Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank Deputy Mulherin for raising this matter which reaches into every corner of Ireland. I have no doubt that everyone in the House is aware of the pressures on the health system to maintain services within the parameters of its budget. It has been a topic for discussion over many weeks. Deputy Kelleher has been actively engaged in that discussion. Notwithstanding these financial pressures, I assure Deputy Mulherin that the Government is fully committed to the ongoing delivery of vital services and supports to children with disabilities to the greatest extent possible within available resources.

Over the past number of years the health sector has invested significant resources in services for children with disabilities. For the first time we have discovered that the budget for all disability services is now more than €6 billion. Disability services for children have a long history and many organisations provide excellent support and interventions for children and their families. However, there is a wide variation in the services available in different parts of the country and for different categories of disability. The HSE is working on reconfiguring existing therapy resources into geographic-based teams for children aged from birth to 18 years of age. The HSE's national programme on progressing disability services for children and young people aged from birth to 18 years, aims to achieve a national, unified approach to the delivery of disability services so that there is a clear pathway for all children to the services they need, regardless of where they live, what school they go to or the nature of their disability or developmental delay.

The Deputy raises the issue of professional accountability of nursing staff and their adherence to proper and standardised clinical procedures in special schools. I am not certain this is what the Deputy meant in her Topical Issue matter but I will deal with it. I do not want us to misunderstand each other.

It should be noted that all nurses are legally required to be registered with the Nursing and Midwifery Board of Ireland and are accountable to the public though the board. They must adhere to a code of professional conduct and a scope of practice guidance document. The scope of practice sets out the range of roles, functions, responsibilities and activities for which a registered nurse or registered midwife is educated, is competent and has the authority to perform. This is the case for all nurses, regardless of their employment setting, including a hospital or a special school. The provision of supports in special schools is an issue which involves both the health and education sectors. These special schools are mainly attached to non-statutory disability service-providers which are funded by the HSE. Many of these service-providers will have support staff, including nursing staff, in place. Special schools provide for those children with the most complex special educational needs, beyond what can be provided by mainstream education. Teaching supports are allocated on the basis of very small class sizes. The Department of Education and Skills also provides over 2,100 special needs assistants to special schools to assist in providing for the care needs of pupils attending those schools.

As a result of the considerable medical advances that have taken place in recent years, a small number of children survive premature births or serious illnesses. They continue to have chronic needs that require ongoing medical intervention to ensure their survival. Some special schools catering for children with severe or profound general learning disabilities now have a small cohort of these children enrolled.

The National Council for Special Education, in policy advice to the Minister for Education and Skills earlier this year, recommended a more consistent approach to accessing nursing support for children with high medical needs in special schools through dedicated health service funding,. This recommendation raises significant issues for the health and education sectors. The stakeholders involved, including the HSE, the Department of Education and Skills and the Department of Health, will need to examine this issue fully, including the resource and overall policy implications.

I thank the Deputy for raising this matter.

See this speech in context