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

I move:

That Dáil Éireann shall take note of the Report of the Joint Committee on Autism entitled "Final Report of the Joint Committee on Autism", copies of which were laid before Dáil Éireann on 14th June, 2023.

I will share my time with Senator Micheál Carrigy. I express my thanks to my fellow members of the former Joint Committee on Autism who worked diligently to produce this report. The collaborative and considered approach we took to our engagement is reflected in this report. In particular, I thank Senator Micheál Carrigy, the committee Cathaoirleach, for campaigning to establish the committee and for capably steering it throughout the course of its work.

It is important to acknowledge the contributions made by the many witnesses whose expertise and lived experience informed the committee's work, including teachers, psychologists, therapists and all the professionals who support the autistic community, the families and carers of autistic people and, most importantly, the autistic self-advocates who shared powerful insights with the committee in what was often a very challenging set of circumstances. I acknowledge the members of AsIAm, who are in the Gallery with us this evening and who were a wonderful support to the committee all through its existence and since. Their contributions have resulted in this comprehensive report and its recommendations. Before I move on, I also acknowledge the committee clerk and all the staff of the committee for their work and diligence.

The committee's final report features 109 recommendations, all of which must be implemented by the Government as soon as possible. I will focus on some key recommendations from the report. The first recommendation in the report is one of the most important. It calls on the Government to enact legislation which requires the State to publish an autism strategy every three years, establish a committee or monitoring group featuring autistic people to participate in drafting and monitoring the strategy, and require the Minister with responsibility for disabilities of the day to address both Houses of the Oireachtas annually to provide an update on its progress. While the publication of the initial draft of the autism innovation strategy is welcome, it is essential there is legislation in place to guarantee its implementation in the years to come. The autistic community in Ireland has been repeatedly let down by the State, and many autistic people and their families will wonder whether they can trust that services will ever improve. Legislation which will compel the Minister of the day to monitor and implement a national autism strategy would go some way towards rebuilding that trust and providing the services which are so desperately needed.

There is a particularly urgent need for properly resourced health services for the autistic community. The committee heard shocking evidence from self-advocates and healthcare professionals regarding the inadequate provision of healthcare and mental health supports to the autistic community. Dr. Mary Doherty, an autistic self-advocate and healthcare professional, told the committee that autistic adults have poor physical and mental health compared with the general population and that the life expectancy of autistic people is potentially reduced by 16 to 30 years. Additionally, Adam Harris told the committee that the risk of suicide among autistic people is seven times higher than that of the general population. These are stark figures which tell of the need for urgent action in respect of healthcare provision for the autistic community. Among the recommendations put forward in the report are the introduction of mandatory autism training for health and social care workers in the HSE and in section 38 and section 39 organisations, the provision of funding to health service providers to make their services more autism-friendly, and the creation of a pathway for multidisciplinary support, including mental health services for autistic children and adults. At present, disability services are among the least accessible services for autistic people in Ireland. Chronic under-resourcing under the PDS model has resulted in young autistic people facing extremely lengthy waiting times for assessment and therapies, ageing out into adulthood, where few services, if any, are available to them. They are forced to seek services in a private market which is expensive and where proper oversight and regulation cannot be guaranteed.

Nineteen of the report's recommendations concern disability services, and each of these recommendations seeks to remedy distinct issues which impact autistic children and adults trying to access vital disability services. The first of this suite of recommendations calls for the establishment of a single clear entry point to children's disability services and CAMHS. At present, autistic children are passed between services. The committee heard from several witnesses that CAMHS refuses work with children who have a primary diagnosis of autism on the basis that CAMHS services are unsuitable for them. However, no alternative services are accessible to autistic children. It is essential the HSE provides a single point of entry for autistic children where they may access disability services and mental health services in tandem.

Along with making disability and mental health services more accessible, we must also build capacity in these services to provide assessment and therapies to autistic young people. The committee heard from the HSE that the average national vacancy rate of positions in CDNTs is 34% - that was a year ago - with a vacancy rate as high as 43% in some CHOs. It is clear, therefore, that the challenges around staffing represent some of the main obstacles to providing high-quality and timely services to the autistic community. For this reason, the final report of the joint committee on autism makes a number of reasonable and achievable recommendations to address the staffing crisis in disability services. These recommendations include actions that will have an immediate impact on waiting lists for disability services as well as actions that are needed to build capacity in the long term. The report also recognises that there are no overnight solutions to the current staffing crisis. For this reason, the committee made a number of recommendations that, if implemented, would bear results in the future, among them maybe speaking to secondary school students and third-level students, bringing campaigns into those institutions, working with professional bodies of the various disciplines and developing opportunities for career progression within public disability services.

The disability capacity review to 2032 and the action plan for disability services are welcome, and it is positive to see that some of the recommendations of the final report have already helped to inform policy. The report reflects contributions from professionals who work directly with autistic children, including representatives from the Association of Occupational Therapists of Ireland, the Irish Association of Speech and Language Therapists and the Psychological Society of Ireland. These witnesses told the committee that little or no effort was made by the HSE to take their views into account when assigning the progressing disabilities services model. The report urges that the HSE learns from the challenges that have arisen from the roll-out of PDS and embeds a culture of collaboration and consultation with therapy, psychology and nursing staff as well as their representative bodies.

I am conscious of the time and want to allow Senator Carrigy in. The 109 recommendations featured in this report are the product of considerable engagement with the autistic community, their families and service providers. We have an opportunity to vastly improve the lives of autistic people in Ireland by implementing these recommendations, so I urge the Government to adopt this report and its recommendations.

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