John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I understand the Minister is sharing her time. Deputy McGuinness spoke to me just before I came in and he is not available. I see he is listed to share the Minister's time. He is speaking later on though.

Norma Foley (Kerry, Fianna Fail)
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I will fire away.

Ruairí Ó Murchú (Louth, Sinn Fein)
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He is very unreliable.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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Yes, very unreliable.

Norma Foley (Kerry, Fianna Fail)
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Gabhaim buíochas leis an gCeann Comhairle as ucht an t-am agus an deis seo a thabhairt dom. Cara Darmody, a 14-year-old child, will be outside Leinster House for 50 hours starting today, highlighting the deficiencies in the assessment of need system and the impact it has on families. I have met and engaged with Cara and her father Mark on three occasions, including last week. I have been impressed by her intelligence, passion and enormous commitment. She is a strong and vocal advocate for her own family and other families across the State affected by assessment of need delays. Cara is highlighting the impact that delays in access to an assessment of need can have on children who need them and their families. The Minister of State, Deputy Naughton, and I are firmly committed to addressing these delays and ensuring the assessment of need process is effective and efficient.

This Government remains committed to delivering real and tangible solutions to enhance services to better support children with disabilities. This is clearly reflected in the programme for Government, as is our commitment to address the challenge of growing waiting lists for assessment of need. I am under no illusion about the issues facing the assessment of need system. They are complex and a multifaceted approach is required to address them. These issues are not just a priority for my Department but require a cross-governmental and cross-departmental response. It is important to note that children do not require an assessment of need to access health services, including primary care, children’s disability network teams, CDNTs, or mental health services. Children with complex needs may require supports from their local CDNT. More than 43,000 children are currently supported by these teams with or without an assessment of need. Children whose needs are more moderate are supported through their primary care team. I know these systems face their own challenges.

People are pursuing assessments of need because they feel they need to due to issues in the wider system. I know from speaking to parents that this system is not working as it should for their children, many of whom are on long waiting lists for those services. Indeed, some children may be on multiple waiting lists. It is within this broader system that the assessment of need process sits. I understand that a significant source of concern and frustration for parents is a lack of clarity about where they should go, in particular where they are seeking an autism assessment or diagnosis for their child. Data on the disability category identified in completed assessment of need reports show that the "autism spectrum disorder” category increased from 18% of all completed assessment reports in 2013 to 36% of all completed assessment reports in 2023. The HSE has been developing an autism assessment and intervention protocol. I look forward, as a priority, to its introduction and incorporation into the existing health and education systems. Once in place, I believe this will help to alleviate the confusion and stress experienced by a lot of children and their parents.

More generally, I believe that parents would like more clarity about the path to take within the healthcare system when they feel their child may have a disability or additional needs. The HSE is working on a single point of access to disability services to ensure children are directed to the correct service provider and receive the necessary services as soon as possible. It is an area in which we need to see more progress in the coming months. Delays in service provision in other parts of the system mean that parents look at all options, including assessment of need, to get early access to services and supports for their child. However, parents find that having waited to get the assessment, they may then face another long wait to access the services their child needs. This understandably causes frustration and stress for families. It is not acceptable. We need to look not only at the assessment of need process but also at the wider system to identify the barriers and delays and remove them. I would like to see a process that ensures a child receives an assessment that is appropriate to their needs because every child is different, with his or her own unique abilities and needs.

HSE data shows there has been significant growth in the number of applications for assessment of need in recent years. Applications increased from 8,400 in 2023 to more than 10,600 in 2024, a 26% increase. HSE figures for the first quarter of this year indicate that there has been a 20% increase in the number of applications compared to the same period last year. At the end of March, almost 15,300 assessment of need applications were overdue for completion nationwide, an 8% increase on the number overdue at the end of December 2024. These figures are worrying and demonstrate the nature and extent of the challenge we face. Behind these numbers are children and families facing their own challenges every day, relying on the State to help and support them. Although these numbers are growing, initiatives are already under way to address this increasing volume. In 2024, more than 4,100 assessments were completed, an increase of 30% over the previous year. Recent HSE data shows that this upward trend is continuing with more than 1,400 assessments completed in the first three months of this year, a 65% increase compared to this time last year.

While this is welcome progress, it is clear that much more needs to be done. It is essential that we maintain this momentum and accelerate it even further. The fact that demand continues to outpace the capacity of the system was recognised in May last year when the Government introduced the targeted waiting list initiative. This provides funding for the procurement of assessments from approved private providers for families who have been waiting the longest. Between June and December last year, it resulted in more than 2,470 assessments being commissioned from private providers at a cost of €8.23 million. The Government has allocated €10 million this year to deliver approximately 2,850 assessments of need as well as to provide for additional capacity within the public system. I am confident this initiative will continue to support and deliver for children and families who have been waiting longest for assessments. I am also determined that funding will not stand in the way of doing what is necessary and effective to respond to these challenges. Although there is a limit to the capacity of the system to provide private assessments, if there is the capacity to do more, the Government is giving the commitment that we will not let financial resources be a barrier. However, I am acutely aware that this measure in isolation is not sufficient to support the capacity of the healthcare system to deliver assessment of need. We cannot rely on the private sector indefinitely; we must ensure that the public system can meet the clearly growing demand. As part of the efforts to support the efficient delivery of assessment of need within the public system, regional assessment hubs are being rolled out by the HSE, aligned with the six new HSE health regions. This will help in some way to streamline the assessment of need process while preserving the time of clinical staff to provide therapy interventions for children and their families.

Another, more significant factor is addressing workforce issues. I am conscious of the challenges and strains facing the health and social care sector when it comes to the recruitment and retention of staff, not to mention the impact this has on the delivery of therapeutic services to children with disabilities and on the delivery of assessments of need. It is a key focus for the Department to fill vacancies within the 93 CDNTs. Clear progress has been made in this regard in recent times with the workforce increasing by 17% from 2023 to 2024. This represents significant growth of an additional 272 whole-time equivalent staff working across CDNTs. We will build on this progress with funding of €2.84 million provided by the Department this year for 75 additional posts. The Department and the HSE are also looking at staffing levels for the assessment of need process. This requires both assessment officers, who are responsible for the production of assessment reports, and liaison officers, who produce service statements on foot of assessment reports. We must ensure that the assessment of need system is adequately staffed to meet demand, with the necessary administrative supports in place to ensure that the assessment and liaison officers can focus on the core aspects of their roles - the production of assessment reports and service statements for children.

We also need to look at the bigger picture of how disability services are staffed. In this regard, a dedicated disability workforce strategy is being developed to meet growing service demands and address recruitment and retention challenges across specialist disability services. This will include identification of barriers to increasing the disability workforce both within the HSE and funded agencies as well as factors that influence staff to remain in practice in the area of disabilities. The HSE continues to drive intensive domestic and international recruitment efforts and to undertake a portfolio of workforce initiatives to support sustained growth of CDNTs and the wider disability service. I am not naive about the scale of the challenge or the impact on children and parents should we fail to meet that challenge. I also know there is so much more to be done. I have tasked officials within the Department to delve deeper in identifying issues within the assessment of need system that are causing delays and larger system-wide factors such that parents feel their only option is to seek an assessment of need for their child.

Intensive analysis is under way at present by officials in my Department, working with HSE senior management and experienced clinicians, with the intention of bringing forward such changes as might be required as quickly as possible. I emphasise that this process is to support effectiveness and efficiency within the assessment of need process. It will not affect the statutory right of any individual to access an assessment of need.

The Department is also looking at whether there is misinformation or misunderstanding about what an assessment of need is for, particularly where there may be a belief that the assessment will bolster or enhance applications for other Government services and supports. This will require some Departments to review their schemes and programmes to ensure they are not inadvertently encouraging people to seek an assessment of need where one is not warranted. It should not be the case that a person feels they need an assessment of need to access a service or support to which they may already be entitled. For example, people may think they need an assessment of need to get their domiciliary care allowance. I have spoken to the Minister for Social Protection, Deputy Dara Calleary, in this regard. There will now be no requirement for an assessment of need report when a person is applying for the domiciliary care allowance for their child. This is a positive development.

Any work addressing the assessment of need challenges must also note the continued work of the education system to develop an inclusive education system for all children to reach their fullest potential. The commencement of a national therapy service in education is a commitment under the programme for Government. It is intended that the national therapy service will commence work on a phased basis initially in special schools and subsequently extend to special classes and mainstream classes at a later stage in the 2025-26 school year. This service will be delivered by the National Council for Special Education, NCSE. Officials in the Department of Education and Youth have begun engagement with my Department and other relevant Departments and agencies on the design, timelines, alignment, integrated working and costings involved to deliver this ambitious programme of work.

The national therapy service will provide occupational therapy and speech and language therapy supports directly to children in schools. This will be in addition to, and aligned with, existing services. While the national therapy service will not have a direct role in the assessment of need process, it is expected that a more effective and direct system of therapeutic support delivery can only help alleviate the pressures felt in the assessment of need system. A co-ordinated approach is required to deliver this range of activities, with Ministers and their Departments working closely and collaboratively to deliver the results that children and their families need. I assure the House that this issue has the highest priority for the Taoiseach, the Tánaiste and the other Members of the Cabinet committee on disability, who are closely following all activity in this area.

At departmental level, a cross-departmental steering group has been established. I expect this group to identify and address any blockages or barriers across the system that may be affecting the delivery of assessments of need. The Department is working closely with HSE colleagues and clinicians to ensure that any changes introduced will have a positive and noticeable impact for children and families who are applying for an assessment of need. Ensuring that necessary changes are introduced and implemented correctly and promptly requires the delivery of a range of actions. The Department will manage this process, monitor delivery and report regularly on progress to me, the Minister of State, Deputy Naughton, and the Cabinet committee on disability.

Returning to the critical issue of information and communication, what I hear from parents most frequently is their sense of frustration and confusion. They do not know where they should go for support or who to ask. This is an area ripe for immediate improvement. We need to be better at explaining to parents what is available, whether an application for an assessment of need is actually required and who is the best person a parent can talk to for advice about the service their child needs. We need to look at how best to make this information available and ensure it is up to date and accurate as well as helpful and useful. This is the very least we can do. It is what families need and deserve.

As I said earlier, I will not understate or sugarcoat the scale or nature of the challenge we face in addressing the growing backlog of assessments of need. However, this is an issue the Government is taking extremely seriously and according to it the highest priority. As Minister for Children, Disability and Equality, it is one of my highest priorities because I find the current situation both unacceptable and, indeed, untenable. There are a range of activities currently under way or being developed that will help to address this complex and multifaceted problem. It will not be a quick fix, however. While we cannot click our fingers and make it go away, we will work every single day to do better. We need a system that works and can be sustained over time. In order to do this, my Government colleagues and I will work intensively, persistently and collaboratively to put in place an effective and efficient assessment of need system to deliver the service that children and their families deserve.

James Geoghegan (Dublin Bay South, Fine Gael)
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First, I recognise Cara Darmody. I met her when I was the Lord Mayor of Dublin. I brought her into the Mansion House as part of our initiative to make Dublin the world’s first autism-friendly capital city. Cara is a determined and brave person. I absolutely lament the fact she feels she has to sleep outside the Dáil for the next 50 hours in order to highlight one of the biggest challenges we have in this State when it comes to the delivery of disability services, that is, the assessment of need process.

It is important to highlight the areas in which the State has delivered improvements when it comes to supporting children with needs. For children in a preschool setting, there is an access and inclusion model, AIM, programme. It supports staff to identify need and then be supported by that AIM programme in order to ensure that, where a need is identified, the appropriate services are provided. In primary school settings, we have tooled up our schools with SNAs, increased the number of autism-friendly and special classes in schools and also increased the number of special schools. There is so much more to do to ensure every child of every need, irrespective of whether they have an assessment of need, is getting the type of education they require. There is so much more to do. Significant changes have also been made in the access to, and delivery of, third level education.

The law as it relates to assessment of need simply is not working. It is a law that is being broken 94% of the time, based on figures the HSE has produced. That is not good for anyone. The Minister highlighted an important factor in her statement before this House, namely, the importance of parents knowing what services are available to them, with or without an assessment of need. That does not dilute, however, the absolute need to get this right as a State to ensure every child’s pathway is an appropriate one and that we have identified the level of need every child requires.

