Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann:

notes: — the High Court judgment of 11th March, 2022, in C.T.M. (A Minor) v Assessment Officer and Anor, J.A. (A Minor) v the Health Service Executive 2022 IEHC 131, which found that the 2020 Standard Operating Procedure (SOP) adopted by the Health Service Executive (HSE) was causing its Assessment Officers to "err in law", and that the HSE do not intend to appeal this case;

— that the HSE is in breach of the rights of children with disabilities, as set out by the Oireachtas in the Disability Act 2005, when it does not conduct an Assessment of Need (AON) which identifies the nature and extent of a disability and the corresponding level of service need;

— that the HSE has not submitted a report as required under Section 13 of the Disability Act 2005 since 2015, despite being required to do so annually;

— that, when questioned about the deficit in Section 13 reporting, the HSE have blamed "the outdated database we are currently using" which "was developed by a small software development company, which no longer provides maintenance or technical support for the system", and acknowledged that "the database is 20 years old and has not had the necessary upgrades or technical changes in recent years", but stated that they intended to complete the outstanding reports by year end, in response to Parliamentary Question No. 762 of 1st March, 2022; and

— that fears have been raised by activists, families, and members of the Oireachtas that a review of the Disability Act 2005, as advised by the HSE, could lead to a dilution of the rights of children with disabilities; reaffirms its commitment to upholding the rights of people with disabilities;

agrees with the assessment of the Ombudsman for Children that the review of the current AON operating procedure is now redundant, and the current procedure is untenable;

further notes the passage of the Sinn Féin motion in relation to Assessment of Needs for Children with Disabilities on 8th March, 2022, with the assent of the Government, which called on the Government to: — establish Children's Disability Network Teams (CDNTs) in full;

— report to the Dáil on how it intends to ensure that all children have a proper AON and real access to the services which they need;

— publish a costed and timebound implementation strategy for the Disability Services Capacity Review and a cross-departmental strategic workforce development plan; and

— transparently publish all waiting lists for these services; and calls on the Government to: — ensure that the rights of children with disabilities are not undermined and, that, if the Disability Act 2005 is to be reviewed, the existing rights of people with disabilities are not diluted and that children with disabilities have access to the services they need;

— immediately ensure that the Assessment Officers' System Database which is used to manage and report on AON and access to children's disability services is updated to reflect changes in policy, operational practice and user requirements;

— engage in proactive, joined-up workforce planning to develop a cross-departmental strategic workforce plan for the breadth of health and social care services, streamline the recruitment process, and work to entice health and social care professionals who have recently left the HSE to return to the public service;

— review the critical skills list in the context of demand for health and social care professionals, while remaining cognisant of the State's international obligations;

— urgently implement the Optional Protocol to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) allowing individuals and families means to challenge the Irish Government on any current or future failures to guarantee the rights contained within the UNCRPD;

— provide a job guarantee to health and social care graduates and proactively engage with them during their degree to advise on employment options in the public health service;

— lay a report before the Houses of the Oireachtas within three months outlining in full the number of Whole-Time Equivalent staffing posts that will be provided to children's disability services for 2022, including the details of the package of supports to provide CDNTs with additional resources to address the backlog of AON and AON which were conducted incorrectly, and to provide additional therapeutic supports as indicated by the Minister of State at the Department of Health, Deputy Anne Rabbitte, in her address to the Dáil on 8th March; and

— report back to the Dáil before the summer recess on how it intends to fully address the matters in this motion and the motion of 8th March, 2022, and lay each outstanding Section 13 Report before the Houses of the Oireachtas by the end of the year.

The focus of a recent motion on disability services was to call on the HSE to stop using the standard operating procedure, SOP, which involves carrying out preliminary team assessments and implying to parents of children with disabilities and additional needs that this was fulfilling the statutory right of a child to a full and proper assessment of need. We indicated that this is not the case and that the HSE must stop trying to avoid its obligations under the Disability Act 2005.

Our call has been further vindicated by the recent High Court ruling in C.T.M. (A Minor) v.Assessment Officer and Anor, J.A. (A Minor) v. the Health Service Executive which found that the standard operating procedure adopted by the HSE in 2020 was causing assessment officers to err in law. I welcome the fact that the HSE does not intend to appeal this case but urgent measures must be taken to ensure that all children with disabilities are getting access to a proper and comprehensive assessment of need which would identify the nature and extent of disability and the corresponding level of service needed. Children are entitled to this assessment within a period of six months from when they first apply, with an additional month to allow for a service statement to be drawn up which will outline the precise services and interventions that they would require, going forward, to address their disability or additional need.

There is a serious problem among the 91 children’s disability network teams, CDNTs, because it seems that none of them is fully staffed and in fact many of them are operating on a 50% to 60% staffing level. Even if the staffing level was at 100% of the level currently resourced, it has been relayed to me by numerous staff within the CDNTs, including management, that this would still not be sufficient to meet the level of need among children requiring assessment and services. Parents are very aware of this, with one parent responding to a survey from Down Syndrome Ireland by saying that there are not enough therapists to deal with the increased numbers, that there is already a major shortage, and that their client load will now be completely unmanageable.

It is this shortfall in staff and resources that has led to the long delays that parents of children with disabilities face, the extent of which is reflected in a recent report from Inclusion Ireland which states that many parents have reported that their children have spent a significant time on waiting lists for services. Some 85% reported that they had waited or continue to wait for more than a year. Of these children, 27% were waiting two to four years, 16% were waiting four to six years, and 5% for six years or more. We need to see a fully costed implementation strategy and a strategic workforce development plan within a specific timeframe indicating precisely how the shortfalls in the disability sector are going to be addressed.

There are very significant problems within the recruitment procedures for therapists and clinicians to the disability network teams. The recruitment systems to me seem to be archaic and take an inordinate amount of time to actively recruit someone to a position. We need to see an end to the national panels and instead look at recruitment on a regional basis within a very short space of time. Many therapists have left this sector as they would not and could not agree to the preliminary team assessments. Now that the High Court ruling means that this practice must cease, perhaps some of those who left could be enticed back to the sector if offered positions at suitable grades.

The disability sector is receiving bad press due to the preliminary team assessments and the long waiting lists that are ever-growing for assessments and therapies. This was reflected recently in a survey conducted by AsIAm which found that 54% of respondents felt very dissatisfied with the support services from the HSE for their autistic children, with as many as 65% of respondents going on to express dissatisfaction with the broader disability services. This is unfair on the very dedicated staff working within the disability sector where teams are under-staffed and under-resourced to carry out the tasks that they have been set. This negative publicity has become so bad that people are reluctant to work in this sector. This must be addressed. The blame for this lies entirely with Government policy and with years of neglect of this sector. There is a need for a long-term plan to address this to ensure CDNTs are fully staffed and fully resourced in the years to come.

I am very concerned about the children who require intervention and therapies now. Early intervention is vital for children to progress in life. Many who do not receive early intervention cannot progress to be the best version of themselves and will require more interventions and supports in later life, meaning that they will be less able to lead a fully active and independent life. The Government needs to look at urgent measures to address the immediate requirements within the sector to ensure that all children’s needs are met.

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