Mary Seery Kearney (Fine Gael)
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I welcome the students from Dalkey School Project in Dún Laoghaire. They are guests of Senator Barry Ward and they are very welcome to the Seanad.

I welcome the Minister of State to the House.

Micheál Carrigy (Fine Gael)
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I welcome the students and I welcome the Minister of State, Deputy Rabbitte, to the Chamber to take this Commencement matter about setting up one-stop shops in Ireland to provide for all those on the autism spectrum.

One may ask what one-stop shops are. They are basically community-based supports for young children and adults on the autism spectrum. They were first introduced in Scotland as part of its autism strategy. The services provide barrier-free supports to individuals and families created by autistic persons and are responsive to the needs in each individual locality. Some of the services and supports they provide are advice and information services, drop-in sessions, one-to-one appointments, peer support groups, support for transitions, social activities, support and advice to access services within the community, parent groups, information and advice for professionals and supports developed in partnership with other local organisations and public services.

It is a community-based model that will be collocated with existing support services and staffed by a range of non-clinical professionals providing complementary, rather than competing, services to the CDNTs and disability services, which is a key point. It also provides important opportunities for promoting autistic self-advocacy and providing employment within the community.

A number of members of the joint committee, of which I was Chair, visited Scotland in October. We met with the Scottish health minister, department of health officials and a significant number of autism advocates who work with the Scottish health department developing legislation. One of the key points we brought back from Scotland was the success of the model as it is there. We strongly believe it needs to be implemented here.

To give background, AsIAm, a significant organisation supporting those on the autistic spectrum, recently produced its Same Chance report. Less than one third of those represented in the report, in which 1,603 took part, reported receiving support from their local CDNT. Of those not receiving supports, the vast majority, some 68%, were on waiting lists, whereas others were simply outside of the system. That cannot continue. Over a quarter, some 26%, of those on the waiting lists were reported to be expecting to wait more than four years to access the services they need. More than 15,000 are waiting for first-time assessments for occupational therapy, 15,000 are waiting for speech and language assessments, more than 8,000 are waiting for further SLT therapy and 16,000 are waiting for psychology treatment. These are significant challenges. The waiting lists for assessments remain extensive and there is a recruitment crisis within disability services.

While there is an urgent need to reduce waiting times and improve pathways to the multidisciplinary supports for autistic children and adults, there is an important opportunity to build on the complementary – “complementary” is a key word – supports within the community to provide timely support to families in the current context.

I know the Minister of State read our report and was very supportive of the committee. This is one point that has come up from a number of organisations we met with that gave testimony to the committee and was key to our report. The NDA was very supportive of the one-stop shop. Indeed, Áine Lawlor of the IASLT spoke to the committee and highlighted the positivity of a one-stop shop, highlighting the fact that there were pockets of services that work very well and we have excellent skills and clinicians who can provide support but what about the families and the people involved?What about the other supports for them? That is a significant challenge for us but this can be the answer. Will the Government support the piloting of a model of a one-stop shop which has been successful in our neighbouring country with a similar sized population? Scotland had an autism innovation strategy from 2011 to 2021. They have reviewed it and are moving forward but this is one thing that has proven successful. It can be successful in this country. I want the Government to introduce a pilot and recognise the opportunities it will provide, including in the context of the HSE children's disability grant round and the forthcoming autism innovation strategy on which I know the Minister is working and which we are waiting to see shortly.

