Thomas Gould (Cork North Central, Sinn Fein)
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I will raise the case of Michael Barry with the Minister of State. Michael, who is ten years old, has been prescribed a new wheelchair by the HSE. He desperately needs it, particularly coming into the summer months when he should be able to get out and about with his family and friends and enjoy the good weather. I have seen a letter that was sent to Michael's mother. Michael was given a prescription on 5 May. The HSE advised that the resource allocation group only funds a certain number of prescriptions every time it meets and there was no timeline given for when Michael would get his wheelchair. How is this acceptable? A prescription should be funded. It is given on the basis of a person's need. There is no reason given for this decision. Once his prescription is funded, Michael will get his wheelchair but it will need to be ordered, which will take time. Michael deserves to enjoy the summer with his family and to live in comfort. He needs to get his new wheelchair.

I am disappointed that the Minister of State with responsibility for disability, Deputy Rabbitte, is not here to take this Topical Issue debate. She comes into the House an awful lot talking about how funding is not an issue and telling us what she wants to do. That sounds great and ambitious but she is failing Michael. I ask the Minister of State, Deputy Joe O'Brien, to ask her to instruct the funding allocation group to fund all prescriptions that come before it at every meeting.

The Government is saying money is not the problem. In fact, it is the problem because these prescriptions are not being funded when they are needed.

Every summer since I became a Deputy, families have contacted me about issues with their children accessing equipment. Last year, there was a situation in which a child who was waiting for a wheelchair could not go on a school trip because there was no wheelchair available that was suitable and big enough for the child. No child should miss trips away with his or her school or family in such circumstances. It is a scandal that children and families are being left in this position. The Taoiseach, the Tánaiste and the Minister of State, Deputy Rabbitte, come in here and say funding is not an issue when it comes to providing services and equipment to people with disabilities. Here we have a child who has a prescription to get a new wheelchair because he is too big for his existing one. The provision of the equipment is being dictated by budgets, not by medical need.

Surely the Minister of State, Deputy Joe O'Brien, agrees with me that a child should not have to wait for an essential piece of equipment. That is what a wheelchair is. Michael should not be expected to crush himself into a wheelchair that is too small. This is a child with serious health issues and a serious disability. The State is failing Michael. I met and spoke to him and his mother and father at the weekend. Why should they be in this position? Will the Minister of State go back to the Minister of State, Deputy Rabbitte, and ask her to instruct the HSE that funding be given for Michael and for any child or person with a disability who has a prescription for equipment that is urgently needed, whether it is a wheelchair or anything else, and they will not be left waiting for weeks and months? Will he give that commitment today?

Joe O'Brien (Dublin Fingal, Green Party)
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On behalf of the Minister for Health, I thank Deputy Gould for raising this matter with reference to the situation of Michael Barry. It is an issue that is of importance to many children and their families in community healthcare organisation, CHO, 4. The HSE provides an extensive range of medical aids and appliances to individuals living with a wide variety of different medical conditions. These aids and appliances support individuals to continue living within their communities and enjoy a greater quality of life than would otherwise be the case.

The community-funded schemes, CFS, is the collective name for the provision of these products and services. The HSE spends in excess of €300 million per annum on their provision nationally. The medical aids and appliances are prescribed on the basis of an identified clinical need. The HSE advises that current vacancies in children's disability network teams, CDNTs, can cause delays in these assessments being carried out. However, this is not a matter in which the local resource allocation group is involved. The role of the local resource allocation group is to make a determination regarding funding approval for each application within the CHO. This determination is based on the clinical priority and the funding available. In this regard, the HSE notes that it is important the applicant's requirements are assessed appropriately before prescribing any device.

At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items. However, a range of initiatives is undertaken to ensure optimum use of resources, including recycling of appropriate items. Waiting times for approved items also vary depending on the priority rating. In addition, they may be affected by the following factors: the time required for the appropriate clinical assessment to be undertaken; the time taken for the approval process, which can be impacted by the value of the equipment being requested and the available budget; the time for the manufacturing process, if it is not a stock item; and the time for shipping and delivery, depending on the particular item being requested. The HSE advises that clinical demands on local budgets remain high.

