Dr. Louise Higgins:

To respond to the first question Deputy Collins asked, on how many autism assessments were not done after the preliminary team assessment and need to be redone, the answer is we do not know. As we said, we know that approximately 10,000 preliminary team assessments were completed. We know that just under 5,000 of these need an autism diagnostic assessment but there may be more. We do not know how many of them have been completed but I do know if there are still children and families waiting for assessments. They may have had a preliminary team assessment in 2021. We are now in 2023 and the assessment may not yet have taken place.

All our colleagues here would agree that there is a lot of work to do on recruitment and retention. We all agree that the HSE's panel-based system of recruitment is not working. It is not getting the right people at the right time in place. We are losing many experienced clinicians who may work in a team at what we call a basic grade or staff grade. They build up lots of skills and experience from being on the team but then when it is time for them to potentially be eligible for a senior post, at the moment the national panel system manages that. We can end up losing very experienced staff from disability sectors into other sectors. For a long time, we have been calling for that to change.

Some of the other recommendations are clear such as increasing the number of training places and planning ahead. Regarding an agreed lifespan pathway, consultation needs to happen with the representative bodies, including those here today and with front-line clinicians, as has been outlined. Work is ongoing to establish a pathway. Our understanding is they have been piloted in number of areas but our professional bodies have not been consulted on that. We would clearly recommend that that needs to happen to ensure that the mistakes that happened with PTA do not happen again.