Equally, in the context of the systems and the moments when children interact with the State, such as with their public health nurse in their developmental checks, for example, how can we improve the pathways direct from that check into the supports that child needs? How can we improve the pathways of services for a child who has been identified with a need in a preschool setting? How can we support primary schools and secondary schools where needs have been identified? I refer to the initiative of the Minister, Deputy Helen McEntee, of prioritising therapeutic services with a direct delivery in schools. Programmes the NCSE already delivers in schools are making a big difference. One of the big differences that delivering direct therapeutic services in schools can make is it can reduce the pressure on SNAs and teaching staff because children get the services they need to support them through their education pathways. Similar approaches need to be adopted, not just in special schools, where projects are being piloted, and in the programme for Government where we have made clear commitments, but also in mainstream schools. We do not wish to arrive at a situation where, in order to get services, parents are trying to, perhaps, find a setting for their child that may not be the appropriate one but where they know they will get the necessary supports.

As a State, we must support all of those parent support groups that every one of us deal with both inside and outside of this House as constituency TDs. They support children in their locality. Groups in my constituency, such as Involve Autism in Dublin 6 west, Neurodiversity Ireland and Neurodiversity Irishtown, Ringsend and Pearse Street, do extraordinary work on their own. Perhaps there are better ways in which the State can support them in the work they do to support children.

I absolutely support Cara Darmody and what she is doing. She is a determined young lady who has already done too much in terms of what she should be doing as a child. So many parents of children with needs are similarly out there campaigning all the time. We need to deliver the services to which every child in this State has an entitlement. The Minister is committed to improving how we deliver the assessment of need process. I welcome the announcement she has made with regard to the domiciliary care allowance. I ask that increased flexibility be afforded to the whole method by which the domiciliary care allowance is awarded because we all deal with parents who have been refused that domiciliary care allowance on the first point of entry and are subsequently awarded it on a later appeal.

However, the bills have been mounting due to spending money on private SLTs and OTs.

Recruitment is going to be absolutely key here. Replies given to me about how many OTs and SLTs we have recruited from abroad, which are based on employment permits issued, indicate the figures are extremely low. That is an area in which we could do an awful lot better. Of course we must invest in the long term in delivering more OTs from our college and third level system, but in the short term, similar to what we have done in maternity services, there must be a better way in which the State can try to recruit a larger number of OTs and SLTs to deliver direct therapeutic services in schools and support all the needs of children.

Paul McAuliffe (Dublin North-West, Fianna Fail)
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I thank the Minister for her statement. As Fianna Fáil spokesperson on disability, I attended a fairly powerful workshop held by the Independent Living Movement Ireland and the Dublin City Council public participation network. There were adults with all ranges of impairment. That was the word they used. They spoke about three things, namely, their freedom to make decisions, choice and labels and being defined by a label. Each of them is a person who has lived experience of disability. Interestingly, when they spoke about freedom, they also spoke about the freedom to fail and their own freedom to make mistakes that anybody has. The difference is that with many of these people, we are talking about adults but with the assessments of needs, we are talking about children, meaning all of those decisions fall on the carers of those children which in most cases are the parents.

“Disability” is such a broad term and often has become focused very much on the space of neurodiversity. If somebody had a congenital physical defect, then the parents know from the first moments that they have challenges, that they need to have a treatment plan and that there needs to be a diagnosis and the health services put in place measures to do that. The difficulty is that for some children their disability is not as obvious. It often comes about as part of development checks or suspicions or concerns of parents. Then there is a referral to CAMHS in some cases or through the schools, where teachers reinforce the concerns of parents. One of the huge difficulties with the current model is parents are just fighting for an intervention. What they want is not any technical document but a treatment pathway for their children who they know have needs.

Often, acknowledging the need in the first place is the first step. A parent told me the best and worst day they ever had was when their child received their diagnosis, because at the very least they knew the scale of the challenge ahead and they knew the mountain they were climbing. Part of the debate on the assessment of needs is the desire of the parents to crystalise the diagnosis and the needs. I reference the Taoiseach’s comments earlier on perhaps changing legislation and so on. We need to get back to a place where the diagnosis and the treatment pathway is the priority, rather than a technical document. I say that with some experience, although without the permission to define anybody in my family publicly here. One of the issues we have to deal with is that when people receive a diagnosis there are often different levels of literacy. We talk about digital literacy, but there are different levels of health literacy and sometimes parents are given a diagnosis in the coldest and most clinical of language and they have no real understanding of how they progress it. There is not a continuum of care from the moment concerns are raised to when we diagnose a condition to making an intervention to putting in place the support at preschool and primary school, despite there being lots of interventions available. Part of the difficulty we have and one of the challenges for the Minister is the putting in place of a pathway parents can easily understand so they do not feel they must advocate at every level. Parents only advocate at every level when the services are not readily available and they only advocate at every level when they do not feel they are being listened to.

I have lots of comments around the assessment of needs. One of the most startling things was that a third of therapists’ time last year was taken up by assessment of needs. As somebody who would like to see, and very directly like to see, more treatment, therapies and interventions I have to ask myself what the Department’s priority is. I ask if we can have that better pathway. If we provide a better line of sight for parents, listen to parents more and provide diagnoses we will be able to provide that better pathway and a better experience for the people who have the disability.

Aisling Dempsey (Meath West, Fianna Fail)
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I thank the Minister, Deputy Foley, for her words and her hard work driving reform with a sharper focus on the delivery of therapies for children. I also thank the Minister for taking the time to hear my voice as a representative of families who are facing unacceptable and heartbreaking realities. In my constituency of Meath West I have, first as a councillor and now as a TD, dealt with a number of parents in really difficult situations who are fighting daily to get the supports needed for their families. We do not agree on a lot in this Chamber but on this we certainly do. Children with special needs are waiting far too long for the supports and services they require. These are children who need early intervention, therapies, educational support and timely diagnoses to ensure they get the best start in life, yet they are caught in a system that asks them and their families to wait, sometimes indefinitely.

One of the reasons I got into politics is I am a caregiver and a mother and I understand the challenges families are facing to access the support, the services and the recognition our children all deserve. I believe in the purpose of committees that advocate for children and that we can turn the stories we hear every day into action and make changes effective. At almost every door I knocked on during the recent general election I was told a tale of a child – a niece, nephew, neighbour or a friend’s child – unable to access the support so badly needed. We will and must do better for these children. The areas of housing and disability are the two main focuses of this Government, as well they should be. I want to return to those doors having enriched the lives of families living daily with the most difficult of circumstances. The rise in population, the backlog during Covid, the lack of therapists and therapies not being completed in the school setting have no doubt contributed to our longer waiting lists and all our issues that need addressing. I implore the Minister to carry on her work in this area and progress the commitments we have made in the programme for Government, which I have no doubt will positively reform the area of assessment of needs.

Since 2020, the need for assessments has increased by more than double. The waiting lists initiative is tackling the families longest awaiting assessment of needs and additional funding is in place for therapists in our CDNTs. Over €2 billion has been added to the disability spend in that same timeframe. These are all positive moves and steps forward, but unfortunately little comfort to the families awaiting assessment today. Urgent and radical actions need to be taken. It would be remiss of me not to mention, as many Deputies will, the brave and exceptional Cara Darmody who first advocated so strongly for her brothers and now does so for children across our country. So too do organisations like AsIAm, which play vital roles in advocating for some of the most vulnerable in our society and raise awareness and promote acceptance for those with special needs and disabilities. I am proud to have been part of the founding team of the Trim Autism Friendly Town committee, which is one of a number of neurodivergent committees in Meath West representing our most vulnerable people. The work of Cara, AsIAm, Trim Autism Friendly Town, Enfield Autism Friendly Town and Neurodivergent Navan has all contributed to parents, children and those with special needs and disabilities feeling embraced, feeling seen and feeling heard. We now need to catch up with those therapies.

Every day is a struggle for these families, even when they have the right supports in place and it is the least we can do to provide them. I was glad to hear the Minister say two things today, namely, her absolute understanding of the stress these situations cause families and also that finance will not be a barrier. However, we know staffing is a major across the health service.

In Trim, last week alone, a new GP opened, with hundreds of patients clamouring to join her list. We are the mothers, we are the caregivers and those who shoulder the majority of the responsibility for the children of Ireland, and we must resolve this for our families. As the Fianna Fáil spokesperson on children and a member of the Oireachtas committees on education and youth and on children and equality, I look forward to continuing to work with the Minister to solve this major issue for our families.

Grace Boland (Dublin Fingal West, Fine Gael)
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I thank the Minister for her acknowledgement and honest assessment of the challenge facing many families whose children are waiting for an assessment of need. The issue of disability has activated many of us in this Chamber to become politicians. We have seen An Tánaiste and the likes of Cara Darmody all activated on the issue of disabilities. It is a key reason we are here today. Dublin Fingal West is home to one of the youngest populations in the country. Balbriggan is the youngest large town, as I may have mentioned before, and it is rapidly growing, yet the children in my area of north Dublin face an extraordinarily long waiting time for assessments of need. Almost 2,000 children in the north Dublin health area alone are awaiting an assessment of need. If there are 15,000 children on the waiting list nationally, my area, staggeringly, accounts for approximately 12% of the entire country. Given the length of time we all spend in this Chamber talking about this issue, as it is one of the top five queries we all receive, I think the Minister knows the system is broken. Because my area makes up 12% of the waiting list, she can imagine the number of queries I receive. Children living in Balbriggan, Skerries, Rush, Lusk and surrounding villages are not waiting months but years. The process simply is not working. This backlog is a combination of administrative failures, cumbersome assessment processes, a lack of resources and outdated legislation.

We need to remove the bureaucratic barriers, and I welcome the Minister's comments on better communication with parents. The assessment process is confusing and filled with administrative obstacles. To fix this, we need a simplified online application system; a clear roadmap outlining the process, timelines and next steps; a reduction in unnecessary paperwork; and a streamlining of internal processes. We also need to communicate clearly with families. We need a tracking system that communicates with them. I have lost count of the number of parents who have contacted me about accessing assessments of need or therapies. We need a real-time tracking system to assure these families that their request is progressing and so that they receive regular updates, instead of feeling ghosted by the system and chasing politicians for answers who are equally frustrated and ghosted.

Assessment delays also stem from staff shortages, particularly in specialties such as speech and language therapy, psychology and occupational therapy. We have to do more to grow the expertise we need in Ireland, as well as attracting the right people from abroad. The increase in therapy college places announced last year is welcome and the programme for Government commitment to double the places even more so. Will this doubling occur in September 2026 or will it be graduated over the lifetime of the Government? Is it enough? Has the Department run the numbers and projected the number of therapists needed to meet future demand? Will doubling the places satisfy this demand? Can the Minister assure us that this assessment has been carried out by the Department and that the doubling of the numbers will be enough?

We also need to make sure resources are prioritised and allocated based on demand and demographics. North Dublin, Balbriggan, Skerries, Rush, Lusk and the surrounding villages of Garristown, Naul, Ballyboughal, Oldtown and Rolestown, because of their demographics, constitute 12% of the national waiting list. It needs to be prioritised. We need to have the resources allocated to deal with the severe backlog of children waiting for an assessment of need and waiting for therapies. Please end the postcode lottery. These delays represent lost developmental opportunities for our children, frustrated families and children missing vital early interventions that really could help shape better futures for them. Please ensure that the children of Dublin Fingal West have ease of access to a fit-for-purpose, streamlined assessment of need process allied with receiving the appropriate therapies. This should not be a privilege dictated by geography.

Claire Kerrane (Roscommon-Galway, Sinn Fein)
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Listening to the contributions made on the Government side of the House, most of them sound like commentators. The waiting list for assessments of need did not increase overnight. This has been an issue for many years and the demand for an assessment of need or for disability services has been rising consistently. This is absolutely nothing new. I pay tribute to Cara Darmody and her dad, Mark. At 14 years of age, she has made a really valuable contribution to the debate around assessment of need and highlighted the difficulties in accessing autism and disability services. She has been a real voice for children and parents and she is due a great deal of credit. The best way we can honour Cara's advocacy is to turn the tide on this issue once and for all.

Last week, the HSE provided me with the latest waiting list figures for assessments of need. There are 15,296 children, a record number. These are children who have not had their legal requirement met as they should have received their assessment of need within six months. This impacts on every aspect of their lives, particularly in school. We often hear from parents that schools are totally hamstrung in providing the supports and services children need. In the case of services and supports for these children, every day counts. The Government is failing these children and, again, this is not a new issue. The actions taken by the Government - there have not been many but I am thinking of Cara's fund in particular, which was welcome - have not been enough. No matter how many achievements are lauded by the Government in terms of the number of special classes or the money put into private capacity for those waiting for an assessment of need, it has not been enough.

Sometimes waiting list numbers are just seen as numbers and are almost normalised. Nobody is surprised any more as they continue to go up and up, but we have to remember all the time that these are children. They are children who require additional supports to meet their potential but the Government is not doing enough. Parents are at the end of their tether. We need to see private capacity bulked up and Cara's fund adequately funded. We also need to see the workforce plan to provide the number of therapists needed. The top and bottom of this issue is that we do not have the people to do the job they need to do.

