Thomas Pringle (Donegal, Independent) | Oireachtas source

I fully support the motion and its call to remove the barriers that are currently in place and preventing many children from getting an adequate and timely assessments of need. Early intervention is essential in appropriately meeting the educational and health needs of children with disabilities, yet there are more than 18,000 children on occupational therapy waiting lists alone. This is not acceptable. It is of utmost importance that the long waiting lists are addressed as soon as possible. It is completely disingenuous for the Government to claim these waiting lists have been addressed when that is simply not the case. The short preliminary assessment that was introduced does absolutely nothing to address the issue of waiting lists; it merely moves children onto another waiting list, for further assessment, with no obligation on the HSE to address their assessment within a specific timeframe. The introduction of the standard operating procedure has done nothing but further frustrate families, causing them more distress. It has actually inadvertently lengthened already long waiting lists.

This has been an issue in County Donegal for some time. Last year, I contacted the Minister for Education, Deputy Foley, the Minister of State with responsibility for special needs and inclusion, Deputy Madigan, and the Minister of State with responsibly for people with disabilities, Deputy Rabbitte, on behalf of concerned constituents of mine. I outlined my concerns regarding the proposed changes to the assessments of need system and my worry that, under the changes, children would not receive the opportunity to be assessed according to best practice. I outlined how the Association of Occupational Therapists of Ireland, the Irish Association of Speech and Language Therapists and the Psychological Society of Ireland had expressed concern regarding the new and substandard screening system. Each Minister told me the assessment of needs was under the responsibility of the Minister for Health. However, despite having contacted the Minister for Health, Deputy Donnelly, on 21 April last year, I have yet to receive a response on these concerns. We cannot blame the HSE for that.

It is very worrying that the HSE has become completely unreliable in providing people with the necessary services to which they are entitled. Parents have said they cannot depend on the HSE for anything. That is something we are hearing ever more often. As the Minister of State, Deputy Rabbitte, is aware, it is difficult for anybody to have faith in the HSE at this stage. That might be the crux of the problem and what needs to be addressed. It will be a big task. I am not exactly sure how it can be addressed but it has to be tackled because even the Taoiseach is now saying it is not a problem of money as the money has been provided and all that kind of stuff. It is as if the political system is okay because the Government is providing the money and the HSE is this mammoth standing in the corner that does everything and just eats up money. As far as I know, however, the HSE works for us. I have stated before in the House that the HSE works for all the citizens of this country but it seems to me that we work for the HSE. It seems to me that the role of the Government to give the HSE money with which it can do as it pleases and then people have to put up with a substandard service from the HSE because that is what we deserve. So long as the HSE is working and paying its employees big money, that is okay and everything else is grand. Ultimately, that is the problem. There needs to be a shift and rebalancing such that the HSE comes to terms with the fact that it works for us; not the other way around.

Many parents have been pushed by the HSE into paying for private diagnoses due to unreasonable waiting times. AsIAm conducted a survey, to which reference has been made already, that revealed 80% of parents and guardians had to wait at least a year for an autism diagnosis. How is that acceptable in this day and age? Many families are unable to pay the significant cost of a private diagnosis, so what has been created is yet another system of inequality and inaccessibility for lower income families. Schools have provision to get a couple of assessments done every year, but they hold off on doing so in case they need them at a later stage. Parents who need the service and may not be able to afford it then lose out because schools are holding on to the couple of assessments they are allocated. That is just not acceptable in this day and age. There is something seriously wrong when people are forced into private healthcare because the public healthcare system is unable to adequately support them. That can be said about every area of healthcare. However, the fact that children are not only struggling to get the treatment they need, but are unable to even get a proper assessment of their needs in the first place is particularly shocking.

The healthcare system is overwhelmed and broken. That has been the case for many years - long before the pandemic - and it demonstrates a significant issue in respect of how the system is set up and runs. Unfortunately, I believe the Government lacks the vision and ambition to even address this broken system. Not only that, the Government is actually failing to fulfil its legal obligations. Under the Disability Act 2005, children have a statutory right to an assessment of need which must be carried out within six months of an application. The inadequate preliminary assessment that was introduced is not a viable solution and does not speed up the waiting lists in any real way. It is only a con to try to get over the fact that, under the Disability Act, the assessment has to be provided. it only creates even more complex problems further down the line. It increases the risk of inaccurate or incomplete diagnoses. This has exacerbated the length of waiting lists that already contravene the Disability Act 2005.

In addition, Article 7 of the United Nations Convention on the Rights of Persons with Disabilities provides, "States Parties shall take all necessary measures to ensure the full enjoyment by children with disabilities of all human rights". We are not honouring our commitment to that international standard. This is completely unjustifiable and more needs to be done to ensure children are receiving the assessments of need to which they are entitled. The HSE needs to allocate funding to increase the number of staff and level of service available. It needs to ensure the assessment of need process is comprehensive and identifies the full range of supports and services a child needs, rather than diluting the service that is delivered to children. The current system is nothing short of neglect. These long waiting lists are nothing short of neglect. This needs to be addressed immediately, so I strongly support the motion.

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