Mr. Tiernan O'Neill:

I thank the Deputy for his questions. To further articulate the points already made, it is about joined-up thinking across Departments. It is not rocket science. It really is not, if we can create a cross-departmental coalition of the willing.

The Deputy raised an interesting question around assessments of need. The waiting list for those will be close to 25,000 by the end of the year. Children are floundering on lists. The old adage is that time waits for no man, but it certainly does not wait for children with additional needs.

We have tried to be creative on the ground. At times it is not so much about money. It is about how we better co-ordinate and align resources. There are lots of money and resources there but it is so disparate and the systems are so disconnected.

I will give an example of how we in Limerick have tried to join the dots. The socioeconomic context in Limerick city is quite stark. According to the CSO data, seven of the ten most disadvantaged electoral districts in the country are still in Limerick city. Marry that socioeconomic context with a child with additional needs. A lot of the children we work with, similar to Ciarán's experience, are really swimming against the tide. Homelessness, addiction and poverty, married with additional need - it is a very difficult landscape for many of our children. We have looked at creative ways to engage additional supports and services whereby, as was alluded to already, schools become hubs for the delivery of services.

An example of that would be the HAPPEE initiative we ran. It is an acronym for the Health Alliance for Practice-based Professional Education and Engagement. In Limerick, we are very fortunate to have the school of allied health in the University of Limerick. We have a pipeline of trainee occupational therapists, speech therapists and physiotherapists looking for clinical placements. Schools are very much a natural habitat for these placements. The issue was that no clinical supervision could be provided because we did not have occupational therapists or speech therapists in the schools to provide the clinical oversight. Through the economic and social intervention fund, which was enabled through the regeneration programme in Limerick, we accessed funding that enabled us to work with the local child disability network team, which is doing tremendous work but has been so frustrated by the waiting lists. Children were foundering on waiting lists with very little therapeutic support. We secured funding that enabled some of its staff to be seconded to a programme where they provide clinical supervision to trainee therapists coming into schools. Six of the most disadvantaged schools in the country were able to facilitate 98 student placements in the past two years. Students came into schools for ten-week and 12-week blocks and provided universal supports and targeted supports under the clinical supervision of OTs, SLTs and physios. It is very simple but it works well. Not alone did the clinicians leave less frustrated, because they were achieving something, there was a pipeline of children coming into an environment children were comfortable in. Parents were coming to appointments in the school. The children were much happier not having to leave the school. They were much more comfortable in their own environment. As well, we were building teacher capacity. We were not looking for teachers to become therapists but just building their capacity. There is a legacy piece there as well for teachers. We joined up the dots, we worked more cohesively and more coherently. The answers are not that complex. They really are not.