Darren O'Rourke (Meath East, Sinn Fein)
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To follow on from that point, in respect of my county, Meath, and the lack of capacity in the system, in CDNT 2 covering the Kells area, and CDNT 5 covering the Navan and Slane area, one in four posts is vacant. Those are the best figures. In CDNT 4, covering the Ashbourne and Dunshaughlin area, one in three posts is vacant. In CDNT 6, covering the Trim area, which Deputy Dempsey represents, almost two in three positions are vacant, or 62%. That is not unique across the State. It has a profound impact. Other Deputies will be familiar with responses such as this example:

Currently there is one psychologist for a service of over 800 plus children. While the team will make every effort that this assessment is completed on time, we cannot guarantee this given the significant demand on limited psychology resources.

It is the same in respect of primary care for those children with less complex needs. In the Ashbourne area, since April 2022, more than three years ago, "1.5 whole-time equivalent paediatric occupational therapist posts based in Ashbourne and Dunshaughlin are vacant." That means there is no occupational therapist in that primary care service. Again, this is replicated across the State. Finally, when we meet parents who actually have a service, support or therapy for their child but where that therapy is being withdrawn, it is clear that the benefit of these therapies for children is absolutely profound and to deny them of it is absolutely cruel.

It has to change.

Shónagh Ní Raghallaigh (Kildare South, Sinn Fein)
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Kildare has the highest number of overdue AONs, second only to Dublin, with 1,700 children on waiting lists. I want to take this moment to speak about Isaac. He is 14 years old and has four siblings. He first got onto the AON waiting list eight years ago and has yet to receive a written diagnosis. Back in 2017, Isaac was first seen for an occupational therapy, OT, assessment and was diagnosed with developmental co-ordination disorder, DCD, despite his parents, Vivienne and John, suspecting something more was going on. They were told to come back in two years. When they did, there was no record of Isaac's file - the HSE had lost it - and he had to go back to the bottom of the waiting list.

When he began school, his mammy, Vivienne, fought for a National Educational Psychological Service, NEPS, assessment but was told Isaac's condition was not severe enough. All the while, he was struggling emotionally, socially and academically. On the advice of the school, his parents forked out €2,000 for ADHD and dyslexia assessments. In 2023, Isaac was finally taken back into primary care, where a psychologist confirmed his previous diagnosis and flagged autism as a required assessment, saying it should have been picked up seven years earlier. After yet another year of waiting, Isaac finally had a CAMHS appointment but it did not have the authority to conduct an autism assessment. Only in March of this year did Isaac get his assessment. He went eight years without the proper support and has been set back enormously by this. All along, it was an easy diagnosis.

Then there are Ruby and Luna McGarry, who are nine and four years old. Their parents submitted AON applications in February 2024. By law, assessments, as we know, should have been done by August 2024. We are now in May 2025 and there is still nothing. The HSE is blaming a backlog due to a High Court ruling but their mammy, Orla, notes that her third child was seen as part of that backlog two years ago, but only after paying privately. Orla and Andrew cannot afford to go down the private route this time. The McGarrys, like so many, are being strung along by a system that is breaking the law and breaking families in the process.

Those are just two stories from Kildare; there are thousands more out there.

Johnny Guirke (Meath West, Sinn Fein)
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In 2025, just 7% of assessments have been completed within the legal timeframe set out in the Disability Act 2005. To say that some children are being failed is an understatement; 93% of children requiring an assessment of need are being failed. Experts in the field advise that early intervention is critical. It allows for a family to plan the supports that a child with an autism diagnosis will need and to arrange the provision of any additional supports the child may need when entering the education system.

The inclusion in the Disability Act 2005 of a legal requirement for children to be assessed within six months of referral demonstrates how important this is, yet 15,296 children are on assessment of need waiting lists. This list looks set to only grow, with an estimate of 24,000 children being on the list come the end of 2025. On average, children are waiting 32 months, more than five times longer than the Disability Act allows for. This is what parents are facing. This is the level of failure when it comes to children with disabilities. I was contacted by a family whose son was referred for an autism assessment in September 2022, when he was four years old. They are loving parents and they want a good quality of life for their child, like the parents of any other child in this State. To date, however, he has not had that assessment. If he waits 32 months for the assessment, the young lad who was four years old when the referral went in will be seven years old when he is fully assessed. That is just not good enough.

With these wait times, children and their families are being failed. We know that early assessment is crucial to ensure children and parents get the supports needed so that children on the autism spectrum can live fully and have happy childhoods. When the wait time for an assessment of need is 32 months, however, early intervention is impossible. These assessments are needed early so that these children can avail of specialist school support to help them learn. Without the assessment, they will not be added to a specialist class or a hub but on this element, too, the Government is failing. The failure to implement the Education for Persons with Special Educational Needs Act 2004 has meant the education system is struggling to deliver for children in the school environment.

At every hurdle, the Government parties have stumbled on this issue. Waiting lists are rising, schools do not have the resources and 93% of children in 2025 are not being assessed as promptly as the Disability Act recommends.

Sorca Clarke (Longford-Westmeath, Sinn Fein)
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As well as being a TD, I am the mother of four amazing children, two of whom have autism. The assessment of need road is very familiar to me. I cannot say I have walked it, because you do not walk this road but endure it. You climb, you fall and you pick yourself up repeatedly. The Government's ongoing inability to uphold the legal requirement to complete AONs within six months is unjustifiable. This is not just a missed deadline; it is a breach of legal duty. More important, it is a betrayal of vulnerable children and their families.

The assessment of need is not a bureaucratic formality. It is a key element to identifying and providing proper supports that children rely on to thrive. Delaying assessment means delaying therapies, supports and a chance of a more equal and dignified life for those children. Families are left in a cruel limbo. Parents watch as their children struggle, knowing that early intervention, proven to make a real difference, is being withheld because of inaction and indifference and because the system that is supposed to help is in fact failing them.

Delays are not a glitch. They are systemic, persistent and unjust and that deepens inequality. They punish those who are already carrying more than their fair share of the burden. A legal obligation is not optional, and every day that passes without emergency action is another day lost for a child who cannot afford to wait. To hear the Taoiseach say this afternoon that he thinks the problem here is the law itself is absolutely mind-boggling. The Government cannot comply with the law, so it will simply change the law. What message does that send to the 14-year-old girl at the gates of Leinster House this evening? What message does it send to those parents who are waiting in absolute turmoil?

Pat Buckley (Cork East, Sinn Fein)
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More than 15,000 children are overdue their assessment of needs. Approximately 1,000 of these are in my county, Cork. To make matters worse, parents in Cork are waiting up to 30 months for these assessments for their children. This is a far cry from the six months' waiting time required by law. In fact, more than 90% of assessments of need are completed outside of the legal time limit. It is absolutely bonkers.

These delays are not just numbers. They represent real children who are missing out on critical early intervention, which could significantly damage their development and their quality of life. The assessment of need scandal sits within the broader context of extensive and abject policy failure across our disabilities sector, which is causing so many families immense suffering. In a country as rich as this one, it is shameful that so many children have been failed so consistently and so comprehensively. When a child finally does complete an assessment of need, families are often faced with a further abyss of prolonged waiting to access therapies. At one point, waiting lists in Cork and Kerry primary care psychology exceeded 6,000 and waiting times were close to six years for some children.

The current situation is certainly untenable. We cannot in good conscience allow the children of this country to languish on waiting lists while their developmental needs go unmet. We must ensure the voices of affected families are heard and that their experiences inform the policy decisions. Every child deserves timely access to the assessments and services they need to thrive, and it is our collective responsibility to ensure no child is left behind. I plead with the Government to please commit this time to taking the necessary actions to rectify this situation and uphold the rights and dignity of all the children in this country.

Donna McGettigan (Clare, Sinn Fein)
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More than 15,000 children are now overdue their assessment of need. That is 15,296 children who could be left with a decline in their quality of life. It is 15,296 children whose development and learning will be potentially impacted, who could be missing out on opportunities for support, who could be missing out on therapy and other services that could help them reach their full potential, and whose parents or guardians are experiencing significant stress and frustration.

This week, I am glad to see the combined Opposition coming together to bring forward a joint motion on this, but I am extremely angry it has come to this and that we have to stand here and demand that the Government provide children with an assessment of need within six months, as required by the law. I am in awe of a 14-year-old disability rights campaigner, Cara Darmody, who is staging a 50-hour sleepover but angered that she feels she has to do this to be heard. The Government's failure to implement the Education for Persons with Special Educational Needs Act 2004 has meant the education system and the National Council for Special Education are not capable of delivery for children in school settings, which is directing additional pressure to overburdened specialist services.

I visited two schools in Clare with the Minister of State, Deputy Moynihan, St. Anne's in Ennis and St. Conaire's in Shannon, and witnessed this. The HSE anticipates that this will only get worse and there could be as many as 24,796 left waiting by the end of 2025. This needs emergency action to make funding available to Cara's Fund to clear the backlog and to get a specific target date by which the Minister aims to comply with her legal obligation.

Fionntán Ó Súilleabháin (Wicklow-Wexford, Sinn Fein)
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As someone who was in my 35th year of primary teaching when I finished up in December, having taught in the area of special education for most of the past decade, it is an area that I am quite familiar with. A shockingly high figure is that of 2,314 children still waiting for an assessment of need in the Wicklow-Kildare HSE area, which is the highest number outside of Dublin. A smaller but significant number are languishing on waiting lists in County Wexford, awaiting an assessment.

Like other Deputies, I could mention numerous case studies, but have just two minutes, so I will briefly mention two cases. One is a Gorey parent, Kellie Nolan, who contacted me, stating that her ten-year-old son, Finn, has been waiting for seven years for an assessment of need and supports, so basically has had no supports since preschool, which is mindboggling. He had a private ASD assessment and has been waiting for years for a communication device, as it is the only way for him to communicate with his parents. This is shocking. I could speak of equally shocking stories from County Wicklow, where a Carnew mother fears for the mental health of her son, who is staying in his room due to a very frustrated younger brother, who is lashing out at him, harming him and harming himself, so much that she has had to send the older brother to their grandparents, who are over an hour's drive away. This is heartbreaking for the parents concerned.

Under the Disability Act 2005, children are entitled to an assessment of need within six months. However, 15,296 children are overdue their assessment of need. Worryingly, the HSE anticipates that this will only get worse and expects that by the end of this year, there could be as many as 24,796 assessments of need due for completion. This is not good enough. The Government is failing to implement the Education for Persons with Special Educational Needs Act 2004, and is therefore breaking the law. We in Sinn Féin will continue to fight until it is sorted and children get the services and supports that they are legally entitled to access and deserve. I call on the Government to support Sinn Féin's motion this evening.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I presume when the Deputy mentions families, the names of family members and so on that he has the permission of the family to do so.

Ann Graves (Dublin Fingal East, Sinn Fein)
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This Government has once again failed the most vulnerable. A total of 15,296 children are overdue for an assessment of need. It is nothing short of a scandal. It is a priority for Sinn Féin. We and the combined Opposition have come together to table a motion during Sinn Féin's Private Members' time, demanding that the Government moves urgently on this matter. Children are entitled to an assessment of need within six months under the Disability Act. The reality is different, however, and the Government is breaking the law. A young four-year-old from Swords, identified as having speech and language difficulties, had a check-up as a two-year-old. He was referred to Swords Health Centre. Eighteen months later, he received an appointment, for 1 February 2025, only to be told that he was number 26 on the list to see a therapist. He will be six years old before he sees a speech and language therapist. That is four years.

James contacted my office in Fingal East. His son has been waiting for 18 months for an appointment for an assessment. I tabled a parliamentary question in an attempt to draw attention to this serious matter. The response from the Department confirmed that his son will not get an appointment until October 2025. I met a woman during the general election campaign who is a mother of twins, one of whom has additional needs and is waiting for a psychological assessment. He is non-verbal and awaiting a speech and language assessment. They both start school in September. The mother just wants the best and most equal chance for both her children. I met her again in my office yesterday and nothing has changed. It is anticipated that by the end of 2025, there could be almost 25,000 children whose assessments of need are due to be completed.

The solution lies with the Government. The Minister must take emergency action and make funding available to clear the backlog and provide these children with assessments, which they are legally entitled to. Longer-term, the Government needs to deliver a sustainable solution, including an urgent workforce plan to recruit, train and retrain enough staff to finally end this serious breach of children's rights.

Dessie Ellis (Dublin North-West, Sinn Fein)
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In my constituency of Dublin North-West, there are a great number of children and young people with autism and other special needs and disabilities who have been waiting for assessment and support services for a long time. I have had many parents come into my constituency office who are frustrated at the long waiting times for their children and who cannot progress or get the service they require without first having this assessment carried out.

