative. Secondly, for many from local development funding Rural and Gaeltacht Affairs, people, it has facilitated very by the Department of Community, seven rural transport projects are real and tangible improvements Rural and Gaeltacht Affairs. A being supported on a pilot basis in their quality of life, to the number of schemes have received throughout the country. Services extent that it can be considered funding under the Community under the scheme commenced a social service as much as a Services Programme, from the on a gradual basis throughout the transport service. This has included

17 Funding under the RTP is provided on the basis of business plans submitted in the context of existing transport deprivation in an area. Funding under the programme is not available for capital costs. 18 The Rural Social Scheme was set up by the Department of Community, Rural and Gaeltacht Affairs in mid-2004. The aim of the scheme is to provide income support for farmers and fishermen in Ireland who are in receipt of long-term social welfare payments. In return, those participating in the scheme provide services that benefit rural communities. 19 Schemes already in receipt of aid from public funds for the same purpose or where there is funding available from other sources are generally excluded from the Rural Social Scheme.

18 Getting There: Transport and Access to Social Services reduced levels of isolation, RTP at local level into the future. for the Dublin area providing greater opportunities for social In the short-to-medium term, demand-responsive door-to- interaction and improved levels of the primary focus is on building door transport services. It also independence and self-sufficiency. capacity within the programme to provides self-hire wheelchair- Thirdly, the RTP has allowed for expand rural transport provision accessible vehicles, which can be considerable local flexibility in by way of better services and hired by members to be driven deciding what type of service wider coverage. Specific attention by member-nominated drivers. is appropriate to meeting the is being given to rural areas Vantastic is supported by the needs of a local area, and the that do not currently have Department of Justice, Equality direct involvement of the local access to public transport. The and Law Reform and by Pobal. community in the development of further expansion of the RTP is services has been crucial to this. regarded as presenting significant Many organisations provide challenges, particularly in terms of accessible transport at local level. The RTP evaluation report capacity building at local level.20 For example, Disabled People of also highlighted a number of Clare operates a transport service challenges that will have to be through a Dial A Ride System. addressed if the programme is 3.7 Similarly, Clare Accessible Transport to lead to an expanded national (CAT) supplies transport services rural public transport service. Community and Voluntary to people with disabilities living These include the requirement for Transport Services in the East Clare Region. There are expanded geographical coverage A number of national and local also a number of private operators to cater for unmet needs. voluntary organisations have at local level that offer a service to Fitzpatrick Associates also found fleets of accessible vehicles that mobility-impaired people who need that running the programme has are used to provide transport transport to hospitals, day centres placed a considerable burden of for their own members, mostly and other venues. management, administration and in connection with their own governance on RTP groups, with activities and to their own The Irish Cancer Society has the people involved having little facilities. Such services generally established on a pilot basis a prior experience of such matters in fit the description of non- volunteer driving service, Care to most cases. This includes the need conventional transport services Drive, to transport people from to deal with general management discussed in 2.4 above. These their homes in South Dublin, and administration issues, national organisations include the Wicklow and North Wexford transport planning and logistics, Irish Wheelchair Association and for treatment in St Vincent’s community development, finance Enable Ireland and, at local level, University Hospital. Modelled on and accounting, public tendering Centres for Independent Living. a successful Canadian initiative, procedures, health and safety, and it was devised in response to an insurance and legal matters. A pioneer in the development identified need for a different of accessible transport was type of transport to and from Pobal is engaged in a process of Vantastic Dial-A-Ride Limited, hospital to cater for existing and extending the Rural Transport established by the Centre for emerging needs. It is envisaged Programme (RTP) on a phased Independent Living in 1994 as a that the pilot project, which is basis with a goal of achieving way of addressing the absence being evaluated, will serve as a nationwide coverage in due of accessible public transport. blueprint for the development course. This involves consideration Vantastic operates a call centre of a nationwide volunteer-based of the best structural booking and scheduling service system of transport. arrangements to manage the

20 A Value for Money Review of the RTP is to be undertaken in 2010.

A Citizens Information Board Social Policy Report 19 Current Transport and Mobility 4 Support Schemes

» Those registered as blind 4.1 4.2 or with a severe visual Introduction Free Travel Scheme impairment who satisfy the medical conditions for Blind This chapter describes the The Department of Social and Person’s Pension various transport and mobility Family Affairs administers a Free support schemes21 currently Travel Scheme for older people, » Anyone who has been receiving available. These are supports people with disabilities and carers. an Invalidity Pension for at provided directly by the State The following categories of people least 12 months from an EEA to individuals who have been are eligible: state or from a country that assessed as meeting the relevant has a bilateral social security eligibility criteria. The schemes are » Everyone aged 66 or over and agreement with Ireland and is summarised in the table below. living permanently in the State permanently resident here Regulations governing provision for parking by people with » Recipients of Disability » People who were receiving disabilities are also described. Allowance, a Blind Person’s Invalidity Pension or Disability Pension and people who have Allowance and changed to been receiving Incapacity State Pension (Transition) Supplement (with Disablement at age 65 Pension) for at least a year

Table 4.1: Transport/Mobility Support Schemes Scheme Year Reviews No. of Users/Recipients* Annual Cost* Established Free Travel Scheme 1967 2000 637,312 €68.43m (2008) Rural Transport 2002 2006 1.2m passenger journeys (2008) €11m (2008) Programme** Mobility Allowance 1979 Guidelines amended 1974, 1998, 2008 Motorised Transport 1968 €3.58m Grant Disabled Drivers and 1994 2002 13,000 (2008) €76m (2008) Disabled Passengers (Tax Concessions) Regulations HSE Non-Emergency 1970 2008 Non-urgent calls – 192,000; Patient Transport Community Transport – 420,000 Services (2008 figures) SWA Exceptional 1977 2004−2006 €2.8m (2008) Needs Payments SWA Travel Supplement 1977 2004−2006 1,037 (2007) €1.34m (2007)

*Data for recent years not always available ** See Chapter 3

21 See also Citizens Information Board, Entitlements for People with Disabilities (2008).

20 Getting There: Transport and Access to Social Services » People in HSE-approved will be continued beyond the age of residential care who were 4.3 66 but a person may not apply for previously getting Disability Mobility Allowance it after that age. The allowance is Allowance (DA) or would paid monthly. The Mobility Allowance (current satisfy the conditions for DA top rate €208.50 per month23) and are medically assessed as is a means-tested payment. It being unable to travel alone is payable by the HSE to people 4.4 aged between 17 and 66 who » Recipients of Carer’s Allowance Motorised Transport Grant have a disability and are unable to and carers providing full-time The Motorised Transport Grant walk or use public transport. The care and attention to those (currently €5,020.50) is a means- following conditions apply: getting Constant Attendance tested HSE payment for people Allowance or Prescribed with disabilities who need to buy » The person must be unable Relative Allowance a car or have a car or other vehicle to walk, even with the use adapted in order to enable them to of artificial limbs or other » A widow/widower aged 60–65 drive and, as a result, earn a living. suitable aids, or the person’s inclusive, in receipt of certain Persons wishing to receive the health must be such that payments and whose late Motorised Transport Grant must: the exertion required to walk spouse held a Free Travel Pass would be dangerous, » Be over 17 years. Free travel is available on road, » The inability to walk must be rail and DART services, the Aran » Have a disability which likely to last for at least a year, Islands22 ferry service, certain impedes their use of public private services that have opted transport. » The person must not be into the scheme and on public medically forbidden to move, transport between Ireland and » Hold a current driving licence. Northern Ireland. The Free Travel » The person must be in a Pass can also be used on schemes » Be physically and mentally position to benefit from a funded under the Rural Transport capable of driving. change in surroundings, Programme. There is no restriction on the amount of free travel or on » Require a car or other » The person must be living the times of travel. vehicle in order to obtain/ at home or in a long-term retain employment or live institution, and The spouse of a Free Travel Pass in a very isolated location. holder may travel free of charge. Where an application is made » The person must pass a People who cannot use the pass on the basis of obtaining or means test. because they are unable to travel retaining employment or self- alone may get a Companion Free employment, the HSE must The decision on whether or not the Travel Pass. This allows the holder be satisfied that the person is medical criteria are met is made to be accompanied by any person capable of holding down a job. by the HSE Senior Area Medical over 16 years of age, free of charge. Officer. The means test is similar Total expenditure on free travel in The grant may also be considered to but not the same as the means 2008 was over €68 million. in exceptional circumstances for test for the Disability Allowance. If people with severe disabilities a Mobility Allowance is awarded, it who are over 17 years and under

