Dáil debates
Thursday, 2 July 2015
Topical Issue Debate
Autism Support Services
7:45 pm
Ciara Conway (Waterford, Labour)
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I am highlighting an issue that has been causing ongoing difficulties, which I have mentioned previously to the Department. It concerns diagnoses and assessments for those with autism. According to a study from the Irish Society for Autism, about one in 100 people in Ireland have autism. It is imperative that if a person is presenting with autism, he or she receives an assessment as soon as possible to determine the services and supports that are required.
The reason I raise this issue as a Topical Issue is borne out of huge frustration in that I submitted parliamentary questions on 9 June and I was informed today that the questions were misdirected within the HSE. This is hugely frustrating. It is a source of great difficulty for many families in Waterford to find out how many children are currently waiting for a full diagnostic assessment for autism in Waterford University Hospital, the composition of the team, whether all the positions are covered, how many psychologists on the autism team can give a full diagnostic assessment, how long will it take to recruit staff, and what the HSE plan is in the absence of a fully trained psychologist to undertake the assessment procedure. These issues are barriers that parents and, more particularly, young children face every day. I have been waiting for an answer for nearly five weeks and this is a source of huge frustration.
I am also concerned that vacancies currently remain to be filled. It has come to my attention that the speech and language therapist on the autism team in WUH will be leaving in July. This leaves the diagnostic team without a psychologist and a speech and language therapist. These are two key roles. If a child presents with difficulties and a diagnosis for that child is not provided, it prevents the child from getting the services in a timely way. We all know that the sooner services can intervene with the child, the better for the child and, more important, the better the outcome in the long run.
By way of example, I refer to the case of a young boy who, as far back as November 2013, was assessed by the speech and language therapist who concluded that the child was showing some clinical significant markers for autism. It was stated that he would be monitored in future sessions and that he would be referred to the autism team as required. There were further reports from the occupational therapist and assessments were carried out over a number of months which were referring this child to an autism spectrum disorder team for the assessment. The family was informed this would happen in February or March of 2014 and, to date, nothing has materialised. I use this as a case study to show the frustration. It has taken five weeks for me not to get an answer from the HSE and it has taken this young child and his family over a year not to get a service. That is not good enough.
It becomes more idiotic. In the meantime, the family has paid for a private assessment which can be accepted by the Department of Education and Skills but the HSE will not accept it. We have a Minister for Children and Youth Affairs who sits as a full Cabinet Minister and yet we cannot get the HSE and the Department of Education and Skills to work together for the betterment of our children's health, development and well-being. It is a crazy scenario. I understand the Minister of State may not have all the answers here tonight but he can see the frustration that is created when arms of government do not speak to or engage with each other. It creates huge frustration for parents who are very stressed and very concerned about their child's welfare and development.
Over recent months I have tabled a number of parliamentary questions about speech and language therapy staff in Waterford. We have significantly lower numbers of staff compared with other counties in the south east. It is a situation which results in huge frustration for children and their families right across Waterford city and county.
7:50 pm
Gerald Nash (Louth, Labour)
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I thank Deputy Conway for raising this matter which I am taking on behalf of my colleague, the Minister of State with responsibility for primary and social care, Deputy Kathleen Lynch. I assure Deputy Conway that the Government is committed to the provision and development of services for children with special needs, including autism, and to improving access by those children to services within available resources.
The HSE national review of autism services and the programme for progressing disabilities services for children and young people from birth to 18 years set out the overall policy context for the provision of autism services to children and young people, including assessment and intervention. This programme aims to remedy the variations in service provision that exist throughout the country. The objective of this programme is to bring about equity of access to disability services in all regions in the country and consistency of service delivery, with a clear pathway for children with disabilities and their families to services regardless of where they live, where these children go to school or the nature of the individual child's difficulties. The transition to this new service model is taking place on a phased basis and includes consultation and engagement with stakeholders, including service users and their families. A number of HSE community health care organisations are successfully implementing this programme which requires significant preparatory work in engaging with families, schools and local communities as well as new policies, procedures and protocols in respect of multidisciplinary and multi-agency working. Once this preparatory work has been completed, additional posts are being provided to support the implementation of the new model of service.
Waterford, which has been working with the other counties in the local HSE community health organisation area, has put in place the required governance structure which will allow for additional posts to be provided in 2015. Additional funding of €4 million has been allocated to the programme in 2015, equating to €6 million in a full year. A total of 120 new therapy posts will be provided throughout the country in 2015. Work on finalising the specific allocation of these posts is nearing completion. The HSE has informed me that Waterford and the south east are being prioritised for therapy posts in 2015.
