Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank the Deputies for bringing forward the motion. It is important for me to make every minute count. Sometimes I do not get asked questions or they are not selected for Oral Questions to the Departments of Health or Children, Equality, Disability, Integration and Youth, so when I get a motion like this, I welcome it because it gives me an opportunity to lay out my stall on the floor of the Dáil. I thank my colleague Deputy Pádraig O'Sullivan who has kept me company all evening. It is greatly appreciated.

We are here to discuss what I believe is one of the most important and ambitious policy reforms in the health service in recent memory, namely, the implementation of the progressing disability services for children and young persons, PDS, programme. It is clear from the debate this evening that the roll-out of the PDS has not been as smooth as we would like. Several issues have been highlighted and it is important to outline some of the plans on which I am working to improve disability services. I chose to speak at the end of the debate because I wanted to hear the contributions of Members. I hope that somewhere in my contribution we will marry in agreement right across the House.

I wish to put on record my sincere apologies to any family experiencing delays. These families are angry and frustrated at a health service that is failing their children. Parents should not be left fighting for services. I am working to make our services better. I am acutely aware of the issues facing families with children with special needs and it is incumbent on me to meet these families and hear their experiences, good and bad, in getting a service for their children. I have done whatever can be done.

Later this month, I will start a new parents' forum that will take place in every county and give parents an opportunity to air their concerns as well as to hear how PDS should be working for them. I look forward to meeting parents as well as engaging with the HSE and the lead agencies on the matters raised. I will have further details on the parents' forum in the coming weeks.

Investing in children's specialist disability multidisciplinary services is an important priority for the Government. Through the two budgets I have introduced, I have created an additional 375 posts to strengthen children's disability services across the country. This is on top of the 100 posts allocated in 2019.

As well as increasing staff numbers and new recruits, we also need to stop the flow of staff out of the disability area. To do this, there must be more career opportunities for clinicians so that they have the space to further develop their skills in disabilities and to stay working in this space. I have been told by lead agencies and the HSE that there needs to be more senior grade posts and I can confirm to the House that disability services management will appoint more senior posts in 2022 than in previous years. The HSE also informed me that it has indicated to the CHOs that the recruitment of staff at a senior grade, particularly with the goal of enhancing retention, can and will be accommodated. The CHOs believe they will exceed their 2022 allocation and HSE headquarters will consider a business case to allow some increase in senior posts. This is a very welcome change for 2022-23. I will continue to engage with the HSE on the matter.

The role of administration cannot be underestimated and I have secured more such posts in the 2022 budget. Teams need to have a sufficient administration staff so that the clinicians can do their job. We need to recruit into grades 3 and 5 to ensure clinicians are not doing administration work such as answering telephone but are delivering on intervention.

Another important issue raised with me is the increased strain on psychologists. To address this, a request has been made for the use of assistant psychologists on children's disability network teams, CDNTs, which would help ease some of the pressure on an already strained area of expertise. The HSE confirmed to me today that it intends to open the recruitment and deployment of assistant psychologists in line with what was sanctioned and issued to the Department of Health in 2021. We have seen how this use has been bolstered best in the mental health services. We must ensure we are utilising all possible resources to support children and families.

I hope the substantial investment by this Government in all of these resources will go a significant way in dealing with concerns expressed by parents and the Ombudsman for Children. It is important to note that while I welcome this conversation, it is a shame more suggestions have not been made. The assessment of needs process did not work in the past. The standard operating procedure is under review and when that review is completed I will take on board all of the outcomes. We have cleared 98% of the backlog in assessments of need. The SOP was introduced prior to my appointment and I allowed it to go through. I am now awaiting the outcome of the review because we have moved from one list to another and there is no denying that. I will act in accordance with the findings of the review of the SOP. The HSE and the trade unions are engaged in that review process. As I said, I will await its outcome and pursue its recommendations and any potential changes it may suggest.

On autism assessments and supports, I discussed this matter last week during a meeting with the WHO in Copenhagen. Countries across Europe are trying to address issues similar to those we have here and no consistent approach is being taken. All countries are looking around to see what may be the best model of support.

An interesting point raised by the WHO was that in Azerbaijan, a regionalised assessment and diagnosis programme is in operation and appears to be working for that country. It is something that I will look further into with the HSE as there could be lessons learned from it. It involves having a preliminary assessment done by a diagnosis assessment team while, at the same time, the children come straight back into intervention. One of our colleagues at the meeting set out clearly what was being done. What is needed is an assessment of diagnosis and intervention, which should be needs-led rather than diagnosis-led. An assessment should be intervention. To be honest with the House, one of our colleagues asked what was going on and why everything seemed to go into diagnosis.

Questions have to be asked of the education sector when schools state they will only accept children if they have a diagnosis and children will not get supports if they do not have such a diagnosis. Nowhere in the Disability Act does it state that a diagnosis is needed to access education. I accept Deputy Ó Ríordáin's point that the EPSEN Act and the Disability Act both need to be reviewed. There is no doubt about that.

We must strike a balance to ensure that no child is left waiting and I am determined to ensure that disability services are functioning fully and working for families, not leaving them stranded without support.

I confirm to the House that I am working on a package of supports to provide the CDNTs with additional supports to address both the backlog of autism assessments and to provide additional therapeutic supports. I hope to confirm that in the coming weeks.

I assure the House that I will leave no stone unturned when it comes to finding the solutions we have discussed this evening.

Regarding the ratification of the Optional Protocol to the UN Convention on the Rights of Persons with Disabilities, the Minister, Deputy O’Gorman, and I have indicated that we are open to an early ratification of the optional protocol, if possible. Our approach to the UNCRPD since ratification of the main convention has been one of progressive realisation where we make progress towards full implementation step by step and year on year.

I acknowledge the work of parents and I again apologise to the parents of children who are on waiting lists. I acknowledge the work of AsIAm, Involve Autism. I am afraid I will leave people out but Inclusion Ireland and the Rainbow Club in Cork are doing phenomenal work in peer-to-peer support of parents but also in supporting children. The Rainbow Club in Cork is not open even a year at this stage and is supporting 500 families in a particular area. It is phenomenal to see what it is able to do in its community centre. I also thank the Joint Committee on Disability Matters for putting such a focus on disability and allowing various voices to appear before it to share their experience and enable us to take from their learning.

Deputies asked what exactly is happening with the autism strategy. A consultation document will be published in the coming weeks seeking an input from the autism community on what direction it believes the strategy should take and the priority issues it wants to focus on. I have secured funding for the strategy and the next phase will be announced very soon.

I thank both Ministers, Deputies Stephen Donnelly and O’Gorman, for ensuring the funding I will announce in the coming weeks will be provided to deal with the backlog of assessment of diagnosis in respect of autism. Many families are very frustrated about the waiting lists for assessments. I need to ensure, however, that it happens in every CHO. There will be substantial investment and a plan for addressing the waiting list. It will only be as good as the integration into the PDS teams.

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