22 Permanent residents of any of the Aran Islands may get up to 12 air trips each year between the islands and the mainland. People who live permanently on Tory Island (Co. Donegal) are entitled to a number of free journeys on the seasonal helicopter service operating between the island and the mainland. 23 A lower rate is paid to persons who are availing of the Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme.

A Citizens Information Board Social Policy Report 21 66 years, who live in remote (Tax Concessions) Scheme. Nor » Relief in respect of Vehicle locations and who are impeded does failure to qualify mean Registration Tax (VRT) and from using public transport. An that he/she is not eligible for Value Added Tax (VAT) may be individual who is unemployed tax exemptions. obtained, subject to specified may be able to get a grant if maximums in respect of a access to a car would allow them It should be noted that the driver, a passenger and a family to take up work. Motorised Transport Grant is member. not automatically available to Normally, the grant is payable those who do not have access to » A vehicle on which tax relief where someone drives himself public transport. Its purpose is has been given may not be or herself. It may be possible to address a mobility difficulty disposed of for at least to get approval for a grant arising from a person’s disability two years. where the person owns the car as distinct from a mobility and arranges for someone difficulty due to a lack of » A person admitted to the else to drive it because he/she is available and accessible transport. scheme may also apply for a not physically or medically able repayment of excise duty on to drive. fuel used in the vehicle for 4.5 the transport of the person When a grant has previously with the disability, up to a been paid towards the purchase Disabled Drivers and maximum of 600 gallons or of a vehicle, a grant towards the Disabled Passengers 2,728 litres per year. replacement of the car will not (Tax Concessions) normally be paid for three years Regulations 1994 » A vehicle which has been from the date that the previous admitted to the scheme is also The Disabled Drivers and Disabled grant was paid, unless there are exempt from the payment of Passengers (Tax Concessions) extenuating circumstances. annual road tax. Regulations 1994 provide a range of tax reliefs linked to the Any individual in receipt of the The person applying to the purchase and use of vehicles by Motorised Transport Grant is not scheme must be severely and disabled drivers and disabled eligible to receive the Mobility permanently disabled and have at passengers. Allowance. This is because the least one of the following mobility payment of a Motorised Transport impairments: The main provisions of the Grant is subject to the condition scheme are outlined below: that the HSE will not be called » Be completely or almost upon to contribute towards the completely without the use » The scheme is open to running costs of the vehicle. The of both legs persons who meet the person will not be eligible for specified medical criteria the Mobility Allowance again » Be completely without the and have obtained a Primary until three years after the date use of one leg and almost Medical Certificate to that of payment of the Motorised completely without the use of effect. A person can apply for Transport Grant. the other leg to the extent that relief either as a driver or a they are severely restricted as passenger. Alternatively, there Qualifying for the Motorised regards movement in their legs is provision for family members Transport Grant does not to apply. guarantee that the individual » Be without both hands or concerned will qualify for tax both arms exemptions under the Disabled Drivers and Disabled Passengers

22 Getting There: Transport and Access to Social Services » Be without one or both legs spends a significant part of his/ her time at home, for example 4.6 » Be completely or almost every weekend and holidays. The Ambulance Services completely without the Revenue Commissioners may, in In Ireland, there are three types of use of both hands or arms exceptional circumstances, waive ambulance services available: and completely or almost the residency requirement. completely without the use » Public health ambulance and of one leg The average benefit in terms of transport services (emergency VAT and VRT relief per person and non-emergency) » Have the medical condition of per year is estimated at €5,250 dwarfism and serious difficulties and there are some 13,000 » Private ambulance and of movement of the legs beneficiaries of the scheme. transport services

Eligible drivers and passengers can The strict medical criteria » Volunteer ambulance services claim tax relief on a new vehicle applying to the scheme exclude or a used vehicle that has been a wide range of people with 4.6.1 Emergency Ambulance purchased from an authorised various disabilities, for example Services dealer and not previously people with visual impairment Generally, ambulances are used registered in the State. They can who may need assistance with when the emergency services are also buy a previously registered transport and mobility costs. called but there is no clear right used vehicle, in which case the The Interdepartmental Review to an ambulance service. The amount of the repayment will be Group (Department of Finance emergency ambulance service is the residual tax contained in the 2002), which examined the generally provided by the HSE but value of the vehicle. scheme, referred to possible Dublin Fire Brigade provides an inequalities between people with emergency ambulance service for If the person bought the vehicle various disabilities in terms of the greater Dublin area. Part of before he/she qualified as a access to State subvention for the HSE covering the Dublin area disabled driver, a repayment of VAT private transport expenses. “At (formerly the Eastern Regional and VRT will be made, appropriate one extreme, some persons with Health Authority) also has its to the market value of the vehicle severe disabilities are in a position own ambulance services. The at the time of entry to the scheme. to avail of the tax concessions and two services, which operate from one of the means-tested health the same control room, are not A family member of a disabled board allowances…meanwhile integrated. passenger can also qualify for other persons, with serious relief provided he/she is living disabilities, even on a low income, 4.6.2 Non-Emergency Patient with and responsible for the are unable to avail of any scheme Transport Services transport of the disabled person for private transport costs” The HSE provides non-emergency in question and has acquired the (Department of Finance 2002:12). and non-ambulance transport in vehicle for that purpose. If the circumstances where a person’s person with the disability only As already stated (see 2.11 above), healthcare needs have been stays with the family member on the Interdepartmental Review identified as requiring specialist a part-time basis, the residency Group took the view that the transport and where conventional requirement is not met. However, future direction of the scheme transport is not an option. There the residency requirement may was best considered in the context are diverse practices throughout be met if the person with the of dealing with the question of a the country due, in part at least, disability is a minor who is in Cost of Disability payment. to local responses that evolved residential or medical care on a under the former health board part-time or occasional basis and structure. The diversity is also

