Mr. Mark Smyth:

On Deputy Whitmore's question as to whether it is possible to complete a evidence-based assessment in 90 minutes, the answer is "No", as it is not. None of our psychology, speech and language therapy or occupational therapy colleagues would stand over that. It goes completely against all standards that we have and is contrary to our training on evidence based practice. The HSE is asking us to rely on a subjective opinion, as to whether a child has a disability within too short a timeframe. It also goes against all international standards and our training using psychometric testing to be able to get a standardised approach to testing. Staff are being put under intolerable pressure to come to a conclusion based on that 90-minute assessment already, where they literally have to tick a box which states that a child either has or does not have a disability. As we explained in our opening statement, if the clinician ticks one or the other, the child may then go on for further assessment, because it is an assessment to determine whether or not the child needs an assessment. This means that they no longer come under the scope of the Disability Act and then must wait for further assessments. It is a significant challenge and an impossible decision for a clinician to make which, as we have outlined to the HSE, may place occupational therapists, psychologists and speech and language therapists in a position in which they are expected to act contrary to professional and CORU standards. Services are grossly inadequate at present in respect of the number of clinicians available and if they are being put in a place where they are being asked to act contrary to their training, the recruitment and retention of disciplines within the disability services will become much more difficult.

Significant risks also exist in respect of unmet needs. If a child is not designated as having a disability, there are mental health risks for that young person as he or she grows older and wonders what is wrong with him or her, why he or she feels the way he or she does, and why he or she cannot keep up with his or her peers, because such children do not have an identified need for which they can receive support. I wish to echo the points made by Ms Comerford on the cost to parents. The cost to parents of having unmet needs identified makes parents feel like they have missed something, they are not good enough parents and this is simply not fair. Parents are exhausted; they are full-time carers 24-7; they are sitting on waiting lists for three to five years; they are firefighting; fighting the HSE and fighting within the courts. Therefore, the cost in respect of not getting an accurate assessment of needs is a cost to the whole family and not just to the child.