Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Chairman and members of the committee for this opportunity to address some of the issues raised in the recent and very welcome report of the Ombudsman for Children on unmet needs. The assessment of needs backlog has been a top priority for me since taking up office as Minister of State with special responsibility for disability.

To put it simply, the current waiting times for services for children with disabilities are totally unacceptable and they need to be improved dramatically. I have made that clear to all in my meetings with the HSE on this very issue. I have watched previous meetings of the committee on this subject and many valid points have been made by various people on the many aspects of the assessment process. Most importantly, the impact on children and families left waiting for assessments and interventions has really been brought to the fore. From the sheer volume of representations from families to my office, I am very aware of the delays in the assessment of need process and the incredible stress and upset this has caused children and their families.

I agree with the ombudsman when he says steps must be taken to fix this problem. We are on the exact same page in that regard. In order to fix the problem, we must ensure that a permanent solution can be found; not just a temporary one. We must develop a sustainable and child-centred model of service. This will ensure timely access to assessments and interventions for all children who require them.

The key to providing responsive children’s services lies in the rolling out of progressive disability services for children and providing services based on need rather than diagnosis. A report on assessment of need published in 2011 by the National Disability Authority found that the assessment of need process worked better and in a more streamlined way in areas that had reconfigured into network teams. In those areas, there was also less emphasis on using the assessment process to develop a diagnosis as a means to access services.

The report of the ombudsman is an honest and thorough examination of where the State stands in terms of its provision of appropriate intervention therapies for children by way of the assessment of need process. There is no doubt that we have failed many children and their families in this process. However, I hope that several steps I am taking within my remit will dramatically improve access to services within 12 months of my appointment as Minister of State with responsibility for disability.

On the issue of resources, the report of the ombudsman states that, "a much greater resource commitment is required in the longer term". Even before taking office, it was clear to me that this requirement needed to be pursued. This is why one of the first things I did as Minister of State was to secure an allocation of €7.8 million Sláintecare funding to eliminate the unacceptable backlog of assessments of need that has built up in recent years. I am sure the committee will agree this is very welcome news.

To ensure that real and tangible progress is being made in clearing the backlog, I have been holding monthly meetings with all the community healthcare organisation, CHO, heads of disability services. The most recent meeting took place on 8 December. I can confirm to the committee that of the 6,558 overdue assessments of need as of 30 June 2020, a total of 1,798 have been completed through September, October and November. This means that by the end of November, the backlog had already been reduced to 4,760.

Of course, that is only one part of the solution as there is no point having an assessment of need completed if one cannot then access the therapies. The elimination of the backlog will free up therapists to devote more time to providing much-needed interventions for children. The more time therapists can spend with children, the more they can help them.

Beyond that, I also secured additional funding in budget 2021 to add another 100 therapy posts to children's disability services next year. That is on top of the 100 therapy posts secured last year.

The ombudsman's report also makes a recommendation for an interdepartmental group on children with disabilities to be established. I would like to point out to the committee that such a cross-sectoral group already exists and meets quarterly to discuss significant issues on children with disabilities. The group comprises members from the Departments of Health, Education and Children, Disability, Equality, Integration and Youth, as well as associated agencies. In addition, there is, at any given time, a number of cross-departmental and cross-agency initiatives being pursued.

In conclusion, I remind the committee that the Government as a whole has committed to a range of actions in order to improve services for children with additional needs and it is my absolute intention to deliver on that. I am proud to hold the office of the Minister of State with responsibility for disabilities and I hope that over my time in this position, I will, once and for all, bring an end to the constant breaches of the Disability Act when it comes to assessments of need. If that is achieved, the Ombudsman for Children will not, I hope, have a need to publish such a report on unmet needs ever again.