A Citizens Information Board Social Policy Report 23 partly due to the fact that there the development of a national is no mandatory requirement to policy and the overall costs of 4.7 provide patient transport services. the scheme. Supplementary Welfare Allowance (SWA) Scheme For non-emergencies, the use of 4.6.3 Private Ambulance an ambulance is usually a medical Services 4.7.1 Travel Supplement decision and priority is given There are a number of private A Travel Supplement may be to oncology patients, dialysis ambulance services in existence, payable under the Supplementary 26 patients, people with lower limb including air ambulance Welfare Allowance (SWA) fractures and transplant patients services. The person requiring scheme where there is a recurring for six months after treatment. In the service makes the contact travel expense, for example: general, people who do not have and pays for the service in the medical cards may be charged normal commercial manner. On » Where a person is visiting for the service but the practice occasion, these services may be a sick relative or a relative varies between the HSE areas and brought in by the HSE to help in prison charges may be waived in certain with emergencies; in such cases, cases (that is, hardship). Some HSE charges for the services are paid » Where attending for access areas provide transport services by the HSE. visits when a child is in care to hospitals for out-patient appointments and to day centres. 4.6.4 Volunteer Ambulance » In the case of separation, This is frequently done under Services where one parent has access contract to private transport There are also a number rights or agreed visitation operators. The HSE may assist of volunteer ambulance with transport costs, such as taxis, organisations. They are generally In 2007, 1,037 people received for a person who has to travel a used to provide immediate a Travel Supplement at a cost of € long distance to a hospital. assistance at public events. 1.34 million. In 2007, a new scheme was In 2006, the HSE commenced introduced for the provision of 4.7.2 Exceptional Needs a review of the non-emergency ambulances for the Irish Red Payments transport needs of people Cross and the Order of Malta Under the Supplementary Welfare attending HSE facilities. This voluntary ambulance services in Allowance (SWA) scheme, a HSE involved the National Ambulance CLÁR25 areas. Under the scheme, Community Welfare Officer (CWO) Office, the National Hospitals €1.5 million is made available may make a single payment to Office and the Primary, per year for an initial period of help meet essential, once-off, Community and Continuing two years to cover 80% of the exceptional expenditure which a Care Directorate of the HSE. cost of purchasing ambulances. person could not reasonably be This review has been completed expected to meet out of his/her and the HSE is considering weekly income. These payments the report.24 Key issues under are known as Exceptional Needs consideration by the HSE are the Payments (ENPs). Assistance under inequities in the current system, ENP is provided when costs cannot be met from any other resources.27

24 This report has not been published to date. However, the Minister for Health and Children, in a written answer to Dáil questions on 1st July 2009, stated that, arising from the review, the HSE was working to ensure that the most effective arrangements are in place for patient transport services and that there is a consistent national approach. 25 The CLÁR programme (Ceantair Laga Árd-Riachtanais) is a targeted investment programme in rural areas. 26 SWA is a supplementary welfare payment administered on behalf of the Department of Social and Family Affairs by the HSE Community Welfare Service. 27 Section 201 of the Social Welfare (Consolidation) Act 2005 contains the provision that “the Health Service Executive may in any case where it considers it reasonable, having regard to all the circumstances of the case, so to do, determine that Supplementary Welfare Allowance shall be paid to a person by way of a single payment to meet an exceptional need”.

24 Getting There: Transport and Access to Social Services The principal consideration in paying an ENP to address a 4.8 particular need is that the need is Parking for People of an exceptional nature. Payments with Disabilities should arise only under abnormal conditions and should not become Regulations provide for a disabled a regular or standard practice. In person’s parking permit. This can relation to providing assistance be issued by local authorities, the with transport costs to and from Irish Wheelchair Association or hospitals, CWOs are obliged to the Disabled Drivers Association. carry out a thorough assessment Permits may be granted to all of a person’s situation to ensure eligible persons with a disability, that there is actual need in that the irrespective of whether they are costs cannot be borne out of his/ drivers or not and the permits have her own resources and there is no national application. The permits alternative source of funding from are available to any person who is the main service provider, in this suffering from a disability which instance the HSE hospital service prevents that person from walking or HSE transport service. or causes undue hardship to the person in walking. The cost of the travel element of Exceptional Needs Payments was Local authorities are empowered €2.8 million in 2008. to provide parking bays for disabled persons on public roads in In a written reply to a Dáil their charge. The regulations make Question during 2005, the it an offence to park in such bays then Minister for Social and unless a Disabled Parking Permit Family Affairs, stated that, is displayed in the vehicle and it is while every decision relating to being parked for the convenience Exceptional Needs Payments is of the holder of the permit. The based on consideration of the offence of parking illegally in a circumstances of the case, taking disabled person’s parking bay now account of the nature and extent comes within the scope of the of the need and of the resources on-the-spot fines system, which of the household concerned, applies countrywide. assistance with transport costs is primarily the role of the HSE The Department of Transport Non-Emergency Patient Transport is carrying out a Review of Services. The Minister noted that the Disabled Parking Permit these services are funded to Scheme, as committed to in the provide transport, including the Department’s Sectoral Plan. hiring of taxis if necessary, to bring patients and clients to and from hospital appointments.

A Citizens Information Board Social Policy Report 25 Transport and Mobility Supports – 5 Issues Identified by Service Users

(vii) Parking permits for people While the main issue with 5.1 with disabilities free travel relates to lack of Introduction public transport or appropriate (viii) Information alternatives, other problems have This chapter outlines a number of also been identified by CISs: issues arising from the experience of service users that have been » The SmartPass Scheme available identified by CISs and voluntary/ 5.2 in Northern Ireland does not community disability advocacy Difficulties in Availing of allow for companions to travel projects around the country. These Free Travel free as is the case in the Free issues are set out under eight Travel Scheme. Many people main headings: Feedback from CISs and voluntary/ community disability advocacy availing of the SmartPass Scheme need a companion to (i) Difficulties in availing of free projects regularly refers to people travel with them. travel, for those who have who have an entitlement to avail entitlement of free travel on public transport services but who have been unable » A person who loses his/her Free Travel Pass has to have (ii) Problems getting transport to use it. For example, it is pointed the renewal form stamped by a to and from hospitals and out that in many rural counties it Garda. This causes difficulty for related costs: is possible to live 20 miles from some older people who live a – HSE Non-Emergency the nearest Bus Éireann bus stop, distance from a Garda station Patient Transport Services or 50 miles from the nearest train and/or who have mobility – reliance on Supplementary service. While the Rural Transport problems. Welfare Allowance Programme has provided transport Exceptional Needs Payments services in some rural areas, these are not available nationwide. In » People are not able to use a Companion Free Travel Pass (iii) Public transport accessibility some instances where they are available, they operate a scheduled on an outward journey to pick up a person with a disability (iv) Difficulties with transport/ service and people off the main returning home at weekends mobility support schemes: route have difficulty accessing the from college/training. – Motorised Transport Grant service. – Mobility Allowance » People who have been self- – Disabled Drivers and Lack of access to public transport employed and become Disabled Passengers (Tax means that people without cars incapacitated may not be able Concessions) Scheme are sometimes unable to take up opportunities such as adult to apply for a Free Travel Pass because they are not insured for (v) Transport and the cost education, training, employment disability /invalidity benefits. of disability support services and social activities. (vi) Transport and the employment of people with disabilities

Case 1: Using a Companion Free Travel Pass A parent of a third-level student with a disability has a Companion Free Travel Pass but cannot use it on the outward-bound weekly train journey to pick up her daughter (who is unable to travel alone by train) and accompany her back home at weekends. This has significant cost implications for the woman concerned who feels that there should be some provision for people in such situations.

