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

I thank Deputy Tully and the Oireachtas Joint Committee on Autism for sponsoring this evening's motion. I thank her, Senator Carrigy and all who participated in that valuable committee. I thank all of the participants who came before the committee, of whom there were many. I acknowledge the presence of AsIAm tonight and a lot of the families and participants who are watching this evening. I have noted the final report of the Oireachtas Joint Committee on Autism and wish to acknowledge the cross-party work of the committee and its efforts to identify, across 109 recommendations, areas where we can better support autistic people, their families and supporters. I genuinely want to acknowledge the work of the committee. It has enabled me in the work I do. Sometimes, it does not happen that there is a parallel process but at this stage there is, which the report is contributing to big time. Action on autism, as with action on disability more broadly, is advanced on a mainstream-first basis, with individual Departments and agencies supporting persons with disabilities within their areas of responsibility. My Department acts as a central co-ordination point to support these efforts. Within the mainstream-first approach, it is recognised that there are bespoke challenges facing autistic people and their families that need to be better addressed. It is for this reason I have prioritised the development of a new national strategy on autism, the autism innovation strategy. I was just looking at the diary. I hope to have it published within the month. Today is 7 March; I hope to have it done before 8 April.

While the autism innovation strategy was in development prior to the committee's report being finalised, the committee’s recommendations have been and continue to be carefully considered in the context of finalising the autism innovation strategy. The autism innovation strategy will provide a framework for cross-government action on autism by identifying and addressing areas where there are bespoke challenges and barriers facing autistic people and their families. In recognition of the need for timely and targeted action, the strategy will seek to identify clear actions that can be delivered within an 18-month period. I am pleased to say that development of the strategy is currently at an advanced stage and I expect to formally launch it, as I said, before 8 April.

A draft of the autism innovation strategy was published in early February as part of a further public consultation to seek the views of the autistic community, their families and supporters on the draft autism innovation strategy before it is finalised and launched. There has been a very positive response to the public consultation with more than 300 responses currently being collated and analysed. It is crucial that the autism innovation strategy responds to and reflects the lived experience of autistic people and those around them. For this reason, I have sought to ensure that the autistic community is involved in all stages of the development process of the strategy.

The draft autism innovation strategy was prepared based on feedback received as part of an initial public consultation in 2022. This formed the basis of engagements with Departments and agencies to agree actions under the strategy. My officials engaged with more than 15 Departments and agencies to reach an agreement on actions. As part of this process, Departments and agencies were asked to consider the recommendations of the Joint Committee on Autism, insofar as the recommendations pertained to their areas of responsibility.

The draft strategy was also informed by consultation with the autism innovation strategy oversight and advisory group. This gives me the opportunity to thank them for their time in their role. This group, which is majority neurodivergent, comprises autistic individuals, parents, professionals and organisations.

While the autism innovation strategy has not yet been finalised and is still in draft format, I anticipate that the strategy will address many of the committee’s recommendations for action on autism. For example, the final strategy will include a suite of actions designed to generate improved understanding of autism across the public system and society and to ensure that autistic people are better supported by mainstream public services and staff. Another important focus will be improving data and research around autism, and improving information and support for parents. The autism innovation strategy will also contain actions designed to deliver improvements in key areas such as health and social care, learning and education, further and higher education, training and employment, among others, where autistic people face unique barriers at present.

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In addition, the strategy will contain actions to support and empower autistic people in a broad range of areas in the community. In this way, the autism innovation strategy aims to provide for a more holistic and co-ordinated approach to addressing the gaps in services and supports currently facing autistic people and their families over an 18-month period. Part of the strategy’s purpose will be to lay the foundations for the continuation of the work of the strategy as part of mainstream service delivery. It will not fix everything by itself, but it will deliver tangible results in the short to medium term and provide the building blocks for a more autism-friendly society in the longer term.

It is equally important to emphasise that in addressing bespoke challenges and barriers for autistic people, we must not run the risk of creating a perceived hierarchy of disabilities. Many of the issues highlighted in the committee’s report and that have been voiced in the consultation process affect not just autistic people but other persons with disabilities too. Where shared challenges arise we must provide mainstream solutions that work for everyone. There is a balance to be struck in responding to the bespoke and specific needs of the autistic community in a way that, as I said, does not create a perceived hierarchy. Equally, we cannot build services and interventions around overly-medicalised criteria or based on diagnosis-only criteria. The UNCRPD is very clear on this, where we are moving away from overly-medicalised interventions and supports. These shared challenges, some of which are reflected in the committee’s recommendations, are more effectively addressed via other policy frameworks that will deliver results for all persons with disabilities, including autistic people. In the context of my portfolio, these frameworks include the next national disability strategy, development of which is under way. It will be published later this year. The next national disability strategy will provide a blueprint for continued implementation of the UNCRPD in Ireland and further support the rights and inclusion of all disabled people, including autistic people.

