Frank O'Rourke (Kildare North, Fianna Fail)
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I thank the Minister of State for coming to the House to discuss this Topical Issue matter in the absence of the Minister of State with special responsibility for disability issues, Deputy Finian McGrath. Hopefully, she will be able to take some of the concerns I will raise back to the Minister of State. I raise these concerns pertaining to the progress of disability services and the lack of those services on the ground on behalf of my constituents in Kildare North who are parents of children with disabilities.

As I raise this Topical Issue matter, I am conscious that the Minister of State, Deputy Finian McGrath, met these parents on a number of occasions at my request. I want to put that on the record and thank him for doing that and for his co-operation. Before Christmas, I think, in November, he also secured extra funding in this area. Unfortunately, however, as in so many other areas, we are not seeing the dividend of that investment on the ground and services are not being delivered.

One area I want to focus on is the assessment of need. At the moment, an assessment of need is carried out on a child with a disability, but despite what is being said, a period of between 18 and 24 months elapses from then until the actual care plan is implemented. A child with a disability, or some degree of special need, needs to get the appropriate supports as early as possible, as any of us would in order to reach our maximum potential, but that is not happening. When the actual care plan begins to be implemented after 18 to 24 months, that child's disability has developed and progressed further. The care plan that is being implemented therefore does not accurately reflect the child's needs at that time. That is a massive problem.

Occupational therapy, speech and language therapy and physiotherapy, which are critically important in these cases, are not there. They are not being delivered. The reason the resources are not forthcoming and the care plan is not being implemented is not that they are not being provided and the staff do not want to implement the care plan but rather the staff are not there and the services for these children and their parents are not there. We all acknowledge that these parents work tremendously hard. They do an excellent job at caring for these children and helping them to develop to their maximum potential. They do wonderful work. However, it should not be part of their job to fight the system every single day to get services that are needed for their child's development to progress. That is what is happening at the moment, and that is what needs to change.

Another concern is that reviews are suffering because care plans are not being implemented. Once an assessment of need has been carried out, a care plan should be implemented quickly in the areas identified. Thereafter, a review of the case and the child's needs should be carried out within 18 months or two years and the plan progressed accordingly. None of this is happening, however, despite what the Minister of State may have been told and what she may tell me. I speak and engage with the parents in question, who also met the Minister of State, Deputy Finian McGrath, and that is the message they have given.

Certain equipment is critical in helping children with disabilities to make progress. In one case before Christmas, a child needed insoles to assist with walking. In a letter to the child's parents, the Health Service Executive, HSE, stated the insoles could not be provided because it did not have the funds to do so. I provided the Minister of State, Deputy Finian McGrath, with a copy of the letter in question, which flatly contradicts the statement made by the Minister of State six weeks ago that there was plenty of money available for services. While I do not doubt the Government's commitment to provide funding for services for disabled children and young adults, this funding is not getting through and the services are not being delivered.

Area respite is vital for carers, parents and guardians of children with disabilities as it allow them to recharge. However, it is not available to some carers. Providing care is a big job and parents need to be at the top of the game at all times to give their child the full care required. If respite and other appropriate and necessary supports are not available, it will have a negative impact on parents.

The Government must deliver in the areas I have highlighted. I will raise a number of other issues when the Minister of State has responded.

Catherine Byrne (Dublin South Central, Fine Gael)
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On behalf of the Minister of State, Deputy Finian McGrath, I thank the Deputy for raising this important issue. I apologise that the Minister of State cannot be present for this discussion. I will make a statement and refer to some of the issues the Deputy raised. I hope I will also be able to fill in some of the gaps for the Deputy.

I am pleased to confirm that the national programme, Progressing Disability Services for Children and Young People, is changing the way services are provided across the country to make access to services equitable and consistent for all. The programme is based on family-centred practice based around a child's natural environments and the everyday routines, activities and places of daily life of the child and his or her family. This model is recognised as an effective model of support for children with complex needs and lifelong disabilities to support the development of skills to maximise active participation within their communities and daily life. It also recognises that children with complex needs may present with requirements across a number of areas and that services provided in isolation within one environment of a child's life are not appropriate. For these reasons, support and intervention are provided in a variety of environments such as home, school, clinic and community settings.

