Oireachtas Joint and Select Committees
Tuesday, 18 October 2022
Joint Oireachtas Committee on Autism
Autism Policy and Health: Health Service Executive
Professor Malcolm MacLachlan:
They provide the same standard of service. I absolutely agree with the Senator. We wish the other one third of unfilled positions in the teams could be filled. People go to the High Court because of the waiting lists that result from that. The fact that the service is not appropriately resourced does not mean the model is wrong. If one is interested in social equity and having equal access regardless of where people live, how wealthy they are and what sort of school they go to, then a community-based model where specialised services are provided in the community is exactly the right way to go. Of course, the model must be resourced.
Regarding people's experience of autism, I am sure members are well aware that, for instance, women and men can experience and express autism in different ways. It is the same with different cultural groups. If we take on board the idea of neurodiversity and intersectionality, that is, the different ways in which people are oppressed, effectively, influencing how they express their experience of autism, this brings us to the operating model of the CDNTs, which is needs-focused. It is focused on individuals and their families. It is they who determine the outcomes they want to achieve. Again, this is because we cannot put people in a box and tell them they have X and this is how they should be treated. There must be much more individualisation and this approach takes on board those intersectional experiences people have.
I hear the Senator's frustration. We have exactly the same frustration and we wish we could provide all the services with all the resources. We do not have them yet, but I ask the Senator not to question the model.