Dr. Cathal Morgan:

I will go back to Deputy Murnane O'Connor's question on investment. She can correct me if I am wrong, but the question was on what level of investment is going into staffing out of the €7.8 million. The €7.8 million is specifically to address the in excess of 6,000 overdue assessments that need to be completed. That fund, given on a once-off basis, is specifically to address the need for additional clinicians, clinicians working overtime and accessing, in certain circumstances, private assessments. However, the key thing is to undertake the assessments.

In the service plan in 2019, we put in more than €6 million for an additional 100 posts. These are therapy grades that have been added to the system and, in this coming year, we will again add more than €6 million for an additional 100 therapy posts. We will provide administrative support as clinicians often say their time is very caught up in completing administrative tasks. We want to free them up, so they are focused on intervention and clinical work.

It is important to make two other comments on staffing. A number of years ago, the National Disability Authority said there was a basis on which we needed an additional 400 therapy posts. That was some years ago. We feel that the additional 200 posts, comprising 100 in the system and another 100 coming, are more than just a good start on that. I am also conscious of the fact that the programme for Government commits to implementing the capacity review report on disability. That provides a basis for the additional 200 posts because we provided evidence for the year-on-year investment that may be required to keep pace with need and demand, in addition to reform interventions. The final point on staffing is that we will undertake a workforce plan later in the year on what is the optimum level of resources needed, not just now but into the future, to respond to the need that is out there.

Deputy Ward made a number of important observations on the experience and involvement of parents. Professor MacLachlan mentioned that through the establishment of the clinical programme and the work we do in supporting the autistic community, we have parents and people with lived experience on these programmes feeding into how we design better services and interventions to meet the real, lived experience of parents. Parents, through these disability network teams, will have close contact with the network teams throughout the CHOs. It is important to emphasise that it is more than just intervention with the child; it is also about what we call family-centred practice. In other words, the carer or parents should be centrally involved in planning for the supports required for an individual. That expands beyond therapeutic interventions. It is also about providing regular access to respite and on occasion, later in life, some people do need residential support. It is taking a holistic view on the needs of children as they move through the life cycle.

Deputy Sherlock referenced the growing number of requests for assessments via the PQ responses given to him, and their exponential rise. Regarding the more than 6,500 that were overdue at a point in time, we are making really good progress with more than 3,000 assessments completed. I will provide more reports to the committee on the detail of that in terms of preliminary team assessments, PTAs, and so on. The additional therapy posts now coming into the system will make a difference to these network teams that are being stood up to do intervention work directly with children and parents. I mentioned the capacity review report, which is referenced in the programme for Government. That is important to us in making sure we have a plan for the year-on-year investment required. We provided much data to help central Government and the Minister of State at the Department of Children, Equality, Disability, Integration and Youth, Deputy Anne Rabbitte, who is extremely engaged, enthusiastic and energetic and was delighted to see that. She has fought very hard for the resources we need, including the Sláintecare reform fund and the additional €100 million we got into our base budget this year.

On the specific needs of people who are deaf or hard of hearing and, in that context, children who are in schools, what the Deputy referenced is the reconfiguration of existing clinicians working on-site within schools on a sessional basis or full time. Two things should be kept in mind. The idea is that children and families will be attached to a network providing interdisciplinary supports. We expect those networks will engage and work closely with the teaching professions and school principals in their given geographical area. That should always be there as a matter of course. Ultimately, while keeping in mind there is a need for investment and reform, we need to ensure there is an equitable distribution of resources so we can respond to more need that is out there.

I think there was a question from Deputy Whitmore, and Senator Seery Kearney may have raised it as well, on our ICT requirements. I did not mention it earlier but it is important to say that the reason we are not able to give sufficient granularity on data is the system we are working with is quite outdated. It is quite an old system but we have gone to tender for a brand new system, which will help network teams. Referencing what Professor MacLachlan said, an integrated system will help clinicians of all disciplines to work in an integrated way through a shared client database system that will give better and more sufficient granularity of detail.

The reason I mentioned my PQ response is there genuinely is a system. I asked the CHOs to administratively review their cases and tell me what they are seeing in terms of the PTAs and what the outcomes are so that I can tell the committee how we have moved from assessment to intervention straightaway so I am happy to do that work. It will mean that the CHOs and the clinicians involved will have to spend some administrative time pulling that together but it is important because we do not want to come away from this session not having instilled some confidence in what it is we are trying to do by way of reform. I am not sure if I have missed anything.