Paul Gogarty (Dublin Mid West, Independent) | Oireachtas source

Services for people with disabilities are in disarray. There is an ongoing battle for disability services to be provided where needs have been assessed. The National Federation of Voluntary Service Providers, which represents a mixture of voluntary public services organisations and voluntary grant-aided bodies, has gone on record recently to state their ability to deliver existing services and meet the needs in their communities is seriously under threat. These organisations provide a lot more services than the HSE does directly.

The biggest issue relates to recruitment of staff, including occupational therapists, speech and language therapists, physiotherapists and other front-line and support staff. The Government is not making it easy to recruit and retain skilled professionals in this area. I have referred to how difficult it is to get a master's, to the fact that people have to go abroad and to the lack of a Dublin allowance for many jobs that are so valuable and needed. While healthcare is often a vocation, we will only encourage people to train here and stay here if they have a career pathway and adequate remuneration. Record amounts of money have been spent in this area, but we are only running to stand still because costs are rising, wages are rising, and funding is being delayed and not provided in a planned and consistent multiannual way, meaning providers are constantly firefighting. The Minister of State acknowledged that of the €333 million in additional funding provided in 2025, €290 million was allocated to maintain existing levels of service for people with disabilities, so where is the substantive funding for improvement?

In the context of all the pressure to make services available, we are faced with another crisis we are discussing now, namely, the delays in getting assessed in the first place, and in this respect the list keeps getting longer and longer. Under the Disability Act 2005, as everyone has referred to, assessments of need should be carried out within six months of the referral to the HSE. At the end of December 2024 there were 14,200 outstanding assessments of need and now we are past 15,000 with just over 4,000 assessments being carried out each year. It is likely to rise further. I read today that it could be 25,000 by the end of the year according to the HSE’s estimates. This is shocking stuff. The Government is outrageously in breach of its legal obligations, as every Deputy has referenced, and as of now I do not see evidence of a pathway being carved to sort out this mess. Why then has this not been declared an emergency for children, as campaigners like Cara Darmody have called for, and why has a time-limited task force not been set up? We acted during Covid, we responded to Brexit, we supported thousands of Ukrainians and we are mobilising a response to US tariffs – or at least we are in terms of what Ministers have said – so why can this not be declared an emergency and a target set to redress the balance? I acknowledge that even with the best will in the world and all the resources at our disposal being thrown at the problem, filling the vacancies, identifying additional needs and reversing growing assessment of needs waiting lists has a lead time, but does this Government have a six-month target, a 12-month target or a three-year target that can be realistically reached? Is there any way we can outsource assessments in the short term, a bit like the National Treatment Purchase Fund, to utilise the resources of other countries for a specific period or is this going to be tied up in the wider organisational mess that is the HSE?

We are a wealthy country. We do not have unlimited pools of money and there is a need to spend funding wisely in a targeted way, but even if the revenues continue to come in at current windfall levels we should never be talking about tax cuts when we are putting additional costs on families in other ways. We are not looking for miracle workers but a systemic, incremental, recordable progress to ensure the assessments and supports are available for those who need them.

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