Under the national programme, all children disability services in Kildare west Wicklow were reconfigured in May 2014 and three network disability teams were established in south Kildare west Wicklow, mid-Kildare west Wicklow and north Kildare, respectively. Significant investment has been made in the children disability network teams in Kildare west Wicklow. In addition to the staff that reconfigured in May 2014, an additional 22 permanent posts have been allocated to the Kildare west Wicklow network disability teams. Another nine temporary posts have also been provided as part of a waiting list initiative.

The Kildare west Wicklow teams have developed strong working relationships with many of the schools in the area. Supporting children to actively participate within the school environment forms a significant part of the daily work of the network disability teams' therapists. The referral rate to the service continues to grow across all three teams. The average referral rate to the Kildare west Wicklow network disabilities team is 35 children per month, while the current average wait time for services is between six and 13 months.

Frank O'Rourke (Kildare North, Fianna Fail)
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While I appreciate the Minister of State's comment, if they were true, I would not need to raise this issue. The reason I am raising the issue is that the parents of children with disabilities are tired and worn out. They are at their wits' end as they seek to access the necessary and appropriate supports and services identified for their children. They are no longer able to fight. We have all heard about various cases. The Acting Chairman, Deputy Durkan, and I share the same constituency and both of us have heard these problems being outlined at many meetings. Given that the problem has been ongoing for many years, I am not making a party political point.

Services are not available and parents are no longer able to fight. They want the services identified as necessary for their children to be provided. As I outlined, once an assessment of need has been carried out, a care plan should quickly follow. A review should then be carried out after a certain period and the care plan should be changed and modified according to the child's needs as he or she develops. The equipment identified as necessary for a child should also provided and families should not be told such equipment is not available because of a lack of money. Respite is not available at the moment and must be provided.

Behavioural therapists and psychiatrists must also be involved in the assessment and review teams, which is currently not the case. In addition, the July provision should be made available to all children with mild and profound disabilities. This has not been the case for some time. There is also a lack of communication between the Department, the HSE and parents. This is a critical area and the parents of children with disabilities do wonderful work. If they are to sustain this work, they need access to the supports and services identified as necessary for their children and which they deserve.

I thank the Minister of State for taking this matter. I hope she will take my message back to the Minister of State, Deputy Finian McGrath, who kindly met me a couple of times to discuss this issue. I ask that the Minister of State meet me again in the next few weeks to discuss the points I have raised, with a view to providing a timeline for the delivery of these issues, which are important for children who require services and their parents.

Catherine Byrne (Dublin South Central, Fine Gael)
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As I indicated, the rate of referral to the services in Kildare west Wicklow continues to grow. As a public representative, I understand that parents need to have their children assessed within a specified timeframe. If a timely assessment is not carried out, a child will, unfortunately, regress to a certain extent. While there is no issue with funding for services, sometimes staff are not available.

Having spoken to the Minister of State with responsibility for disability, Deputy Finian McGrath, I know everything is being done to deliver services to facilitate respite, especially for children. We all understand that in families with a child with special needs, there can be turmoil in the home and parents need a break to be able to take time for themselves. I concur with many of the points made by Deputy O'Rourke and I will convey them to the Minister of State, Deputy McGrath. I will also ask the Minister of State to meet Deputy O'Rourke.

The Kildare west Wicklow network disabilities teams currently support 367 children in services. There are 21 children on the waiting list and the average waiting time is between seven and 13 months. The area has 19.7 speech and language therapist posts and there is one vacancy in this area arising from long-term sick leave. The service also has 11.8 psychotherapist posts and there are five vacancies for psychotherapists, which is a significant vacancy rate. The Deputy is correct that services are not available in certain areas. Recruitment is a problem in all parts of the health service.