Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I thank the Ceann Comhairle for selecting this issue for discussion today. The issue relates to an individual case presented to me, which I have pursued for some considerable time and has wide ranging implications, in particular for those with autism spectrum disorder similarly impacted as Aaron, the young person in the case involved. While this issue is being dealt with today by the Department of Health, it also comes within the remit of the Departments of Education and Skills, Social Protection and Children and Youth Affairs.

The challenges faced by Aaron's mother in her efforts to access appropriate services to cater for his particular needs have been nothing short of scandalous. Barriers and diversions were and continue to be put up at every opportunity. Aaron's diagnosis of autism was late, at 14 and a half years of age. It was a battle to get a psychological assessment for him. We know from all of the information available that diagnoses post-six years of age have far less favourable outcomes. Aaron, now 17 years of age, spends all his time alone in his room. It is for sure where he is as we speak today. As a result of his condition, he is too anxious to engage with others and too nervous to go outside. Where State intervention was needed it has always come up short. Aaron's family expect that the situation will deteriorate when he turns 18 years of age next month.

Aaron's experience of the education system has been a paltry one. Repeated efforts and attempts to get him to settle in various settings have failed. It is clear to those who have expertise in this area, including Aaron's psychiatrist and psychologist, that one-to-one home tuition is the only option. Aaron's mum has been unable to find a teacher to take up the position. The Department must intervene immediately. This is not the first line of address of this issue. As already stated, I have gone through all other reasonable approaches and felt compelled to bring it to the floor of the Dáil during Topic Issue Debates. My appeal is for the Departments of Education and Skills and Health to intervene immediately. Their record to date in this case has been shameful.

To aid Aaron's development, it is essential that home tuition is provided. It will help to alleviate many of the associated symptoms of his condition, including anxiety, nervousness and depression. Without home tuition, Aaron will become more isolated and angry. Without it, this young person will in a number of weeks become an angry young man. The prospects for him and his future are seriously impaired by the State's failure to respond appropriately to his particular circumstances and needs. In raising this issue today, I am appealing for a cross-departmental response in order to ensure that we are not too late.

Leo Varadkar (Dublin West, Fine Gael)
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I thank Deputy Ó Caoláin for raising this issue, which I am taking on behalf of the Ministers of State, Deputies Kathleen Lynch and Alex White, who are out of Dublin on official business.

As the Deputy will be aware, current Government policy advocates a mainstreaming approach to the provision of services and supports for people with disabilities, including those with autism, whereby people with disabilities have access to the same services as the general population and, in addition, receive the appropriate supports and interventions to address individual needs. The children, adolescents and young people with complex disabilities unit, led by a principal officer, has been established in the Department of Health. This new unit is charged with fostering greater collaboration between the Departments of Health, Education and Skills and Children and Youth Affairs on children's disability issues, including autism and to build on the cross-sectoral working arrangements that are already in place. The Health Service Executive published the report National Review of Autism Services: Past, Present and Way Forwardin February 2012. This covers children's and adult autism services. The review recommends a move to a more consistent model of delivery, in line with the mainstreaming policy. A reconfiguration of existing service provision is recommended. Also, access should be provided at the appropriate level, depending on need, through the primary care system, school age teams, and specialist intervention services as appropriate. The report will be implemented within existing resources and taking account of the need for greater efficiency and effectiveness in the current climate, and in the context of parallel initiatives, including the value for money review of disability services and the progressing of the disability services for children and young people programme, young people in this context being defined as up to 18 years of age.

With regard to the specific case raised, the Deputy will appreciate that it is not appropriate to discuss the matter in detail in the House, particularly when it relates to a child. However, the HSE has indicated that since the young person's referral in 2009 the child developmental team in Cavan-Monaghan has been actively engaged with him and his family in relation to the identification and provision of assessment and appropriate therapeutic and other services. As the young person concerned is approaching 18 years of age, a full transfer meeting has been held to support his transitioning from child development team services to adult services. A meeting has also been arranged between the key worker, the young person and the family to discuss transitioning arrangements.

The Minister for Health has asked the HSE to keep him informed of developments in relation to the case.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I thank the Minister, Deputy Varadkar, for taking this issue in the absence of the health portfolio holders. The Department of Health has failed Aaron and his mother. Aaron is without appropriate speech and language therapy and regular psychology appointments. His mum has applied for some respite but to no avail. A recommendation for theory of mind therapy to help Aaron socialise has been ignored. In my view, this is a textbook case of the experience of many young people.

Aaron's specialist psychiatrist will retire shortly and there are no plans to replace him. Despite having an excellent relationship with his child psychologist, Aaron, now fast approaching 18, will have to move elsewhere. It should be noted that Aaron does not transfer well, despite all of the points the Minister included in his reply, and we can all understand this. This will all be new, and new challenges will present in dealing with new people; Aaron needs consistency in relationships, and this will be all undone when he reaches 18 years of age.

This situation is wholly unsatisfactory and I urge the Minister not just to set aside the paper after this. I understand he will have an appreciation of the seriousness of the case. I would not have raised an individual case only that it is as serious as I know it to be. I ask the Minister to use his good offices to impact on his colleagues at the Departments of Health and Education and Skills because the case needs an immediate cross-departmental co-ordinated response. I appeal on behalf of Aaron, his very understandably distraught mother and his wider family who love him dearly that no further time is lost.

Leo Varadkar (Dublin West, Fine Gael)
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I certainly note the Deputy's comments and his sincerity and concern for the case. I do not know Aaron, and even if I did it probably would not be right for me to comment on an individual case in the House for reasons the Deputy understands. I will ensure the record and the briefing notes I have been given are passed on to the relevant Ministers and I will ask them to take a personal interest in the case.