Tom Clonan (Independent) | Oireachtas source

I thank the Minister of State and all her officials for coming in. Before I ask my questions, because of the time of year and the fact that we may be in recess very soon, and it is not certain what will happen in October and November, I will say the following. I first met the Minister of State in 2020, after she had been appointed to the role. I thank her for all the work she has done. She has done it sincerely and against incredible odds. I am sure her officials have had to work very hard as well. I wanted to put that on the record. I thank her for all the support she has shown me, both personally and as a Minister of State, in not opposing my Bill. I really appreciate that. I know her absolute integrity regarding all these matters. I wanted to say that before I ask my questions.

On the CDNT PDS model, the reason it is not working is not just due to a recruitment issue. My understanding is that there was no clinical sign-off of this at the design stage. Who designed the CDNT model? A number of academics were before the committee recently who said that there is no evidence base whatsoever to support the CDNT model as it is currently operated. It is not based on evidence. It is just something that somebody made off. My understanding is that there was no clinical sign-off or risk assessment on it. We are now in a situation where 10,000 children are on that list and people are being harmed for want of timely interventions within the therapeutic window. It is a very serious question to find out who designed that model.

The committee was also introduced to a person who was described as the clinical lead of the CDNT PDS model, Mac MacLachlan. As far as I can see, he is a full professor of psychology in the National University of Ireland, Maynooth. By what mechanism was he recruited and appointed as clinical lead of the CDNT PDS? How did that happen? Is he remunerated for both positions or is he on secondment? How does that work? Quite rightly, there was some disquiet and many questions asked when it was suggested that the Chief Medical Officer, Tony Holohan, be seconded to Trinity College as a full professor. This is the other way round. Here we have a full professor who suddenly appears before the committee as clinical lead. He is not a medical doctor. In addition, he appears to have disappeared. I do not know where he is. Where has he gone? Who is the clinical lead of the CDNT PDS model now?

In other areas of provision, for example, child and adolescent mental health services, CAMHS, I know that the clinical lead is Dr. Amanda Burke. She is a child psychiatrist with higher specialist training and has done all her courses. She is clinical lead but is also amenable to the Medical Council. We are looking at a system that is not fit for purpose, not simply by virtue of the fact we have difficulties with recruitment but that we are told by the experts that the CDNT PDS, and I do not know who designed it, is not based on any evidence model. It has caused a great deal of harm. I am trying to tease out who is responsible.

My other questions relate to assessments of need. In other jurisdictions, assessments of need are often provided on a two- or five-year basis because of the developmental profile of children, and they also provide the services and supports. The suggestion that the two are somehow mutually exclusive has been a slightly recurring theme in recent interactions. It has been suggested that we cannot have, or need to move away from, providing assessments of need together with services and supports. In other jurisdictions, and even based on the circumstantial logic of it and common sense, of course a person should have an assessment of need and then have the services and supports that are identified as necessary. How come they can do that in other jurisdictions? Could it possibly be that it is because they have models of service provision and assessment that are based on evidence and people who are qualified to make such decisions?

I have a final question for Mr. Brunell.

Could he let me know when the transport working group last had an update on developments in that area?