Liam Quaide (Cork East, Social Democrats)

I thank the Minister for her statement. Cara Darmody, a remarkable 14-year-old disability activist from Ardfinnan in County Tipperary, today began a 50-hour sleep-out on Kildare Street in front of Leinster House. Cara is taking this action to highlight the more than 15,000 young people in this country who are overdue an assessment of need. We hear from the HSE that this figure could reach 25,000 by the end of the year.

Despite all the talk about prioritising disability in the lead-up to the general election it is almost as if the Government has given up. Almost the only strong message it has expressed so far in this regard is the intention to abbreviate assessments of need by changing disability legislation. This is something of which we need to be very careful. We have been here before. In 2020, a previous attempt to shorten AONs led to High Court action as the assessment in question was clinically inadequate. That led to further escalation in waiting lists for AONs afterwards because so many children had to be reassessed. An autism assessment and intervention protocol has been going through consultation in recent times with associations of the interested clinicians, speech and language therapists, psychologists, social workers and occupational therapists. I know from feedback from that consultation that those professionals are raising very similar concerns. We need to be wary of how we change course in this regard or how we might consider it.

Despite her youth, Cara Darmody has been highlighting the issues with AONs for several years. She was moved to campaign on behalf of children with additional needs after witnessing the lack of services available to her two young brothers, who are autistic and have intellectual disabilities. There are many other families like Cara's who have watched their children being failed and felt compelled to become activists and campaigners, all to secure basic services and supports which children with additional needs are entitled to as a right. In a country as wealthy as ours it is shameful that so many children have been failed so consistently and comprehensively.

The assessment of need waiting list crisis sits within a broader context of pervasive and abject policy failure across our disability sector, failure that is causing immense suffering to so many families. Since the general election in November disability issues have had a political focus like never before but we have yet to see political change stemming from this Government. A disability unit in the Department of the Taoiseach to add weight, urgency and focus to the crisis was announced in January. It will be important to see soon what work, if any, the unit has undertaken. The Taoiseach mentioned on Leaders' Questions earlier today that he is in the process of setting up the disability unit in his Department. However, we are now five months on from the formation of Government. Has the unit actually met? Is it still only being formed? Where is the sense of urgency in action that was so vivid in pre-election rhetoric?

My party colleague, Deputy Cian O'Callaghan, speaking on Leaders' Questions called on the Government to comply with the Disability Act and to complete AONs within the statutory timeframe. The Taoiseach responded with a frustrated tone, as if the question was unreasonable. He stated, "The HSE is not in a position to fulfil the law right now. The Deputy knows that and I know that." The Taoiseach reacted as if he was being needled by a question posed in bad faith for political purposes, yet his response raises a further question as to why the HSE is not able to comply with the law in respect of AONs. This is mainly because services, in particular primary care, have been stymied from carrying out clinical work, both assessment and intervention, not just by the official HSE recruitment embargo that took place between October 2023 and July 2024 or the unofficial embargo that has followed since in the form of the pay and numbers strategy, but also by years of severe under-resourcing prior to all of that by successive Governments which the Micheál Martin either was directly part of or supported through confidence and supply. That is the answer.

How do we get out of it? Should we be led to believe that the crises, and there are multiple crises across the disability sector, are extremely complex and will take many years to resolve? If we keep privatising and fragmenting services, these problems will be more intractable. However, the Government can take one straightforward and basic step now and that is to overturn the recruitment restrictions imposed on primary care services by the pay and numbers strategy, commence a comprehensive recruitment drive and provide the staffing to carry out assessment and intervention for young people with mild to moderate difficulties. It will not solve everything but it could be transformative. Many families are getting stuck in the AON pathway because primary care is not available to them. They believe the only way they can access support is through the AON process. It is vital that the Minister, Deputy Foley, and her colleague, the Minister of State, Deputy Michael Moynihan, engage with CDNT ground-level staff who have left those services to establish what exactly is causing the retention crisis in CDNTs.

Change in disability services and resolving the AON crisis can happen but not by robbing Peter to pay Paul or expecting services to function without adequate workforce planning or staffing.

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