Dáil debates

Thursday, 14 November 2019

Progressing Children's Disability Services: Statements


3:00 pm

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent) | Oireachtas source

I am grateful for the opportunity to have this important debate. When I became Minister of State with responsibility for disability services, I made three firm commitments, namely, to reform disability services, invest in those services and, most important, ensure the services are person-centred. It was essential to learn at first hand about the challenges and practical difficulties faced by people with a disability and their families on a daily basis. Through meeting with families and reading the letters and emails from concerned parents to my office, I am aware that one of the most crucial issues that needs to be tackled within children's disability services is the excessive waiting times to access therapy services. We all share a common desire to have the best services for all children, adolescents and adults with disabilities throughout the country. Both personally and in my capacity as Minister of State, I want everyone with a disability to have access to the necessary supports to enable them to achieve their full potential, maximise their independence and live a rich and fulfilling life.

There are two things that must be done if we are to meet these objectives in respect of children's disability services. Services must be properly organised and they must be properly resourced. The HSE is currently implementing the progressing disability services for children and young people programme, which requires a reconfiguration of all current HSE and HSE-funded children's disability services into geographically based children's disability network teams. The programme aims to achieve a national equitable approach in service provision for all children based on their individual need and regardless of their disability, where they live or where they go to school. The core objectives of the programme are to provide one clear pathway to services providing equity of access for all children with disabilities, according to their need; put in place effective teams working in partnership with parents and the education sector to support children in achieving their potential; and ensure available resources are used to the optimum benefit for children and their families.

The progressing disability services programme is working to meet these objectives by forming partnerships between all the disability organisations in an area and pooling their staff with expertise in the different types of disabilities to form local children's disability network teams that will provide for all children with significant disability, regardless of their disability. Children's disability networks will be established in each of the nine community healthcare organisations, CHOs, comprising specialist multidisciplinary teams to work with complex disability needs. Although a number of these teams have been in place for several years, I acknowledge that it has been a long and slow process to put the remaining teams in place. This is due to the lengthy but necessary consultations between the HSE and the voluntary providers and unions. I am happy that the HSE has advised that we have a final resolution and the disability network managers required to head the remaining teams have been recruited and will take up their posts imminently.

As Deputies will be aware, the Disability Act provides for an assessment of need for people with disabilities. Any child thought to have a disability born on or after 1 June 2002 is eligible to apply for an assessment of need, AON, that will detail his or her health needs arising from that disability. Since the commencement of Part 2 of the Disability Act in June 2007, the HSE has endeavoured to meet the requirements set out in the Act. When the Act was implemented in June 2007, it was the State's intention that applicants would be under five years of age at the time of their application. However, a subsequent High Court judgment had the effect of extending eligibility to all children born since June 2002.

Since the Act's commencement in 2007, there have been significant year-on-year increases in the number of children applying both for AONs and for disability services generally. This increase in AON applications has led to the extended waiting periods for intervention services currently being experienced. I am conscious that timely access to services is imperative to a child's development and I fully understand how delays in accessing the service are a source of great concern for children, their families, and my colleagues in the Dáil. The HSE is currently introducing a major reform of the AON process to reduce waiting times to access both assessments and services.

I refer to the new standard operating procedure for assessment of need. While the Disability Act provides for an AON for people with disabilities, it does not define this assessment and, to date, the process has not been standardised across the HSE. This lack of standardisation and clarity has also contributed to significant delays in the AON process. The new standard operating procedure will provide for a consistent approach to assessments throughout the country and the HSE is confident that it will greatly improve access both to assessments and interventions. All community healthcare organisations, CHOs, are currently preparing for this implementation, which will commence nationally in January 2020.

Budget 2019 provided funding for an additional 100 new therapy posts for children's disability services to be in place by the end of this year. This welcome new resource will result in additional new therapy posts, including speech and language therapists, occupational therapists, physiotherapists, dieticians, social workers and psychologists. Some 63 of these posts are in place with the remaining 37 expected to be in post before the end of the year. This latest recruitment of staff should be considered in light of previous investment, totalling €14 million since 2014, in therapy services under the progressing disability services for children programme. This investment has allowed for the provision of 275 additional therapy staff. In addition, significant funding has been provided to primary care services to improve waiting times for therapy services. This has allowed for the recruitment of both additional speech and language therapists and occupational therapists.

The Minister for Health recently announced €2 million in funding for the further development of an autism plan, which includes the implementation of a range of measures to improve health services for people with autism and their families. The funding secured will mean that a range of priorities can now be further developed and implemented. Children and young people with autism comprise a large proportion of the individuals that the HSE meets in disability services, but also in primary care and other health settings. It is important that the health services are equipped at every level to deal with these individuals and their individual sets of circumstances.

The HSE has established a national autism spectrum disorder, ASD, programme board consisting of senior operational and clinical decision makers as well as independent professional and academic support. More important, persons with lived experience of autism will participate as equal members of this important collaborative team effort. The board has been tasked with leading on an agreed set of priorities that will have the greatest impact on improving how services can be delivered to people with ASD and in respect of creating greater awareness of ASD.

Over the next year, the additional funding secured will be used in two priority areas, chosen after comprehensive consultation with service users, parents, and clinicians working in services for people with autism. The first area relates to implementing a programme of awareness raising that can provide a better information resource for children and parents about the supports available and help to create a wider public environment that is more aware of the challenges, needs and experiences of people with ASD. The second priority area relates to building capacity and competence amongst key professionals working with ASD. This is to include a national training programme for clinicians and the implementation of a tiered model of assessment to improve access to, and responses by, services for those with ASD.

As Minister of State with responsibility for disabilities and as a parent, one of the most frustrating experiences for me is meeting the parents of children who have additional needs and who are waiting for therapy services for their sons or daughters. I understand how justifiably angry they are at the length of time they spend waiting for a service. I am fully aware of how important early intervention is and how it can determine not only short-term outcomes but also shape a child's future. The initiatives I have outlined will not lead to a quick-fix solution to the problems of long waiting times for therapy services overnight but they are important, robust and tangible measures that will vastly strengthen and improve our services in a way that will ensure we can provide what children need in both the short and long term.


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