It is important that children are assessed at an early age so that they can get the supports they need, which are crucial for them as they grow into young adults. In CHO 9 alone, which covers my constituency of Dublin North-West, more than 2,400 children have been waiting for over a year for an initial contact from the children's disability network. This is contrary to the terms of the Disability Act 2005, which states that children are legally entitled to an assessment of need within six months of applying. In reality, only a tiny percentage of those who have applied for an assessment have received one. This demand for assessments in CHO 9 is growing. According to the Department of Health's figures, in CHO 9, the demand for assessments of need increased by approximately 14% from 2022 to 2024.

These delays mean that children are being left behind at a crucial time in their development, which negatively impacts both the children and their families, particularly those who need urgent access to specialised services. We are now at a point where we have a 14-year-old schoolgirl, inspired by her own family experiences, protesting outside the Dáil for urgent action on the growing waiting lists for disability assessments for children. The assessment of need process in Ireland is crucial for identifying and addressing the needs of children and young people with disabilities.

Donnchadh Ó Laoghaire (Cork South-Central, Sinn Fein)
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The failure that is happening here is profound for parents and most importantly for their children, but also for the professionals working in the field. It feels as if the system is shuddering to a halt and is completely choking up, and the situation continues to get worse and worse. More than 15,000 children are waiting for an assessment of need. There are more than 2,000 in my county, Cork. Many of them have been waiting for over a year, of which many have been waiting for over 30 months. It is a scandalous situation.

A few weeks ago, I attended a number of protests organised by parents, Nicole Hosford, Karen McGrath and people like that, who have been here and have met officials from the Departments. The focus at that point was on special school places but they never lost sight of the fact that it is not isolated and that does not solve everything by any means. If a child gets a seat in a classroom, it does not solve all the issues and does not ensure that child reach their full potential. Sometimes, in this place, we get so used to a particular phrase for a policy, such as assessment of need, that it loses meaning. If we think about what it actually is and what it means for a parent, an assessment of need identifies what that child needs from the health system, education, therapies, meeting the child, understanding the child, and seeing how you can meet the child's best potential. How frustrating is it for that child and the child's parents to know that there is not even the basis for a plan for them to proceed? Tá mé ag impí ar an Aire maoiniú a thabhairt do Cara’s Fund. I am urging the Minister to support the motion later and to fund Cara's Fund.

Ruairí Ó Murchú (Louth, Sinn Fein)
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We are all here and having this discussion because 14-year-old Cara Darmody and her dad Mark are outside on a 50-hour sleepout. It is nothing short of scandalous. Obviously she is doing this on behalf of her brothers, Neil and John, and all the other Neils and Johns.

The figures were spoken about earlier. At this point, we are talking about 15,296 children who have been failed. That failure is to deliver on an assessment of need within six months. We could be looking at a figure by the end of the year of 24,796. As was said earlier, we are talking about a profound failure. It is all well and good to say that parents and their children can get therapies. We know that the assessment of need is required for parts of the wider system, whether it is school and whether you will be in mainstream or you need to be in a particular unit. It is required for payments, which are necessary for the added costs of disability. We have all spoken for a long time about the single point of access. There are a number of things in this that are good.

However, there is also an abject failure to have delivered upon what should have been done. During my time on the autism committee, we met with the Association of Occupational Therapists of Ireland, the Irish Association of Speech and Language Therapists and the Psychological Society of Ireland. Nobody had a discussion with them on the best means of not only carrying out these assessments but also delivering therapies. We have spoken before about this. We really have to get to the point of offering the therapies where the need is - that is, in the school setting - while being able to deliver some sort of service within the CDNTs. We have nothing but absolute gaps in them. We know from the figures for the end of last year that there were still 529 whole-time equivalent positions missed. We have abject failure, we have breaking of the law and we need to see delivery. It is absolutely scandalous that we are reliant on the actions of a 14-year-old girl to embarrass us into looking at this properly.

Mark Wall (Kildare South, Labour)
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Not a single day goes by on which this Government does not break the law regarding the statutory timeline under the Disability Act for an assessment of need. In a previous Commencement matter with the then Minister of State, she described it as "Groundhog Day" and "as bad as it can get". Unfortunately, it has got worse since then. Now over 15,000 children are waiting on an assessment in my own area of Kildare, where we have the second highest number of children who are overdue an assessment. Nearly 1,700 children are overdue an assessment in Kildare and Wicklow. Even if a child receives an assessment, they are likely to languish on another waiting list with many other children. Waiting lists are in the tens of thousands for essential therapies with over 20,000 children waiting on psychology and occupational therapy, 19,000 waiting on speech and language therapy and nearly 10,000 are waiting on physiotherapy.

Every expert agrees that early intervention is key. We are all aware of this and many Ministers are on record acknowledging this fact. Yet the average wait time for the CDNT in Kildare is more than three years. The Government is missing the critical point for early intervention for these children. It is simply failing them. The Government needs to provide transparency and accountability on this issue. It should be publishing monthly waiting lists for assessment of need and therapies. We need to know that these figures are going in the right direction. Parents need to see some light at the end of what can be a very dark tunnel for their children who need help. We need to train more therapists and specialists. We need to see them on the ground working in schools but there seems to be no strategy for this from the Government. We know there is no quick fix but there are many ways in which the Government can provide immediate relief to those children and their families. Short- and medium-term measures need to be considered by the Government, such as the Labour Party proposal to outsource diagnostic assessments for children waiting the longest. Another proposal is to utilise the National Treatment Purchase Fund to reimburse parents who have already paid huge amounts for private therapies. In the programme for Government there is a mention of grant funding for children's therapies. I ask again for clarity on this fund as I have done before. It may go some way towards addressing the long wait times if parents can access private therapies through a temporary Government grant.

Not for the first time, I raise the issue of the national child development centre to be operated by Sensational Kids. I am aware that the organisation will submit its proposal to the HSE for capital funding in the coming weeks. It is sad to see this potential state-of-the-art treatment centre lying block-high and unfinished in Kildare town. It would have the capacity to see 300 children per week, taking them from the waiting lists I have spoken about in my earlier contribution, but it would also importantly offer much-needed clinical placements and mentoring for the therapists, OTs and other specialists, clinicians and consultants we need in this country. We need to offer them the opportunity to get the placements so many of them are struggling with at the moment. I ask the Minister to urge all in government to get behind this much-needed development in the State. Later this evening we will have the opportunity to discuss this matter further and mention Cara Darmody and her Dad, Mark. I look forward to that. I look forward to mentioning what Cara has done in the battle for her two brothers and also going into some detail of cases I am currently dealing with in my own area of Kildare South.

Marie Sherlock (Dublin Central, Labour)
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The vast majority of the statements here today reflect the absolute anger we all feel about the shambles in the assessment of needs. I refer to the shambles of the 529.77 whole-time equivalent unfilled posts in the CDNTs, the failure to retain staff in both primary care and the CDNTs, the reliance on private assessments because the State cannot get its act together and the devastation for parents as they watch their children regress because they cannot access the services they need. I wish to reflect on what comes after a child eventually gets their assessment of need. In many cases they are waiting three or four years, particularly in my area in the northside of Dublin, for that to happen. Then, of course, they wait another three to four years for those therapies. I recall a time when the CDNTs in my area would say to me that they could not assess until they were ready to provide treatment of therapies to the child. I did not like the answer at the time but they were right. However, even now, those children who have got the assessment of need are waiting another three to four years and that is wrong. The distress and upset out there is absolutely enormous. Families who have been left waiting for so long are now having their hopes dashed and replaced with a seething frustration. They have a document to say which therapies the child needs and yet they have no idea when they are going to get them. This is the abject failure of the State to provide for some of our most vulnerable children.

When we look at the waiting times for those children who have been assessed, it is really astounding. In just three years, there has been a 199% increase in the number of children waiting over one year for their initial assessment for speech and language therapy. For psychology, the number of those waiting over a year has jumped 170% in just three years. There are 11,552 vulnerable children out there deemed to need psychology supports who have been left waiting for over a year. It is absolutely heartbreaking. What damage is this State doing to those children by failing to provide those supports? The horrible reality is that the number of staff who have been recruited in that time has been a tiny fraction of the twofold increase. It is a reflection of a system that is truly broken and desperately failing these children. We are all aware of the crucial need for timely intervention for children. Now the Government needs to seriously rethink the progressing disability services strategy and the Roadmap for Service Improvement 2023-2026. We need to have a fundamental rethink of how, where and when these services are provided to children because the current system is not working. When I say that, I do not mean they should be getting anything less than they deserve or any diminution of the service to which they are entitled but we need to have a rethink of how things are being done.

Ciarán Ahern (Dublin South West, Labour)
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I begin by paying tribute, as others have done, to Cara Darmody. A 14-year-old obviously should not need to be such an ardent campaigner for autism supports and services but she is an incredible one and it was a pleasure to meet her and give her my support outside the gates of Leinster House this morning. Nearly everyday, like everyone here, I am contacted by parents in my constituency who either cannot get an assessment of needs for their child or, if they have got one, cannot get the necessary therapeutic supports. As we have spoken about, there are now over 15,000 children waiting for an assessment of needs in Ireland. Some 10% of those are in my own constituency of Dublin South-West. That is over 1,500 children; the third highest number in the country. Too many of the parents I speak to have had to fork out hundreds of euros for private assessments because they cannot wait any longer. They are the lucky ones. Many other parents just cannot afford to go private. This is not a new problem, but it is getting worse. Two years ago my colleague, Deputy Duncan Smith, brought forward a motion calling for reimbursement for families forced to go private for assessment and therapies. The then Minister of State, Anne Rabbitte, said at the time that she had made a proposal to the HSE where she wanted a minimum of six regional assessment units stood up and that if that was not done by 1 August that year - two years ago - she would take to budget what the Labour Party had suggested which was to fund the families. Those assessment units still have not been rolled out and the Minister reneged on the commitment to take our Labour Party proposals to budget. Since then the issue, the backlog and the wait times have only got worse.

The victims of this Government inaction ultimately are vulnerable children in need of support. It is nowhere near good enough. The same can be said in terms of the actual supports available. Speech and language therapists, occupational therapists and physios are all virtually absent in Dublin South-West and in many other parts of the country. I recently visited the Ballyboden primary healthcare centre in my constituency that previously had five speech and language therapists in 2022. It now only has one working part time and is having huge difficulties in hiring due to the pay and numbers strategy. We are seeing significant issues in our special schools as well. The Libermann Spiritan School in Templeogue, for example, is opening two new classes in September which is certainly welcome.

However, the much-needed therapeutic supports available in the school will remain the same which means the actual services being provided to the students in that school are being diluted. St. Kevin's Girls' School in Kilnamanagh is facing another issue. Enrolment in the school has dropped by just five students for next year, so they are losing a teacher from their allocation and being forced to merge two classes. This will result in a single class of almost 35 students, including children with autism. What will that do to the development of these children from a social and educational perspective and in terms of the management of the SNA resources? Teachers and SNAs are already at breaking point. This cannot be allowed to go ahead. The school should have its teacher allocation restored and I will ask the Minister for education to intervene here.

We are all aware of the importance of early intervention, and it has been mentioned repeatedly today, in giving children with autism or other complex needs the best chance to live fulfilling and dignified lives and independent lives insofar as possible. That opportunity is being withheld from so many children in my constituency and all over the country. We want fewer promises from the Government and more action.

Alan Kelly (Tipperary North, Labour)
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I know the Minister for children is a very decent person. There are tens of thousands of families affected by what we are talking about, my own included. I deal with this issue every day. In my clinic recently, nine out of 17 appointments concerned issues experienced by people with autism.

I have probably been involved the longest with Cara Darmody and with her father and mother in fighting for their two sons. I brought them here two and a half years ago. I know how determined Cara is and how determined the family are.

I will say quite openly that I am so uncomfortable about the fact that it has gotten to the stage where a 14-year-old is sleeping outside tonight and tomorrow night. That needs Government intervention tonight. We, as a country, cannot have a scenario where a 14-year-old who has been fighting - in fairness, this is not today or yesterday - for two and a half years is sleeping outside the national Parliament because we are in a crisis and she, and many of the rest of us, cannot see a way out. It is a national scandal. We cannot allow it to happen. The Minister is a very decent person, I absolutely know that, but someone from the Government - the Taoiseach or somebody - has to go out there. It will be a stain on all of us if something is not done. A 14-year-old has to sleep outside the national Parliament in order for us to put in place crisis measures to deal with this issue.

