Professor Malcolm MacLachlan:

I thank Senator Ruane for the question. It goes to the heart of what the whole PDS reform is about, which is about providing services on an equity basis. This, of course, does not mean on an equality basis, but that the people who most need the services get the sorts of services they need to give them the same opportunities. In terms of people not making it onto the waiting list, that would be a real concern. I would love to know more about that. We had a meeting yesterday where we were told that in one of the CHOs, 40% of the kids on the waiting list there were previously, prior to reconfiguration, not on any waiting lists. Being on a waiting list is not what we want. We want people to be getting an intervention. However, they had previously been invisible to the service. They are now an increased demand on the service, but at least they are on its radar. Therefore, if there are people who continue to not be on its radar, we would be keen to know more about that.

The idea that parents are being blamed and that it is being suggested that it is a parenting issue is absolutely wrong. It is one of the rationales for the individual family plans, so that it is not a matter of clinicians saying what your child needs. It is a matter of working with the family to find out what important outcomes would be, etc. If that is not working effectively, we would love to know that.

Many healthcare professionals come from very middle-class backgrounds. They are often not very skilled in interacting with people from different cultural perspectives and so on. We would like to target that.

On the idea of allocation of staff to children's disability network teams, CDNTs, we looked at that this year on the basis of population versus the number of therapists available within the teams. We want to move to looking at, for instance, social gradients within the different catchment areas. This is because we know the incidents of difficulties around disability are very much associated with socio-economic class and opportunity.

The Senator mentioned the use of artificial intelligence and machine learning. That is an area where there is huge opportunity and a real opportunity for Ireland given we have so many digital multinationals located here. The Global Report on Assistive Technology was launched recently and I am delighted the Minister of State was able to go to Geneva for that launch. One of the reasons Ireland has such an interest in that area is we recognise the opportunity of digital and AI to address some of the social inequities not by replacing human contact but by being better able to target them.