Professor Malcolm MacLachlan:

I just wanted to respond to Deputy Cairns' points about the family focus of our services. She made a very important distinction about the importance of responsiveness to families. There is no excuse for our services not responding to families and their needs, other than being understaffed. Not a single one of our CDNTs is fully staffed and some of them are only staffed to about 50%. There is a difference between the capacity to respond and what we have developed, which is family and person-centred services with the new reconfiguration of CDNTs. That is about the process of delivering both assessments and services and supports. We are absolutely committed to that ethos and Ireland is quite progressive on a Europe-wide basis in pursuing that. The distinction between doing that and being responsive to families when they have queries is something we certainly need to address.

The Deputy also asked about clinical risk. Of course, there is significant clinical risk when people are on waiting lists, either for assessment or for interventions. It has been emphasised already that people can miss milestones and develop secondary disabilities so there is significant clinical risk there. If we are going to be required to do considerably more detailed assessments of people through the assessment of need process, then the clinical risk will increase because we will have fewer people available to provide the services and supports needed to reduce that clinical risk. The disability capacity review identified that €1.1 billion is required to meet our current level of demand. That is an additional €1.1 billion.