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

I am on the Leinster House campus. I will ask my questions at the start and I will leave time at the end for the witnesses to respond. I thank the witnesses for attending today's meeting and for making a presentation to the committee. I had a number of conversations with people who are directly affected by the standard operating procedure and their children's needs not being met. I will raise some of the cases and I would be grateful if the witnesses could respond to them.

I have serious concerns about the replacement of the assessment of need with the new tool, the standard operating procedure, as it does not increase the speed at which children can access meaningful intervention. It only serves to move them from one waiting list to another and there is no statutory time limit for the second list and therefore little recourse. The Ombudsman for Children stated to the committee that it was like an old-fashioned three-card trick, moving children from one list to another without getting the developmental treatment they require. These concerns have been raised by parents and professionals alike. A parent from Enough is Enough stated to the committee that parents are terrified of their requirement under the standard operating procedure. It could mean that they could miss something in their child's development that could hinder them accessing services going forward. Parents are under enough pressure already. As they said at the committee meeting, they are not therapists themselves. What is the role of parents in the new process and what supports, if any, will parents be given? It was raised directly with me that while the HSE talks about reducing the waiting lists that the standard operating procedure is just a box-ticking exercise, as was mentioned earlier. Therapists involved in providing assessments of need have vigorously and repeatedly opposed the changes and have stated that they will harm children, yet the HSE has proceeded with them regardless. The Psychological Society of Ireland, the Association of Occupational Therapists of Ireland and the Irish Association of Speech & Language Therapists have stated their clearly articulated concerns that the SOP does not address the recommendations of the Oireachtas Joint Committee on Health. Is the purpose of the changes to reduce the HSE's legal liability due to breaches of the statutory obligation to assess children in a timely manner?

I was informed in response to a parliamentary question I asked in the Dáil that the HSE has spent more than €700,000 in defending the State in its failure to provide assessments of need in a timely manner under the Disability Act. That money could and should be spent on providing the service the children need instead of defending the indefensible. Why is the HSE defending the indefensible?

In the North, for example in Derry, children identified as having developmental needs are seen by their local intervention team, which includes healthcare and therapy staff, within eight to ten weeks of a referral. If they are deemed to require an assessment, for example, for autism, this assessment is available within another eight to 12 weeks but, crucially, the child is provided with the intervention in the interim. That is the main requirement. Has the HSE considered that approach as a model of treatment?

If a child gets an assessment of need in this State, the problems are only beginning. I recently received three responses from the HSE, which I will read out but I will not identify the children. Connor, aged seven, was transferred to the school age team from the early intervention team. The current wait for these services is 40 months. Tyler was referred to the school age team and was placed on the waiting list for early intervention. The current wait for the multidisciplinary team is 40 months and the HSE will not offer him a service until 2023. Luke, aged five, was referred to the early intervention team. If Luke turns six while he is waiting on services, he will be transferred to a school age team. The current wait is 40 months and it is estimated that Luke will be offered these services in May 2024.

One can understand the concerns of parents given what has been said by the witnesses today. I welcome some of the initiatives that were outlined. However, it is only white noise to them. They are not getting the treatment their children need when they need it. These are more examples of moving children from one list to another without getting the service they need.

In recent weeks the committee discussed the abuse parents and children received in the mother and baby homes. It was said to me that the State could be complicit in the systemic abuse of children by failing its statutory obligation to provide them with the timely treatment they need in order to reach their developmental milestones. I will leave it at that.