Anne Rabbitte (Galway East, Fianna Fail)
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At the outset, I acknowledge the interest of Members of this House in issues surrounding autism. In particular, I thank Senator Carrigy for raising the important issue of the provision of information and services for autistic people. As Minister of State with responsibility for disability, I have consistently sought to advance a national action on autism to address the bespoke challenges that autistic people face today in Ireland. These challenges occur at all stages and in all facets of life, from healthcare, education and employment, among other areas. Some of these challenges relate to access to services as the Senator quite rightly outlined. Some relate to access to information about the services. As Minister of State for disability, I often speak with people who are wondering if they or a loved one might be autistic, along with people who have been diagnosed or self-identify as autistic, and who are asking themselves what they should do and where they can access supports. In those cases, we need to make sure we are giving people the information they need on the supports available. On World Autism Awareness Day in 2021, I announced the Government’s intention to develop a national strategy on autism. If the Senator will bear with me, I will bring him up to speed on that. This has taken the form of an autism innovation strategy, which I intend to launch later this year following a final round of public consultation which will commence later this month. The Government is committed to better meeting the needs of autistic people and their families. In the context of the development of this strategy, work is under way to explore methods of providing enhanced information, signposting of information, and supports regarding autism for autistic people and their families. I want to deliver a shift in the mainstream provision of services which will focus on clear functional actions to identify gaps and bespoke needs on autism that are not accounted for in existing mainstream measures, and to make sure that after the autism innovation strategy, mainstream provision better understands and better meets the needs of autistic people. While I am not yet in a position to outline the specific action plan that will launch within the strategy, I will shortly be in a position to launch the final round of consultation and to set out the programme of work the whole of government will undertake.

To be very clear to the Senator, I have done some individual research on the one-stop shop. I heard members of the committee had travelled to Scotland. When in opposition, I set about looking at dementia, as did the Minister of State, Deputy Butler, and the Scottish model. Hence, she has opened 45 day care centres relating specifically to dementia and that all come from the Scottish model. Therefore, I have looked towards Scotland as well and believe in the piloting of the one-stop shop to see how it would work. I have no doubt it would be a success. It would be a success in an area in which there is a gap that the CDNTs cannot fill, that is, the information piece around the questions people have such as "Am I autistic?", "Where can I go?" and "How can I be assisted?" and proper correct signposting of this. Our CDNTs are under phenomenal pressure and need additional support. Our educational system is also under huge pressure. I am talking about the people under 18 here, never mind how the autistic child or young person who is transitioning at 18 years of age into education or adult education can be supported within third level or as they transition into employment. Therefore, the one-stop shop would be able to signpost and address this, and colocated within the community, to best meet the individual needs. It would have the peer-to-peer leadership piece. At the moment, people in Galway or Longford who are autistic are travelling to one side of the country to be able to participate in that. We need to have a more community-balanced regional development when it comes to supporting young and not so young people who have identified as autistic or who have autistic needs. The only way to do that is through mirroring the Scottish model.

I thank the Senator and the committee for the time and effort they put in to develop a consultation booklet at the close of the committee, within which the need for the community-based approach is also identified. I am hoping there will be the opportunity in this round of HSE grants to identify and work to that piece and take on board the recommendations made by the committee, in consultation with the main stakeholders and partners who all came before the committee. I will be impressing upon the HSE that is it a desire of the Government to see a community pathway developed outside the Dublin commuter belt out into the rest of the country. I will come back in and answer the rest of the questions as to how this will be done.

Micheál Carrigy (Fine Gael)
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I thank the Minister of State. First, I must highlight the fact of the funding she made available to AsIAm for the information line for parents. There is an access point there which must be complimented because as a parent, on hearing those words, you do not know where to go or where to turn and it is important that these supports were put in place. The Minister of State has highlighted the fact that support is colocated within the community. There is a model there and it works. We have met the officials as has the Minister of State. We need to put the funding in place to deliver it.

Anne Rabbitte (Galway East, Fianna Fail)
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It was remiss of me not to mention AsIAm and the telephone line which we launched 18 months or two years ago at this stage. In the first year of operation, it had over 5,500 calls from callers wondering how to assist their children or teenagers and from young adults themselves asking how to access a diagnosis and engage in education. That telephone line has proved its worth in spades. That is why I am saying we need that personal face as well. We need to have the peer-to-peer support groups, the parental group, and the community-based model given that one in 27 within education is now identifying as being on the autism spectrum. With one in 27 people in any community space, we need to have a more accessible inclusive integrated community-based model of support. I support, as does the Government, the Senator's ask today.