Maurice Quinlivan (Limerick City, Sinn Fein)
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I wish to bring an important issue about children's psychology services in Limerick to the attention of the Minister of State, Deputy Finian McGrath, and the Minister for Health, Deputy Harris, and I ask them to take immediate action. I am very disappointed that the Minister is not here to answer for his decisions but I know that the Minister of State will relay my concerns.

Limerick early intervention service and school-age teams have written to parents in the region to say that only urgent cases for those children who attend the school-age children's services aged six to 18 years in Blackberry Park can now be dealt with due to the lack of psychology staff and resources and all other children are to be put on waiting lists. This is completely unacceptable. These services are vital for children. Everyone knows that early intervention is key to addressing many problems. I have been in contact with the service in Limerick and this is the very last thing that it wanted to do. It is completely overwhelmed and understaffed and receiving no help. In this letter, urgent cases are defined as children who are self-harming or have suicidal ideas, children who are hurting others and children whose school placement is at risk of breaking. This should not be the standard at which we provide these critical services. It is completely unacceptable that children, other than those in these extreme cases, are expected to go on waiting lists.

I brought this matter to the Minister's attention in February when I raised concerns about the waiting lists and lack of staff in the service in Limerick. At that stage the figures showed lengthy waiting times for children. I had hoped that by bringing it to the Minister's attention action taken. It is clear, however, that nothing has been done.

This problem has escalated severely since then. The lack of staff and resources in this service in Limerick is astonishing. I have been in contact with the senior clinical psychologist in the school age service, Dr. Moore, who has worked in the service for nine years. She said that when she started the caseload was 120 children but that it is now 410. Despite this, there is just one full-time and one part-time senior grade clinical psychologist to deal with the massive workload. Staffing has not increased despite the trebling of the caseload. How is this allowed to happen? How is this continuing?

The Government is currently deciding how much money it can put away in the rainy day fund. How can the Minister of State tell me that hundreds of millions of euro are better used by being left sitting in a bank account than by giving a tiny fraction to this incredibly important service for children? What does the Minister of State have to say about this and what actions will he take?

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Maurice Quinlivan for raising this very important issue and highlighting this need. I am pleased to confirm that a Programme for a Partnership Government commits this Government to improving services and increasing supports for people with disabilities, particularly early assessment and intervention for children with special needs.

The programme for Government supports the Blackberry early intervention service in Limerick in providing a service to 410 children with very complex needs. A high proportion of the children on the caseload require urgent intervention. Following a recent review of the psychology service, all parents were informed of the need to prioritise the waiting list based on need and that a psychology intervention waiting list was being created. There are now two waiting lists for psychology intervention services - an urgent list and a standard list. Urgent cases will be prioritised for intervention and these include: children who are self-harming, to whom the Deputy referred, or who have suicidal ideas; children who are hurting others; and children whose school placement is at risk of breaking down. All other referrals will be placed on the standard psychology waiting list in order of date of referral to the service. The letter the Deputy refers to did not state that only extreme urgent cases can be dealt with. Children already involved with the psychology service will continue to receive their intervention as planned.

The HSE will continue to support Blackberry early intervention teams to deliver services in line with the service agreements. I support the Deputy's genuine concern. It is recognised that early intervention services and services for school aged children with disabilities need to be improved and organised more effectively. This process has started and is well under way. The HSE is currently engaged in a reconfiguration of existing therapy resources to geographically based teams for children aged from zero to 18 years. The objective of the new model of assessment and intervention is to provide one clear referral pathway for all children under 18 years, irrespective of their disability, where they live or the school they attend. In addition, funding of €5 million was provided in 2016 for the development of psychology services in primary care with a focus on enhanced counselling interventions for children and adolescents. The recruitment process for 114 assistant psychology posts and 20 staff grade psychologists is ongoing.

Maurice Quinlivan (Limerick City, Sinn Fein)
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I thank the Minister of State for his response. To be honest I am disappointed. The Minister of State said that I said that only extreme urgent cases would be dealt with. He is probably right there, but the letter basically said that the waiting list for psychological intervention is likely to be extensive and it urged parents to seek support from other local agencies. Parents read that to mean that they were to find support themselves and get whatever other resources or funding they could find out about. Parents in Limerick are extremely concerned about this development. The services are critical for some children. When I raised this issue back in February the waiting list for school age services was huge. At that stage the number of children on waiting lists for school age assessment and intervention stood at 632. Some 577 children were on the school age waiting list for intervention alone, with 245 of these waiting for more than eight months for intervention. These are truly shocking figures.

The Education for Persons with Special Educational Needs Act 2004 states that every child with special needs is entitled to an education and the notion of inclusion is promoted in that Act. Inclusion, however, is not a reality on the ground as the supports are simply not there to allow for it. The solution is very straightforward. Limerick early intervention services and school age teams need more staff, more funding and more resources immediately. I urge the Minister of State to look into the case I have highlighted, to make contact with the HSE and to ensure the service is provided with what it needs to deliver its services for children in Limerick. I take this opportunity to commend the staff in the Limerick early intervention services and school age teams for working so hard for so many children with the few resources it has. The solution is straightforward and the benefits for these children and their families will be massive.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Quinlivan for his question. I agree with him about commending the staff. They do an excellent job. I was in Limerick recently and I saw at first hand the fantastic work that is done with young adults with intellectual disabilities in respect of third level education and inclusive education. This is very much in line with the UN Convention on the Rights of Persons with Disabilities. I know Limerick is leading on that particular issue. The Deputy's concerns are genuine. We need immediate action. I will relay the Deputy's concerns to the Minister. I agree with him that services are critical. The shortage of psychologists is an issue. That is something we are dealing with in other counties as well. However, the process of recruiting 114 assistant psychologists and 20 staff grade psychologists is ongoing. That should improve the situation.

On the waiting lists, I have no difficulty in saying that the Limerick early intervention service is doing an excellent job. The fact that it is dealing with 410 children and that it has these long waiting lists is something we have to deal with. I also recognise that the first class early intervention services and the services for school age children with disabilities are paramount. There are challenges, however. I accept that. It is expected that the transition of services into multidisciplinary geographically based teams will improve waiting times for children accessing early intervention services. The HSE and partner agencies will remain fully committed to the delivery of needs-based services to children with complex needs within the mid-west disability services, based on evidence-based practice.

On a personal level, over the coming weeks we in the Department of Health will be having talks with the HSE in respect of the Estimates. I have put early intervention services in my top five priorities. I also have to deal with crises in emergency residential services for older adults with intellectual disabilities, but the issues the Deputy raised today are on my priority list. Many colleagues concur with the Deputy. There is great support for the issue in the House. They see the problem. We need to do it, but we also have staffing issues. We have shortages of people and recruitment issues. We are really working hard in going abroad and trying to attract many of our psychologists and speech and language therapists whom we lost over recent years back to Ireland. The Deputy can take it that I will relay his concerns and push that agenda.