Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputies for tabling this motion. I welcome the opportunity to restate the Government's commitment to children with disabilities and their families. There are important challenges we must face if disability services in this country are to meet the hopes and expectations of those at the heart of the service and to enable them optimise their potential as they mature.

It would be disingenuous to ignore the fact there have been difficulties in certain parts of the country in the implementation of the progressing disability services, PDS, programme by the HSE which have resulted in delays for families in accessing much-needed therapies for their children. That position is regrettable and I offer the Government's sincerest apologies to any family experiencing such delays. Such delays are unacceptable. That is why the Government is not opposing the motion. This House stands together on significantly reducing waiting times for children who require therapy supports. Every day delayed for a child is a day lost in his or her development.

There is a strong possibility that each Deputy in this House has been contacted by a family with concerns around delays in getting an assessment of need, speech and language therapy, occupational therapy or other supports to help their child. The sense of frustration and anger which comes across in the letters, emails and phone calls to our offices is heartbreaking, and parents' frustrations are entirely understandable.

My colleague, Deputy Anne Rabbitte, was appointed Minister of State with responsibility for disabilities in July 2020 and I can say without fear of contradiction that she has been relentless in her efforts to champion much-needed improvements in disability services for children. One of the issues the Minister of State sought to remedy immediately was the number of overdue assessments of need for children throughout the country. At the end of June 2020, this backlog, for a number of reasons, had risen to approximately 6,500. By working with the Minister for Health, the Minister of State secured funding to address this issue and clear the existing backlog. When an issue arose concerning existing special schools-based therapy posts transferring off site to children's disability network teams, the Minister of State listened closely to parents' concerns and additional funding was secured and provided to the HSE to allow therapists to stay on site at special schools while allowing network teams to be strengthened through additional posts.

I am sure the Opposition Members will acknowledge that the Minister of State has had significant levels of engagement with them since taking office, briefing them on the services for children in their constituencies while acknowledging problems and seeking solutions. Future solutions are not the exclusive property of Government and the Minister of State is happy to listen to constructive suggestions, regardless of what side of the House they come from. This is a challenge I issue to the Deputies participating in this debate. Criticism of the present position is accepted but constructive engagement on these issues from all quarters is needed so that we can work together in getting an improved service for the children who need these supports.

The implementation of the PDS programme is agreed Government and HSE policy. This policy supports the reconfiguration of children's disability services to provide equitable child- and family-centred services based on need rather than diagnosis and aligns with the UN Convention on the Rights of Persons with Disabilities. The PDS model addresses the previous inequity in service provision, whereby there may have been an excellent service for some children and little or no service for others. This variance may have been linked to diagnosis, age group or geography. Regardless of the reason, it did not represent optimum practice. Children's disability services are changing from diagnosis-based to needs-based so that all children with a disability or developmental delay have access to the right service based on their needs, no matter where they live.

By the end of 2021, all 91 children's disability network teams, CDNTs, were established to provide services and supports for all children with complex needs in their respective geographic areas. These teams comprise health and social care professionals, including nursing, occupational therapy, psychology, physiotherapy, speech and language therapy, social work and others. The teams work closely together in a family-centred model, focusing on the child's and family's priorities. The intention of this model is that every child with complex needs will have access to a team, regardless of the nature of his or her disability, where he or she lives or the school he or she attends. Children and their families will have access to the full range of services and supports of the CDNT according to their individual needs. This includes universal, targeted and specialist supports such as individual therapeutic intervention and access to specialist consultation and assessment when needed.

It must be acknowledged that the implementation of PDS and the subsequent reconfiguration of services has not been without significant problems, the vast majority of which are related to recruitment and retention of the critical staff needed to service the needs of the children. Since 2019, and including 190 posts announced in the recent HSE national service plan 2022, more than 475 development posts have been allocated to children's disability services throughout the country in specialties such as speech and language therapy, occupational therapy, physiotherapy, psychology and dietary. However, there are recruitment challenges in the disability area due to a combination of workforce availability and the significant level of employment opportunities across the wider health sector. These opportunities provide these personnel with options on the areas in which they wish to work. Working with children with complex needs is hugely rewarding but is also very demanding, and recruitment and retention of staff is presenting challenges to the HSE. These challenges affect the capacity of the service being provided. It is obvious that demand for therapeutic supports is outstripping supply and more therapists are required to meet this demand, but this is a recruitment rather than a resources issue, as evidenced by the funding provided to employ almost an additional 500 therapists for disability services since 2019.

I reiterate my challenge to all Deputies in the House. By all means criticise the Government where it is merited but support that criticism with fresh thinking and new ideas as to how this problem can be resolved. No one in the House, irrespective of his or her allegiance, wants to see a child having to wait a year, month or day longer than necessary to receive therapy supports. I assure all that this Government, and particularly my colleague, the Minister of State, will remain focused on providing the best possible services for children and adults with disabilities.

Go raibh maith agaibh. The Minister of State will respond at the end of the debate.

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