26 Getting There: Transport and Access to Social Services Case 2: Use of a Companion Free Travel Pass in Northern Ireland A man in receipt of Invalidity Pension and who has a Free Travel Pass applied for and was granted a SmartPass for free travel in Northern Ireland. He lives close to the border and he has family, social and service access ties in Northern Ireland. His spouse has a Companion Free Travel Pass as he needs her to accompany him but such a companion pass is not available with the SmartPass in Northern Ireland.

transport or lifts from relatives/ transport, this information may not 5.3 friends) and they cannot afford to be widely available. Travel to and from pay for taxis – as a result, they do Hospitals not keep hospital appointments. CISs report a severe lack of provision Very importantly, there is a for people living in rural areas who Difficulties experienced by people dearth of information about what have to travel distances for hospital getting to and from hospitals assistance is available for hospital appointments. While, as already and costs incurred, for example transport. stated, there is provision by the HSE taxi fares, feature regularly in for transport for people receiving feedback from CISs and voluntary/ In relation to information about oncology and dialysis, transport community disability organisations. hospital transport, different to other hospital appointments arrangements apply in respect of is frequently not provided. This The mechanisms in place for people requiring dialysis services understandably causes a lot of assistance with transport to and oncology services. Frequently difficulties, especially for people hospitals are unsatisfactory for too, there is no defined provision who are ill or who have significant a number of reasons. There is for people attending other out- disabilities – some people have no uniform provision and the patient services. Specifically, to regularly make round trips of system varies from one part of information about HSE transport more than 100 miles for hospital the country to another. Cutbacks service curtailment or changed appointments and sometimes incur in services hitherto provided arrangements may not be costs of over €100 for taxis to by the HSE Non-Emergency communicated either within the take them to and from hospitals. Patient Transport Services have HSE (for example to CWOs) or to The issue of people being unable a significant knock-on effect the public. For instance, while new to attend hospital appointments in that people become more arrangements may be in place for because they could not afford the reliant on the Supplementary transport to Centres of Excellence transport costs has been highlighted Welfare Allowance system. People for Oncology Services and while by the Ombudsman.28 sometimes cannot get alternative people must be referred from these transport (for example, public centres in order to avail of HSE

Case 3: Seeking Assistance with Transport Costs A woman with a physical disability needed to attend weekly at a hospital about eight miles from her home. The nature of her disability meant that she was not able to use public transport (a bus or train journey). She had to give up work because of her health and had financial difficulties in meeting the cost of taxis€ ( 40 for each visit). Despite requests from both the woman herself and an advocate, transport was not provided by the hospital and she was referred to the CWO. It was extremely difficult for her to go to the CWO as she could not walk to the clinic. She ran up a debt of €600 when hospital visits became twice weekly at times for various tests. Eventually, when her condition improved (eight weeks after her initial approach for assistance with the transport costs), she was able to apply for and receive a supplementary welfare payment. This, however, covered only a portion of the expenses incurred.

28 A Digest of Complaints Referred to the Ombudsman by Public Representatives. Office of the Ombudsman, October 2008.

A Citizens Information Board Social Policy Report 27 Case 4: Paying for Ambulance to Hospital Appointment A private nursing home invoiced the wife of a resident for €300 to cover the cost of an ambulance to take him to the hospital for an appointment. The invoice also covered the cost of somebody to travel with the man on the journey as his wife could not travel with him. When the local HSE was contacted, they could not give a clear answer as to how this type of journey could be financed.

Where ambulances are provided, Ambulance Control. In order to (iii) Obtain and submit a pick-up and arrival times at qualify for the travel expenses completed Application Form hospitals by ambulances that refund from Ambulance Control, to Ambulance Control have to make a wide round are patients must be in receipt of sometimes not geared to early a social welfare payment and In addition, the person must hospital appointments. If a family attending hospital regularly with a submit the following: member or friend takes a person long-term illness. to the hospital appointment, they » A letter from the hospital would frequently need to allocate For people using a private taxi, confirming attendance a full day for the purpose. In rural there is a 50% refund available. for appointment areas, the journey can be quite The person must arrange for the lengthy and the waiting time in taxi and pay for it on the day. For » An original taxi receipt the hospital can be extensive. people travelling by private car, there is a refund of €4 for every If the applicant goes through the 5.3.1 HSE Non-Emergency 35 miles travelled, round trip. above procedure, they may be Patient Transport Services deemed eligible to claim travel The HSE may assist with In order to receive a refund expenses. transport costs for a person who under the Non-Emergency Patient has to travel a long distance Transport Services, the applicant 5.3.2 Reliance on Supplementary to a hospital. The assistance is is required to: Welfare Allowance Exceptional discretionary and varies from one Needs Payments HSE area to another and within (i) Complete a Financial Feedback from CISs indicates that HSE areas. Assessment Form and satisfy people regularly incur significant a means test expenses getting to and from Where the HSE does not hospital appointments. People provide transport directly under (ii) Get a letter from their GP in such situations regularly seek the Non-Emergency Patient outlining the circumstances and assistance from CWOs. Transport Services, a refund of recommending that the person travel expenses may be available be considered for a refund While assistance with transport to certain people from HSE costs can be and is frequently

Case 5: Transport to Hospital Appointment A lone parent living in a rural area needed to bring her son to an appointment with a hospital consultant some 50 miles from her home. She does not drive and had no way of getting there as the appointment was early in the morning and there is no bus link. She took a taxi which cost her €207. She went to the CWO who covered half of the fare but told her that this should be regarded as a once- off payment. As a result, she has attended no further appointments as she felt she could not afford the cost of getting there. Enquiries from the Citizens Information Centre (CIC) to the Ambulance Control Unit confirmed that if the GP wrote to them explaining the position and the exceptional circumstances, the case would be reviewed.

28 Getting There: Transport and Access to Social Services provided under Exceptional they fall between two stools The following are the main Needs Payments, the CWO must because the criteria for making observations on the current establish that the costs cannot Exceptional Needs Payments system of support for travel be met from any other resources (designed by the Department of to and from hospitals: before a payment can be made. Social and Family Affairs from This sometimes results in people an income support perspective) » Provisions for transport to having to visit CWO offices on do not cater for the regular hospital appointments, other a regular basis, having to wait in payments required to cover than for people receiving a queue and, very significantly, transport costs to hospital (a oncology treatment or perhaps having had to pay for the health service which is the dialysis or those with specific taxi in the first instance, which responsibility of the HSE). named conditions, are some find very difficult to manage. generally inadequate and CISs report difficulties for clients there are variations in practice A number of issues arise from in accessing these Exceptional across the country. reliance on the Supplementary Needs Payments. They have noted Welfare Allowance (SWA) for the following issues: » Many people are unaware of assistance with hospital transport what provisions there are and costs to cover the expense of an » People being questioned as to there is difficulty sometimes in essential, and sometimes ongoing, why they cannot find a family getting clear information about health service treatment: member to take them there entitlement.

» People who are ill (and » Limits arising from means » The refund payment from HSE sometimes very ill) or their testing Ambulance Control (50% of carers have to queue in the cost of a taxi) is inadequate Community Welfare Offices » People having to cover the for people on low incomes who on a regular basis in order to cost (sometimes considerable) have to travel a long distance. get assistance with hospital of the transport in the first transport costs. instance » The refund procedure is too lengthy and stressful for a » The current system of » Assumptions that people, for person who may be very provision for transport to example those with disabilities, unwell: filling out a Financial hospital and for assistance with will be covered by other Assessment Form and transport costs is not patient- transport schemes satisfying a means test, getting centred as people who are a letter from your GP that frequently very ill may often » People being given once-off outlines the circumstances have to go from one service payments but being advised by and recommends you be to another to get assistance. the CWO that such payments considered for a refund, and could not be provided on an then filling out an application » There is a danger that people ongoing basis form from Ambulance Control. may be losing out in that The procedure is not user- friendly or person-centred.

Case 6: Transport from Hospital to Home A woman from a western seaboard county has been in hospital in Dublin for a period of five months receiving treatment. She is frail and unable to avail of public transport. There is uncertainty about whose responsibility it is to arrange transport back home for her – the CIC was told by the local ambulance service that the Dublin hospital where she was receiving treatment could organise an ambulance for her or she could get a taxi and avail of a 50% refund after paying the full fare of something in the region of €250.

