Hildegarde Naughton (Galway West, Fine Gael)

I acknowledge the contributions of everyone here and assure them this issue of assessment of need is a top priority for me as a Minister of State with responsibility for disability who sits at the Cabinet table and indeed it is a priority for the whole of Government, as is the national disability strategy. As Deputies know there is a disability unit set up within the Department of the Taoiseach. We have also had a number of Cabinet committee meetings on disability and assessment of need is a top priority. I assure Deputies I have heard and listened to all their comments. It is an absolute priority for me to ensure we have action on this. I will certainly be open to working with everyone across the House to ensure children have access to the services they require. In my last Ministry of State, where I had responsibility for special education, I travelled the length and breadth of the country and heard the lived experience of parents and teachers and of the children who do not have access to speech and language therapy and occupational therapy. We have put in place a pilot relating to special schools of putting therapists in schools. We are rolling that out to all special schools and beyond. That is work that is ongoing with Government.

I want to make reference to a number of issues raised throughout the evening. Early intervention is absolutely critical if we are to get this right. We are dealing with the issue of waiting lists for assessments of need but we have to go right back to the start and those early milestones of a child’s life to ensure that where they are not meeting them they get access to those therapies at that level. That is what is happening as part of our national disability strategy. This is our all-of-government blueprint that we will be publishing in the coming weeks. It will be the blueprint over the next few years to ensure there is an action plan associated with that strategy as well.

Returning to the Private Members’ motion on assessments of need, there is a huge amount of work happening on recruitment and retention at domestic and international levels. CORU is working on recognising qualifications of people who are working abroad and want to come home. These issues were raised in this debate. Again, I assure Deputies we are working hard across government on that. There is the no wrong door approach.

This comes back to parents who want access to these services for their children, whether they go into the primary care setting, CDNTs or CAMHS, being signposted in the right direction and getting access to the services they need.

The issue of the length of time for the assessments of need was raised. The average length of an assessment of need is approximately 30 hours and it can be up to 90 hours. We want to ensure that children or adults who are going through an assessment of need have access to the therapies they need at the earliest stage possible along that process. I know that parents are frustrated and angry. I meet them regularly in this brief, as I did in my previous brief. I am determined that we get this right but it is complex, as many Deputies have acknowledged. It is not just a question of reducing the waiting list. It is not just about recruitment and retention. It is also about looking at where an assessment of need is required. It is often not required by some of our Departments. In housing, for example, it is asked for but it is actually not required. One is entitled to get services and housing supports such as domiciliary care allowance. One does not need to provide an assessment of need. It is a smaller part of the jigsaw but these are all the areas we need to be looking at to get this right.

I acknowledge Cara. I have met her previously. I know how she has been advocating not only for her own family but for families across the country. She should not be here today; I concur with colleagues that nobody should have to protest outside the gates of Leinster House or a Department to get access to services that he or she needs.

On the challenges associated with that assessment of need process, we need to consider a system-wide approach. It requires a proportionate response from the Government, one that is real, tangible and clear and provides positive outcomes for parents where they actually know the pathway in getting access to services for their children. We need to spell that out.

The motion highlights some of the aspects of a complex issue, including the need to increase the availability of and access to appropriate services for children with disabilities and the need to ensure that children receive an education appropriate to their needs. The Minister, Helen McEntee, is doing a lot of work in this area. We are increasing the number of special classes and therapies in school and we will continue to do that, and to resource it as well.

There are unacceptable delays in accessing assessments of need. The data has been set out many times this evening in respect of the 15,300 assessment of need applications that are overdue for completion. More than 10,600 new applications were received last year, with 4,100 assessments completed last year, so demand is clearly outstripping capacity within the system. That is something we need to address. The introduction of the targeted waiting list by the Government last May is helping, but we need to do much more. Over 3,600 assessments were commissioned from private providers between June of last year to the end of March. We will continue to provide and fund those private assessments as part of the solution. I am encouraged by the 30% increase in assessments completed last year compared to 2023. There was a 65% increase in completed assessments in the first three months of this year. We are moving in the right direction but we have much more to do.

Parents want early access to services and supports for their children. In many cases, they seek support from primary care, CDNTs, CAMHS and are then told that they are going onto another waiting list. To repeat, that is not acceptable. It leads to many people applying for assessments of need, which is their statutory right as set out in the Disability Act. They may believe this will give them early or accelerated access to services but they often find themselves on a further waiting list after getting their assessments of need. There is also the issue of legal bills when parents feel they have to resort to the legal system to ensure they get their assessments of need. This is not where we want to be. What I want as Minister of State is to ensure that children are getting that early intervention and access to therapies at a much earlier stage, it is signposted and it works within the health service in particular.

This will require us to address the issue from a number of angles. Our primary focus has to be on the assessment of need process and identifying the delays and blockages causing these long waiting lists. Then, we need to find the most effective solution to these blockages. It may require legislative changes while preserving the statutory right to an assessment of need. It will also require operational changes, increased staffing resources, better IT systems, or outsourcing to the private sector where appropriate. That work is already under way with officials from the Department of children and the HSE. That is set out in the roadmap for service improvement. We also have to ensure that any changes introduced are effective and can be sustained over time. There is no point in alleviating the current waiting list only to have another backlog appear. We need to look at the system and ensure we can reform it sustainably.

We are all aware of the many demands within the healthcare system. We also have to ensure that our disability services are appropriately and adequately resourced and staffed to meet the needs of people with disabilities. I look forward to the development of that dedicated disability workforce strategy this year, which will meet the growing service demands and address recruitment and retention challenges across specialist disability services. It is also important to emphasise that increased capacity and enhanced service delivery in the disability sector will not be possible unless we as a Government ensure that we are resourcing it properly and ambitiously. We are spending €3.2 billion on our HSE disability services this year, an 11.5% increase on last year or €1.2 billion since 2020. This is significant funding. I appreciate that there are significant pressures. People have referred to the incidence levels of those saying that they have a disability. People are ageing, we are all living longer and disability will be part of what we in the House have to deal with.

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