Dr. Maria O'Dwyer:

I thank Deputy Ward for those questions. We were all nodding along furiously because it is unfortunately a very common story at the minute. Currently there are 2,559 children on the waiting list for CAMHS and that will go nowhere except upwards while we are trying to catch up on the backlog. The idea of a post-code lottery is an awful way to have to think about it but it is the reality, depending on the CHO and availability, of how children are going to be assessed. For us, prevention and early intervention means that when you get in early enough it is not compatible to have an aging-out system which is what we are seeing in many of the assessments of needs. If we intervene before a child is six, for example, we have a window for prevention and early intervention with them whether it is for psychology or speech and language therapy. After six it gets harder and harder and they are in a different place in the system. What we are seeing, and this goes back to the post-codes and differences as well, is there are regional variations. This speaks to the need to standardise the approaches and the protocols we take even around the waiting lists themselves. For example, in different regions there might be a child on a waiting list for psychology who, while on that list, can access other interim therapies such as creative therapies in play, music or art therapy. The child will hold his or her place on the list and progress. In some places there can be up to a three-year waiting list for psychology. In other regions a child may be at the same place on the list but to avail of the same interim therapies he or she must pause his or her position on the list which means others climb up ahead of him or her. That lack of standardisation does not support effective prevention and early intervention because what it means is, depending on where a child lives, his or her access to a service will be quicker or unfortunately will come when the child has aged out of the needs or the appropriateness of that service. I will now pass over to Mr. Chance.