Rory Hearne (Dublin North-West, Social Democrats)
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This issue relates to access to services for children with disabilities. The Government is utterly failing a generation of children with disabilities and their families. We can see this clearly in Dublin North-West, the area I represent. The children’s disability network teams, CDNTs, are under-resourced and there are unacceptable delays in assessments, with multiyear waiting lists for therapies. The teams fail to provide the vital and urgent care children and their families need. The failure to provide assessments of need is impacting on children’s ability to access other services, especially their access to education and preschool, primary school and secondary school places. This Friday, we will see parents, who are stressed up to their eyeballs, courageously holding a 24-hour sleep-out at the Department of Education because of the failure to provide special education school places.

Figures provided by the HSE show that 14,221 applications for assessments of need nationally were overdue for completion by the end of last year. Almost one in four of those overdue assessments are in the area of community health organisation, CHO, 9, which includes my constituency. In this area, which comprises north Dublin, including areas like Ballymun, Finglas, Santry and Glasnevin, there were 3,193 overdue applications. Some 2,791 of the children to whom those cases relate had been waiting more than three months. Under the Disability Act, an assessment of need must be completed within six months.

When it comes to CDNTs, the situation is just as bleak. The most recent data for the CHO 9 area showed 2,596 children waiting for an initial contact with a CDNT at the end of last year and almost 90% of those children had been waiting for more than one year. This is again the same area of north Dublin with the highest number of children waiting for more than 12 months for initial contact with a CDNT. This is unacceptable.

I wish to highlight two cases that have been raised with me. The first concerns Jack who is six and who needs an autism class. He has been tossed around between primary care and a CDNT and has still not received an assessment of need, a diagnosis or therapy. He is six years old and has still not received a school place confirmed for the 2025-26 school year. This is the second year running that he has not received a place. I spoke to his mother, Susan, who explained the level of stress and anxiety that she and her family experience because of the lack of services and clarity around a school place. This situation is not acceptable.

Noah, another child, is three years old. He is non-verbal and severely autistic. After initially having his referrals to the CDNT rejected, he was finally referred two years later only after an emotional appeal from his mother. In October 2024, Noah’s family had to secure legal representation to compel the HSE to complete his assessment of need. They are still waiting for that assessment. They were contacted by the HSE asking them to consent to an incomplete assessment of need, one without his report from the National Council for Special Education and with no forecast date for completion, which would render it effectively useless in securing a school placement. I wish to ask the Minister for children, disability and equality, Deputy Foley, what will she do to ensure that children like Jack and Noah and the thousands of other children in north Dublin have access to the therapies, support services and school places they need.

Niall Collins (Limerick County, Fianna Fail)
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I thank Deputy Hearne for raising this important issue. The Government and the HSE are fully committed to enhancing services to better support children with disabilities in Ireland. The Progressing Disability Services Roadmap 2023-2026 focuses on the ongoing development of CDNTs to meet current and growing demand. A child does not require a diagnosis to access services. CDNTs provide a multidisciplinary assessment of individual needs and strengths as well as therapy supports.

The demand for assessments of need has increased significantly in recent years, a reflection of both the increase of population and of families exploring all options for accessing services for their children. The HSE advises that 10,690 applications for assessments of need were received in 2024, with approximately 4,160 completed, which is a 30% increase on the 3,205 applications completed in 2023. Demand for assessments of need has more than doubled compared with the 4,700 applications received in 2020.

In CHO 9, 1,690 assessment of need applications were received in 2024, which marks a 14% increase from 2022 when 1,467 assessment of need applications were received. As of December 2024, 3,193 assessments of need applications in CHO 9 were overdue for completion. The HSE has also advised that in CHO 9, 2,086 children were offered an initial contact, individual or group intervention with a CDNT in December 2024, while 2,596 were waiting for an initial contact at the end of the month.

While recruitment and retention of staff are a challenge across the sector overall, a significant focus of the Government is filling vacant posts within the 93 CDNTs which are providing supports for more than 42,000 children. The Government has provided funding for additional posts to enhance the capacity of CDNTs in recent years. The HSE has advised that there was a net addition of 272 staff in CDNTs in 2024, a 17% increase compared with 2023. Ongoing recruitment and retention measures include: the HSE facilitating direct access for funded agencies to existing HSE health and social care professionals panels, which will shorten the recruitment process and provide direct access to competent and eligible candidates; the Department of children and equality working with the HSE to seek to introduce specific recruitment and retention incentives for therapists who work in CDNTs and a CDNT sponsorship programme with bursaries for fourth year and postgraduate students linked to acceptance of conditional job offers; placements on CDNTs continuing to be expanded alongside a continued expansion in the number of places in higher education; and the roll-out of regional assessment hubs, including in CHO 9, which will see the provision of personnel dedicated to the delivery of assessments of need, while preserving the time for other clinical staff for purposes of therapy interventions.

In May 2024, the Government announced a decision to finance the assessment of need waiting list initiative through the procurement of private assessments for long-waiting families. Between June and December 2024, some 2,479 assessments of need were commissioned from private providers at a total cost of approximately €8.2 million. The Government has provided funding for additional posts to enhance the capacity of CDNTs and shorten waiting times in recent years, with a further investment in budget 2025 to fund additional therapy posts and clinical trainee places.

Rory Hearne (Dublin North-West, Social Democrats)
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The response, while welcome, is inadequate. If we look at the situation facing these families, particularly the children, they cannot wait. They cannot be left waiting for months and years for access to basic services and assessments of need. Early intervention is absolutely key in this regard. These families are struggling. I have spoken to them and they have contacted me. I have met them during the election on the doors. The level of stress and anxiety that parents of children with additional needs, disabilities, autism or ADHD experience is unacceptable.

Bringing it back to the children again, every day, week and month of delay in the context of intervention has long-term impacts on those children, reducing their potential and quality of life. We should not accept it. The Minister of State set out the ambition to, for example, introduce specific recruitment and retention initiatives and while they are badly needed, we need to see urgent action on them.

We need staff numbers in CDNTs to be increased and therapies provided. Parents explain that just getting a contact and being told they can be part of a webinar or group workshop is not a service in terms of a therapy their children need. We cannot simply say that this is enough or that it is acceptable. The children and their families need it, so I am calling on the Government to put a greater focus on this and not accept these waiting lists as being tolerable.

Niall Collins (Limerick County, Fianna Fail)
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The overall HSE disability budget for 2025 has increased to €3.2 billion. That equates to an 11.6% increase over the previous year. This matter remains an extremely high priority for the Minister of State with responsibility for disabilities, for the Government and for senior leadership within the HSE. The HSE is supporting families of children while they are on waiting lists. These initiatives include access to webinars, workshops and advice clinics among other measures. This will ensure families continue to receive engagement from teams as they await further supports.

It is important to reiterate that a child does not require a statutory assessment of need to access disability services. It is also important to acknowledge that the CDNTs are providing services and supports to more than 42,000 children via 92 dedicated teams across the country. These teams are providing strategies and supports for urgent cases on the waiting lists where staffing resources allow. This Government provided funding for additional posts to enhance the capacity of CDNTs and shorten waiting times in recent years. In 2025, €25 million has been made available for children's services building on existing recruitment initiatives with funding focused on various positions across the CDNTs, including 20 senior therapist posts, 20 staff grade posts, 20 health and social care assistant posts and 15 clinical trainee posts. Detailed engagement continues between the Minister of State's officials and the HSE to seek practical and implementable solutions to address the issues of waiting lists for both assessments of need and interventions. I assure the Deputy that the matter is receiving the most urgent attention.