The provision of wheelchairs by the HSE to eligible people is based on several criteria, the most important of which is assessed clinical need. A priority rating that assesses the impact of the particular equipment on the individual's quality of life, the length of time waiting for the equipment and the available budget are other factors that form part of the decision-making process. At present, the wait time from clinical assessment and approval for standard wheelchairs that are kept as stock items is normally no more than one to two weeks. For bespoke and powered wheelchairs, which need to be manufactured and delivered by the supplier, the wait time is longer and can be up to 12 weeks.

The HSE established a national service improvement programme to develop national prescribing guidelines with the aim of improving the value for money and equality of access of the CFS. In respect of aids and appliances, the category lists are completed and category-specific information for prescribers is now published on the HSE website. The work to improve services is ongoing and further milestones will be reached in the pursuit of the aim to improve the quality of the services the HSE provides to assist people with different medical conditions to live within their communities. I promise the Deputy I will address the specifics of the issue he raised to the Minister of State, Deputy Rabbitte, this evening.

Thomas Gould (Cork North Central, Sinn Fein)
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I received a similar response from the HSE to the one Michael's mother received. It acknowledges that while a wheelchair might be considered essential by families, the resource allocation group has to make priority-based decisions. Wheelchairs are not just essential for families; they are essential for the lives and well-being of children. It is shocking that an appropriately sized wheelchair cannot be sourced for a child and no timeframe has been given for when it will be available.

I listened to the response from the HSE the Minister of State read out. What I take from it are the references to value for money, local budgets and timelines. We are talking about children with special needs, additional needs and disabilities. We are talking about health-based decisions to improve their quality of life. The Minister of State mentioned quality of life. Where is the quality of life for Michael and all the other children who are waiting for equipment? The Minister of State also mentioned assessments. Michael has a prescription. It has been prescribed that this child needs this equipment. Reference was made to budgets being under pressure. How can the Minister of State say in response to a child who needs a new wheelchair because he has grown that budgets are under pressure? Does he know who is under pressure? That child and his family are under pressure. Parents of children with disabilities have had to fight the State at every turn and corner for provision for their children. It is not good enough. Medical equipment should be given on the basis of need and health, not on the basis of local budgets being under pressure.

Joe O'Brien (Dublin Fingal, Green Party)
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I again thank the Deputy, on behalf of the Minister, for raising this matter of great importance to children and their families in CHO 4. The aids and appliances provided by the HSE under the community-funded schemes support individuals to continue living within their communities. They are prescribed on the basis of an identified clinical need and provided in line with established criteria. The HSE advises that age is not a factor when a clinical need is identified. However, vacancies in the children's disability network teams can cause delays in clinical assessments being carried out. This may delay the prescription of appropriate products but is not a matter on which the resource allocation group could have an impact.

Once approved for funding by the resource allocation group, waiting times for items vary, depending on the priority rating. Priority is given to individuals with the greatest level of clinical need. The waiting time for approval of stock items is generally no more than two weeks. For bespoke items such as powered wheelchairs, which need to be designed, manufactured and delivered by the supplier, the waiting time is longer. The HSE reports that the national service improvement programme for aids and appliances has resulted in completed category lists. Category-specific information for prescribers is now published on the HSE website. The work to improve services is ongoing.

When I read the response from the Department, I asked about timelines, considering that the assessment is already done in the case of the child to whom the Deputy referred. I was informed that the resource allocation groups meet once a month to make decisions. It might be helpful to look at how that is done. I will raise the issue of budgets with the Minister of State, Deputy Rabbitte, this evening. I urge the Deputy to do the same.

Thomas Gould (Cork North Central, Sinn Fein)
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I will forward the details to both Ministers of State.