Timmy Dooley (Clare, Fianna Fail)
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I welcome the Minister of State, Deputy Barry Andrews, to the House. He is committed to children with autism and attention deficit hyperactivity disorder.

Recently I received a note from a mother which sets out the concerns of parents of children with autism. She states:

I write with reference to my two and a half year old daughter who has recently been diagnosed with autism and attention deficit hyperactivity disorder. As I am sure you are aware autism is a severe disability that affects the normal development of the brain in areas of social interaction and communication. It is a lifelong disability and there is no cure. Approximately 1% of the population has this condition.

In the last few weeks my husband and I have spent over €2,500 on consultation fees to have our daughter privately assessed in the hope that an early diagnosis and the appropriate intervention will help her have a better future. However, many parents in County Clare do not have the financial means to do this. The average wait time for autism screening in County Clare I believe is approximately one year and often when psychologists, occupational therapists and speech therapists are on leave they are not replaced so this results in even longer wait times. I feel that wait times for this screening need to be urgently addressed as it has been proven that early intervention gives these children the best chance of an independent future and ultimately this will save the State money later on.

In the last few days I have contacted the HSE to see what sort of assistance they can provide my daughter in the future. I have been informed that autism is not regarded a long term illness under the terms of the long-term illness scheme. I would like to know why not. If autism is a lifelong disability with no prospect of a cure why is it not included in long-term illness scheme? With regards to attention deficit hyperactivity disorder, this is officially regarded as a mental disorder yet this is not covered by the scheme either. I have been informed by the HSE that they do cover mental handicap and mental illness in children under 16 but ADHD is not covered under the scheme.

She continues:

With regard to the GP visit medical card, I would like to know why my child and other children who have a lifelong disability do not have an automatic right to this facility? It seems outrageous that a child can be found to have a disability under the Disability Act 2005 yet have no right to a medical card because his or her parent or parents would not satisfy a means test. My child is unable to speak or gesture so I have to rely greatly on my own instincts much of the time to determine if she is ill. Like most autistic children she is completely unable to communicate that she is feeling sick, has a sore throat or tummy pain etc.

I have quoted this into the record to give some sense of the concerns of parents, especially those dealing with children with special needs. It was appropriate and important I do so because from time to time, those of us in this House tend to forget or fail to recognise the difficulties parents have with children with special needs.

I am particularly happy with the Minister of State present because of his function as Minister of State with responsibility for children. I ask him to intervene with the Health Service Executive to ensure a greater level of service is made available to parents with children having special needs, especially with regard to early diagnosis. In this case the parent is concerned about the inability to identify the illness at the earliest possible time. Best practice and research to date shows that early intervention plays a major role in ensuring a child develops to the best of his or her potential, whatever it may be. I look forward to the Minister of State's answer and thank him for being here.

Barry Andrews (Dún Laoghaire, Fianna Fail)
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I thank Deputy Dooley for raising this very tough issue and I note his interest in it. I will take this matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I wish to emphasise the Government's commitment to providing a high quality service to all people with a disability. This commitment is illustrated by the substantial investment we have been making in disability services over recent years.

Very significant additional resources have been provided for services and supports in this area. The multi-annual investment programme, which is a key component of the Government's disability strategy, had by the end of 2008 provided for approximately 980 new residential places, 313 new respite places, and 2,505 new day places for the intellectual disability service. There were 300 new residential places and 950,000 extra home care and personal assistance hours for people with physical and sensory disabilities.

In the period 2006 to 2008, more than €500 million has been allocated to the Health Service Executive under the multi-annual investment programme, of which €425 million was for disability services and €125 million for mental health. The Government has further emphasised this pledge to people with disabilities by allocating additional funding to the continued development and enhancement of services in 2009. In the 2009 budget, an additional €10 million was allocated to the HSE for services in the area of disability and mental health. The funding for 2009 will provide for 125 additional therapy posts in the disability and mental health services area, targeted at children of schoolgoing age. In addition, once-off funding of €1.75 million is being provided for suicide prevention initiatives and mental health projects supporting service users and carers.

With regard to the matter raised by the Deputy, the HSE states that up to the middle of 2008, the waiting times for children receiving psychology services increased owing to the fact that there were major difficulties in recruiting psychologists because of a shortage of qualified candidates for the position. This relative scarcity also presented challenges to the HSE in retaining psychologists to provide services. Both of these factors contributed to an increase in waiting lists.

The HSE states that the current position on the provision of psychology services to children with suspected autism in Clare is that there is a full complement of psychologists working within the Clare children's services since November 2008. Work has been commenced by the HSE on reviewing children who were assessed, diagnosed and put on a waiting list for psychology services. The HSE states that this review will take approximately four to five months to finalise. This review does not impinge on the level of existing services being provided in the area.

The HSE also states that a new development in the provision of services to children with suspected autism is the establishment of a revised assessment and diagnostic procedure which is in line with best practice. All new referrals of children with suspected autism are covered by this process. The assessment process for the diagnosis of autism is complex and can take up to one week per child.

The HSE states that notwithstanding the introduction of these quality improvements and the associated increase in workload, it expects that, on the assumption that staff can be retained, waiting times will reduce from the present average of one year. The HSE states that while approximately a third of referrals are children with suspected autism, the other two thirds are non-autistic children with very complex needs. The HSE maintains that these non-autistic children are also in need of appropriate services and this impacts on the quantum of service available at any given time for autistic children.