Ms Linda Kelly:

The situation with children's disability network teams, CDNTs, is dire. There is no sugarcoating it. Everybody recognises that. Looked at from the perspective of a family or parent, it is overwhelming to try to deal with the challenge in both health and education. Everything we try to do collectively has to be about making that process easier for the family at the centre of the service. Our members on the health side, in terms of health and social care professionals, are clear that they want to provide a high quality public service to children with disabilities and their families.

We talk about engagement with the HSE or about leadership, such as in the three pages in the appendices around all of the issues concerning children's disability network teams. Clinicians are asking questions, some basic and some more in-depth, and there are no answers coming. When you look at what happened in recent weeks around the Government decision to reinstate health and social care supports to school, we had a gap of four weeks where there was no engagement from the HSE with us as the representative body for all of the staff working in CDNTs, even though we made ourselves available to be a willing partner in a constructive process. We were against the decision to remove them in the first instance.

When we eventually got to meet with the HSE and got into the detail of what would happen, there was a comment to the effect that this was about returning health supports to education settings. Okay, what does that look like? Nothing. How did the HSE propose to carry out the first tranche of recruitment for bringing people back into special school scenarios, which is only one educational setting? The other educational settings are totally excluded from this decision, which is another area that clinicians have a concern about because it reinforces an inequity in the system. We are talking about children now accessing two different teams, which I heard from a parents' group last night is being misrepresented across the system as people being obliged to transfer teams. Families do not need to be dealing with this. The answers are in services, with clinicians and with families. Where is the investment into a change programme as fundamental as progressing disability services for children and young people, PDS?

There is acknowledgement that the communication strategy within the services is not working. Where is the resolution for it? So many things can easily be resolved. We have clinicians who do not have offices, clinical rooms or access to assessments. How are they to provide the service that families feel they require in order to hop over the arbitrary fence into education? It is hugely difficult. When the workforce planning was done last year on 11 October - they will repeat it on 12 October this year, apparently, which is not far off - teams were operating at about 30% less than their capacity. Most of that is unfilled posts but a number of those posts are to do with the gendered policy decision not to replace people going on maternity leave, which has a significant impact in a female-dominated profession.

It was something that came about during the austerity years and it absolutely has to be addressed. Not only is it an issue for those who are not on leave having to deal with the increased workload; it also makes it very unattractive for women to want to come to work in these services. The HSE's implementation of this plan from the Government is to reassign people. If a children's disability network team is operating at 70% capacity and the HSE wants to reassign some of those people to provide a service in a special school, it means children on the list who are not attending at primary school will have fewer people to work with them. It needs leadership from the HSE which is just absent at the moment. It is causing so many systemic issues that have now rolled into such a multitude that it is seen as an Everest that somehow cannot be fixed. It is infinitely fixable if there is leadership and investment. Certainly we see that from the discussions with our members.