Dr. Niall Muldoon:

On intersectionality, the constant of our lives in our office is that idea of co-operation, engagement and communication between different elements of a child’s life. We built our Departments and they all work separately. Sometimes they chat to each other. It is the worst way to build any system to provide for children. As a teacher, the Deputy will have seen that in all ways. Whether someone has ASD or is from a minority population, whether it is an ethnic issue or they come from abroad in a refugee situation, none of those are considered when looking at the mental health, because the mental health will just look at that, so to speak. We have constant concern from parents who say they were not accepted into mental health because they have another issue as well.

It ties into the question of what good looks like. When we are talking about what good looks like in providing for our children with disabilities, whatever that disability is, we need to know what that is. What happens in the HSE, the Department of Health and whoever else is engaged with it is they look at what is good with what they have there. They try to build around the system and staffing they have. The pragmatism takes over from reality and what we want to move towards. Universal design, human rights and children’s rights are about providing the best possible system for those individuals. We need to get to a stage where we support and promote our civil servants and policymakers to decide what good is.

Sláintecare was one of the most optimistic things I have ever seen in my life. We had every single party in here for 100 days agreeing a ten-year plan. That was the way forward, yet it is starting to slip. We need to do exactly the same with disability and a number of other areas of intersection, such as racism and support for minorities. Those sorts of areas need to be seen in a ten-year plan. The examples are out there. In Finland, they did it when the were at the bottom of the programme for international student assessment, PISA, scores. They came together over 20 years and decided how to change the education system to reach a target in the future. It takes political agreement and political co-operation so people are not scoring off each other when they decide to change the system. It is the short termism we talked about and that Dr. Conaty very clearly said is detrimental.

The best example we can give is we presented our unmet needs report in December 2020. The Oireachtas committee brought in the HSE and ourselves in, probably, February of 2021. We met with the Department of Health and the HSE in April 2021 and asked them for a roadmap, where they wanted to go for assessment of needs, AON, how it would look, what they needed to get and we told them we would support them to get that. It never arrived. It still has not arrived. We still have our notes. I am looking at my notes here, which state the HSE and the Department of Health are developing a roadmap to progress the implementation of the Progressing Disability Services for Children and Young People, PDS, scheme, including assessment of need requirements. This is now February 2023. The roadmap was to change but it is not there.

Similarly, we are expecting interim clinical guidance. Nobody is saying this is what good is, we need to move towards good, and it will take us five years to get to it. I have always worked on the principle that I am quite happy for any of the Departments to tell me where I need to get to and the stages I will go through. We would all love it to happen immediately but it will not and we know that. What happens is we get a crisis, we throw money at it, we forget about it and we move on until the next crisis comes. I hope I will not be the man in charge anymore or the Deputy or the Minister, but we need Ministers to say they will take a chance and hope people will vote for them anyway when they decide to plan for five or ten years from now.