On health and social care services, the Action Plan for Disability Services 2024-2026 is at the centre of renewed strategic reform efforts to deliver tangible service improvements for all people supported by disability services, including autistic people. Among other areas, the action plan makes provision for maximising the impact and reach of respite services, boosting the provision of community-based residential places and enhancing the provision of adult therapies. The action plan also includes targeted efforts to attract staff to key roles such as speech and language therapy and occupational therapy. In the context of children’s disability services, the progressing disability services roadmap seeks to address the significant challenges faced by children’s disability network teams, including waiting lists, staffing vacancies, growing demand for services as well as a growing demand for assessments of need. An important element of the roadmap is seeking to improve integrated service delivery, so primary care services, disability services and CAMHS work together to address blocks for children with disabilities in accessing supports. That is what Deputy Tully talked about. The HSE has its own plan called NAP, or the national access policy. That should be working. It should not be hit-and-miss between one CHO and another. I totally agree there should be one front door and when a person goes through it they should find their correct and right pathway, but that is up to the leadership within the HSE. At this juncture, I acknowledge the role the Department of Further and Higher Education, Research, Innovation and Science has played under the leadership of the Minister, Deputy Harris, in the creation of assistant therapist roles in the ETBs for speech and language, OT and physio. We have committed in the disability action plan to 250 spaces in that and the training and the framework is in operation. The Minister launched 125 last year for speech and language.

Efforts are also under way to address challenges in relation to recruitment and retention, including via international recruitment campaigns and the establishment of a steering group for the disabilities workforce, which I chair. The autism innovation strategy will complement and enhance these wider efforts and introduce measures to make sure the needs of autistic people are understood within these frameworks and can be progressed within them as part of sustainable mainstream service delivery. Across all these measures, my focus is on ensuring we advance a coherent and effective framework so we are addressing the needs of autistic people on a responsive, equal and evidence-informed basis that is sustainable into the future.

I also draw the House’s attention to the measures that have already been advanced in addressing some of the committee’s recommendations, while acknowledging that there is still a lot of further work to do. Within my Department and remit, both overnight respite and day respite services expanded in 2022 and 2023. In the context of budget 2024, new development funding of €15 million was secured specifically for respite to ensure provision continues to expand significantly. I secured €15 million in the budget, but in a full year it is €25 million. Additional funding has been secured to support the delivery of more assessments of need, including those procured from the private sector. Approximately €11 million was allocated to address waiting lists for clinical assessments identified through the assessment of need process in 2023. To support children with a disability while they await access to CDNT services, the HSE launched the children’s disability grant fund last October. There was a huge response, with 495 applications for funding. The HSE intends to issue letters to applicants before the end of the month and commence the process of engagement around the drawdown of the fund. I hope that will address some of the issues Deputy Tully and Senator Carrigy raised about Easter camps, summer camps and the various other supports required. On recruitment and retention, disability service employment levels grew significantly in 2023, with approximately 662 new whole-time equivalent staff recruited to HSE and section 38 disability services over the course of the year versus 231 whole-time equivalent staff recruited in the year prior. An agreement was also reached in October 2023, culminating in an 8% increase in funding for pay for section 39 and section 56 employees.

Beyond the work of my Department, there are a range of actions being undertaken by my colleagues across Government to better support autistic people and their families, including in the areas highlighted in the committee’s report. In 2023, the Department of Education spent over €2.6 billion on special education and further progress will be made this year as an additional €113 million will be dedicated to providing supports for children with special educational needs.

The progressive realisation of an inclusive education system is a common theme between the committee 's report and the recently-published NCSE policy advice. A lot has been done across a range of policy areas that will assist in achieving a more inclusive education system, including the adoption of the principles of universal design for learning in school building programmes and in curriculum design, efforts to build teacher capacity and strengthening approaches to ensure that learner and parent voice is central. With regard to higher education, the Department of Further and Higher Education, Research, Innovation and Science has invested a total of over €4.8 million to enhance universal design across higher education institutes to benefit all students, but especially autistic students and students with intellectual disabilities. It is important to acknowledge it was €8.6 million the Minister, Deputy Harris, launched in the last ten days on top of the €4.8 million. Work is also being done by my colleague, the Minister of State, Deputy Butler, to better meet the mental health needs of autistic people. A new child and youth mental health lead has been established in the HSE. A focus for the new office will be an improved approach to service access and integration. To this end, the HSE is currently piloting a central referral mechanism, which is referred to as “No wrong door”.

I welcome these developments and reiterate the Government’s commitment to delivering for autistic people, their families and their supporters, both within the forthcoming autism innovation strategy and across the breadth of mainstream service provision. I will continue to prioritise the autism innovation strategy and will continue to drive progress on the broader challenges for people with disabilities and continue to engage with my colleagues across Government in the context of my portfolio. I look forward to working across Government and with the Members present to deliver tangible improvements for autistic people and their families.

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