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

I thank Deputy Ó Ríordáin and the Labour Party for bringing this Bill to the House. Along with my colleague, the Minister, Deputy O'Gorman, I support the Government's decision not to oppose this Private Members' Bill at this stage of the process. I would like to bring the House through my thought process in this regard.

I read through this proposed legislation intensely. By any manner or means, this is not a million miles from the autism innovation strategy I have got up and that I am trying to pull together. This Bill refers to all the pillars within the strategy, such as housing, education, post-primary education, higher education and employment. Deputy Nash spoke very clearly about that aspect. I hope the legislative piece in respect of moving from 3% to 6% will be addressed when the Assisted Decision-Making (Capacity)(Amendment) Bill comes to pass, that is included as part and parcel of it. What has been said by the Deputies referred exactly to all the pieces that explain why I found myself developing an autism innovation strategy.

We must remember that while many people and many Governments might have talked about it, this Government is actually doing it. The reason I am doing this is because I can see in all the different Departments where we are failing families and children with autism, from the very early years to the transition into higher education and then out into employment and to accessing housing. I have taken this approach to ensure we can have the consultation aspect, where the persons in the autism community, whether those are the advocates or the individuals themselves, shape the strategy. It is not the legislators. It is not us. I want this to be led by the people most impacted. I will address why I have done it this way.

All of us in this House know the Department of Education has been failing. We also know the Department of Health is failing. Why is that Department failing? It is because it is needs based and the Department of Education says it needs to have a diagnosis. The Department of Social Protection also says it needs a diagnosis, and if a person does not have a diagnosis, it cannot support him or her. It is to try to break down those barriers and ask how we can make a functioning system work. How can cross-Government, cross-Department and cross-State bodies work to ensure there is better delivery? We will see on Friday what is going to happen, but we already know the process is too long. Twenty-one steps and 18 months are not a functioning part of it. Bringing it back to eight weeks will perhaps make it. Perhaps it will ensure more within the Department of Education will also step up to the plate. No longer should parents and advocacy groups have to beg continually.

I acknowledge and complement everyone in the Gallery from Involve Autism, AsIAm, Families Unite for Services and Support, and Inclusion Ireland. I appreciate all the work they are doing, but it is wrong they should have to do it continually. That is why I believe in this strategy and that there should be various pillars. The Deputy and I agree, as I believe everyone else in this House does, where we need to have the pillars and that level of cross-Government understanding of what autism is about and what is required in the Departments. There is a complete lack of understanding, awareness, empathy and implementation, and that is what the strategy is about. By the end of this year, when it goes out for its second round of consultation, I will invite the Deputy to feed into that process. I would love the Labour Party, and all parties, to feed into it. These are not weightless words. That is where Deputies will see their input being part and parcel of the process.

As I have gone through the Bill, and the Deputies will see all the tick marks I have made, I agree completely with everything that is in the Bill, but I am asking the Labour Party to give me the opportunity to see if the strategy works. That speaks to Deputy Joan Collins's asking of me why I am not supporting the Labour Party. The reason is I want to see first if the strategy works. I am not opposed to legislation. I want to see if I can make the system work and use my position as a Minister of State within the Department with responsibility for equality and inclusion to make other Departments work together and to put the children and their families at the centre when it comes to education, health, housing, employment and transitional planning.

Where I have seen the system work in recent weeks is with the Minister, Deputy Harris, on higher education. He launched a plan amounting to €3 million every year for the next five years for accommodation for children with autism and needs transitioning into higher education. That is how the system should work, whereby there is communication with the system and having that inclusive piece within it. We now need to go back to the start, to the early years piece. We know the AIM process works in the early years. That should be the transition piece that brings us into primary and post-primary education, taking the learning from there.

I speak again to what Deputy Collins said about the CDNTs. I cannot leave the Chamber without acknowledging, because the Deputy has met with the parents, that one of the biggest barriers for accessing many of the services is the health aspect of it. In recent weeks, I have written and put it to the HSE that therapists, occupational therapists, physiotherapists, and speech and language therapists should be added to the critical skills list. They were not on the list; they will be included now. Training behavioural therapists in NUI Galway and not having a behavioural therapist pay scale within the HSE is wrong. I have asked the HSE to add behavioural therapist to the pay scale. We are about autism and behavioural therapy must be part and parcel - a core piece - of it.

We know the figures that have come out and there was no new news on that for me last week as to how many therapists we do not have. The reason the parliamentary question was asked was because people could not believe it when I said it an Oireachtas committee that I was being open and honest about it. The parliamentary question went in and the answer came out. We need to pause the IFS piece. We need to deliver on the intervention. Therapist teams delivering 66% of their time on a desktop exercise and not delivering an intervention is wrong. It is wrong until such a time as the teams are fully populated. Until the teams are fully populated to 90%, I cannot include student therapists in third or fourth year to be part of the assessments for the simple reasons of clinical governance and clinical oversight. Therefore, we need to bulk up the teams.

The final piece on CDNTs and what needs to happen here is, every CHO up to this had only €25,000 for assistance with purchasing private assessments. Some €25,000 annually would not buy five therapy interventions. It is not enough. They have to go to the European level of public procurement so that we will have intervention and assessment on a twin, parallel approach. It cannot be either-or. It must be both until such time as there are enough therapists, and I go back again to the Minister, Deputy Harris, adding an extra 1,056 college places for therapists this week. A portion of those places will be held for occupational therapists, physiotherapists, speech and language therapists and psychologists. By the time those therapists come on board, perhaps we will have the capacity for in-house assessments and doing them ourselves, but until such time, we cannot leave families waiting four or five years.

The preliminary team assessment stoppage was a direction that came from my Department to pause it. The court made its decision. Let us stop faffing around. Let us pause it and find another agile way to approach it. Of the 10,000 who are there at present, 4,500 of them are in critical need of an assessment. There is a plan being devised as we speak for that.

To the Labour Party I say that, while I might not have given the response that was wanted, that is not to say I am totally opposed to legislation. I want to see if I can deliver in making a whole-of-government approach work. I like to think we could. We have seen how it happened in the cancer care strategy. Why can we not do it within autism? It is important to say I have found a willingness on the part of colleagues within Government to work with me, and that is awfully important. What I need now is officials to buy into the contributions that have been made by the families and persons directly impacted. While I might not often agree, if at all, with Deputy Barry, housing is a big part of this and we need to understand accessing housing. Even diagnosis, for the purpose of housing persons with autism, is not on some county councils' radar at all. That is what I am trying to do.

I welcome the debate. I normally do not get a chance to express my knowledge of this area. I also acknowledge the work Deputy Ó Ríordáin and his party have done and for giving me the platform to share this with the House. I do want to work with the Deputy on this issue.

See this speech in context