I received figures from the HSE in relation to this issue. I just want to say this out straight. I often ask questions of the HSE and it is not always so forthright. This is a cry for help from the HSE. The HSE admits the list will go to 25,000 within another eight months. This is not sustainable for all the families out there who are fighting. The HSE also tells us it cannot provide the figures on how much longer than six months families have been waiting. All of us in this House know that it goes on for years. Not alone does it go on for years and years but then afterwards when one gets a service statement, it will take another number of years. It takes years to get an AON, it takes years to get a statement of service and then it takes years to get occupational therapy, speech and language therapy and everything else. It takes a block of years to get the AON, a block of years to get the service statement, and a block of years, if at all, to get the therapies. That is reality. Also, for families who move in and out of the system to the private system, having the best of intentions, and try to jump back into the public system, there are complications there.

I have a situation where somebody who is well known to many of us in this House has verified something which I have always thought, where when one's child seeks to be dealt with by CAMHS, it often looks for an assessment of need to rule out autism. I am beginning to wonder if that is just to keep the numbers down in CAMHS. I am fairly convinced it is a real issue.

Many people speak about this issue but do not actually come into this House to look at solutions when they are in opposition. I will change that and talk about where we have to go as regards solutions. We all know we need more people working in this area. That is the ultimate issue. We all know the former Minister of State, Anne Rabbitte, stood in this House two years ago responding to a Labour Party Private Members' motion and made commitments that, no disrespect to her, have not been honoured. We need to bring in more people who are working in the private sector. We also need to upskill a large number of people who are in other disciplines in order that they are able to cross-work in this area. That is the quickest way in which we will deal with this issue. We also need to bring in more people from outside this jurisdiction in order to deal with this.

We need to ensure we are not only training more people but that we are dealing with pay parity issues. Many people are working in other organisations, privately, etc., because of the pay parity issues with working in the HSE. I know people who want to work in the HSE and who want to work in this sector but they have mouths to feed. The pay parity issue, which has gone on for years, is a real one. They are the four different components which I believe will go a long way to helping with this issue.

I will conclude by repeating that I am not comfortable that we, as a State or as a Parliament, are allowing a 14-year-old child, who I totally and utterly respect and whose family I have worked with for many years and who I brought here initially a number of years ago, to sleep outside our Parliament tonight because she is so desperate to see this issue dealt with. It is the lowest thing I have seen in my 17 to 18 years in these buildings.

Michael Murphy (Tipperary South, Fine Gael)
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I acknowledge the extraordinary Cara Darmody. She is such an amazing campaigner and advocate for her brothers, Neil and John, but also in particular for all young children awaiting an assessment of need across the country. I also mention Cara's dad Mark and her mum Noelle. They are both amazing parents and carers to Neil and John.

Living so close to Cara and the Darmody family, I have engaged with her, especially over the past four years. I have been so impressed with her passion, commitment, intelligence and steadfast determination to effect meaningful change. Cara is such a positive force. She is very clear. The political system needs to urgently apply itself to finding solutions to the assessment of need emergency. It is time all of us across the political divide started listening to Cara and that we all work together in a solution-focused manner.

This is an emergency. Our primary focus must be on the assessment of need process and this may require legislative change. However, such change must not in any way dilute the crucial need to identify the exact therapies a child would benefit from in order to reach the maximum of his or her ability. I fully support allocating more resources to significantly increase Cara's fund in the short term and indeed in the medium term so that those who are longest on the waiting list can be referred to private providers. To date, this fund has helped more than 3,600 children on the waiting list. It is so important we better resource this initiative in order to continue to support and deliver for those families and children who have been waiting the longest.

We need a real focus on recruitment and retention. While the workforce across the 93 CDNT teams increased by 17% between 2023 and 2024, there are still too many vacancies. I appeal to the Cabinet subcommittee on disability to establish a task force around recruitment. For example, notwithstanding the existing pathways in education to qualify as a therapist, how can we better recruit more therapists from abroad? While the HSE maintains a panel of external suppliers to support recruitment of therapists internationally, this procurement model is not working and I can point to many examples to support that view.

We need to engage with CORU because the process by which international therapists must, in the first instance, have their professional qualifications recognised by the regulator to be considered for registration needs to be reviewed.

There is no doubt that addressing the problems with the assessment of need process is a real challenge. As Cara wants, let us all work together. We owe it to the children of Ireland. As a new TD, this is a key priority for me.

Keira Keogh (Mayo, Fine Gael)
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I thank the Leas-Cheann Comhairle and the Minister. When I worked for 19 years with the neurodiverse community, I was often the first point of contact after a parent acknowledged a concern for their child, or was potentially nudged by a relative, a childminder or a preschool teacher to talk to their GP or public health nurse. It takes real courage for a parent to do this when they notice that milestones are being missed or when they start to see struggles in areas like speech and language, difficulties with motor planning, behavioural struggles, social challenges or learning difficulties. It takes real courage to take that first step to seek answers, a diagnosis and a roadmap.

Why do parents do that? They know the assessment of need process is objective. They want and crave that statement of need in their hand because it tells them the list of services and supports that should be provided to their child. I commend Cara Darmody who is outside protesting for 50 hours, but I am uncomfortable because it is terrible that she has to do that, and it is terrible that we have over 15,000 children on our waiting list. There are almost 200 children in my own constituency of Mayo waiting for an assessment of need. We must do better. We must continue to increase resources. We have to use the private sector and continue to do so where needed, and we have to address recruitment and retention issues.

I welcome the 65% increase in completed assessments of need in the first three months of this year. I welcome the regional hubs that have been set up to target the backlog, and I also welcome Cara's fund. However, we must recognise why there has been such an increase in the demand for assessments of need. Parents know that services are stretched. They know CAMHS services are stretched, as are primary care services and the CDNTs. There are almost 700 children in CHO 2, which comprises my area of Mayo, Galway and Roscommon, waiting for CDNT appointments. These parents feel that they need the diagnosis and they need to get that statement in their hand. They need the diagnosis if they want to access home tuition or if they want to access a special school or an autism class.

Without the assessment of need, providers like NEPS psychologists or therapists like speech and language therapists are often working off anecdotal information, school data or their own observations. NEPS psychologists and therapists have said that they want that detailed knowledge and diagnosis because the assessment notes are really key for them to work off. We also have to acknowledge that sometimes parents feel the assessment of need is their only route to services, but actually they can access CDNTs, primary care, SET and SNA hours in school and NEPS psychologists. I welcome that they can now access the domiciliary care grant without the assessment of need being completed but we also have to acknowledge that these services are really stretched.

I welcome the roll-out of therapists within schools. This is going to be one of the step changes we have discussed, and it is really welcome. We need to continue fighting and working as hard as we possibly can. This debate in the Dáil is really helpful because we keep talking about how disability is at the forefront of all of our minds. There is cross-party agreement that we have to do better and that this issue and the issue of housing are going to be the measure of our Government. They are our two biggest challenges. I look forward to working collaboratively with my colleagues on the disability matters committee. When we are working together and bringing solutions from across the House, we can make inroads in disability.

We have to continue to expand services, and address recruitment and retention issues. There is a 21% vacancy rate on CDNT teams across the country. I have been guilty of not signing up to HSE jobs when I had the option. I chose instead to go and work privately for myself, where I could manage my caseload and see my clients on a regular basis. I knew that early intervention and regular appointments were where the difference was going to be made, and that is where we see a lot of struggles for therapists who are pulling away now. So many of our therapists are caught trying to catch up on the assessment of need backlogs and are maybe not providing the therapies where they want to. We know that the CDNTs are really struggling, so we have to increase our staff and train more therapists.

We also have to continue our investment in disability services. I know it is at record levels but we must continue to do more. Really and truly, we have to completely clear the backlog with the assessment of need process so that therapists can get back to providing therapies, and Cara can get back to school.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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At the outset, I welcome this debate and thank colleagues across the House for their contributions. It is clear we are united by a common concern for children with additional needs and their families, who deserve timely assessments and tailored supports. Far too many people are waiting far too long. No one here today can ignore the facts. There are over 15,290 overdue assessments, a figure that represents children, families and futures being left in limbo. Applications have more than doubled since 2020, rising to over 10,600 last year. These delays are unacceptable and must be addressed head-on.

It is also important to be honest with the public about the complexity of the challenges and the work that is already under way. I note the Opposition has tabled a motion on this issue this evening, which the Government is not opposing. In fact, we all share many of its objectives. They are shared priorities but real, lasting solutions require more than emergency funding; they require structural reform, workforce expansion and smarter delivery.

I welcome the Government's allocation of an additional €10 million this year to deliver nearly 3,000 additional assessments and to expand our capacity with new specialist teams, including senior therapists, health and social care assistants, as well as clinical trainees. We are already seeing progress on that front. Last year, we saw a 30% increase in the number of completed assessments, thanks in part to the targeted waiting list initiative. Over 2,400 assessments were procured through private providers, targeting families who have waited the longest.

That said, it is clear that it is not enough. No family should be forced to seek legal redress to access a right they are entitled to under the Disability Act 2005. It is deeply concerning that €7.9 million has been spent on litigation since 2021, money that should have gone to services, not to lawyers. The reality is that too much of our current system is still shaped by bureaucracy, not by the best interests of children. We have therapists spending a third of their time conducting lengthy assessments instead of delivering therapies. This needs to change.

We need a model that responds quickly to identified needs, whether that is speech and language therapy, occupational therapy or mental health supports, without unnecessary delays. Where legislation needs to change to support that, I know the Minister, Deputy Foley, will act. The Minister prioritised special education in her time with the Department of Education with regard to the SENs. I acknowledge the leadership of the Taoiseach, who from his first days in office ensured that disability had a full voice at Cabinet and created the first disability unit in the Department of the Taoiseach. The Cabinet Committee on Disability, which he chairs, continues to drive co-ordinated action across Departments.

As with her progress on the SENs, I want to highlight the work of the Minister, Deputy Foley, in placing a sharper focus on delivering therapies directly in our schools, starting with special schools and ultimately extending across the system. The funding for disability services in 2025 stands at over €3.2 billion, up €1.2 billion since 2020, but I and families know that funding alone is not enough. It is about access, delivery and outcomes, and that is where our focus must stay. We are also investing in school places and specialist support. Budget 2025 provided for up to 2,700 new special education placements and nearly 400 new special classes. We are on track to deliver five new special schools and to expand existing ones too.

In conclusion, the scale of this crisis is acknowledged. The focus must be on investing in services and reforming and restructuring services to deliver a better, faster and more equitable system, which meets the needs of every child not just in law but also in practice.

Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Today, the combined Opposition will put a motion forward in solidarity with Cara Darmody.

Today, the Government does not cherish the children of our nation. It is in breach of the law because it has denied children their rights. This Government of Fianna Fáil, Fine Gael and the so-called Independents has denied children their rights. This has a real impact on the lives of parents and children. Assessments of need are needed, otherwise parents are out of pocket because they have to pay privately. The outcomes for their children are not optimal and the situation is getting worse. In September 2020, 5,083 children were on a list. In June 2024, there were 11,131 children on a list for AON. In September 2024, there were 12,722 children on a list. Today it is embarrassing for this Government. I do not know how Government Members can stand up and make statements in this House when more than 15,000 children are waiting for assessments of need and, by year end, there will be a projected 25,000 children waiting for assessments of need.

A task lies ahead for the Government. The united Opposition has brought a motion to this House asking the Government to clear the backlog, comply with the legal obligations and provide all children with an assessment of need within six months. What the Government must do is take emergency action and make funding available to Cara's fund; set a specific target date by which the Government aims to comply with its legal obligations; deliver a longer term, sustainable solution including an urgent workforce plan to recruit, train and retain enough staff; fund special needs services, including speech and language, physio, occupational and behavioural therapies; and provide appropriate school places for children with special needs.

Verona Murphy (Wexford, Independent)
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I thank Deputy Bennett and call Deputy Ward.

Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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In Monaghan we recently got a new special school but more needs to happen for every child.

Verona Murphy (Wexford, Independent)
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Deputy Bennett is taking her colleague's time.

Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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They need to get more day services and the Government needs to plan for every child's future.

Mark Ward (Dublin Mid West, Sinn Fein)
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At this moment more than 15,000 children are waiting for an assessment of need. An assessment of need is an assessment carried out by the HSE of children with disabilities. The assessment identifies the child's needs and what services are needed to meet them. This sounds like a simple procedure, but Fine Gael and Fianna Fáil have made a right hames of it. They have scandalously left children waiting for the treatment that will allow them to reach their developmental milestones. Only 7% of assessments were completed within the six-month timeframe required by law. In 2023, the State spent €1.2 million defending itself against parents of children with disabilities because Fianna Fáil and Fine Gael broke the law. How messed up is that? It gets worse. The HSE is now recommending that parents take the HSE to court because assessments of need are not being delivered on time. One parent applied for an assessment of need for her son. The assessment was not provided within the six-month statutory time-frame. She made a complaint to the HSE using the correct procedure. The HSE again failed to provide the assessment on the new date it gave after the complaint. She asked the HSE what options were open to her at that stage and got a reply stating that the only escalation available to her at that point was for her to go to the Circuit Court. The system is so broken that the providers of the assessments are telling the parents to sue them. You could not make this up. Fianna Fáil and Fine Gael have turned their backs on our children.

