Dáil debates
Wednesday, 4 October 2023
Saincheisteanna Tráthúla - Topical Issue Debate
Disability Services
9:35 am
Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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I mean no disrespect to the Ministers who are present - I am not sure which of them is taking this matter - but I hoped the Minister of State, Deputy Rabbitte, if not the senior Minister, would be here to take this. The Minister of State, Deputy Rabbitte, has been directly involved in this matter and is aware of the issues involved. I regret that neither she nor the senior Minister is here. I mean no disrespect to the Ministers present. It is unfortunate.
Carrigaline Community Special School was set up two years ago. It was the first special school established under the patronage of Cork Education and Training Board, ETB. Its establishment came in the context of coming out of Covid. There was a very tight timeframe from its being announced to its opening. The issues I am raising are no reflection on the ETB or the principal, Colm Manley, who are both doing an excellent job. This is about respite and therapies and the fact that the children in the school and their parents feel profoundly let down. They believe they are receiving a lesser quality of service and treatment than that provided to children in other special schools and their parents.
There are two primary issues here. The first relates to respite. Most special schools in the Cork area are operated by organisations that have been in the disability and special education sector for some time and, as such, have their own respite resources. They are the service providers for respite and therapies. Cork ETB has no such background and did not, therefore, have respite at its disposal to support the parents and ensure the children get the benefit of that respite.
During this time, these parents have not even been able to get onto the list for respite. There are 48 children in the school and the parents of many of them are under very severe pressure. That they have not been able to get onto a waiting list is simply not good enough. There were, I believe, ten suppressed beds for some time. Parents are still waiting for clarity on when those ten suppressed beds will come back into circulation and whether they will be able to access them. That is the first question.
On therapies, the HSE has been saying there are school-based therapists. In reality, insofar as it is the case, my understanding is that these therapists have only been coming into the school to work with the staff and provide training. Even where therapy has been available, it is provided to four of the 48 children in the school, namely, those who reside in the nearest children's disability network team, CDNT, area. This means there is no therapy available. The HSE has been trying to tout these as school-based therapists when they are available one day a week, and really only for the staff so far. The other 44 children are being told to go to the therapist in their home team. Some of them have not been seen by their home team. They should be getting support in the school. I know in other areas such as in Danu Community Special School in County Dublin, all children were allocated a CDNT team in the vicinity of the school to ensure they had access to the therapies they need.
I will raise a few more points in my next contribution. I am raising this issue on behalf of Cork Parents Unite, which has been pushing it as hard as it can to try to get answers on the respite and therapies that these parents so badly need for their children.
9:45 am
Martin Heydon (Kildare South, Fine Gael)
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I thank the Deputy for raising what is no doubt a very important point for the pupils and parents of Carrigaline Community Special School. The Minister of State at the Department of Health with responsibility for disability, Deputy Anne Rabbitte, sends her apologies that she could not be here and has asked me to take this Topical Issue matter in her place. The Minister of State is fully committed to the development and enhancement of children’s disability services and to ensuring access for all children with complex needs across the country. This includes all appropriate respite services and therapies, including in-school supports.
Following discussions with the Taoiseach and Government Ministers in 2022 regarding the priority requirement to reinstate the health and social care supports that were historically provided in some special schools in the State, it was agreed that funding would be provided for an additional 136 posts to progress this requirement. It was also agreed that the special school-based services must be aligned with the existing CDNTs.
Having listened to the ongoing concerns of parents of children with complex needs who attend special schools, and mindful of this Government’s priority to deliver comprehensive on-site health and social supports to special schools, the HSE was requested to commence the process of allocating further staffing resources to these schools. Following a recent meeting between the Department, the HSE, the ETB and the school principal, positive developments have been made recently regarding Carrigaline Community Special School. An update from the HSE advises that there is now an on-site presence for speech and language and occupational therapists in the school, notwithstanding the concerns the Deputy just raised about the extent of that presence. I am left in no doubt about based on the points he raised. I am told, however, that work is actively ongoing to reinstate similar psychology supports to the school, with posts being advertised for relevant therapy assistant positions this week. In addition, the CDNT is working with the school to support the team there in developing the pupils’ functioning and participation in their educational setting.
