Dr. Rosalyn Tamming:

That is a difficult question and we are probably too early in the process to be able to say that definitively. I do take the Deputy's point and it reflects what we have heard before. It is disruptive and the child is missing out on educational time when they are away from school and parents have to take time off work and whatever. About 20% of children in CDNTs attend a special school, which is where these initial therapies will go in. One CDNT manager said to us that she did not lose any sleep over the children in special schools. They are already fairly well supported. In a way, it could be argued that the current model of putting therapists into special schools means those children now have better access to therapists than other children do. It is detracting away resources. They are the children who have the most need, but still we have to look at a level playing field, to some extent. There are issues with the equity part of this.

If it is an education-led system rather than a health-led one, the outcomes will always be focused on the educational outcomes. It is very difficult, when developing an individual family-centred plan, to determine what the child's health and social are needs versus their educational needs. These are not equally divided. If a child uses an alternative, augmentative communication device, that is their voice. Whether that is in school or at home, the support the child gets has to be seamless. There is a lot still to be teased out in this area but it certainly needs to be done.