Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank Deputy Tully and Sinn Féin for tabling this motion and colleagues on all sides of the House for their contributions. The Minister of State, Deputy Rabbitte, wanted to be here this evening and she apologises for her absence. As she said in the House three weeks ago to the day, the matters being discussed at that time, and which are raised again in the Private Members' motion, are hugely important and require a ruthless and ambitious focus on our health services and on the implementation of the progressing disability services programme for children.

There is considerable work to do. When I was on the other side of the House, I made very similar contributions to those I have heard today. One of the many reasons I asked to be Minister for Health in the incoming Government was to be able to provide funding, focus and resources for children who need help. It simply is not acceptable in our republic that children should have to wait for an assessment of need. It simply is not acceptable that having been assessed as needing help, they should have to wait any length of time to receive it. We all have friends and family, we all know children who need a service and we all know how important those services are and that children need to access them as quickly as possible.

While some areas of the country are doing well, particularly in some therapeutic areas, the reality is that far too many simply are not. We will have to redouble our efforts in this regard. We have invested the money in assessment and hiring therapists. I assure the House that the Minister of State, Deputy Rabbitte, has worked tirelessly on this issue. She has driven around the country since she was appointed, CHO by CHO, meeting one therapeutic team after another and asking what money and staff they need and what are the barriers to hiring those staff. I, too, have had many of the same conversations. We all know that, unfortunately, there still is a long way to go. The money has been invested and the policy for a national network, namely, the progressing disability services model, although not perfect, is a good approach. There is a very good relationship between the Minister of State, the Oireachtas committee and those of us in this House who are really passionate about this area.

Before addressing some of the technical issues raised, the court ruling and the content of the motion, I repeat that there is a lot more that needs to be done. We all are aware that in every one of our constituencies, there are mums and dads who are desperate to get therapies for their children, whether occupational therapy, psychology, speech and language therapy or whatever it may be across the range of therapies. We are not going to stop until we have made sure the teams are in place at entry, senior and management level to ensure that when a child gets an assessment, it is the right and appropriate assessment, and that when a need is identified, he or she gets help. I know that nobody on either side of the House will stop until we achieve that.

I acknowledge the content of the judgment that was issued by the High Court on the SOP. It is important to state that in terms of the rationale under which the SOP was introduced, the overarching principle was to establish the needs of children rather than providing a diagnosis. It was about establishing needs and ensuring a quicker route to intervention services. It never was intended to prevent or reduce children's access to their legal entitlements. The SOP was developed following a lot of engagement with expert stakeholders, there was an extensive industrial relations process involved and legal advice was taken on it. The procedure was agreed at the start of 2020 and I allocated money towards the second half of that year to the Minister of State to ensure as many children as possible were assessed. There was a very large backlog of children waiting for assessment and we needed to make sure as many as possible of them were seen.

The question rightly has been raised as to what was done to put the therapies in place. We invested a very considerable amount of money in increasing the workforce. However, as has been pointed out by colleagues this evening, by the Minister of State and by the HSE, it is currently challenging to hire, not just in children's disability services but in acute services, adult services and primary care services right around the country. There are a lot of good things happening, the money is there and the posts have been sanctioned across the board. We are hiring many thousands of therapists but it is a challenge and it is one on which we must continue to work.

The court judgment puts the HSE in a position whereby, obviously, it now must consider the assessment of need process. I note the comments by Mr. Paul Reid in regard to the consideration of an appeal. I believe the judgment provides the State with an opportunity. We need to build on the elements of the process that work and we need to eliminate or amend the elements that do not work. I know the Minister of State made similar comments three weeks ago. We need to assess the full picture and gather a lot of information. In this regard, I am conscious of a case in the Court of Appeal, a ruling on which is expected shortly. An independent review of the SOP is under way and is now being finalised. Needless to say, the legal framework for the State takes precedence but it is prudent to gather as much other information as possible.

The core of any future action has to be the delivery of services to children as quickly and effectively as possible in line with the legislation. While addressing the judgment of the courts, which is important and must be resolved, it is worth saying that the assessment of need is only one part of the service delivery. We are very determined to address the standard of that assessment but we also must create a model that ensures the therapies identified, as we have discussed this evening, can be delivered. In that context, the HSE is consulting the chief executives of the organisations designated under sections 38 and 39 of the Health Act 2004, the lead agencies and other stakeholders. In the meantime, the assessment of need will no longer be issued on the basis of a preliminary team assessment. Where appointments have been scheduled, they will form the first step in the assessment of need process.

The initiatives mentioned in the House recently will continue to be developed. As many colleagues will be aware, they include the development of parents' forums. The Minister of State has advised me that she intends to commence the countrywide forums next week, starting in Cork. A major focus for her will be on developing enhanced communication with parents and seeking to build trust in the services provided. We need to listen very carefully to the parents.

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