Billy Kelleher (Cork North Central, Fianna Fail)
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I welcome the Minister for Health, Deputy James Reilly. I appreciate his coming to the House to take this Topical Issue matter as I know he is also participating in a debate in the Seanad.

We on this side of the House are very concerned about the discovery that of the €3 million allocated for the provision of services for children with autism, only €300,000 has been drawn down, primarily in the north Dublin area. I note that the Minister is a GP in that area and has his own personal circumstances. I am not questioning the validity of the decision to allocate €300,000 for services in north Dublin, but I am asking why the remainder of the money was not allocated. That is incomprehensible and has left us with an unequal and unfair distribution of supports elsewhere in the country. The records show that a senior disability official expressed disappointment to colleagues in the Department of Health that the Minister was funding only the north Dublin elements of her proposal. Likewise, the Health Service Executive's assistant national director for disability services, Dr. Cate Hartigan, has described it as regrettable that the available funding could not be used to promote equity and consistency across the country by improving access to services for all children with autism.

The review of services ordered by the Minister in 2012, following his expression of concern about spending in the area, has not been completed. More than a year later, a spokesperson for his office would only indicate that it would be done in the near future. People have a right to services and supports based on need and equity and there must be a proportionate distribution of funding for that purpose throughout the country. The Minister is the political heavyweight in north County Dublin. In fact, he is the northside bruiser in the Government and what we are seeing is a continual bias towards the funding and provision of services in and around his political heartland. I have no difficulty in supporting the allocation to north Dublin, but there must be equity in the distribution of funding across all services. The €3 million that was committed for services for children with autism must be spent in the next three years for the benefit of the entire country and not withheld on the basis that the promised review is not yet complete.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Yesterday's report in The Irish Times raises many questions, including, yet again, a question regarding the Minister's decision-making capacity. Why is it, some 18 months after the welcome announcement in January 2012 of €3 million in additional, much needed funding for autism services, that we find that only 10% of that allocation has been spent, all of it this year, with nothing at all utilised in the entirety of 2012? Why is it that of the €300,000 drawn down, only one facility has benefited? Is it a coincidence that this facility is in an area close to the Minister's political heartland? Why make an exception of this facility knowing, as he surely must and as I certainly do, of the cries of parents of children with autism right across the State who are struggling to secure their essential support needs? It is wholly unacceptable. Will the Minister indicate when he expects the independent review that he has commissioned to be published, if he will bring it to a close as quickly as possible and when the remaining funds will be allocated?

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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As the Minister knows, it is a struggle for the parents of children with autism to obtain the services and support they need, even more so in the current climate of cutbacks. As such, it is utterly inexplicable that he would make the welcome announcement of an additional €3 million for the provision of these services only for us now to discover, through a freedom of information request, that only 10% of that funding has been allocated, all of it to Beechpark Services in the Minister's constituency in north Dublin. Why was that area prioritised, while others, where there is just as much need, have been left to wait? There are 138 people awaiting services in north Dublin, while 241 are on the waiting list for services provided by Beechpark Services in south and west Dublin. Will the Minister explain the anomaly, whereby north Dublin, although undoubtedly in need of funding, was given priority in the provision of services over areas in the city?

These questions have greater strength given the debacle over the issue of primary care centres in the Minister's constituency and how two were bumped up from an original list, which led to the resignation of the former Minister of State. The Minister has to answer the question of whether he is the Minister for Health or the Minister for north Dublin.

James Reilly (Dublin North, Fine Gael)
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First, to correct the record, Beechpark Services is not located in my constituency. I thank the Deputies for their concern and raising this matter. The HSE publication National Review of Autism Services: Past, Present and Way Forward and the Progressing Disability Services for Children and Young People project, known as the zero to eighteens programme, set out the policy context for the provision of autism services to children and young people. The objective of the zero to eighteens programme is to achieve a national, unified approach to delivering disability health services so that there is a clear pathway to services for all children, regardless of where they live, what school they go to or the nature of their disability.

Disability health services for children, including those for autism, are organised very differently across the country because of the way in which they have been initiated and developed over many years. Some organisations provide services for a specific group of children who have a particular kind of disability, or they may only operate in one part of the country. This means that while there are excellent services for some children in an area, there may be little or none for others. The zero to eighteens programme aims to remedy this inequity in service provision. To address some of the inequity, I announced the allocation of €1 million in funding for autism and early intervention services in 2012. Beechpark is a regional, community-based HSE service which provides specialised clinical supports for children with a specific diagnosis of autistic spectrum disorder up to 18 years of age who attend designated special schools, outreach preschools and outreach classes in Dublin, Kildare and Wicklow. Based on a report prepared by the HSE, I approved €300,000 of this funding, which equates to five therapist posts, for Beechpark Services in Dublin, north of the Liffey, to address the pressing needs of its catchment area, with a particular emphasis on reducing waiting times.

It is important for Deputies to recognise the scale of the work that will be enabled by the investment. I have a list of 29 schools in which services for autism will now be put in place as a result of the new posts in Beechpark Services in north Dublin. Far from being in my constituency, as is being suggested, the vast bulk of them are not. They are schools in Donnycarney, Finglas, Castleknock, Glasnevin, Artane, Clonee, Swords, Fairview, Tyrellstown and many other places.

