Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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I thank the Minister of State for listening to the concern and, I hope, providing some answers. I raise the issue of assessments of need and the bleak reality facing the parents of children who are waiting for that all-important assessment of need. As the Minister of State knows, the assessment of more than 4,000 children nationally is overdue, which demonstrates a huge problem with a ripple effect that seeps into every aspect of those children's lives. As we know, for any child with special needs or a disability, early intervention is key. An early diagnosis is critical to having a positive outcome to provide a fast and effective intervention of therapies.

It was great to have the Minister of State in Castleblayney recently. He opened the new group home, where there is fantastic work happening for adults and young people with disabilities. In the wider Cavan-Monaghan area, however, the assessment of need is overdue for 177 children. These children, therefore, are denied the speech and language and occupational therapies they need, which negatively affects the ability of these children to access the supports they need for their education and schooling. While waiting times for assessments of need is at an unacceptable level, it is exacerbated by the fact that Cavan and Monaghan were without an assessment of needs officer from September 2017 to May 2018. That is nine months without the expertise to conduct the critically important assessment of need for those 177 children, who are arguably the most vulnerable as they struggle to grow, achieve and develop their individual potential, not only because of the lack of appropriate intervention but because of the absence of any intervention. Will the Minister of State address this immediately by employing extra staff, providing extra resources and doing whatever it takes to clear these backlogs and reach the three-month turnaround time that parents should be able to expect from their service from the time of application to the implementation of services such as speech and language and occupational therapies?

In case the Minister of State thinks for one second I am exaggerating the local situation in Cavan and Monaghan, I wish to outline two cases from a long list of cases that are coming through my office. One little boy has waited four years and eight months for his assessment of need. As the Minister of State will be aware, there is a mechanism for parents to make a complaint if they feel the process is failing them. Out of pure frustration, these parents used that mechanism but, alas, they are no closer to achieving their initial assessment of need for their child. Not only is their child losing out on the therapies he needs, he is also missing out on the special needs assistant, SNA, whom he desperately needs to support and assist him in school. It must be said that the school makes a great effort to assist this little boy, but I have photographs in my office that the parents brought in of bangs and bruises on the child from when he fell in school. His mobility and ability to get around school are affected because he does not have that SNA. He cannot wait four years and eight months for an assessment of need.

The second case I wish to highlight is another little boy who desperately needs an occupational therapist. I have a letter from the child development team in Cavan-Monaghan informing the parents that this little boy is on the list for his occupational therapy but the estimated time he can expect to wait is four years and five months. He has autism and needs a home and school plan, but his integration in his mainstream school is achievable with the right resources in place. The crux of the problem seems to be that there is a gap in the transfer for children from Enable Ireland to the child development team.

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this important issue of assessments of need. She mentioned my trip to Castleblayney last Monday and I thank her for the warm reception I received. It was great to meet the families, parents and carers and to say well done to everyone directly involved.

As the Deputy may be aware, Part 2 of the Disability Act 2005 provides for a statutory system for the assessment of individual health service needs, an assessment report, a service statement and a complaints mechanism. Since its commencement in 2007, there have been significant year-on-year increases in the number of children applying both for assessment of need and for disability services generally. Regrettably, these increases have led to extended waiting periods being experienced, with almost 4,000 applications overdue for completion. The Deputy is not exaggerating, therefore, when she raises these issues. The HSE and I recognise that assessments of need and early intervention services for children with disabilities are paramount and need to be improved. I am aware the HSE has undertaken a number of initiatives to address the excessive waiting times.

Assessment of need compliance improvement plans are in place in all areas and are being actively monitored. Additional resources have been allocated to the areas with the most significant backlogs and those areas have shown a steady decrease in percentage of overdue assessments over the first six months of this year. HSE disability services is currently engaged in a major reconfiguration of its existing therapy resources for children with disabilities into multi-disciplinary geographically based teams, as part of its national programme on progressing disability services for children and young people, 0 to 18 years. The key objective of this programme is to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities and their families to services, regardless of where they live, what school they go to or the nature of the individual child’s difficulties. Evidence to date from areas where this has been rolled out shows that implementation of this programme will also have a positive impact on waiting lists both for assessments of need and therapy provision. It is estimated that, on average, one in five children completing an assessment of need do not have a disability. As Deputy Smyth said, I want to focus on the children in most need, and 20% do not have a disability. The introduction of a new standard operating procedure, SOP, for carrying out assessments of need is expected to reduce the number of inappropriate referrals for assessment and will facilitate more timely access for children and young people. While the introduction of the SOP has been delayed by necessary discussions and consultations with professional bodies, I understand that this process is now entering its final stages.

The Deputy will also be aware that funding for an additional 100 therapy posts was secured as part of budget 2019. These additional posts, along with the reconfiguration of services and other initiatives outlined, are expected to have a significant positive impact on waiting times for assessment of need and ultimately therapy service delivery. It will also help meet the needs of children and young people in a more efficient, effective and equitable manner. I accept the Deputy's point about there being 177 children in Cavan and Monaghan. Something must be done. It is unacceptable that Cavan and Monaghan have been without an officer for nine months and that children are waiting for four years and five months. That is why I am pushing very strongly to resolve these issues.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
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The move by children from Enable Ireland to the child development team seems to be where the gap occurs and where children lose out on the interventions they need. They are getting lost in the transfer and there does not seem to be the continuity of care. As a result, these children are suffering. Parents tell me that while they are in Enable Ireland, the services are there and they get the intervention they need but once they reach six years of age, they go on to the child development team. It is heartbreaking to see people being told that they will have to wait up to four years and five months.

Nine months is too long for the system to lack the expertise and it must have exacerbated the problem in Cavan and Monaghan. I ask the Minister of State to take a positive bias towards the constituency to ensure the backlog is cleared and that parents can get the services they need in the turnaround time of three months laid out by the Department. Ultimately, if the interventions are not there early, there will be repercussions. It has a ripple effect at home, in school, and in school work and it is holding these children back from developing, and from getting the education they deserve and need. It is their basic right to have that. I ask the Minister of State to ensure that such positions do not lie vacant. Can he shine light on why such a position would lie vacant for nine months?

I welcome the additional posts to address the issue. They are needed and are welcome. I hope we will see the benefits for the children on those waiting lists.

Finian McGrath (Dublin Bay North, Independent)
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I share Deputy Smyth's concerns and fully appreciate the frustration felt by parents and public representatives at excessive waiting times. I assure the Deputy that the HSE and myself are acutely aware of the urgency of this matter. The implementation of the compliance improvement plans, reconfiguration of services, the prioritisation of areas of greatest need, the standardisation of the assessment need process and the introduction of revised standard operating procedure are some of the many initiatives being undertaken by the HSE nationally to address the waiting times for assessments and needs. The Deputy referred to Enable Ireland and I agree about the continuity of care. There are vacancies and there is a problem getting people into posts. Recently, many occupational therapists, psychologists and speech and language therapists have returned from England and things are improving. A figure of 177 is something that we should make a dent in and make a positive contribution. It is a figure that could be targeted and dealt with by providing extra resources that could resolve the problem before it goes further out of control. The Deputy spoke of a positive intervention. I will make my views known to the HSE, which I am currently in talks over the extra funding in the budget 2019. I give a commitment that I will make it a priority issue.