A Citizens Information Board Social Policy Report 29 » An appointment notice, stamped despite increases in the number her disability in that she could not on the day, along with original of accessible taxis, feedback from walk the distance to the bus stop receipts should be adequate people with disabilities indicates and, therefore, could not actually proof of a person’s visits to that it is extremely difficult to get use the bus service. hospital. Requiring people to ask an accessible taxi in many parts of for a letter from the hospital on the country. 5.5.2 Mobility Allowance the day of their appointment is Scheme unduly burdensome and time The Mobility Allowance is a means- consuming. It also adds to the 5.5 tested monthly payment. It is workload of hospital staff. payable by the HSE to people who Transport and Mobility have a disability and are unable to Support Schemes walk or use public transport and 5.4 5.5.1 Motorised Transport Grant who would benefit from a change in surroundings. A number of issues Accessibility of Public The Motorised Transport Grant is generally available only to those have been identified in respect of Transport who are in employment. CISs have the Mobility Allowance: The issue of accessibility continues drawn attention to the fact that to be identified as a significant people who have applied for the » The level of payment being too one. There is no low-floor Motorised Transport Grant on the low to cover costs accessible public bus transport in basis of living in a very isolated » Criteria for eligibility being many parts of the country. State- area though not in employment too restricted funded local transport initiatives (which is provided for under the in rural areas are not required to grant) have been unsuccessful » People with disabilities who have fully accessible vehicles. Train in their application. This issue are over the age of 66 not accessibility for wheelchair users was raised in the Ombudsman’s being entitled to apply for the continues to depend on ramps Annual Report 2007 in respect of Mobility Allowance being put in place in response a case where the Ombudsman to requests from individual successfully argued that the » Low levels of awareness of passengers. Taxis are expensive and, person was isolated by virtue of the scheme

Case 7: Free Travel and Visually Impaired Person A daily commuter has a Free Travel Pass because he is visually impaired. He used to be able to board the train using this Free Travel Pass but since the introduction of automated ticketing, he and other people with disabilities have to queue at the local station for a ticket each day. This commuter is hugely inconvenienced each day on his journey to and from work by not being able to show his pass or use an electronic pass unlike other passengers who are able to use the system unhindered. The advocacy worker involved noted that it is unclear when the electronic ticket system will be available to those who use the free travel system.

Case 8: Refusal of Application for a Motorised Transport Grant A woman, whose husband has a disability, contacted the CIS for advice and assistance because she was finding it difficult to cope due to caring and financial pressures. The couple’s application for a Motorised Transport Grant was turned down on the basis that “an applicant must be seeking to obtain or retain employment, have secured a place in full-time education or be eligible to participate in a FÁS course”. No reference was made to the provision for the payment of the grant in exceptional circumstances to people living in a very isolated location and who are impeded from using public transport.

30 Getting There: Transport and Access to Social Services Case 9 below raises a number of » The full rate of Mobility In relation to Case 10 below, issues in relation to the Mobility Allowance would make a major the Mobility Allowance generally Allowance: difference to the quality of life caters for situations where a for the woman involved as she person is aged under 66 years. » The assessment in effect is unable to transfer from her It provides financial support to nullifies the payment of two wheelchair into a car or use the eligible people who are unable to full-rate Disability Allowances. bus on her own. A wheelchair- walk or use public transport and accessible taxi is the only way who would benefit from a change » Information on the Mobility she can get anywhere away of surroundings (the Allowance Allowance which states that from the house. can finance the occasional taxi “the means test is similar to the journey, for example). means test for the Disability It is suggested that the wording Allowance” is inaccurate. of the Circular on Mobility An individual must be under 66 Allowance could be changed to qualify for the Allowance. The » The reduction in this instance to allow for the assessment to information provider for Case was made only to one Mobility be based on the appropriate 10 commented: “This does not Allowance (the wife’s) rather Disability Payments rate for seem to account for the fact that being divided between the two. the family involved. The overall prospect/incidence of mobility cost of this change should be difficulties may increase with age » The reduced amount paid relatively small as there are and that significant sectors of the (€57.94 a month) does not likely to be only a small number population who may be in need even cover the return cost of of couples where both are on of such an allowance are debarred a wheelchair taxi into town Disability Allowance payments from receiving it.” once a week (€20) for the and fewer again where both would woman involved. be eligible for Mobility Allowance.

Case 9: Mobility Allowance Means Test/Determination of Amount Payable* A couple, both with disabilities and both in receipt of the full Disability Allowance (no means-test reduction), each applied for a Mobility Allowance. In calculating the applicants’ means for the allowance, the rates for Disability Allowance and Dependant Rate (€329.10) were used and not two Disability Allowance rates (€395.60). This meant that one Mobility Allowance was reduced to €57.94 a month compared to the full rate of €202 a month.

The procedure for assessing means is that joint assessable incomes are added together. Any amount of this joint assessable income that is in excess of the Disability Allowance Rate for the family composition is taken and divided by two. This figure is deducted from the amount of Mobility Allowance payable. The HSE interpret family composition as personal rate plus adult dependant and child dependant rates as appropriate. (This is based on the HSE’s interpretation of the Department of Health and Children Circular on Mobility Allowance.)

* Case study uses 2008 payment rates.

Case 10: Mobility Allowance and Person Aged Over 66 Years A client of the Citizens Information Phone Service enquired whether her father could avail of any financial assistance from the HSE in relation to transport costs. She explained that he was a person with a disability and was 81 years of age. He did not get the opportunity to leave the house very often because public transport was not an option given his mobility difficulties. However, he was not eligible to apply for a mobility allowance because he was over 66 years.

A Citizens Information Board Social Policy Report 31 5.5.3 The Disabled Drivers which allows them to avail of as too restrictive (see and Disabled Passengers (Tax the relief available at the time of the conditions outlined in Concessions) Scheme purchase, but who do not need 4.5 above) Eligibility for the Disabled Drivers to have the vehicle adapted. For and Disabled Passengers (Tax example, a person with MS may » The process for application Concessions) Scheme is restricted not need any adjustments to a and appeal is regarded as to people who are severely and vehicle, at least in the early stages unsatisfactory and lacking full permanently physically disabled. of the illness. transparency In order to get this concession, a person must be in possession of a Issues identified in relation to Another issue identified concerns Primary Medical Certificate (PMC). the Disabled Drivers and Disabled the situation where the person with The relief is limited to a Passengers (Tax Concessions) the Primary Medical Certificate vehicle that has been specially Scheme include: (PMC) is the passenger but is not constructed or adapted for use by getting the benefit of the scheme a person with a disability. There » Criteria for eligibility for because the driver does not use the may be people who have a PMC, assistance are widely regarded vehicle for the purposes intended,

Case 11: Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations A woman who is physically disabled by way of her upper arms was refused a Primary Medical Certificate. She appealed this decision to the Medical Board of Appeal and the decision was upheld. The reason given for refusal was that her disability does not come within the criteria of the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994. This is because she is not wholly without the use of both hands or arms and wholly or almost wholly without the use of one leg. She believes that the definition of “severely and permanently disabled” within the Regulations is extremely limited as she is severely disabled due to her medical condition. However, there is no scope for interpretation within the Regulations for those who have a physical disability affecting their arms, whereas, for those with restricted mobility, there is a degree of flexibility or interpretation on the basis of being “almost wholly” without the use of both legs.

Case 12: Application for Assistance with Vehicle Adaptation A man with a significant mobility disability gets Disability Allowance and a Mobility Allowance. He is not working due to his disability and has no other income apart from social welfare entitlements. He bought a van to enable him to leave his house and also bought a second-hand lift to ensure that he can get in and out of the van safely. He sought funding from the HSE to help with the cost of the lift and its installation.

