Maureen O'Sullivan (Dublin Central, Independent)
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I thank the Ceann Comhairle for the opportunity to discuss this matter. While I will refer to Dublin Central, the issues facing parents of children with special needs who are trying to access the relevant services is not confined to that constituency. I acknowledge the progress that has been made compared with the situation for children with special needs years ago. I also acknowledge those who work with children with special needs, especially in schools. In my experience in schools, I have seen the frustration of staff and parents. They know the needs of the children. They know the services that are needed and which will make a difference. Without the timely and appropriate services that a child requires, the situation worsens, the child regresses, and the needs become greater. Everybody agrees on the need for timely and appropriate services.

I have a particular case which brought all of this to light. I will not use the child's real name. I will call him Tom. He was born in 2005. Some months ago his parents had a feedback meeting with the clinical psychologist concerned. It was confirmed that Tom has autism spectrum disorder. The assessment of need identified what was needed: occupational therapy, OT, psychological services and speech and language services. The parents also received the service agreement, one part of which reads:

Under the Disability Act I am to provide you with a Service Statement specifying the Health Services which will be provided to [the boy in question] to address the needs identified in the Assessment Report. The Service Statement is based on a number of factors including the needs identified in the Assessment Report and the resources available to provide the services required.

Having consulted with you and potential service providers, I regret to inform you that the services outlined in the Assessment Report as required to address the needs identified for [the boy involved] are not available at present.

That is the reality. I also found out that there are no OT services for children over the age of 12 in Dublin Central. There is a waiting list of at least two years for child psychological services, and the waiting list for speech and language services is unknown. The recommendation of the psychologist was for the parents to get private services. The Minister of State can imagine the dilemma. Every parent wants to do the best for his or her child. It is a horrible scenario in which a child will get services if a parent has money but the child will not get those services he or she does not. I know the Minister of State's views on this. A child's special needs should not be dependent on the parents' ability to pay. The service level agreement did say that referrals have been made to the primary care service etc., and provided further information. However, we know the reality of the waiting list for OT, speech and language therapy and psychological services.

I will refer to the situation of another young boy who is ten or 11 years of age and has major behavioural issues. Eventually all the players came together. It was obvious that the needs of the child had to be addressed. Otherwise the situation would worsen considerably. The range of services that came together for this child was amazing. Why do we not have a central point of co-ordination for this? About six services were involved here. At the end of the day the child decided not to pursue services, with the backing of the parent. In this case a service is available but there is no compulsion. I know that to engage we must have the agreement of the individuals involved, but who is going to provide encouragement and support so that the parent and the child will engage? I am not being negative, but I know from my own experience of young people that if the child does not engage, we are storing up problems for the future.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Maureen O'Sullivan for raising this very important issue. I am well aware of her genuine concern for children with special needs in the Dublin Central area. Disability services in Dublin Central are delivered through a combination of directly provided HSE services and statutory, non-statutory and private providers. A wide range of these services are provided to children with special needs on behalf of the Dublin north city and county HSE community healthcare organisation, CHO. Children’s services are provided through multidisciplinary teams. and assessment and ongoing therapy are provided to meet their prioritised needs.

A Programme for a Partnership Government commits to improving services and increasing supports for people with disabilities, particularly for early assessment and intervention for children with special needs. However, at the core of the issue Deputy O'Sullivan raises is the fact that challenges concerning therapy services remain. The Government and I acknowledge that more therapists are needed to reduce waiting times for children and their families and to increase access to vital therapy assessments and interventions. Funding for an additional 100 therapy posts was secured as part of budget 2019. A commitment to recruiting these posts is reflected in the HSE national service plan for 2019. The 100 therapy posts provided for in budget 2019 have been allocated to each of the community healthcare organisations to recruit on a phased basis. Dublin Central is situated in community healthcare organisation 9, which has been allocated a total of 16 posts. Each CHO is finalising the allocation of these posts across its network area. The posts are being recruited on a phased basis and the target date for all posts to be in place is the end of the fourth quarter of 2019.

