David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I will share time with my colleagues, Deputies Tully, Ward, Martin Kenny and Gould. I thank the Leas-Cheann Comhairle and Minister of State.

I appreciate the opportunity to speak on this important Bill, which Sinn Féin will not oppose. It gives effect to the Government decision to transfer responsibility for specialist community-based disability services from the Minister for Health to the Minister for Children, Equality, Disability, Integration and Youth. We can now add "disability" to that Long Title.

The Bill, while largely technical, is quite substantive and will ostensibly bring an additional layer of accountability for the development and provision of disability services once fully implemented. It will give the Minister the power to give directions and set priorities for the HSE in the delivery of these disability services and make it separately accountable to the Minister for them. However, that will not automatically improve disability services. This will require substantial sustained investment and services to train and retain more occupational therapists, speech and language therapists, physiotherapists and other specialists in the empowerment of people with disabilities.

Many challenges in this area need be addressed urgently. The absolute priority must be tackling waiting lists and reducing wait times. This must be done across a range of services to improve access to assessment of need for children and especially young people. We must improve access to speech and language therapy, physiotherapy, counselling and the wide-ranging supports many children and adults need to help them live a full and independent life.

Responsibility for children's mental health remains with the Department of Health but there is an onus on the Minister with responsibility for children and the Minister of State with responsibility for disability not to lose sight of the toll on children's mental health that is caused by obscene waiting lists for disability services and the difficulties that being differently abled in this world can bring. At the end of last year, 4,000 children were still waiting for an assessment of need and more still were waiting for further diagnostic assessment. In the south east, more than 1,000 children are waiting for diagnostic assessment. The Ombudsman for Children cited one case of a 6-year-old who has been waiting for assessment for four years. That is an unacceptably long wait. An unacceptably high number of children who are waiting when a child's entitlement to this assessment is, and should be, within three months.

There are also significant concerns that due to pressures services are under as a result of understaffing, assessments are not being carried out as thoroughly or extensively as even the professionals carrying out the assessments would like. We have all heard anecdotal evidence from those professionals in that regard. We see it in many areas in healthcare. We saw it with the child and adolescent mental health services, CAMHS, and see it in other areas where real pressures with regard to staffing capacity can make life very difficult for those trying to provide services. That is without going into the thousands of children and adults on waiting lists for speech and language therapy, physiotherapy and counselling.

In more recent times, a person does not need a diagnosis and, essentially, the assessment for some of the services to follow but in practice, that is not always the case. The experience of many families when it comes to their children is that the range of therapies a child needs are not always provided. It can be very patchy; a bit here and a bit there. Very often, they have to battle with the system to actually get the services a child needs. It is all down to a lack of capacity. We have a system. Those at regional level are trying their best to provide the service to as many children as possible but it is equivalent of the loaves and fishes in trying to do it. We must, therefore, advocate for all those children.

In conclusion, the way in which society currently operates places many barriers in the way of differently abled people. They have been consistently disadvantaged by a lack of State supports to overcome these barriers. This has led to disempowerment, dependence and a loss of control and choice in people's lives. To counteract this, it is incumbent on the Minister of State to ensure a real whole-of-government approach to empowerment and to deliver a new social model of disability inclusion. I hope she will work closely not only with the HSE and Minister for Health in improving the health and social care services people with disabilities need, but also with the Minister for Housing, Local Government and Heritage to ensure appropriate housing provision, the Minister for Social Protection to ensure adequate income supports and the Minister for Enterprise, Trade and Employment to ensure everyone's right to work is not impeded by obstacles that people with a disability have to face because, unfortunately, they are different.

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