He submitted an application to the Disability Unit of the HSE in an attempt to secure funding. No information was forthcoming from the HSE for two months and attempts to find out the status of the application were unsuccessful. The HSE decided subsequently not to fund the lift out of its disability budget and advised the applicant that he should apply for an Exceptional Needs Payment under the Supplementary Welfare Allowance Scheme. The Community Welfare Officer took the view that the application for the lift did not meet the criteria for an Exceptional Needs Payment.

Following further correspondence with the HSE, the Disability Unit agreed to write a letter stating that it was not going to provide the lift and an application should be made under the exceptional needs mechanism. This letter arrived two months later. A re-application for an Exceptional Needs Payment was made enclosing the HSE letter but the application was again turned down. The man appealed the decision and is currently awaiting a decision.

32 Getting There: Transport and Access to Social Services Case 13: Primary Medical Certificate Holder A person availing of the Disabled Drivers and Disabled Passengers Tax Concession Scheme as a passenger told an advocate that her partner had been using her Primary Medical Certificate (PMC) to avail of the tax relief available under the scheme for 10 years but that she had not been brought anywhere in the car for over 6 years. She said that she no longer wanted her partner to use her PMC for the tax concession. The advocate was told by the Central Repayment Office that once the PMC is sent in with the first application, it is taken that permission is given at each subsequent application for change of vehicle and that no check is done with the PMC holder as to whether he or she is getting the benefit of the tax concession. The woman in question decided that from now on she wanted her PMC to be used by another person so that she could avail of and benefit from the concession. The advocate was initially advised that for this to happen, the partner should write a letter stating that he would no longer be claiming tax relief on the basis of his partner’s PMC. When it was pointed out that this was not an option, it was agreed that a letter from the advocate would suffice provided it was corroborated by another professional. The advocate noted that the administration of the scheme needs to be revised to deal with situations where the scheme is being abused − specifically, where the person for whom the scheme is intended is not benefiting from it − and also, to make it easier for a transfer of the tax concession to another person in such instances. namely transporting the passenger. or to areas where there are better Related to this is the difficulty 5.7 employment opportunities. The experienced by the PMC holder Transport and Employment majority of the people who avail in getting the tax concession of People with Disabilities of the service depend on public transferred to another person or transport, on family members/ vehicle (see Case 13). The issue of transport is a recurring friends or on transport provided one in relation to supporting by disability service agencies in 5.6 people with disabilities to integrate the area. It is sometimes the case into the workforce. People with that transport is not available from Transport and the disabilities remain relatively any of these sources. While the Cost of Disability excluded from the labour market. majority of people availing of the Additional costs associated supported employment service For example, the Kildare Coalition with transport for people have Free Travel Passes, these of Supported Employment, a with disabilities are regularly are frequently of no use because voluntary/community organisation, highlighted by CISs and voluntary/ suitable transport is not available. looks at the skills and abilities community organisations. People Feedback from CISs and of people with disabilities and with disabilities often face extra voluntary/community advocacy endeavours to match the people costs not normally incurred by projects indicates that this issue to jobs. It reports that one issue people without a disability. Such is replicated in other parts of which constantly comes up is the costs involve payment for taxis. the country where people with lack of transport to and from work disabilities cannot take up training

Case 14: Visually Impaired Person Attending College A visually impaired person attending college (35km from home) has to get a taxi to the local bus station, travel by bus to the city, get another taxi to the college on arrival in the city, and then do all this on the return journey in the evening. This costs a considerable amount of money and puts severe pressure on the family budget.

A Citizens Information Board Social Policy Report 33 and/or rehabilitative employment were issued and it is estimated Two issues identified by CISs and opportunities because of the that there are currently more than voluntary/community advocacy absence of transport. 30,000 Disabled Parking Permits in projects relating to information circulation. The IWA report states about transport are: 5.8 that this increase is not matched by an increase in the number of (i) Difficulty in finding out what Parking Permits for People accessible parking bays. transport is available for with Disabilities29 travel to and from hospital Feedback from CISs points out appointments and what Parking permits are a recurring issue that people with Disabled Parking assistance is available to help for people with disabilities. The Irish Permits have to apply every two with taxi costs when there is Wheelchair Association (IWA) has years for renewal. In order to do no other transport available over a number of years campaigned this, they have to send back the for a comprehensive review of the current parking disc. This leaves (ii) Difficulty in finding out about current process of issuing parking them without any permit during the availability of accessible permits. Of particular concern is the period they are waiting for bus transport the level of increase in the number the new disc to be provided. There of parking permits being issued is evidence of a small number of While public transport providers without any corresponding increase cases of clamping and fines where (Iarnród Éireann, Bus Éireann in accessible spaces. no disc was displayed during this and Dublin Bus) give general waiting period. information on accessibility for An Irish Wheelchair Association people with disabilities, this may Report (2007) has made not always meet the requirements recommendations to address of individual passengers as Case difficulties and to assist the 5.9 15 demonstrates. Department of Transport’s Review Information of the Disabled Parking Permit Scheme, as committed to in the People with disabilities, and their Department’s Sectoral Plan. The carers, need to have information report highlights the significant readily available about accessible increase in the number of Disabled transport and transport supports. Parking Permits being requested by the public. In 2002, just over 3,000 Disabled Parking Permits

Case 15: Seeking Information about Accessible Buses A CIS received a query from a wheelchair user who wanted to establish if it was possible to travel by bus to Dublin City Centre. The CIS logged on to www.buseireann.ie and, while finding the website very user friendly (clearly highlighting a section on accessibility and several pages about Bus Éireann catering for people with disabilities), could not get the information requested by the client. The CIS information provider rang Bus Éireann in Store Street, Dublin but nobody there was able to answer the query and they suggested that the CIS ring Disability Federation of Ireland or Enable Ireland. Following further discussions on the issue with Bus Éireann personnel, an Accessibility Officer contacted the CIS and acknowledged that it was not possible to answer the query as presented but that they would seek to clarify the matter. The CIS commented that they were still waiting for clarification, and that “in the meantime our client has decided to use the train”.

29 The Irish Wheelchair Association and the Disabled Drivers Association issue the Disabled Persons’ Parking Permit on behalf of the Department of Transport.

