Mr. David Walsh:

There was a significant number of questions but I will try to get through them. Approximately six weeks ago, the Ombudsman for Children met with the entire senior leadership team of the HSE to discuss this report. I think even before that but certainly after that, it was clear the desire of the CEO, Mr. Gloster, is that we resolve these issues insofar as they arise internally within the HSE, such as the linkages between the acute services and community services, but also the linkages between ourselves and other agencies, and most especially Tusla. He has been clear on his direction out to our system that care planning is to start much earlier in respect of children who end up in acute settings and that arguments about money simply should not occur. We design the service, put it in place and figure it out at that point.

It is to give that clarity and avoid circumstances like we had in the past where local HSE services have not been in agreement with local Tusla services about who should pay for what. As far as I am concerned, that is a thing of the past. Where people now hit blocks in terms of funding, they need to escalate that and it needs to be dealt with at a higher level. The resourcing side and money side of that should not be an issue. What we need to do now is make sure the various professionals, both internally within the HSE and then in other agencies, are aligned and that we focus on designing the correct package of care and sourcing it. There are still issues in sourcing the correct skill sets, which Ms Murphy said in her opening statement. There are certain skill shortages. It can take time sometimes to put packages together. The way to shorten that is by having care planning happening at the earliest possible moment and preferably before a child ends up in an acute setting. I might ask Mr. O'Regan to talk about the autism pieces and other good practices we are trying to introduce.