The HSE advises that until staffing is fully resolved for the initial cohort of special schools, including Carrigaline, interim bridging arrangements required to meet the instructions supplied to the HSE are being developed. The HSE and lead agencies are working through a process with parents of children attending these schools.
The provision of respite services has come under increasing pressure in recent years due to an increase in the number of children and adults who are seeking access to respite as a reflection of general population increase, along with increasing levels of complexity across the sector. The Government is committed to the provision of additional respite as a key priority. This is reflected in the additional funds provided in successive budgets in recent years.
A Cork regional children’s respite forum was established in 2022. The forum manages referrals and respite service provision in the Cork area. Children up to the age of 18 years with a disability who are in receipt of services from a CDNT in Cork-Kerry Community Healthcare are eligible to apply for respite and-or home support services to the committee. This process will ensure there is equitable provision of service based on prioritised needs. The HSE has advised that the forum met throughout the summer, most recently on 6 September 2023. A total of 133 children were referred during these meetings. Children from ETB schools, including those in Carrigaline, were included in the referrals.
The Minister of State, Deputy Rabbitte, is awaiting clarity from the HSE on the number of referrals that have translated into actual overnight placements. This information can be supplied to the Deputy once it is received. While these issues present challenges, the Minister of State wishes to reiterate her full commitment, and that of the Department and HSE, to pursuing every avenue in order to ensure access and availability of appropriate respite and therapies for children with disabilities in Carrigaline, the wider community healthcare organisation, CHO, 4 area, and across the country.
Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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I thank the Minister of State. There are two specific points I ask him to bring to the attention of the Minister of State, Deputy Rabbitte, after this debate. First, a school in Enniscorthy is being provided grants to source the therapies that are needed locally through the private sector. Can such an approach be considered for Carrigaline Community Special School? It has been on the go for two years now and it has not received anything. Second, there is the issue of having a nurse on site, which is not currently the case. Obviously, that presents challenges with catheters and so on.
The Minister of State referred to the commitment of the Minister of State, Deputy Rabbitte. I do not dispute that one bit but that is not the issue here. The parents believe the Minister of State she is very sympathetic to what they are trying to achieve. The problem is trying to get the HSE to enact what is being brought forward by the Minister of State. A big part of the problem is making sure the HSE is properly accountable here. My understanding is that the Minister of State walked out of a meeting recently because she was dissatisfied with what she had been told about the therapies.
This Minister of State referred in his reply to having an on-site presence for speech and language and occupational therapies in the school. "On-site presence" is a clever use of language. There is a presence but it has primarily been working with the teachers and staff, and they can do nothing to even indirectly support 44 of the 48 children who are on site. Even in the coming weeks, when one of those additional positions will be filled for one day a week it will effectively operate as a satellite for the CDNT for one day week. For the other children, that service is not available and I do not believe there is any prospect that it will be available. A model needs to be adopted similar to, although not precisely the same as, the one adopted in Danu Community Special School.
Catherine Connolly (Galway West, Independent)
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The Deputy is over time.
Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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How can we ensure the HSE delivers what the Minister of State is asking it to do? How can we ensure it is accountable?
Martin Heydon (Kildare South, Fine Gael)
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I thank the Deputy again for his contributions and highlighting this important issue. I reassure the House that the Minister of State, Deputy Rabbitte, will continue with the Department and the HSE to drive progress on both the reinstatement of therapists in special schools in Carrigaline and elsewhere across the country, and increasing the availability of respite services to children with disabilities.
The Deputy compared the situation with one in Enniscorthy, spoke of how these issues could be resolved and made a point about the nurse at the school. I will bring these points back to the Minister of State and her officials to consider. The HSE has relayed to the Department of Health the level of activity and engagement taking place within the HSE on the issue of special schools, from the CEO all the way to the heads of service and lead agencies. The HSE has left us in no doubt that it has heard the message from the Department and is doing everything possible to accelerate support to schools.
I can report that the Minister of State recently held very positive discussions with the CEO of the HSE, Mr. Bernard Gloster, on ensuring that priority is afforded to children's disability services. I assure the House that the Minister of State and her officials will continue to engage with HSE senior management to drive enhancements in disability services for children in Carrigaline and the rest of the country. Again, I thank the Deputy for raising these points. I will bring the specific elements he has raised back to the officials and the Minister of State.