34 Getting There: Transport and Access to Social Services 6 Addressing the Issues

provision is the co-ordination of role of the other mobility support 6.1 different schemes at local level schemes and the broader question Introduction and the integration of these of addressing the cost of disability. with mainstream provisions The previous chapter highlighted (see 3.5 above). The Working Group on the Review a number of issues relating of the Supplementary Welfare to people’s ability to access The Citizens Information Board has Allowance Scheme (Department appropriate transport and mobility in the past called for an integrated of Social and Family Affairs 2006), supports. This last chapter and comprehensive package of commenting on payments made explores how the issues identified transport/mobility measures for under the category of Travel, might translate into policy and people with disabilities in order concluded that “given the practice and, specifically, how a to address current and evolving varied and critical nature of the more integrated response might needs. It has recommended that financial supports provided under be developed to address the needs transport and mobility schemes be this heading, and in the context of people currently experiencing amalgamated into a co-ordinated of other initiatives such as the transport and mobility difficulties. mobility/transport subsidy granted rural transport [programme], on the basis of individual needs there is a requirement to A key consideration in the current assessment. Citizens Information review existing arrangements economic climate is the cost- Services, the Citizens Information at an interdepartmental level” effective and targeted use of Phone Service and voluntary/ (Department of Social and Family resources. The present situation community organisations regularly Affairs 2006:147). of State funding for a range of make the point that people should parallel and fragmented initiatives not have to undergo repeat It is now vitally important that which frequently operate assessments for different transport/ existing schemes are reviewed to independently of each other is mobility support schemes delivered achieve better resource efficiency unlikely to provide the best use by different agencies. and greater co-ordination and of resources. Greater synergy is integration. There is also potential required between the various A number of reviews during the for greater rationalisation and joint schemes to ensure the most last decade have called for greater working between transport services efficient use of available resources integration between the various at regional and local levels through and, at the same time, equality of State-funded transport/mobility maximising the use of information access across all groups of people schemes. The Interdepartmental technology to enhance demand- with transport and mobility issues. Review Group on Disabled Drivers responsive services. There is also a need to explore and Disabled Passengers (Tax further how the provision of Concessions) Scheme (Department The Interdepartmental Review publicly funded local transport of Finance 2002) referred to Group on Disabled Drivers can be improved to meet the possible inequities between and Disabled Passengers (Tax requirements of individuals and people with various disabilities Concessions) Scheme suggested communities, particularly for in terms of State subvention for that in the long term the solution accessing necessary health and private transport expenses. The may lie in some combination of social services. Review Group also concluded the following options: that the scheme could not be 6.2 looked at in isolation but had to » Concentrating public funding be considered in parallell with Need for a More on making the public transport similar developments concerning system more accessible for Integrated Approach accessible public transport, all people A key aspect of international transport initiatives by the best practice in rural transport voluntary/community sector, the

A Citizens Information Board Social Policy Report 35 » Funding voluntary groups therefore not be aimed solely at the Current mechanisms for refunding that can provide a locally socially excluded, however defined, the cost of trips to hospitals for based, flexible and accessible but could also provide services for people who are on low incomes transport system for persons employment and work purposes. and need transport services are with a mobility impairment unsatisfactory. Medical card Such a rollout of the RTP is holders may receive refunds from In line with the Government’s unlikely to take place in the short the HSE for expenses incurred commitment to mainstreaming to medium term. However, in while travelling to hospitals and and service integration, cross- calculating the cost of public out-patient clinics. Payments are cutting issues relating to different transport in rural areas, account largely at the discretion of the HSE Government departments and should be taken of the cost of Non-Emergency Patient Transport agencies involved in the provision not providing transport. Apart Services or the Community Welfare of transport and mobility supports from the social costs, the inability Officers, and vary considerably should be identified and addressed of people to access social and from area to area. by the Department of Transport. health services or employment In developing a more integrated and training can frequently Each HSE area should examine approach, there is a need to further result in significant additional its current ambulance transport evaluate transport provision by costs to the State. Older people policies in relation to how they voluntary organisations and the and people with disabilities in affect people being treated in HSE, and how these groups fit with particular can have problems hospital, older people and people the Rural Transport Programme and accessing hospitals and other with disabilities in rural areas. The other State-funded local transport healthcare providers due to lack following factors are pertinent in initiatives. of appropriate transport and there addressing the issues identified: is evidence to suggest that lack of public transport leads to older (i) Assistance with transport costs 6.3 people foregoing healthcare and/ should be dealt with in the or becoming socially isolated. context of a patient-centred The Central Role of and integrated response to Transport in Accessing 6.3.2 Transport and Access to treatment and care. Services Health Services 6.3.1 Transport and Social Better co-ordination between (ii) The costs of transport to and Inclusion hospitals and other healthcare from hospitals for those who Lack of adequate public transport providers and transport services cannot meet them out of is one of the major factors is needed so that appointments their own resources should be contributing to social exclusion for people who rely on public subsidised by the HSE as part in rural areas. Fitzpatrick and transport can be made with bus of this integrated package of Associates (2006), in their review timetables and availability of care and treatment (see 4.6.2 of the Rural Transport Programme transport in mind. In addition, above). (RTP), favoured a rollout of flexible modes of transport that national rural public transport that could be booked and used at low (iii) People should not have to would involve wider coverage of cost are required by people living negotiate with different socially excluded groups. Fitzpatrick in remote areas who need medical parts of the HSE system in and Associates suggested that the services. These should also be order to get assistance with programme should extend target adapted or adaptable for people transport costs. group coverage in the longer term with disabilities, and drivers to include all potential users of should be trained to assist people rural transport. Services would with mobility difficulties.

36 Getting There: Transport and Access to Social Services (iv) The Department of Social policy as opposed to add-on opportunities for many people and Family Affairs and the provisions. This approach is all the with disabilities or people living HSE should engage in joint more important because people’s in many rural areas. discussions to examine their needs in relation to transport respective responsibilities may evolve or alter suddenly To help ensure equality of access in relation to providing necessitating changes, sometimes to public transport, options other assistance with costs of major, to their transport than a Free Travel Pass should transport to and from requirements. It is also important be available in the longer term. hospitals. This should be to note that the incidence of For example, there could be a done in conjunction with the disability increases with age and corresponding cash payment Review of Non-Emergency that most disability is acquired for those people who are Transport Needs of Patients over the life cycle. unable to use the pass due to Attending HSE Facilities which the inaccessibility of transport. has been completed by Adopting the ‘Transport for Alternatively, vouchers could the HSE. All’ approach will require the be made available for use in integration of transport policy taxis, hackneys, community bus 6.3.3 Transport and Access to with policies on mainstreaming, schemes and private buses. Employment and Training social inclusion and the built It is particularly important environment. While the Transport providers funded either to devise transport strategies full implementation of the directly or indirectly by the State aimed at helping people in rural ‘Transport for All’ concept may in respect of free travel should be areas who are unemployed or not be achievable in the current required to have clearly stated underemployed. Inadequate economic climate, the further policies on ensuring that the public transport prevents people development of locally integrated vehicles used are accessible. State from taking up employment and/ accessible transport services, funding should be targeted towards or training that would otherwise including demand-responsive providers with comprehensive and suit them, and leads to some and flexibly routed services, must flexible policies in this regard. people foregoing more suitable be kept clearly on the long-term employment opportunities. In the policy agenda. 6.5.2 The Rural Transport interest of social inclusion, it is Programme important to ensure that the lack The Rural Transport Programme has of transport is not a barrier to 6.5 in the longer term the potential taking up employment or training. to address many of the needs Existing Transport Schemes identified in respect of people and Supports living in rural areas. In light of 6.4 6.5.1 Free Travel the challenges of the current economic downturn, the question Implementing the The Free Travel Scheme is very popular, highly regarded and of of investing in the programme to ‘Transport for All’ Concept significant benefit to many older provide comprehensive coverage There is no panacea for the people, people with disabilities to those most in need should accessibility problems of and carers. However because of be addressed. public transport. However, the the fact that public transport (or systematic implementation of the qualifying private transport) is There should be a clear target ‘Transport for All’ concept would often inaccessible geographically of making all transport services create a policy context where the and from a disability point of view, funded under the Rural Transport accessibility issue for people with the scheme can be inequitable. Programme accessible to people disabilities would be addressed A Free Travel Pass may not in with mobility problems and within mainstream transport practice provide additional travel of ensuring that the demand-