In particular, this initiative will have a positive impact on the waiting list for assessments of need under the Disability Act 2005. It will also drive implementation of the progressing disability services for children and young people programme through new staff appointments to reconfigured multidisciplinary geographically based teams. The progressing disability services for children and young people programme requires a reconfiguration of all current HSE and HSE-funded children's disability services into geographically based children’s disability network teams, made up of teams for early intervention and school-age children aged zero to 18. This programme aims to achieve an equitable national approach to service provision for all children based on their individual need and regardless of their disability, with service provision close to where they live or where they go to school. Some 56 children’s disability teams have been established and it is envisaged that the remaining 82 children’s disability network teams will be reconfigured from existing services in 2019.

There is a high demand for early intervention services in the CHO area 9, especially in the Dublin north city and county area. The service is working proactively with the HSE national disability office to meet this need.

The Government will continue to work with the HSE to ensure that therapy posts are recruited as quickly as possible and the remaining children's disability network teams are reconfigured this year in line with progressing disability services.

Maureen O'Sullivan (Dublin Central, Independent)
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When I listen to the Minister of State, I must ask myself how much satisfaction will the parents of those children or those of other children with special needs get from that reply. I acknowledge that progress is being made but I return to the point that services must be timely and while we are waiting on the reconfiguration and the posts to be filled, children are missing out on a service which, if it were available to them now, would have a really important impact on their recovery and ability to get on with their lives. I accept that progress is being made but I also make the point that urgency is needed because children are falling through the cracks at the moment and the situation is worsening.

The National Council for Special Education, NCSE, gave a very interesting presentation in the audiovisual room last week or the week before. It brought it all together for me. We were given a nice, glossy information booklet for parents of children and young people with special educational needs. I have that book to hand and there is a lot in it, including information for parents, children and young people with special needs. It covers a range of topics including definitions, assessment, supporting roles and organisations that support children. That book also refers to a number of other publications. However, all of us in the audiovisual room had faced situations showing that what is contained in the book is not being delivered. There is a disconnect between what agencies and Departments claim to be happening and available or what is supposed to happen or to be available and the reality. The reality is that those services are not there when parents in that situation look for them. Alternatively, they are told there is a waiting list and no parent wants to wait for a service they know is vitally needed for their children. Booklets like that are false advertisement giving out false information. They are raising parents' hopes that all they have to do is check this leaflet, ring that organisation and they will get the service. I do not think that is fair.

Finian McGrath (Dublin Bay North, Independent)
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I absolutely take the Deputy's point about the two families she mentioned, their expectations and the urgent need for services. We all share a common desire to have the best possible policies and services for people with disabilities, children in this case. Both personally and as Minister of State with responsibility for disability issues, I want every child with additional needs to have access to the necessary supports in every aspect of their lives to enable them to achieve their full potential, maximise their independence and live a rich and fulfilling life. This includes ensuring that therapy services are available on an equitable and accessible basis to all children regardless of where they live, the school they attend or the nature of the disability. A key priority for the HSE in north Dublin city and county is to improve the waiting times for early intervention services through the reconfiguration of the network teams and a revised model of care for children's speech and language therapy, psychological services, occupational therapy, social work, physiotherapy and other specialist child mental health services.

This year's budget has allocated €1.9 billion to the HSE disability service plan. This is the highest in the history of the State and constitutes an increase of 7.5%. This will fund the provision of a wide and complex range of services for children with disabilities, including the provision of the 100 new therapy posts across disability services for children through the HSE and voluntary providers. This will continue the Government's commitment to maximising the potential of children with disabilities through the provision of high-quality therapy assessment intervention.

I fully acknowledge the concerns that Deputy Maureen O'Sullivan has articulated to the House today in respect of services for children with disabilities in the Dublin Central constituency. I sincerely hope I have been able to address her concerns and I will address them. The HSE has assured me that it is a priority to ensure the recruitment of 100 therapy posts for children's services in 2019. I take on board the Deputy's points, will follow up on them, and thank the House for the opportunity to address this issue.