Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

I thank Dr. Muldoon for his opening statement and for the report. The report states that the average waiting time for an assessment of need is 19 months. Despite legal requirements to the effect that the HSE commence and complete an assessment within three and six months, respectively, of an application having been received, this is not being done. What does Dr. Muldoon recommend be done to improve the service? Parents are at their wits' end trying to get assessments of need for their children in order that they can access the appropriate services.

Are long wait times for assessments of need occurring throughout the State, in each CHO area, or are there differing levels of waiting lists among the CHOs? If there are areas where the system is working, can we examine what is happening there and try to replicate it? We need to move away from this post-Covid politics and provide the same level of treatment for everybody, irrespective of where in the State the person lives.

An hour or two ago, I received copies of letters sent to parents of children in my area of Dublin West in respect of Covid. One might ask what impact Covid-19 has had on assessments of need. One letter is to the parents of Teddy, a young boy from Clondalkin on the waiting list to be seen by the children's disability team. The letter states:

As some of you are aware we are operating with a much reduced team in recent months. Some of our team are supporting Covid-19 testing part-time while continuing to work with the team. Recruitment for more permanent staff for testing centres is taking place and we look forward to our team testers returning to us full time in the coming weeks.

To support the processing of the backlog of Assessment of Need (AON) requests in this Community Health Organisation (CHO) some of the team have been redeployed temporarily to assist colleagues across the CHO with this backlog.

Testing and tracing is vital, as we have heard since day one, when this pandemic landed on our shores, but it cannot be to the detriment of a child's development. It seems that the unmet needs that Dr. Muldoon mentioned are being pushed further down the line due to Covid. He might comment on the impact that Covid is having on the service, which was already not meeting the needs of children.

I will read out one of the stories that was told to me in order to put it on the record. It is well documented that early diagnosis, intervention and access to services greatly improves the development of the child. There were four stories in the report, one of which, about a girl called Sarah, stuck with me more than the others. The report states:

Sarah has been privately assessed as having ASD. She also has sensory issues, is unable to wash or dress herself, and her co-ordination is poor. When she was four years old, her mother applied to her local HSE Early Intervention Team for an AON. She was informed that Sarah would have to wait at least 27 months for an AON and that, when she turned five, she would be transferred to the School Aged Team waiting list. Sarah would not receive any priority on that list, despite ‘aging out’ of the Early Intervention Team waiting list.

This seems to be the case across the spectrum. When kids get to a certain age and have not had their needs met, they put back to the bottom of another list. That needs to be addressed. The report goes on:

Sarah’s mother complained to the HSE regarding the delay. Her complaint was upheld but Sarah has still not received an AON.

The report states that 100% of complaints in 2018 were upheld. That is a damning indictment of the system. All the complaints were upheld, yet still there have been no changes. If a child gets treatment when he or she needs it, he or she will be less likely to need acute adult services. Prevention is better than the cure.

The OCO could probably write another report to answer my questions but I am not asking for comprehensive answers to all of them. What are the problems with the assessment of need process? I acknowledge that our guests have mentioned some of them. Is it a funding issue or a lack of resources? Is there an issue with the recruitment and retention of staff? Are there systemic failures or is there a lack of political will? Is it all of the above? How can things be improved? That is the question that parents have been asking me today. They are at their wits' end and some of them are pulling their hair out trying to get the services their children deserve.