The report also proposed an allocation for Beechpark in the Dublin-mid-Leinster region which was to be rolled out in year two. I also established an independent review group in 2012 to look at the Beechpark model of services and how resources could be used in the best and most effective way in light of the HSE review of autism services and the reorganisation of services that is under way in line with the zero to eighteens programme. Further funding for Beechpark and other regions of the country is scheduled to be released after the outcome of this review. I understand the review is expected to be concluded shortly.

Following ongoing discussions on the best way forward for Beechpark autism services, the HSE has confirmed that the funding approved will be allocated to HSE Dublin North East in 2013 for Beechpark in order to address the waiting list for services in Dublin north-east. This will provide, in the first instance, for the recruitment of the necessary five therapy staff. I am aware, however, that addressing the significant pressures in Dublin north east is only a starting point. The HSE has confirmed that the €300,000 is just a first step in 2013. The balance of funding for autism and early intervention services nationally will be made available. The allocation of these further resources must be considered in light of the findings of the independent review.

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Minister for his reply. The bottom line is that he decided to go off and announce that he was going to provide an additional €3 million in funding for autism services. He then decided to announce a review. One of his senior officials described the Minister's announcement in January 2012 as "news to me". Another said that it had come "out of the blue". When it was announced, his decision to carry out a review equally came out of the blue to many of the people providing services, including Dr. Kate Hartigan. Nobody denies that Dublin North deserves the resources and the allocation but what is critical is that priority was certainly given to the allocation north of the Liffey while services elsewhere are under huge stress and pressure. Children in any part of the country are entitled to equality and equity in accessing these services. Rather than carrying out reviews and stalling the process, the Minister should have ensured that the allocation that was made, granted and announced by him was supported and enhanced, as was the wish of Dr. Kate Hartigan and others, who felt this was particularly important for the development of services and equality throughout the country.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister knows personally, at least as well as anybody else, that there is an identifiable need in this area that does not need to be highlighted by an independent review. The information is undoubtedly within the system, within the HSE and within the Minister's Department. There is no excusing the fact that he did not use any of the announced funding in 2012. He has used only €300,000 of it this year and, while another €1 million is signalled for 2014, there is now €1.7 million that could be spent on enhancing services for children with autism at different locations around the State. That need is beyond review. It is long established and is crying out to be addressed. How quickly will the Minister ensure that the essential money is released to those who will make the best use of it and deliver the best additional high quality services for children in all of these other locations, who most certainly are as deserving as the children of the greater north Dublin area for whom the Minister has already provided?

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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I wish to make it absolutely clear that I am delighted that people on the north side of Dublin, whether from the Minister's constituency or other parts of north Dublin, are to receive extra services. What is not clear from the Minister's answer is why only a small portion of the money that he initially announced at the end of 2011 has been allocated and why the money that was allocated has been allocated first to north Dublin, the Minister's political heartland. Could he explain why that is the case? What are the criteria for selecting the areas to which money is allocated, and why has it not been allocated? On the face of it, according to the waiting list figures, there is as much demand and need in other parts of Dublin and other parts of the country as there was in north Dublin. Otherwise, inevitably, there lingers a suspicion of favouritism for particular areas.

James Reilly (Dublin North, Fine Gael)
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I am interested in ensuring equity of access across the system and I look forward to getting the report I have mentioned in the shortest possible time - in the next few weeks, I hope. That will allow us to distribute the resources available to us as equitably as possible and as soon as possible. I have been asked specifically why I took the decision I took. I allude to the report that has been published on the Department's website and is there for all to see. The back page offers two options.

The overall allocation of €300,000 equates to approximately five whole-time equivalents. Option one was the deployment of the total resource to address the waiting lists either in Dublin north east or in the Dublin-mid-Leinster region, which would enable a more effective and speedy approach. This option could only operate equitably on the basis that if one region got the entire allocation in 2012, the remaining regions would get a similar allocation in 2013. Accordingly, in 2012, Dublin north-east would receive €300,000, while in 2013, Dublin-mid-Leinster would receive €300,000. Option 2 was the division of the €300,000 in line with waiting list data as detailed above. The 138 children from Dublin north east on waiting lists constitute 36% of the overall waiting lists for Beechpark Services, which would come to €108,000. The remainder, €192,000, would go to the 241 children from Dublin-mid-Leinster.

In the context of the focus on pressures on Dublin north east and representations by schools and parents to the Department of Health, an allocation of €108,000 would provide for just short of two whole-time equivalent basic-grade clinicians to enhance the north-side team providing these services. While the additional resource would have a positive impact on tackling the waiting list, the speed of progress would be much greater if a full multidisciplinary team was approved. I followed the Health Service Executive’s recommendations. Although Deputy Kelleher has name-checked an individual, this report comes from the HSE, not an individual.

Billy Kelleher (Cork North Central, Fianna Fail)
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I was quoting from information provided in response to freedom of information requests.