Joan Collins (Dublin South Central, Independent)
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37. To ask the Minister for Health if staff and resources will be provided in order to resolve a situation (details supplied) regarding the Dublin south west school age team [50999/18]

Joan Collins (Dublin South Central, Independent)
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There are 298 children on the Dublin south west school age team's waiting list. A further 18 are awaiting transition from the early intervention team to the school age team's waiting list. The waiting time to see the school age team is 41 months which is growing monthly in circumstances in which the team does not have the capacity to safely take on additional cases. There has been no movement on the waiting list in the past ten months. This situation has developed in the past few years. The limited human resources to address waiting lists for intervention, coupled with demand and high deprivation in the area, have been widely reported on. I ask for immediate intervention to resolve this shameful situation.

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this very important issue. The HSE and I acknowledge that waiting times to access the school age team for children with disabilities in CHO 7 which covers Dublin south, Kildare west and Wicklow are unacceptably long. It is due to high demand for services and challenges in staff recruitment and retention in the area. The Dublin south, Kildare west and Wicklow community healthcare organisation area has a growing population, with an increase in the number of children with a disability. The population of the area has increased by 33,175, or approximately 5%, since the 2011 census. In addition to the increase in population, a high proportion of children presenting to disability teams have a diagnosis or suspected diagnosis of autism spectrum disorder. A typical ASD diagnosis can take more than 30 hours to complete.

While the CHO 7 school age team is operating without a dedicated team manager, recruitment to fill the post is under way via a national recruitment process. It is an essential appointment in managing resources and waiting lists within the team. The HSE is engaged in a reconfiguration of existing therapy resources to provide geographically-based teams for children from birth to 18 years. The intention is to roll out an integrated care model which will allow children, whatever the nature of their disability, to be seen as close to home and school as possible. The team manager appointment is key to facilitating the reconfiguration. Funding for an additional 100 therapy posts was secured for children's disability services as part of budget 2019, in which I was glad to be involved. Some of the posts will be allocated to CHO 7. The additional posts, with the reconfiguration of services and other innovative approaches, will have a significant positive impact on waiting times for assessment and therapy service delivery over the course of the next year.

Joan Collins (Dublin South Central, Independent)
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I thank the Minister of State. This situation has developed in the past two to three years. The team in CHO 7 has flagged the pressure it is under and the fact that waiting lists have been stagnant for the past 41 months. In reply to an earlier question I was told that there had been no movement on the waiting list in the past ten months owing to the volume of children transitioning from early intervention services, capacity caseloads among team members, delays in the filling of vacancies and maternity leave positions not being filled. The reply also stated the team was operating without a dedicated manager, which is crucial. There is a lack of services. The resources are as follows. One staff grade educational psychologist post has been filled, but the person in question is soon to move on on promotion. There is a staff grade psychologist. However, because of engagement with psychological initiatives, the person in question is only available at the rate of 0.6. Staffing levels are dire and must be addressed. The children waiting for these services need them today, not next month or next year.

Finian McGrath (Dublin Bay North, Independent)
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I accept completely that it is important to intervene as early as possible. I take that point at a personal level. I also accept that the waiting lists are unacceptably long. However, there is difficulty in filling some of the positions. That is the bad news. The good news is that in recent months I have noticed that a lot of occupational and speech and language therapists who emigrated during the austerity years are returning to Ireland and that some of them are filling these posts. The recruitment of a further 40 occupational therapists is nearing completion, while the occupational service improvement working group is reviewing options in the allocation of posts across CHO areas. This is being done having regard to the occupational therapy service report on improvements in primary care. Funding for an additional 100 therapy posts was secured in budget 2019 and they will have an impact. The reality is that we have to focus on getting people in place in order that we can provide services. There has been a huge increase in the numbers of families and children presenting in CHO 7 with autism spectrum disorder. That is something to which we are trying to respond as quickly as possible.

Joan Collins (Dublin South Central, Independent)
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I take on board the Minister of State's point about problems in recruiting staff to fill these positions. I took up the issue initially on behalf of a young lad with severe autism in foster care. He went through the Cheeverstown House process and Abacus special school and discharged to the school age team in Chamber House in Tallaght and placed on its waiting list three years ago. He was put on the waiting list at the age of five years. He is now eight years old and still waiting for basic services. He cannot even get into Chamber House. He is just one of the 298 children on the Dublin south west school age team waiting list. There must be a radical rethink. While I understand there are problems in recruiting, this issue was flagged a long time ago. I am not saying the Minister of State is directly responsible; he has a legacy he is addressing. However, there has to be a radical approach. I am sure CHO 7 is not the only area in which this is happening. I am sure it is also happening in other parts of the country. We have to think radically, given that 298 children are waiting.

Finian McGrath (Dublin Bay North, Independent)
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I do not dispute the issue. There are problems in the Deputy's area, as well as in counties Kildare, Kerry, Wexford and Cork. That is the reality. What we must do is try to put the resources in place and fix the problems. I managed to secure an extra €150 million for disability services in budget 2019. I give the House a commitment that we are sitting down to finalise the HSE's service plan for 2019 and that I have put early intervention and speech and language services among my top five priorities. Of course, I face issues such as the provision of emergency residential places and personal assistance hours, but I have put the issues of assessment of needs and speech and language therapy services at No. 1 in the discussions. That process will be completed in the next week to ten days and we will I hope have something in that regard. We have an issue that we must resolve. We must ensure there is investment and that staff are provided. The earlier one intervenes for a child with any disability, the better it is in the long term. It is good for the family and the child, but it is also good for the Exchequer in the provision of public funding.