Mr. Paul Reid:

One of the Co-Chairmen has introduced the supporting team who are with me today, so I will not read out their names again. It is a pleasure to present to the committee along with the Minister of State.

Children with disabilities or developmental delays access health and social care services in a variety of ways. Most of them access services such as occupational therapy, psychology or speech and language therapy through primary care services. Children with complex needs access specialist disability services from the HSE and section 38 and section 39 providers. Children's disability services have developed in an ad hocmanner whereby some children have received an excellent service and others have not done so. The provision of services was inequitable and highly dependent on the child's disability, his or her age or where he or she went to school or lived. Establishing children's disability network teams is an integral part of Sláintecare's health reforms and is a key policy commitment in the programme for Government. These teams will provide a better and clearer pathway with fairer access to services for all children with a disability based on their needs, utilise and fairly distribute available resources for the benefit of all children and their families and ensure effective clinical teams work in partnership with families and educational staff to support children with disabilities to reach their full potential.

The HSE is committed to providing high-quality and safe health and social care services to all service users, including those with disabilities and their families. The HSE fully accepts that there are very significant challenges in current service provision, the level of unmet need and engagement and communications with service users and families. In this regard, the HSE is committed to working with the Minister of State and all relevant stakeholders to ensure we provide appropriate supports for children with disabilities and their families.

At a recent meeting with the Minister and the Minister of State, the principles of the Progressing Disability Services, PDS, policy and service model were restated and agreed as the continued implementation imperative while also acknowledging that the transition to policy based CDNTs has been challenging for many families and staff.

The HSE, in collaboration with departmental officials, is working to develop an overarching roadmap to support all stakeholders to support children with disabilities. This roadmap will be completed in the coming weeks. The document will broadly address the following key areas: communications and engagement with families-service users, Departments and relevant Ministers; reporting on CDNT activity; workforce planning; family-centred practice; education sector engagement; a process for ongoing review of the implementation of the PDS model; and assessment of need under the Disability Act 2005.

The Minister of State and I also attended a recent workshop involving clinicians, managers, service providers and family representatives. This workshop is informing the development of clinical guidance to guide practitioners conducting assessment of need to take account of the recent High Court decision. The HSE is also committed to an initiative to address the assessments required as a result of this judgement in addition to a commitment put in place earlier this year to provide 1,000 assessments for autistic children and expects to finalise the plan for this shortly.

HSE children's disability services have been reorganised under PDS. The aim at the heart of PDS is to achieve fair access to services for all children with disabilities based on need. Before this policy, children in different parts of the country with the same needs could be given much more or much less service based on geography rather than need. This was unfair, inequitable and needed to change. Making that happen is one of the most complex change programmes undertaken within our health service and while we have made good progress, we have a lot more to do before it is complete.

The HSE is facing some specific challenges in CDNTs, including a high level of staff vacancies and a limited employment market, large caseloads and long waiting lists and the legislative focus on assessment rather than intervention. Recruitment is a major challenge across the health system including in disability services. The HSE is progressing all available options to secure the necessary staff and we can further elaborate on actions we are taking to recruit staff. We recognise that difficulties accessing services create additional stress for families. Our programme of reform is intended to ensure that children have timely access to services based on their needs. The HSE regrets the negative experience of families where the current service may fall short of what is required to meet the needs of their children. This concludes my opening statement and together with my colleagues, we will endeavour to answer any questions members may have.