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

I welcome the opportunity to speak on the topic of autism and disability assessments and supports today. I thank the Labour Party for bringing this motion forward.

All 91 children's disability network teams, CDNTs, are up and running since 2021. The establishment of these teams was part of the reconfiguration of children's disability services and the aim was to ensure fairer access and clearer pathways to assessments and therapies for children and young people with autism or a disability. These aims are simply not being met. We are failing children and young people who need timely and appropriate assessments and therapies. The numbers waiting for an initial contact from their CDNT demonstrate this. More than 17,000 children and young people are waiting. Almost 11,000 of those are waiting more than 12 months.

The latest CDNT staff census and workforce review reveals that the staff vacancy rate has risen from an average of 28% in 2021 to 34% in 2022. There were 707 posts vacant across the 91 children's disability network teams. Some teams have vacancy rates of more than 60%; one team has a vacancy rate of 68%. In my county of Cavan, the vacancy rate is 41% and in County Monaghan it is 47%. In fact, Cavan has worsened since that census was done and we are about to lose our only speech and language therapist in the coming weeks.

In February this year, the Joint Committee on Autism engaged with some of the organisations representing therapists involved in the CDNT, namely, the Psychological Society of Ireland, the Irish Association of Speech and Language Therapists, and the Association of Occupational Therapists of Ireland. I was shocked to hear from these organisations that although they had requested meetings to discuss the best way forward in the implementation of the children's disability network teams, they were never, and still have not been to my knowledge, facilitated in this regard by the Department of Health or the HSE. Turning a deaf ear to those on the front line, who are delivering the assessments and the therapies, is most definitely not the way to ensure the CDNTs are fit for purpose and delivering for children and young people with autism or disabilities. Meaningful consultation should have taken place with these organisations well in advance of the reconfiguration. Consultation should now take place without further delay and should include representatives from the HSE's national clinical programme for people with disability, HSE operations and HSE resourcing.

Sinn Féin brought forward a number of motions in 2022 relating to children's disability services and each of these called on the Government to put in place a comprehensive workforce plan to train, recruit, and retain CDNT staff. This plan was to be completed at the end of quarter 1 of 2023. The Minister said his roadmap is imminent. Have the organisations representing therapists been consulted in this process? Does the roadmap progress delivery of the terms and conditions for section 39 workers? Has it looked at the issue of career pathways for staff?

The programme for Government has a commitment to extend the remit of the National Treatment Purchase Fund, NTPF, to secure timely assessment for both child and adult psychological services. This commitment has not been delivered. In a letter to me, the Minister said that the joint waiting list initiative has been used to source assessments. I welcome that but we need to use every possible avenue to ensure urgent access to assessment of need, AON, and to services. I am hearing from families who are receiving service plans outlining the services their child requires after the AON has been carried out, with no service date. It is that far ahead in the future that they cannot even be given a date.

We have a lot of people from other countries coming into this country, in particular from Ukraine. Has a skill set been established of those people? Have we found out what their skills are and how many might be qualified in the areas we need within the CNDTs? Maybe with a little bit of work, if their qualifications need a bit more to meet the qualifications required here, they could work in those CDNTs. I do not think that has been done.

The Disability Act 2005 was specifically designed to advance participation of disabled people in society, both by improving access to mainstream public services and supporting the provision of special service where required. Given the developments within the Irish landscape since its enactment, such as the adoption of the UN Convention on the Rights of Persons with Disabilities, a review of the Act should be undertaken to update it and to encompass a rights-based approach to disability. That view has been expressed by the National Disability Authority, many disability groups have made similar calls, and several committees including the Joint Committee on Children, Equality, Disability, Integration and Youth, the Joint Committee on Disability Matters, and the Joint Committee on Autism have all called for that Act to be reviewed. It could and should have taken place in tandem with a review of the Education for Persons with Special Educational Needs Act 2004. Those pieces of legislation were originally drafted to operate in a joined-up way and this needs to be reflected in any reviews.

Sinn Féin committed in its previous alternative budgets to develop and implement an autism plan and a new carers strategy as priorities and it will do that.

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