Holly Cairns (Cork South West, Social Democrats) | Oireachtas source

First, I thank the Labour Party and Deputy Duncan Smith for tabling this very important motion. I welcome the opportunity to speak about children’s autism and disability services. It is also a sign of a failed Government policy that we are having another motion on this topic. Opposition parties keep having to table motions on disability services and, in particular, on children’s services.

Parents of children and adults with disabilities are one of the groups I meet most frequently, and I think all Deputies will also say this. They are often the most at their wits’ end, beyond angry and frustrated and all they actually want is the basic services their child is entitled to. It is literally the bare minimum. Under the United Nations Convention on the Rights of Persons with Disabilities, each child has the right to appropriate healthcare, education and supports that will help them live independent lives in the community. Moreover, therapeutic interventions are crucial for children and they can be life-transforming. That is why this is such a significant and emotive issue. Parents and families know the difference timely therapies can make. We all know the importance of early intervention.

Another motion on this topic is necessary because this area is too important to let it slip. I accept that the Minister is pushing for change, but this needs to be a priority for all of the Government, the Department of Health, the Department of Children, Equality, Disability, Integration and Youth and the HSE. The recent report by Families Unite for Services and Support, FUSS, which Members will know, has key points that are extremely relevant to this discussion. Its survey of parents, carers, guardians, clinicians and therapists revealed that 97% identified staffing recruitment and retention as a vital threat to the success of service provision. Disability services have been described as disjointed, diluted and clinically unsafe for staff and users. These findings are stark, but they are also unsurprising. There has been report after report after report from disability organisations which have had similar results. For example, a survey by AsIAm from two years ago found that 54% of respondents felt very dissatisfied with the support services from the HSE for their autistic children, with as many as 65% going on to express dissatisfaction with the broader disability services.

The progressing disability services programme is currently not working and there is no other way of saying it. There are more than 4,600 children on waiting lists for assessments of need and over 10,000 waiting over 12 months for initial contact with a children's disability network team, CDNT. There is also the issue of geographic lotteries, with considerable variations in services, service qualities and waiting lists. To give one example, figures from December show that CHO 4, the Cork and Kerry region, has a list of 1,488 children who have been waiting over 12 months for initial contact, while in this category it was 186 for the northwest area and 80 for Mayo, Galway and Roscommon.

There are also the larger differences at a local level, with the CDNT for Carrigaline, Kinsale and Bandon having the largest waiting list in the Cork and Kerry region at 331 in total, with 316 children waiting more than a year. In contrast, the west Cork team had a waiting list of ten, all of whom were only waiting for under 3 months. None of this is the fault of individual teams. The clinicians, therapists and others on these teams are doing everything they can. Staffing is the issue that comes up every time. Teams are not fully staffed, and even if they were, the waiting lists are so bad in many areas you are going to have to hire more clinicians to clear the backlog. The last time we heard about this at the disability committee, not one of the 91 CDNTs in the country was fully staffed. I have consistently raised this matter with the Minister, at the Joint Committee on Children, Equality, Disability, Integration and Youth, at the Committee on Disability Matters and through parliamentary questions. I have encouraged the Minister and the HSE to look at different ways of recruiting staff.

Staff are also deeply frustrated and demoralised. One of the respondents to the FUSS survey explained:

Vacancies are too long empty and it's just a revolving door. In order to progress you've to leave your post. I'm just waiting for something to come up so I can leave.

Of course, therefore, frontline staff are burning out, transferring or going into private practice. As an example of how this could be addressed, there is persistent inequity of how the section 39 organisation staff are treated. How can anyone believe the attempt is meaningful enough to address staffing issues when they continue to be denied pay parity? They have exactly the same working conditions as other people, but they do not have parity with jobs in the HSE.

We have identified that the staffing issue is the main cause at the disability committee, the children's committee and at the AV Room events. This is always what it boils down to. There is a concrete action that can be taken that is a drop in the ocean of the Government's budget, but it is not being taken. The Social Democrats, in our alternative budget, proposed to increase the allocation for section 39 organisations, Tusla-funded section 56 organisations, and section 10 homeless services by a total of €80 million as a first step in addressing this disparity. These issues start even earlier in healthcare professionals’ careers. Nurses are paid shockingly little for their placements in hospitals, but the situation is even worse for therapists, psychologists and others. I have raised this point with the Minister, Deputy Donnelly, repeatedly. The Government has to understand that the key to ensuring young people want to work in the Irish healthcare system is in valuing them from day one.

I welcome the motion’s inclusion of the disability payment in the next budget. Last July, the Social Democrats had a motion calling for an increase of at least €20 per week as a very first step in addressing the costs of having a disability in Ireland and to increase the disability allowance by at least €15 per week. That is a total of €35. Instead, the Government gave €12 more on core welfare payments and several once-off payments. While these provided some help, they did little to address the long-term systemic issues faced by disabled people. A one-off payment for a disability is insulting, because, in the vast majority of cases, it is a matter of 365 days of the year. It is acknowledging it costs more, but only acknowledging it for a day.

The Government’s own report, The Cost of Disability in Ireland, revealed that people with disabilities face up to €12,300 extra costs annually on transport, fuel, equipment aids, medical expenses and much more. Additionally, this report was published before the current cost-of-living crisis. There is a substantial additional cost to living with a disability in Ireland. This impacts an individual’s and family’s quality of life and their future prospects. Most significantly, the social model of disability shows that this is a constructed barrier - Government policies and society make it more expensive to have a disability. It is up to the Government to adjust that by providing a comprehensive and long-lasting solution.

Government kite-flying about the budget has already begun. Before any tax cut is even considered, there should be a firm commitment to providing a permanent cost of disability payment and to funding the massive staff shortages in disability services and healthcare more broadly. Similarly, the motion mentions the need to review the carers' allowance and other income supports-----

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