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

I welcome the debate on the issue of services in autism disabilities. I thank the Labour Party for bringing forward this motion today, giving us the opportunity to discuss it. I wish to read into the Official Report part of the contribution by Mr. Adam Harris from AsIAm to the Oireachtas Joint Committee on Autism on 16 May 2023. He encompasses a lot of the issues we have discussed:

Many members of our community can point to numerous policy initiatives over the years that were promising and that reflected community priorities but that sadly simply never became reality. They became reports gathering dust on shelves ... The strongest tool to at least monitor implementation would be the passage of legislation along the lines of Malta’s autism empowerment Act from 2016. To be clear, the latter is not designed to address every issue facing the autistic community, nor is it designed to create a new schedule of rights for autistic people over and above what exists for other disabled people.

This legislation would simply require the State to publish an autism strategy at regular intervals, to involve autistic people in the process of drafting and monitoring the implementation of the strategy and to require the relevant Minister of the day to report on progress annually. We know it is not uncommon for the State to have overarching strategies for broad policy areas, with specific strategies or focuses where they are clearly required. [For example, Sláintecare does not prevent the publication of a national cancer strategy.]

It is reassuring for us to see the broad political support at present for a national autism strategy, and the work of the Minister of State, Deputy Rabbitte, in the promised forthcoming autism innovation strategy ... [but] we know it has faced significant opposition from Government Departments in the past and we are concerned that a general election could see this go right back to day one unless it is protected by legislation. We also know there is strong support for this within the general public, with 75% of the Irish public answering "Yes" to the question “Ireland should have a law in place to ensure we have a National Autism Strategy”. Unsurprisingly, 96% of autistic people share these views.

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We are conscious that several important pieces of work are taking place, including the Government’s forthcoming autism innovation strategy and the HSE's autism programme board, which is based on the HSE review of autism services in 2017. It is important that the committee consider these two pieces of work in any recommendations it might make so as to avoid conflicting plans or a watering down of any solutions.

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[On human rights compliance] AsIAm welcomes the recommendation of the Oireachtas Committee on Disability Matters on behaviour-based approaches, which have caused much harm to many in our community. We would also point out the large number of so-called therapies and therapists that operate in the field of autism that are not regulated and which practices have no scientific basis. This poses a waste of resources for families at best and exposes autistic children and adults to significant risk of harm at worst.

Mr. Harris noted that the failure of the State to protect the term of "psychologist" and to provide formal guidelines for autism assessments continue to expose community members to inexcusable harm. AsIAm does not agree with educators filling out the education section of the assessment of needs and says it may face challenge in the courts in the future. It fears a conflict of interest among educators. Mr. Harris went on, "We ask that the committee's recommendations place a strong emphasis on all supports for autistic people funded by the State being evidence-based and human rights-compliant." AsIAm also asks that stringent regulation of therapies and practices in this sector are drafted and implemented.

Mr. Harris added:

To achieve an equitable Ireland for autistic people, two distinct ranges of actions are required. First, we need timely and effective autism-specific supports, such as access to assessment, therapies and educational services. Second, we need to autism-proof every aspect of Irish society, particularly all public services, to ensure autistic people have parity of access to supports such as healthcare, social protection, employment and housing.

Mr. Harris also spoke about the role of community, which is a very important point. I am involved with and in contact with parents’ organisations in our communities in Crumlin, Dublin 12, in Bluebell, in Ballyfermot, and all around the country. These groups should be recognised. They are the ones that have strengthened the autism community. Mr. Harris said:

Most of these groups operate on a shoestring or have little to no funding. We would like to see ... [this addressed] and support [for] the development of autistic-led groups across the country, while ensuring every area also has access to ... [a] parent support group.

It is important to bring that into the discussion and maybe get the Minister of State's response to it. We have a scandalous situation whereby children and parents who are entitled to assessments of need and education are not meeting their full potential. It is a Third-World service in a First-World country. We have to recognise that. Even yesterday, and was mentioned earlier, when the Minister of State was before the Joint Committee on Autism, it seemed there was no amount of money she does not have to create new jobs. She made the point that in HSE disability services, there was funding for 190 posts in budget 2022, while budget 2023 contains provision for a further 136 posts to provide services and 104 special schools. However, the Minister of State then went on to say that there was an average vacancy rate of 34% across CHOs, which equates to approximately 700 full-time jobs, although she also stated there were full-time equivalents. However, the fact is that the high vacancy rate means we cannot deliver services. That is the crux of the problem.

The point was made that there is a 40% vacancy rate for occupational therapists, in addition to vacancy rates of 39% for psychologists, 28% for social workers, and 29% in nursing. We cannot deliver the service these people need. A radical approach has to be taken to this. I will make a point about international recruitment. There is a conflict of interest in that regard as it takes professional staff away from countries that need them, such as India and Third World countries, and they are then not given proper wages for jobs in this country. Yesterday, we made the point that nurses and healthcare assistants are being brought over to work in private nursing homes at a rate of pay of €27,000. They cannot bring their families here. When we bring workers over, first, their conditions and pay have to be protected and, second, we now have to start giving scholarships across the board in certain areas, such as therapies and nursing, to bring people into training. We should then get them to pledge to stay in the country for a number of years to backfill the CDNTs and the areas where there are vacancies.

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