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

I thank Deputies for bringing forward this motion and I welcome the opportunity to speak to the House to reassure Deputies that the Government is fully committed to people with disabilities and their families. I do, of course, acknowledge that there are important challenges that we must address, many of them raised by the Deputies in their contributions, if disability services are to fully meet the needs and expectations of those at the heart of the service. I would like to thank the Minister of State, Deputy Naughton, for her important contributions regarding recent developments in the special education sector.

The programme for Government has seen, year on year, increased investment into disability services, with this year's budget seeing a record of approximately €2.8 billion funded for community-based disability services. This funding will help reinforce and support the sector and provide new and improved services, as an increase of €195 million on 2023. Sometimes we forget when we talk about respite. When I came into post, €55 million was ring-fenced for respite. It is now at €120 million. That is the investment and the weight that I have put on the value of respite.

It is also important to note that there has been substantial additional investment into children's disability services in recent years, with funding provided for over 600 whole-time equivalent posts. Notwithstanding that significant investment, I personally know of the frustrations that families experience in accessing the services they need. However, I want to tell Deputies that the Government has listened to the families and is pursuing significant investment and reform as part of the programme of radical transformation across disability services.

The HSE is taking a planned approach towards building capacity and addressing the service deficit, informed by the action plan on disability services that my Department published last year. The plan aims to build the capacity of disability support services to meet changing needs, improve timely access to services, and strengthen the focus on individual services and support. The action plan will be a key to enhancing services and ensuring that we have a human rights and person-centred approach to both policy and service delivery, requiring a concrete Government approach to disability.

With regard to the children's disability services, the PDS Roadmap for Service Improvement 2023-2026 provides a framework to improve services for children and their families, and clarifies the commitment of the HSE supported by Government by providing high-quality, responsive supports and services for children with disabilities. The roadmap includes a robust suite of 60 actions, with 45 either completed or in progress. As noted by Deputies, there are indeed many challenges facing children and young people with disabilities. We all recognise that working with children with complex needs is hugely rewarding but also very demanding, and I need to acknowledge that recruitment and retention of staff is presenting challenges to the HSE and the various lead agencies. These challenges are reflective of the issues affecting the wider health and social healthcare sector. This is borne out by the CDNT staff census, which notes an average vacancy rate of 36% across the CHOs - and I use the word "average".

The HSE continues to explore a range of options to enhance the recruitment and retention of staff to CDNTs, working collaboratively with the lead agencies to market the CDNT as an employer of choice in a competitive employment market. Some 21 of the actions contained in the PDS roadmap are focused on CDNT retention and recruitment targets, including national and international recruitment campaigns, along with the launch of the new therapy assistant grade.

While acknowledging the challenges that are faced by children's disability services across the country, and similar challenges faced in the special education sector, we must also acknowledge the developments and the investment that have taken place during this programme for Government. We can see the positive impact of these measures in various areas. Funding has been provided in recent years for specific measures to address the AON backlog - €11.5 million in budget 2023, and €5 million in budget 2024. In the first six months of 2024, completed assessments were up by 28%, aided by the recently introduced investment of €6.8 million for the waiting list initiatives.

Despite the recruitment and retention challenges across children's disability services, the number of whole-time equivalents working in our CDNTs is increasing year on year but I acknowledge we still have over 700 vacancies. In July, the Government approved the prioritisation of funding to support the expansion of training places in priority healthcare areas, including speech and language therapy, occupational therapy and physical therapy. Working with the Department of Further and Higher Education, Research, Innovation and Science, we plan to increase our places in our OTs, physios and speech and language therapists over the two recruitment cycles by 33%.

There were 3,393 children on the CAMHS waiting list in July 2024. Nationally, this represents a decrease of 900 children waiting for the CAMHS community mental health services, down from 4,293 in December 2022. The data also show that at the end of July 2024, 94.2% of all urgent cases were responded to within 72 hours. The growth in care being delivered in primary care in the community is reflected in the 6% increase in therapy services delivered within communities in 2023, with primary care services delivering service to 1,397,679 therapy users in 2023.

In August, the Government agreed to support the special schools pilot for enhanced in-school therapy supports for 16 schools, developed by my Department and the Department of Education, supported by the HSE and NCSE. It is important to speak exactly to the point Deputy Tully raised. She asked why we were doing a pilot when therapists were already back in schools in 2019. It is important to say that in 2021, we secured funding to put back in 81 therapists. Unfortunately, the HSE applied the line of aligning to but not in. Aligning to was keeping them in the CDNTs but not putting them back into the special schools. In some schools, therapists were not removed, so there is an inequity in our education system at the moment.

To ensure there is good governance and the right supports, it is now a collaborative approach between the Department of Education and the Department of Children, Equality, Disability, Integration and Youth, the NCSE and the HSE so that we can assess the support that children are receiving. It is in therapies that are going into the pilot as opposed to aligning to them. That is a Government policy and direction that has been taken. An additional ten schools will come on board on a phased basis. The announcement of those ten additional schools will be in October this year. The significant benefit to this pilot is that therapists will be on-site during school hours. Home-based supports will be provided outside school hours in the usual way, delivered through the CDNTs. This will be recorded and tracked to demonstrate that children in special schools are being prioritised. We need to continue to invest in children's services and special education. The motion raises important points and while we have made significant progress over the last five years, I think we all acknowledge how important it is that we continue to develop services so that all children are provided with an appropriate level of services.

The scale of the challenges in this area is well understood by Government and the HSE. However, substantial and concrete efforts are being made to focus on finding workable solutions to address the issues and improve services and supports for children with disabilities and their families. Personally, during my time in office as Minister of State with responsibility for disabilities, I have been consistently proactive in my engagements on all these issues, to drive reform and improve services. I am acutely aware that, like me, no one wants to see a child having to wait one year, one month or one day more than necessary to receive the therapy supports that they need. I sincerely thank all the Deputies who have contributed to the debate this evening. I assure them that this Government will remain intensely focused on providing the best service we can for children and adults with disabilities.

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