Anne Rabbitte (Galway East, Fianna Fail)
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There is a lot in that. At all times, my focus and that of the Department is to ensure that the child at the centre gets the intervention he or she needs in a timely fashion. I will be honest. We talk about the special schools. I was in Wexford over a year ago with Deputies James Browne and Kehoe and I visited a special school. I met with the principal, the board and some parents who were part and parcel of the delegation that was there. They spoke exactly to the Deputy's point. Parents were paying themselves to bring in the OT to support the children. To me, that is totally wrong because I have the resources to ensure therapists can go in if we can get them. With the help of the principal, we developed a Wexford model where three therapists - an OT, a physio and a speech and language therapist - were going in. They were reporting back to the CDNT team. There was no breach of data. The parents had chosen the closest school as their option. The therapists were able to report back if they met with Johnny or Mary on how they were doing. Those therapists were going in for the five days. That is the model to which I still aspire. It is a simple model. Where we do not have a CDNT fully resourced, and when I say resourced I mean it cannot attract the required staff for whatever reason and there is a special school or a need, we should be able to recruit therapists, place them within the school and have them report back to the CDNT so there is a follow-up connection. When the staff do come to the CDNT, they have a full picture of what therapies and interventions the child has received.

I have seen in Longford the model to which the Deputy referred, where parents pay for therapists to go into the school. In fact, we can align it to the CDNT team. There is understandable concern within the Department of Education about who holds the clinical governance responsibility. The Department of Education does not want to hold it, nor should it have to hold it. We want to hold it within the CDNT team. All we are saying is that while we are recruiting, it is an interim measure. It is not a permanent solution but it is while we are recruiting the staff within the CDNT team until such time as they can go in.

The Deputy referred to all the different silos. To be honest, the HSE has developed its own national access policy, NAP, where they all are talking to each other. Some CHOs talk to one other better than others and you have the whole mix of it, but I have seen huge improvements under the leadership of Bernard Gloster in respect of the NAP piece. That is where primary care, disabilities, mental health and acute medicine are all talking, not just in disabilities but in older persons and right across the board. They are implementing their own policy and it is far more co-ordinated and child-centred. The whole purpose of the NDA review is to find where are the gaps, what looks good, where are there good performances and where are the better outcomes because where we have good working we need to actually look at that to scale it into other areas. The other piece around the review is to identify why we are struggling to recruit staff into some CDNTs. Why can we not raise the bar there? What is wrong there? Is it a clinical governance issue? That is why we are holding the review.