Keira Keogh (Mayo, Fine Gael)

I thank the Leas-Cheann Comhairle and the Minister. When I worked for 19 years with the neurodiverse community, I was often the first point of contact after a parent acknowledged a concern for their child, or was potentially nudged by a relative, a childminder or a preschool teacher to talk to their GP or public health nurse. It takes real courage for a parent to do this when they notice that milestones are being missed or when they start to see struggles in areas like speech and language, difficulties with motor planning, behavioural struggles, social challenges or learning difficulties. It takes real courage to take that first step to seek answers, a diagnosis and a roadmap.

Why do parents do that? They know the assessment of need process is objective. They want and crave that statement of need in their hand because it tells them the list of services and supports that should be provided to their child. I commend Cara Darmody who is outside protesting for 50 hours, but I am uncomfortable because it is terrible that she has to do that, and it is terrible that we have over 15,000 children on our waiting list. There are almost 200 children in my own constituency of Mayo waiting for an assessment of need. We must do better. We must continue to increase resources. We have to use the private sector and continue to do so where needed, and we have to address recruitment and retention issues.

I welcome the 65% increase in completed assessments of need in the first three months of this year. I welcome the regional hubs that have been set up to target the backlog, and I also welcome Cara's fund. However, we must recognise why there has been such an increase in the demand for assessments of need. Parents know that services are stretched. They know CAMHS services are stretched, as are primary care services and the CDNTs. There are almost 700 children in CHO 2, which comprises my area of Mayo, Galway and Roscommon, waiting for CDNT appointments. These parents feel that they need the diagnosis and they need to get that statement in their hand. They need the diagnosis if they want to access home tuition or if they want to access a special school or an autism class.

Without the assessment of need, providers like NEPS psychologists or therapists like speech and language therapists are often working off anecdotal information, school data or their own observations. NEPS psychologists and therapists have said that they want that detailed knowledge and diagnosis because the assessment notes are really key for them to work off. We also have to acknowledge that sometimes parents feel the assessment of need is their only route to services, but actually they can access CDNTs, primary care, SET and SNA hours in school and NEPS psychologists. I welcome that they can now access the domiciliary care grant without the assessment of need being completed but we also have to acknowledge that these services are really stretched.

I welcome the roll-out of therapists within schools. This is going to be one of the step changes we have discussed, and it is really welcome. We need to continue fighting and working as hard as we possibly can. This debate in the Dáil is really helpful because we keep talking about how disability is at the forefront of all of our minds. There is cross-party agreement that we have to do better and that this issue and the issue of housing are going to be the measure of our Government. They are our two biggest challenges. I look forward to working collaboratively with my colleagues on the disability matters committee. When we are working together and bringing solutions from across the House, we can make inroads in disability.

We have to continue to expand services, and address recruitment and retention issues. There is a 21% vacancy rate on CDNT teams across the country. I have been guilty of not signing up to HSE jobs when I had the option. I chose instead to go and work privately for myself, where I could manage my caseload and see my clients on a regular basis. I knew that early intervention and regular appointments were where the difference was going to be made, and that is where we see a lot of struggles for therapists who are pulling away now. So many of our therapists are caught trying to catch up on the assessment of need backlogs and are maybe not providing the therapies where they want to. We know that the CDNTs are really struggling, so we have to increase our staff and train more therapists.

We also have to continue our investment in disability services. I know it is at record levels but we must continue to do more. Really and truly, we have to completely clear the backlog with the assessment of need process so that therapists can get back to providing therapies, and Cara can get back to school.

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