Ms Ciara McKenna-Keane:

There is a lack of consistency between CHOs, as we addressed a little bit in our report. From the HSE quarterly reports, we know that there has been an increase in the volume of assessments of needs within all the CHOs. There is certainly a divergence and disparity in terms of the final number received, how quickly the assessment reports are completed and how quickly the service statements are finalised and the services provided to those children. It reflects a lack of cohesion and consistency in approach across assessments of needs within and between CHOs. We deal with it a little in the report. As Dr. Muldoon has stated, the standards for assessments of needs were actually devised during the interim HIQA in May 2007 and I think HIQA itself would say that they are outdated. We had put in a proposal for that to be prioritised. That will not happen and perhaps it will go in the mix in August 2022. In the meantime, we need to look at what can be done to standardise approaches and make sure that the actual care received by the children is measured against optimal care. These children need early intervention and services to meet the needs assessed.

The other issue in this area is the standard operating procedures that were introduced by the HSE. They now have preliminary assessment teams who are doing a 90-minute assessment with two professionals within a three-month time limit. While they are keeping within the time limits of the Disability Act, the actual substance of the assessments is, arguably, not as sufficient as that envisaged within the Act. Timelines are being met but obligations under the Act are not. That is another issue. As Dr. Muldoon has stated, we would be in favour of an expert group on children with disabilities to look not only at a review of the Disability Act and how it would align with the Education for Persons with Special Educational Needs Act, which is a little more needs based, but also how, in practice, that legislation and those regulations are implemented in terms of the assessments themselves and how services flow from those assessments. While it is disappointing that HIQA will not be looking at this, there is still something that can be done in this area. We can also align it with policy changes that have taken place since 2005 whereby there has been less of a diagnosis-led approach and more of a needs-led approach that looks at the child holistically. That is required under the United Nations Convention on the Rights of Persons with Disabilities and the United Nations Convention on the Rights of the Child.