When a child eventually receives an assessment of need, parents have to fight again to get the treatment that the assessment recommends. There is nothing worse than a parent receiving a letter to say they will be waiting years for an appointment for occupational therapy, speech and language therapy or psychology. In my own area, there is no psychology team or physiotherapy team for those who live in Palmerstown. There is a 183-week wait list for occupational therapy. There is no greater crime in this State than denying children the right to reach their full potential but that is exactly what Fianna Fáil and Fine Gael are doing to our children.

Liam Quaide (Cork East, Social Democrats)
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I thank the Minister for her statement. Cara Darmody, a remarkable 14-year-old disability activist from Ardfinnan in County Tipperary, today began a 50-hour sleep-out on Kildare Street in front of Leinster House. Cara is taking this action to highlight the more than 15,000 young people in this country who are overdue an assessment of need. We hear from the HSE that this figure could reach 25,000 by the end of the year.

Despite all the talk about prioritising disability in the lead-up to the general election it is almost as if the Government has given up. Almost the only strong message it has expressed so far in this regard is the intention to abbreviate assessments of need by changing disability legislation. This is something of which we need to be very careful. We have been here before. In 2020, a previous attempt to shorten AONs led to High Court action as the assessment in question was clinically inadequate. That led to further escalation in waiting lists for AONs afterwards because so many children had to be reassessed. An autism assessment and intervention protocol has been going through consultation in recent times with associations of the interested clinicians, speech and language therapists, psychologists, social workers and occupational therapists. I know from feedback from that consultation that those professionals are raising very similar concerns. We need to be wary of how we change course in this regard or how we might consider it.

Despite her youth, Cara Darmody has been highlighting the issues with AONs for several years. She was moved to campaign on behalf of children with additional needs after witnessing the lack of services available to her two young brothers, who are autistic and have intellectual disabilities. There are many other families like Cara's who have watched their children being failed and felt compelled to become activists and campaigners, all to secure basic services and supports which children with additional needs are entitled to as a right. In a country as wealthy as ours it is shameful that so many children have been failed so consistently and comprehensively.

The assessment of need waiting list crisis sits within a broader context of pervasive and abject policy failure across our disability sector, failure that is causing immense suffering to so many families. Since the general election in November disability issues have had a political focus like never before but we have yet to see political change stemming from this Government. A disability unit in the Department of the Taoiseach to add weight, urgency and focus to the crisis was announced in January. It will be important to see soon what work, if any, the unit has undertaken. The Taoiseach mentioned on Leaders' Questions earlier today that he is in the process of setting up the disability unit in his Department. However, we are now five months on from the formation of Government. Has the unit actually met? Is it still only being formed? Where is the sense of urgency in action that was so vivid in pre-election rhetoric?

My party colleague, Deputy Cian O'Callaghan, speaking on Leaders' Questions called on the Government to comply with the Disability Act and to complete AONs within the statutory timeframe. The Taoiseach responded with a frustrated tone, as if the question was unreasonable. He stated, "The HSE is not in a position to fulfil the law right now. The Deputy knows that and I know that." The Taoiseach reacted as if he was being needled by a question posed in bad faith for political purposes, yet his response raises a further question as to why the HSE is not able to comply with the law in respect of AONs. This is mainly because services, in particular primary care, have been stymied from carrying out clinical work, both assessment and intervention, not just by the official HSE recruitment embargo that took place between October 2023 and July 2024 or the unofficial embargo that has followed since in the form of the pay and numbers strategy, but also by years of severe under-resourcing prior to all of that by successive Governments which the Micheál Martin either was directly part of or supported through confidence and supply. That is the answer.

How do we get out of it? Should we be led to believe that the crises, and there are multiple crises across the disability sector, are extremely complex and will take many years to resolve? If we keep privatising and fragmenting services, these problems will be more intractable. However, the Government can take one straightforward and basic step now and that is to overturn the recruitment restrictions imposed on primary care services by the pay and numbers strategy, commence a comprehensive recruitment drive and provide the staffing to carry out assessment and intervention for young people with mild to moderate difficulties. It will not solve everything but it could be transformative. Many families are getting stuck in the AON pathway because primary care is not available to them. They believe the only way they can access support is through the AON process. It is vital that the Minister, Deputy Foley, and her colleague, the Minister of State, Deputy Michael Moynihan, engage with CDNT ground-level staff who have left those services to establish what exactly is causing the retention crisis in CDNTs.

Change in disability services and resolving the AON crisis can happen but not by robbing Peter to pay Paul or expecting services to function without adequate workforce planning or staffing.

Jennifer Whitmore (Wicklow, Social Democrats)
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A total of 15,296 children. I know the Minister has heard that figure a lot today but each one of them is a child that is being failed by this State and the Minister’s Government. Each is a child that cannot reach his or her full potential because of that failure; a child who is living a life where they are uncertain, do not know what is happening and do not know their place in the world, where they face huge challenges integrating, making connections with other people and being seen for their own potential and what they can bring, and the value they bring to their communities. It is not only those children but also their brothers, sisters, parents and grandparents who are being impacted by all of this. Tonight, we see Cara Darmody out in the rain, protesting in order to support not only her two brothers but all children and families who have been left in this awful situation by the Minister’s Government.

The promise of something like early intervention must feel like an impossibility for most of these families. They see their children suffering. They know that were they to get the right supports, their futures would be so much brighter than what they will have now but, because this Government and previous Governments have failed to provide the necessary supports and services, those children are left in a very difficult and precarious situation.

What I am hearing a lot today - something that really frustrates me and must make those families feel invisible - is a Government that is describing a problem and keeps saying, "Yes, we know it is really bad. We know we are letting children down. We must do better." Well, do better. This is not the Minister's first rodeo. She was in office in the previous term. The Tánaiste said today that this is a top priority of his. Fine Gael has been in government since 2011. How many more terms are needed in order to get this right? It is not fair on these children and it is not fair on their families. We hear people continually repeating the accolades we are hearing for Cara Darmody. What she is doing is incredible but no child should be put into that situation where they have to put their own lives at a standstill to fight for things that are her brothers' rights. It is their rights that are not being met and it is the same for children around the country. In my constituency, there are 854 children on the east coast of Wicklow and 1,692 between Kildare and west Wicklow whose rights are not being met. For any Government to come in here and say it is not in a position to meet the law when it comes to these children is completely unacceptable. It is also completely unacceptable for the Government to pretend this is something that has just happened and that it has not been in government for the past 14 years, or the past ten in the case of Fianna Fáil. I ask the Minister to see today’s motion and the sacrifice that Cara and her family, and families across the country, have made and just start getting this right. The solutions have been put forward. The Government knows what they are. Just put the focus on it because I do not want to have this conversation again five years from now.

Gary Gannon (Dublin Central, Social Democrats)
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I welcome the opportunity for statements on assessments of need. We often talk about demand and need and solutions. The Government today has made reaffirmations. The Tánaiste reiterated his commitment to address this issue after 14 years of Fine Gael in government. We must also give voice to many people who are now teenagers or adults who have been left behind because of the failures of successive Governments and the structures of this State which did not meet their needs.

The Opposition is often told we misconstrue arguments and offer no solutions but the evidence of failures and the facts speak for themselves. No spin can change the reality of countless families in Ireland who are suffering and have suffered due to the lack of the most basic care by the State in education appropriate to their need with the therapeutic supports necessary to make their situation comfortable. It is well past time for the Government to finally act on the assessment of need crisis. What is happening in our health and disability services is not a minor administrative delay. It is a systematic failure and a breach of legal obligations. It is a betrayal of the children and families impacted.

Under the Disability Act 2005 every child is legally entitled to have their assessment of need completed within six months of their application. That is not a target; it is the law. The Taoiseach should be reminded that this is not a law that we change because it does not suit the narrative of the day. It is a law we must strive to uphold. However, in the first quarter of this year only 7% of assessments were completed in that timeframe. That is an outrageous figure. It tells us plainly that the law is being ignored and that, for thousands of families, the promise of early intervention is nothing more than a broken commitment. Early intervention is to meet a child’s most basic needs. We know how critical those early years are and that timely support can change the entire trajectory of a child’s life but, instead, the families are left waiting. Months turn into years. Promises from Ministers go on and children, especially those from disadvantaged backgrounds, are left to fall behind. Governments have been making the same assurances on this issue for years and in that time waiting lists have not improved but, rather, got worse. Workers are still waiting for pay parity and that contributes to the crisis in staffing in the sector. Families are tired and advocates are burned out. Today, Cara Darmody sits outside the Dáil doing her homework in preparation for an exam next week. That is a failure of a republic. I have watched parents who have had to come and sleep outside the Department of education or Dáil Éireann, assemble on WhatsApp groups and develop their own support networks. Who are we? We talk about being a successful economy but what is the purpose of it if it is not meeting those basic needs?

Jen Cummins (Dublin South Central, Social Democrats)
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It is nothing short of a national scandal that over 15,000 children are still waiting for an assessment of need. I know these numbers have been read out several times today but I want to keep saying it because it is an absolute scandal that we are saying there are 15,000 children waiting for an assessment of need and that over 90% of those assessments are not being completed within the legally mandated six-month timeframe.

In Dublin South Central at the end of 2024 there were 1,652 children waiting over three months for an assessment of need. From speaking to parents in my constituency, I know the level of frustration, heartbreak and need there. What are we doing as a country if we cannot get an assessment of need for a child when they most need it? When a child receives an assessment of need, where are the services thereafter? The Disability Act 2005 clearly sets out that children should have an assessment of need starting within three months of application and concluding within six, yet, with this Government in its second term, it is still not working. There are still missed targets, persistent failure and no meaningful accountability. Why is it necessary for a child to sit outside this Dáil for 50 hours to bring shame on what is happening here? No family should have to fight the fight they are fighting. They have enough to deal with in their own daily lives. They should be getting their basic rights.

The Government is pointing to funding and pilot schemes. I do not know about anyone else here but I am sick of hearing about pilot schemes. We should know what we are doing at this stage. We are not a fledgling. We did not just come about yesterday. We have been a State for so long. Why can we not get this right? This number of children is not a surprise. They were born. They have needs. They do not just magic down from the clouds and land here and have assessments of need that must be done. We need forward planning. We need staff who are trained. For the third time in the Chamber I make the point that we have heard so often that we will have more college places next year for therapists but I have not heard that it is definitely happening and I really want to know if it is. If these children get an assessment of need and they get the therapies, we still do not have enough therapists. Will I get an answer next week on whether there are enough people training in third-level institutions?

I commend all the families throughout the country who are bringing the attention of politicians to this issue. Everyone in the Dáil and Seanad hears about this all the time. Let us keep fighting on their behalf. It is just not good enough.

Pádraig O'Sullivan (Cork North-Central, Fianna Fail)
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The situation is unacceptable. Like the Minister, I spent 15 years in a classroom and delivered hours as a special education teacher from time to time. In that 15 years, I have seen things improve in terms of resources and overall funding but in what is being experienced on the ground, particularly in the area of assessments of need, things are definitely regressing. We need to put that on the record from the outset. That is generally agreed by all parties here.

I fully understand the frustration of parents. Not a week goes by in our clinics when we are not dealing with parents where there is some difficulty in accessing therapies, assessments of need or some type of service, be it from the HSE or a charitable provider. That said, it also needs to be acknowledged that we are facing an unprecedented level of demand. I will not repeat the statistics the Minister outlined, but there is a clear surge in the number of assessments of need applications that are coming through every year. We need to be grown up about the conversation that needs to be had. As a State, what we have done over the past while clearly has not worked. We now need to look to the future to see what we can do and what we can change to ensure children get the diagnosis they need and deserve and, following on from that, that we can deliver the therapies they deserve.

There is something I have never understood in my six years in national politics. How is it I can attend a service such as the Rainbow Club in Cork, which can advertise for a physiotherapist, an SNA or a speech and language therapist, and get genuine competition for the job it is advertising, but that is not the case for the HSE? I am not sure of the latest figure in my region of Cork but the HSE is in the fiftieth or sixtieth percentile as regards vacancies for roles. I can never marry in my own head why a service such as the Rainbow Club, which is a very well-run charity run by Karen and Jon O'Mahony, can succeed but the HSE consistently struggles to hire these staff. I will spend a minute talking about the Rainbow Club as an alternative to the way we do things. I happen to have been a director of the Rainbow Club for the past 12 months, where I have seen that more than 1,300 children can avail of a service every week. They do not require a diagnosis. If a child presents with a need of any description, or if a parent or schoolteacher has concerns, they can refer that child to the Rainbow Club in Mahon. There is no compulsion to have a diagnosis. We need to look at a model where a diagnosis is not required and not the clinical model we seem to have been focused on for far too long. The priority now needs to be on delivering therapies.

