Joan Collins (Dublin South Central, Independents 4 Change) | Oireachtas source

I thank Sinn Féin and particularly Deputy Tully for tabling this motion on services for children with disabilities. At the end of last year I submitted a question to the HSE and got a very detailed six-page reply on CDNTs, the SOP, preliminary team assessment, resources and so on. According to that reply, all our problems were solved. It stated that the SOP for the assessment of need process sought to ensure children with disabilities and their families access appropriate assessment and intervention as quickly as possible, and that the approach to assessment of need is consistent across all areas. It broke down what the primary team assessment is as a guideline, and talked about setting up the CDNTs. Clinicians were being brought back from their reassigned Covid-19 roles, overtime was being given, and all this was being done to deal with the SOP. The reply went on to give details of the composition of the teams and stated that they would all be set up and running by the end of 2021.

We have always known the reality for parents because we are dealing with them every day of the week. It is totally different. We know from the Joint Committee on Health last week that not one of the CDNTs is fully staffed and there is an average vacancy rate of about 25% across the teams. Professor Malcolm McLachlan, clinical lead for people with disabilities, said some of the CDNTs are only staffed to around 50%. The CDNT in Armagh Road in my area of Dublin 12 needs 11.7 whole-time equivalents. When that question went in at the beginning of March there were 8.8 staff. They had just recruited two and the two left within a matter of two weeks. That was for occupational therapy and physiotherapy. In Brú Chaoimhín, which is also in my constituency, there are nine vacancies.

Families are extremely frustrated and children are open to developing secondary disabilities as they spend longer on waiting lists. The new Our Lady of Hope special school has no on-site therapist and this is scandalous as it leaves teachers, SNAs and children in very difficult situations. CHO 7 is at 60% of the capacity it should be at. This did not happen today or yesterday. It happened when the Minister was putting questions in as an Opposition Deputy in the last Dáil. It was the same thing.

One parent went through the assessment of need procedure. She put a complaint in because her son was still waiting. They have absolutely no supports for their son. They were advised as to what the parent can do but she has absolutely no support. The reply that came back was very simple: that the staff were not there and her son was going to have to wait until they got staff in the next period. It is very demoralising for the parent. The reply stated that recruitment continues to be a major issue, and while all the teams are doing everything possible, which I know they are, the parent's complaint was being closed on the recommendation that the CDNT would continue to engage with her in relation to her child and that clinically appropriate interventions and therapies would be provided when the appropriate clinicians are on board and her child is reached on the waiting list. These families were given a great buzz about the fact that things were changing, they were going to get their assessment of need, and they were going to get their access to therapy. It has just been smacked in their faces again. That is the terrible outcome of this.

The court case is just damning. I will read a few of the judge's points in my last minute. The judge made a ruling in two test actions brought on behalf of minor children who in judicial review proceedings brought against the HSE sought to quash reports compiled after they underwent SOPs. They wanted their assessments quashed on the grounds that they did not comply with the requirements of the 2005 Act. It was further argued that the SOP findings did not amount to a proper diagnosis or assessment of their needs, which amounted to a breach of their rights. In her decision, the judge said that in order to comply with the time requirements of the 2005 Act, the HSE developed the SOP which was implemented from January 2020. The SOP, she said, provides for preliminary or triage type assessment instead of the full assessments which had previously been carried out. She said the SOP came about because in a significant number of cases the statutory time period fixed for completing the assessment of need was not respected and this in turn led to delays in completing assessments and associated litigation. It is a damning judgment of the HSE. I would really like to know exactly how it affects the 10,000 children who underwent that SOP.

See this speech in context