Mr. Odhrán Allen:

I would like to respond to Deputy Durkan's questions. The Deputy's question, "why do we have waiting lists?", is an important one. There are two issues that need to be looked at. The first is what structure of services is the right structure. The HSE has identified a good structure called the progressing disability services programme. There is buy-in from all stakeholders that this is the right structure. It is the right structure because it provides a consistent structure of services throughout the country, it is a needs-based service rather than a diagnostic-based service, there is equity of access to services and there is one clear pathway for all children according to their needs, and effectively, children would be identified as either having complex or non-complex needs. If they are non-complex needs, they are dealt with by primary care services. If they are complex, they will be dealt with by children's disability network teams.

However, as good as that structure is, it cannot work without adequate resources. The Deputy is correct that the issue of resources always comes up. We understand the constraints. There is not a bottomless pot of money. However, the reality is in the past 20 years there is a greater awareness and openness to the needs of children with disabilities. More and more children are presenting with difficulties and needs that need to be met and there is an increased demand on services. There are more children with needs coming forward but the progressing disability services cannot be implemented without the adequate resources.

As for the waiting lists, there are variations. Ms O'Malley will say a little bit more about that.

In terms of Deputy Durkan's question about the assessment form, who designed it and why it is so unwieldy, we had no involvement. As I stated, while it states in the SOP that professional representative bodies were consulted, for the record, we were not. No doubt there were occupational therapists and other professionals who work in the HSE who may have been involved, but as the professional body for occupational therapists, we were not consulted. As I stated, we have never been sent the SOP and were not involved in its development.

In terms of comparison with other jurisdictions, what works elsewhere or what might work here, the Deputy raises an important question, which is the issue of evidence-based service delivery. We would question what the evidence base is for this SOP. Some of the evidence can be service audit. It can be the experience of professionals on the ground and feedback from users of services and families, but also what clinical evidence is there for good practice. We would all agree that having a safe evidence-based and ethical approach is the right one.

I agree that delays in diagnosis are difficult for families. As Deputy Durkan stated, families need to know where they are going. We would feel that this SOP does not improve services towards meeting that end of helping families know what is going on for their child.

Ms O'Malley will try her best to respond to Deputy Donnelly's questions.