On the specific issue of autism assessment raised by the Deputy, the HSE has informed me that the multidisciplinary autism diagnostic service for Waterford is operated by the community-based disability service. This comprises a senior clinical psychologist, a senior speech and language therapist, a senior occupational therapist and a liaison worker who is a senior team leader. The first two of these posts are or will soon be vacant and are being prioritised for filling by the HSE.
The Deputy has referred to the consultant child and adolescent psychiatrist post at Waterford University Hospital. In line with a Vision for Change, there is an important liaison role for these services with the disability services described earlier, particularly in relation to ASD cases where issues of co-morbidity or complexity arise. I understand the consultant child and adolescent psychiatrist post at Waterford University Hospital is vacant. The HSE has informed me that every effort is being made to fill this post, including on a temporary basis while the procedure for permanent filling is proceeding. The HSE is also finalising proposals for a second child and adolescent mental health service response in Waterford.
I am surprised that the Deputy could not have been provided with that information without having to go through this process of submitting a Topical Issue matter. Unfortunately, this happens too often. The Deputy should be entitled to have her parliamentary questions adequately responded to by the HSE and by the Minister for Health.
Ciara Conway (Waterford, Labour)
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I thank the Minister of State for his response. I welcome the news that Waterford will be prioritised for speech and language and other social care posts. We are particularly lacking in these services and it is beginning to raise its head more frequently. As a parent I know we all want the best for our children, and when this is not available, we will do what we can to ensure the child gets every access to the service.
The Minister of State referred in his reply to progressing the disability services for children and young people which is being piloted throughout the country. The case example I used illustrates clearly the absolute imperative for this to progress much more quickly when the Department of Education and Skills assesses a child and the HSE not willing to accept that report. Will the Minister of State relay this information back to the Minister because this is not good enough? It is the child and the family who are falling through the cracks. I do not understand why the psychologist in the HSE will not accept the information provided by a psychologist in the Department of Education and Skills.
The Minister of State will be aware that our colleague, Deputy Michael McCarthy, introduced the Autism Bill which has passed Second Stage. The Bill was introduced to provide for the preparation of an autism strategy and a national framework for addressing the specific needs of adults with autism. The broad thrust of the Bill was accepted by the Government and it was not opposed on Second Stage. Will the Minister of State contact the Whips and the relevant Minister to see how and when we can have this Bill on Committee Stage? The issues I have raised are specific to my area but I am sure they are replicated throughout the country for a group of children, young people and older adults who are deeply in need of our support.
I would appreciate if the Minister of State could do this. I ask him to ask the Minister of State to answer me urgently on the more specific questions that were not answered.
8:00 pm
Gerald Nash (Louth, Labour)
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As I said, I am taking this debate on behalf of the Minister of State, Deputy Kathleen Lynch. I will relay the concerns the Deputy raised to her. I understand she has been raising them for some time. I will repeat what I said. It is not satisfactory that Deputies are waiting an excessive period of time for information that should be available very quickly from the HSE which is an agency of the State. I hope we have moved some way towards addressing some of the concerns the Deputy has outlined. These are issues we all want to see addressed in our constituencies. I reassure her that the Government has an ongoing commitment to address the needs of all children with special needs, including those with autism. The particular issues she has raised relating to the autism diagnostic service in Waterford are being addressed by the HSE in Waterford and should be resolved in the near future, as I outlined.
I have some experience of the provision of services for young people with autism. For some time I served as a board member in my local ABA school and continue to work very closely with parents of children with autism. I am very familiar with the challenges them, those who teach in that sphere and those providing services. The Deputy is correct in pointing out that Deputy Michael McCarthy's Bill developed a very structured and strategic response to the challenges in autism service provision. In coming days I will establish with the Whip's office the status of the Bill and what the expectation is in getting it through the system. As the Deputy correctly pointed out, it was accepted on Second Stage. It should provide the House with some good policy indicators in terms of what we need to do in the future to provide the level of services to which children with autism are entitled.
We all know that early intervention is critical in allowing children with autism to realise their full potential. I have some experience in my constituency of dealing with the issue of, for example, the Department of Education and Skills or a school accepting a diagnosis from a qualified psychologist and the Department of Health or the HSE taking the opposite view, which I find bonkers. There needs to be consistency on the issue. However, that is a matter for another day. I will relay the Deputy's concerns to the Minister of State at the Department of Health, Deputy Kathleen Lynch, and we will establish the position on Deputy Michael McCarthy's Bill.