A Citizens Information Board Social Policy Report 37 responsive aspect of each service is The provision of a transport/ Also, where two persons in a as strong as is practically feasible. mobility subsidy to a wider group household are in receipt of Disability of people with disabilities than Allowance, there should be more 6.5.3 Disabled Drivers and those covered under the Disabled flexibility in applying the means-test Disabled Passengers (Tax Drivers and Disabled Passengers criteria, particularly as there would Concessions) Scheme (Tax Concessions) Scheme be a relatively small number of The Report of the Inter- should receive ongoing active households where this is the case. Departmental Review Group on consideration. the Disabled Drivers and Disabled Passengers (Tax Concessions) 6.5.4 Motorised Transport Grant 6.6 Scheme (Department of Finance) The Motorised Transport Grant was published in 2002 but no is currently generally only Voluntary Sector Initiatives decisions have been made on available to employed people The voluntary/community sector its implementation. A Comhairle with disabilities. There is a has been at the forefront in (now the Citizens Information provision for the grant to be developing innovative responses to Board) Submission to the paid on occasion to a person meeting the transport needs of local Review Group argued that the living in a very isolated area even communities and different target scheme should not be viewed in though he/she may not be in groups, including people in rural isolation from other transport/ employment. However, a number areas and people with disabilities. mobility schemes for people with of Citizens Information Services Transport initiatives by the sector disabilities and should also be have noted that older people who have been strongly supported by reviewed in the context of a Cost have applied for the grant on that Government, in particular through of Disability payment. As already basis have had their application the Rural Transport Programme. stated, the Review Group included turned down. While there is much merit in this as one of their conclusions. continuing support for voluntary As part of a more integrated transport initiatives, a key issue The Review Group also system of transport and mobility is the capacity of the voluntary/ recommended that the criteria for supports, the transport needs of community sector to meet new the scheme should be changed to older persons and persons with demands. incorporate an: disabilities living in isolated areas should be kept under active review. The optimum development of “overall assessment of the mobility local community-based transport level of an individual rather than 6.5.5 Mobility Allowance initiatives in the future requires concentrating purely on the People over 66 may not apply for that funding mechanisms take specifics of the physical disability… the Mobility Allowance although into account: the alternative approach offers the they may retain the Allowance prospect of addressing the situation if awarded it before that age. » Capital costs of vehicles as well of anomalous cases where the This is unfair as many over this as operational costs existing medical criteria exclude age are likely to need it, and it is an applicant who is equally, if not discriminatory. People do not » The need for training in more, disabled than others who do have a choice about when they organisational management qualify under the current medical acquire a disability and may need criteria – for example it could assistance with mobility at any age. » The need to enhance capacity permit inclusion of certain persons People who fulfil the criteria for at local level with severe cardiorespiratory Mobility Allowance should be able incapacity and stroke victims” to apply for it after the age of 66. (Department of Finance 2002:45-46).

38 Getting There: Transport and Access to Social Services mobility, sensory and cognitive made in recent years in relation to 6.7 impairments” (Department of accessibility on public transport. Travel Information and Transport 2008:5). However this issue continues People with Disabilities to present major challenges; for example, many parts of People using public transport 6.8 the country still do not have need timely, accurate and accessible buses and accessible reliable information on the travel Parking Permits for People taxis can be difficult to get. choices available to them. This is with Disabilities particularly important for people In relation to parking permits for There is a strong case to be made with mobility disabilities who people with disabilities, a range for including the transport needs need to be sure that they do not of issues need to be addressed of people with disabilities as encounter an accessibility problem concerning assessment and part of an overall assessment of at any stage of their journey. allocation. These include the their needs. This should take into Accurate information is, therefore, allocation and availability of account the widely accepted social required on: wheelchair-accessible bays, policy principles of social inclusion, – Routes abuses of the scheme, lack of equality of access, choice, person- – Stops and interchanges enforcement and the lack of a centred planning, independent – Costs co-ordinated approach. living and changes over the life – Timetables cycle. – Connections The Department of Transport’s – Accessibility Review of the Disabled Parking To arrive at an efficient, cost- Permit Scheme should address effective and equitable system While the main public transport these issues as a matter of urgency. of publicly funded transport that providers have developed useful provides access for all, further information dissemination exploration is required in two systems, there is a need for a 6.9 distinct areas: single travel information source. The Dublin Transportation Office Conclusion » Streamlining (or cohesion) has submitted a report to the Transport availability is widely to achieve greater co- Minister for Transport – A Strategy regarded as a key determinant in ordination between services for Integrated Public Transport both combating social exclusion for the benefit of the users, Information, including Real Time, and enabling access to services. particularly in respect of in the Greater Dublin Area. This The lack of availability of public accessing necessary health could be a useful model for the transport significantly diminishes and social services development of such a service the quality of life for people nationwide. who are heavily dependent on it. » Rationalisation of the current This impacts on their ability to multiplicity of schemes to The gradual rollout of a access health and social services provide the most efficient Smartcard-based integrated and services necessary for daily use of available resources and ticketing system and the living or to pursue education, improved equality of access introduction of passenger attend training courses or work. for all groups of people with information systems with Inadequate public transport has transport and mobility issues accessibility features should, been identified as one of the as stated in the Department of major factors contributing to Transport Sectoral Plan, “greatly social exclusion in rural areas. enhance public transport travel Significant progress has been experiences for people with

A Citizens Information Board Social Policy Report 39 Appendix: Social Policy Alert

To: Citizens Information Services and Disability Advocacy Projects

The Citizens Information Board is preparing a Social Policy Report on transport and access to services. Areas under consideration for the report include:

» Access to Free Travel

» Transport to hospital and other health/welfare related appointments

» Access to HSE patient transport schemes

» Operation of the Motorised Transport Grant, the Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme, and the Mobility Allowance Scheme

» Accessibility of public transport

» Availability and operation of rural transport initiatives

» Difficulties in accessing centralised services

» Transport costs for people with disabilities

» Role of Supplementary Welfare Allowance Exceptional Needs Payments in assisting with transport costs

We very much want to capture the experience and perspectives of organisations working with and for people with disabilities on the ground and would, therefore, appreciate if you would submit any issues that have emerged in your work in relation to any of the above. Illustrative case examples of difficulties encountered and exceptional costs incurred would also be very much appreciated.

40 Getting There: Transport and Access to Social Services References

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Central Statistics Office (2008a), National Disability Survey 2006, First Results Report. http://www.cso.ie/releasespublications/nationaldisabilitysurvey06first.htm

Central Statistics Office (2008b), EU Survey on Income and Living Conditions 2007. http://www.cso.ie/releasespublications/documents/silc/Current/silc.pdf

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A Citizens Information Board Social Policy Report 41 Irish Wheelchair Association (2007), Review and Analysis of Disabled Persons’ Parking Permit Scheme in Ireland.

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National Disability Authority (2005b), Submission to Taxi Commission on Roadmap − Towards a New National Code of Regulation for Taxis, Hackneys and Limousines in Ireland. www.nda.ie

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Office of the Ombudsman (2008), A Digest of Complaints Referred to the Ombudsman by Public Representatives. www.ombudsman.gov.ie

Office of the Ombudsman (2008), Annual Report 2007. www.ombudsman.gov.ie

O’Hanlon, A., H. McGee, M. Barker, R. Garavan, A. Hickey, R. Conroy, and D. O’Neill, (2005), Health and Social Services for Older People (HeSSOP II): Changing Profiles from 2000 to 2004. National Council on Ageing and Older People.

Quinn, O. (2000), A Review of the Free Schemes Operated by the Department of Social, Community and Family Affairs, Studies in Public Policy 5. The Policy Institute, Trinity College Dublin in association with the Department of Social, Community and Family Affairs.

Treacy, P., M. Butler, A. Byrne, J. Drennan, G. Fealy, K. Frazer and K. Irving (2005), Loneliness and Social Isolation Among Older Irish People. National Council on Ageing and Older People.

Tyler, N. (ed.)(2002), Accessibility and the Bus System: From Concepts to Practice. Accessibility Research Group, Centre for Transport Studies, University College London.

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42 Getting There: Transport and Access to Social Services

Getting There Transport and Access to Social Services

A Citizens Information Board Social Policy Report