As I said, 1,300 children - statistics are done every week and the number is growing - can be catered for in an environment that they are very comfortable with. Some of those children have left school places but thrive when they come to the Rainbow Club. In the coming months, we hope that a new home can be built for the Rainbow Club under the HSE capital plan. That is something all Deputies in Cork who have involvement with the charity will be pushing for, when that moment arrives. Thankfully, it has secured its site. We need to look at the Rainbow Club as the model for how to deliver therapies because the HSE clearly cannot provide that for us.

I will make one last point on the assessments to be provided. The Minister mentioned an additional €10 million in funding will be provided under the current budget. I implore her to look at children who were previously assessed by a private therapist, which was paid for by the State. I ask for that to be done as an interim arrangement. I am not saying that is the optimum situation to be in but it needs to be done urgently, if it can be done again. I will add only more thing to that. I came across two families in my area that have had that publicly funded, private assessment and diagnosis of their child. They had to then go back to the CDNT or SENO, who stated that because it was a private diagnosis, it is not recognised, even though it was a publicly-funded assessment. That situation is not an isolated one. I have come across it on a few occasions. That needs to be clarified. There is no point in us publicly funding assessments in the private sector only for them not to be recognised subsequently.

Naoise Ó Cearúil (Kildare North, Fianna Fail)
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Like others, I acknowledge an incredibly brave and courageous young person at the gates of Leinster House when it is lashing rain - Cara Darmody. She is protesting outside not for herself but for her brothers and thousands of children throughout the country who are being denied timely assessments of supports. Cara's strength is extraordinary. Her message is one that we in this House must listen to. That message is that we are in an emergency. I also acknowledge my colleague, Councillor Donna Phelan, who, like so many parents, has been fighting for years just to get an assessment for her children. Donna's story is not unique. It is shared by too many families in Kildare North and throughout Ireland. We owe them more than sympathy. We owe them action.

During the general election and since, the issue of assessments has probably been the one that comes most frequently to my office, as it did when I was campaigning. Under the Disability Act 2005, every child is entitled to an assessment of need within six months, yet throughout the country more than 14,000 children are waiting beyond that legal limit. In Kildare North, families are waiting 18 months or more on average and the children's disability network team is operating with a 41% vacancy rate, which is a statistic that tells its own story. I appreciate that efforts are being made to open up more places at university and third level and to hire more people in this space. Early intervention is not a luxury; it is a necessity. Delay leads to more complex needs, more stress on families and more pressure on our system down the line. Indeed, the HSE is telling families to go to court to try to find a resolution to this. It is putting too much pressure on families.

I will offer two solutions that could work. I am looking at solutions rather than complaining about issues all the time. One solution is to establish a dedicated assessment hub or assessment hubs. We need specialised centres staffed by multidisciplinary teams with a singular focus on clearing the backlog and providing timely, high-quality assessments. This model has been piloted successfully in Scotland, particularly in NHS Greater Glasgow and Clyde, where dedicated hubs help to reduce assessment waiting times for children with developmental needs by more than 50%. It is targeted, measurable and replicable. We could begin by piloting this in Kildare or another county where needs are demonstrably high. A second solution is to provide interim therapeutic access to those awaiting assessment. My colleague, Deputy O'Sullivan, mentioned something similar in Cork. Too many children are being denied any supports until the full process is complete but in the UK and parts of Australia, families can access early interventions, including speech and language therapy, OT or behavioural support, based on flagged preliminary needs. Let us not let bureaucracy get in the way of a child's development. Interim access would ease family pressure and reduce long-term need. When a GP sees a child with clear speech and language difficulties, we should be getting speech and language therapists for these children straight away and not wait for an assessment of need.

The Minister is new to her brief. She has taken to it and has worked diligently and extremely hard. This is an extremely difficult situation to be in. I commend the Minister on her action on this. I appreciate her co-operation with some of the suggestions that I will bring forward. I also acknowledge the investment made in recent years and the sincere efforts of this Minister, the previous Minister and HSE staff, who are under immense strain. However, good intentions are not enough. We now need structural changes that are fast, fair and family centred.

What we need to do more than anything is listen to families, parents and, more importantly, the children who are being impacted, some of whom are non-verbal. It is clear that we need to treat this as an emergency. It needs to be solutions based, for example, on the solutions I brought forward, but other groups and Deputies will bring solutions forward as well. By working in a collegial manner, trying not to politicise this for political gain and working with the Minister to the best of our abilities, we will be able to work not just on the backlog but ensure we are forward planning for children coming through the system in times to come.

Erin McGreehan (Louth, Fianna Fail)
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I am very grateful for the opportunity to speak on this issue. I wish the Minister very well in her role.

Having listened to everyone who contributed, I believe there is not one Member across these Houses who is not inundated with queries and concerns over children’s therapies, waiting lists and assessment of need. So many of us are supporting parents and families to get services for their children.

The difficulty with the assessment of need process, the waiting lists and vacancy rates is that they are all leaving the children’s families in limbo. The services are failing the families. It is a matter of absolute urgency and it directly affects the well-being and future of our most vulnerable population, our children. It is nothing short of a stain on our health service and society. It is a disgrace that over 15,000 children are waiting for an assessment of need, and also that thousands upon thousands of children are not receiving care and the therapies they need. So many times, I had in my constituency office in Dundalk people who told me their children had aged out of the system and had not received one appointment in their lives. This proves the system is entirely broken. It is safe to say that we must shake it up completely.

Before I go on, I must pay tribute to the staff in the services. They have very important jobs caring for our children and trying to give them the tools to thrive. They do so within a system that ties their arms behind their backs. We have to be cognisant of the staff. They are overworked and, in most cases, on a team with a vacancy rate of 50%. We are not giving these professionals the space in which to provide the services to the children who most need them. It is incumbent on us to ensure the HSE looks after the staff in question, gives them the supports they need and fills the teams as soon as possible. We need to attract more staff. We want them to enjoy the incredibly valuable work they do. The recruitment and retention of therapists are so important.

We must consider the mutual recognition of qualifications across Europe, including the UK, to enable us to attract more therapists from overseas. In addition, as other Members have stated today, we must consider how we can train people and put them through our colleges. We hear about apprenticeships. In this regard, we must consider how we can train people to ensure they are working in our health services.

As the Minister well knows from her constituency office, families are struggling to survive, to be heard and to get the help they need for their children. We need assessments of need to identify and address the specific requirements of the children who need therapies, educational supports and other services if they are to reach their full potential. However, the current system is riddled with inefficiencies, delays and obstacles that prevent our children from receiving timely assessments of need. We need to act fast. However, the system is anything but fast. Respectfully, we need to be able to change it, be it through legislation or otherwise. I am not sure whether it is a question of legislation but it cannot be a matter of diminishing the right of children to get an assessment. We must ensure we enhance their rights and that practitioners can look after children, determine what they need and support them from a very early stage. We need to examine the legislation to determine how we can change it for the better. We must ensure we direct the therapists and streamline the services. We must ensure the services are in place to assist children more quickly than at present.

This is all going to be very challenging politically. I was glad to hear the Taoiseach speak today about how the Minister and her Department have been asked to come back with proposals for changes. We need to make sure that we hire from within the public sector. If we outsource constantly, we will only encourage the private sector to grow. We must ensure the private sector is not the one winning out, that staff in our public sector are encouraged to stay in it and that the State provides the required service in the most efficient way.

As everyone in this House, including the Minister, has said, the waiting lists are unacceptably long. Early intervention is critical given how children develop so rapidly at an early age. Every month and week is important. We need to ensure people with developmental delays and special needs are seen quickly.

Our system is not working for anybody, including staff, children and families, and it is not working for the State. In this House, we have identified endless problems and also some solutions. We must be unapologetic in pointing out problems. There will be feathers ruffled but we need to make a change.

Natasha Newsome Drennan (Carlow-Kilkenny, Sinn Fein)
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Over 15,000 children are currently awaiting an assessment of need. By the end of this year, that number is expected to soar to over 24,000. The law set out in the Disability Act clearly states children must be assessed within six months, but only 7% of children are assessed within that timeframe. Day after day, the Government is breaking the law and, in doing so, failing vulnerable children.

After more than a decade of Fianna Fáil and Fine Gael running the Department, the neglect of children reached limits that none of us thought possible. To leave children waiting years for crucial interventions is nothing short of systemic child neglect. Every week and month, without proper supports in schools and communities, this inflicts untold damage on the children’s development. This crisis disproportionately targets ordinary working families. It is they who have been hit the hardest. Parents are forced to watch on as their children suffer and are denied the correct supports in school. The whole family bears the mental and emotional strain. An affected family is left with only two options: sit patiently for years as all the pressures build on it and their children suffer or pay thousands of euro for a private assessment.

With all the Government’s failures, there are people in the private sector profiting on the back of this. An autism assessment costs €2,000, an ADHD assessment costs €1,500, and a speech and language assessment costs €600, with follow-up sessions costing €90 each. What will the Government say in ten or 15 years’ time to the children failed under its watch? Children have been waiting years for an assessment and for proper supports. Right now, Fianna Fáil, Fine Gael and the Lowry Independents are carving out an utterly shameful legacy of neglect of tens of thousands of children across the State.

I cannot not name for the Minister all the families who come to my door, because there are too many, but what I can tell her is that they are struggling. Some are on second mortgages and some have lost their house. Families have torn apart by the cost and stress. Enough is enough; it is time to act now.

Pa Daly (Kerry, Sinn Fein)
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Any parent will say that if they discover or suspect their child has developmental difficulties, the first thing they will want to do is find out what the problem is. Second, they will want fix it. Here again, we have another crisis, which is on a long list of crises under the current Government.

As Members will have heard earlier, the number of children languishing on a waiting list is now more than 15,000, and it is anticipated, according to the speaking note received from the Minister, that it will be 25,000 by the end of the year. Many parents and children are becoming increasingly desperate. Some parents, if they can afford it and because their children have been waiting so long, fork out the €2,500 or a sum to that effect to have a private assessment, but what about the people who cannot afford or who do not have access to those kinds of funds? They are pleading with anyone who will listen for some sort of reprieve.

I pay tribute to Cara Darmody and members of her campaign team, including Mr. Thomas Ryan, who is in the Gallery. We should not have circumstances in which Cara and campaigners in support of her must come from Clonmel and Ardfinnan and stand in the rain outside Leinster House. Under the 2005 Disability Act, children are entitled to an assessment of their educational health needs within six months, but only 7% of assessments were completed within the timeframe set out in the Act. I am not surprised, however, because dozens of people come to my office in this regard. The issue is probably next in line to that of housing, which see people come to my office daily.

Just this week, we heard from Maria, whose son has been on a waiting list for a staggering 22 months. He has many sensory issues and is often overwhelmed by sensory overload and has to leave the classroom setting. Again, Maria is a worried mother anxious about what is wrong with her child. She needs to find out what exactly it is so it can be fixed.

Without this essential support, her son is forced to miss out on a proper education and time with his peers. An autism unit is due to open at the school in Ardfert next September, but without the assessment this boy will be locked out. Maria's son is desperately worried that September will roll around and this will remain exactly where it is.

The Government must take emergency action and implement a Cara's fund, including a workforce plan to deal with this issue.

Brian Stanley (Laois, Independent)
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I welcome the opportunity to speak on this important motion and commend the campaign team and Cara and Mark Darmody. They should not have to be here. This should have been sorted because people have been raising it for over two decades. The waiting times are scandalous. Under the Disability Act 2005, the waiting time is supposed to be a maximum of six months, so the law is clearly being broken here. A total of 15,296 children are overdue their assessments of special needs. Only 4,162 were carried out by the HSE in 2024, according to its figures. Only a measly 7% are being done within the legal timeframe of six months. This is clearly a failure on every count. The Government is failing in its legal obligations and, according to the Minister, the number waiting for these assessments of need could run to 25,000 by year end.

In Laois, the waiting times to get an assessment of need are absolutely shocking. Aileen, a mother, is just one of many people who have contacted me on this. She waited for years to get her son an assessment of need and then had to go private for it. They had to pay and they had to have the assessment of need and then a multidisciplinary assessment, which in total cost €2,000. This family are on a modest income. For the past six years, Aileen has been paying privately for therapies. Her son got just four short sessions in the six years. She paid for all the other sessions. Her second child, a daughter, has been on a waiting list since 19 September 2023 and has not yet been called for an assessment of need. Aileen cannot get a reply by either telephone or email as to when she may get one. This is part of what parents are up against. They are left in the dark. There are just no answers. Sandra is another parent I have dealt with. Her first daughter was on a waiting list for a year and a half before getting an assessment of need. Her other daughter was put on a waiting list on 12 August last year and Sandra has not received any information whatsoever since then as to when she may be called or whether she will be called.

Assessment of need appointments, of course, are only the start of it. Once the assessment of need is done, the assessor has to do a report, they have to pass it on to a liaison officer, a service plan has to be drawn up and the liaison officer is then supposed to arrange the delivery of services. This is where it really gets difficult because next you have to do battle to try to get these sessions. I can tell the Minister of State that it is a battle in Laois because they hardly exist. I will quote to her the figures for the multidisciplinary teams in the CDNTs in Laois. The level of staffing for occupational therapy is at only 33%. These are HSE figures, not mine. Speech and language therapy is at 46%. Physiotherapy is at 50%. Therapy assistance is at zero. Dietetics is at zero. Behavioural therapists - this is incredible as this is one of the most important positions on the team - are at zero. They are not there. The service just does not exist. What is happening in County Laois, therefore, is that parents are being offered group sessions where parents are brought in. That is fine and dandy, and group sessions may have a role. That is being offered in nearly all cases, from what I can find out, but there are no services for the child - none whatsoever. Laois Offaly Families for Autism and other voluntary groups are filling the gaps as best they can. They pay 50% of the cost of the therapies and the parents pay 50%. It is a stopgap solution. LOFFA tells me it spent €38,000 last year on matching funding to try to do this. This is not acceptable.

I am trying to impress on the Minister of State as best I can the need for the Government to comply with its legal obligations, take emergency action, make the funding available and set specific target dates by which the Government can comply with its legal obligation and deliver long-term solutions. As the Minister of State knows as well as I do, that needs workforce planning. We need to start training and recruiting people and we need to retain them. One area that has been mentioned in the past for some of those disciplines is apprenticeships. That may be appropriate. I know they are not appropriate for some other disciplines. The Government really needs to be imaginative about this and push it on. We need to fund the special needs services and provide this and provide appropriate school places. I know that work is being done on this, but there are still many children without places who will need them in September, and that work needs to be progressed quickly.

Paul Murphy (Dublin South West, Solidarity)
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I thank Cara Darmody for forcing this issue onto the Dáil agenda. Her bravery in protesting outside the Dáil for 50 hours has forced the Government to sit up and pay attention. However, I want to make a very obvious point: that it is a disgrace that Cara and other disability campaigners, including the parents of children with additional needs, are having to resort to sleep-outs outside the Dáil to try to enforce their legal rights. What sort of society are we living in where children have a constitutional right to an education and a clear right to an appropriate education in their community under the UN Convention on the Rights of Persons with Disabilities, where in law you have the right to an assessment of needs within six months, where we have these rights enshrined, we have had these debates, we have passed these laws, in some cases we have a Constitution and we have a UN convention, yet people have to sleep out outside the gates of the national Parliament to try to enforce what are already their legal rights? Even a basic republic is not meant to act in that fashion. You are meant to have a democratic discussion, you pass laws and the laws are meant to be implemented. It is reminiscent of what you read about tsarist Russia, of people petitioning the tsar for their rights to be met. It is obscene that having to sleep outside our national Parliament urging for one's rights to be met is becoming a regular feature of disability justice campaigners.

Then there is the smaller scale. I am sure other Members are in the same position. What Deputy Stanley spoke about is exactly the same as the situation in Dublin South-West. The issue of parents of children with additional needs is now definitely the second issue after housing that comes to me. I now have a close relationship with solicitors whom I immediately put parents in touch with, saying, "You can take the State to court for that." That is incredible. The State is breaking its own laws and then we, correctly, have to encourage people to take the State to court just to get the State to move - because it works. People know that if you take the State to court, you will get your assessment of need eventually. Similarly, by the way, you can take the State to court for not meeting your educational needs. Again, it is obscene that we have a law and that the State, the Government, is breaking its own law and then 25 families a month have to take the State to court at significant expense, not to them but to the State, in order for this to happen. The parents are absolutely right to do it - they are fighting for what they can for their kids - but it creates another inequity. It does not cost any money, to be clear; many solicitors will do it for nothing and then they will win the case and the State will pay. However, those parents who know that this exists as an avenue and so on are the ones who end up getting the assessments of need not on time but more on time than those who do not know that this is a route they can take. It is outrageous.

The pattern for the Government has been one of tea and sympathy on these issues but no real action where it counts. The motion will be passed tonight - that is welcome - but then will the Government act? The problem for the Government is that the roots of this crisis run deep and are all of its own making. Fifteen years ago, 1,000 children were waiting on assessments of need; now there are more than 15,000.

The HSE projects that to rise to 25,000 by the end of this year. The Minister spoke about welcome progress with the increase in the number of assessments but in the context of the increased need overwhelming the system, it is difficult to talk about progress. The reason for this is that the Government has consistently failed to plan for needs it knows exist. Not only that, it has actively ignored those needs by ensuring the assessments of individual needs are delayed. It should be emphasised, as mentioned, that this is just the start of a journey of long waiting lists, of being let down and disappointed and of parents being offered group sessions when they want their kids to get the necessary therapies and supports they need. The average waiting time for an assessment of need is now more than two years, during which a child cannot access the therapies they need in the public system. It is a way of rationing resources, forcing those who can afford it to go private and saving money for the Government regardless of the human cost.

When faced with determined campaigners like Cara Darmody and the Equality in Education campaigners, the Government may regret its extreme rationing of resources, which created the current crisis, but there is an attempt to find other systems to blame. The Taoiseach's remarks earlier that effectively blamed the model of CDNTs miss the point. I welcome the decision to have therapists go into schools. It makes sense, but it does not deal with the fundamental problem of the high level of vacancy. Situating therapists in schools versus in CDNTs will not deal with the fundamental issue of resources, and nor will changing the law. Every time I hear that suggestion, I hear that the Government is breaching the law and that instead of stopping to breach the law, it wants to change the law so that it will not be breaching it, without dealing with providing assessments of need in time.

The fundamental issues include the years of restricting the number of college places for therapists. There are between 25 and 40 in most specialties, when there should be more than 100 a year. Other issues include the years of austerity cuts and the underfunding of the health service, the pay and numbers strategy, and the years of enabling the housing crisis to get worse so that rents and property prices rise. There is an alternative. There are plenty of actions the Government could take such as bonuses, speeding up recognition and improving training. I could go on and on.

Ryan O'Meara (Tipperary North, Fianna Fail)
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I would like to start by recognising the young Tipperary schoolgirl outside the gates of Leinster House this evening in the pouring rain. We are discussing this incredibly important issue because of her. Cara Darmody is an inspiration for the work she has done. She is not doing it for praise or recognition but rather for the love she bears for her brothers and family and the empathy and understanding she has for thousands of children and families waiting on lists for far too long for an assessment of need.

I am mindful not to repeat what many of the speakers who went before me said and who spoke passionately about this issue. Many quoted the statistics. It is completely unacceptable that so many families and children are waiting so long for the services, supports and treatments they deserve, but behind every statistic is a human being. I acknowledge the work the Minister has done to date and the mammoth task in front of her in her new position as Minister for disability, along with the Minister of State. During the general election campaign, this issue arose time and again on the doors in north Tipperary and north-west Kilkenny, as it did in every village, town, city and rural road. My experience of meeting families affected by the waiting times for assessments of need and the services their children need was that it was first parents themselves raising this issue, then grandparents and other family members and then neighbours. By the end of the general election campaign, it was regularly raised on the doors even by people who did not have a close connection to this issue but who felt a sense of urgency and concern for the young people the system is currently failing.

I appreciate that this issue has been given priority by this Government. Deputy Foley sits at Cabinet as a senior Minister with responsibility for this issue for the first time. The area of disability as a whole is intertwined throughout the programme for Government. This will be a defining issue for the Government, that is, whether it can deliver on this issue and provide the assessments of need and services as a matter of urgency for those on waiting lists for years. My constituency, spanning north Tipperary and north-west Kilkenny, covers two HSE areas. A small part of north Tipperary is in the south Tipperary HSE area. The postcode lottery is real and scary. It is frustrating and angering to speak to parents who live in a boundary area and to see it myself. That the place where a person comes from determines whether they get a service more quickly than others, although still in an untimely manner, is completely unacceptable. We need to look at private funding to get these assessment of need waiting lists cleared as a matter of urgency. More than 15,000 was the number quoted today. That is 15,000 children, families and parents who sit in front of us in constituency offices as we try to figure out what we can do to help them in their particular circumstances.

Over the course of this debate, we have met so many parents, who are ferocious advocates on behalf of their children. They know the system inside out and live the frustrations every day, but they should not have to be advocates for their children to get these services, whether an assessment of need or all the services that should automatically come to their children thereafter. They are supposed to be there to love, protect and support their children, not to be their voice on this issue. The system should be that child's voice. Parents should not have to do it. The voice I want to be heard today in particular is that of children waiting on lists who cannot access services and do not have parents who can be that advocate or that voice to shout and roar for their children and fight for them if they have to - those children who are going unheard. It scares me that there are children whose parent, for whatever reason, is not able to be that advocate. We have to be that voice. They have to be heard. Cara Darmody is that voice today in the pouring rain. She deserves the recognition. I do not think for a second that she wants it, but we have to stand up and fight as legislators, as she is doing for her brothers and every one of those 15,000 children who are waiting.

Catherine Ardagh (Dublin South Central, Fianna Fail)
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Families are exhausted, battling not for something extraordinary but for something fundamental, an assessment of need. It is supposed to be a gateway to support. In practice, it is a locked door. Without it, children cannot access home tuition, school places, the domiciliary care allowance or, most critical, any therapy. The message that families receive is simple: no assessment, no services. More than 15,000 children have been waiting for more than six months for an assessment of need, and the HSE predicts that could rise to 25,000 before the year is out.

That is not a waiting list; it is a crisis. Even when an assessment is secured, it does not guarantee help. Families are offered group webinars, leaflets or parenting courses, often scheduled during working hours. That is not meaningful support but window-dressing. Some families, like my own, are forced to go private. We paid for our son's assessment over two years ago. Even that report is now out of date. Finding a provider was not easy. We were lucky to be in a position to pay; most families are not.

Families do not seek assessments for the sake of paperwork. They do it because they want to help their child and they know, as we all do, that early intervention works. The sooner you start, the better the outcome, yet our system delays at every step. It frustrates and withholds and in doing so lets children fall behind, sometimes permanently. I acknowledge my good friend Cara Darmody, an amazing autism advocate, who has begun her 50-hour sit-out outside Leinster House today with her father Mark. Cara has done more to shine a light on these failings than many adults in public life. She is a teenager and is already showing extraordinary courage and leadership.

One development I welcome is the pilot programme placing therapists back into a small number of schools. It is a step in the right direction but we must go further. I understand 39 placements were on offer and the number of therapists who sought a place was overwhelming. It shows where therapists want to work. We need therapists to be restored to all special schools and special classes in mainstream schools.

That is where children are and where the support should be. The progressing disability model removed therapists from schools, fragmented the system and made it harder for children to receive the care where they learn. This resulted in families feeling exhausted, staff demoralised and national vacancy rates in CDNTs of more than 22%, with higher rates in areas such as CHO 7 in Dublin South Central. We have built a system in which even therapists no longer want to work. That tells you everything you need to know. We need action. We need: access to assessments that do not require people going private; a statutory right to therapy following a diagnosis; therapists based in schools and special schools; a full review of the progressing disability model; and a real workforce plan to recruit and retain skilled professionals.

I heard Ministers and the Taoiseach suggest that legislative reform may be needed to improve how assessments of need are delivered and used. If that is true, we need detail and we need it now. How will this legislation work in practice? Will it simply reframe the process or will it guarantee that identified needs are actually met? How will need be recorded, tracked and enforced? Will these written pathways have legal standing? Will they include timelines and entitlements to therapy or will they become yet another document that families cannot rely on? We cannot let this be another policy promise that sounds good on the plinth but falls flat on the ground. Families need certainty. They need follow-through and, most of all, they need the State to stand with them rather than against them. We are not seeking gold-plated care; we are asking for fairness, respect and for a child’s right to be supported in reaching their potential. Cara should not have to sit out in the cold to get that message across to us. While she does, however, we should listen and act.

Catherine Callaghan (Carlow-Kilkenny, Fine Gael)
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Disability is something that touches most of our lives. We all know someone who is living with a disability or is caring for someone with a disability, be that a seen or unseen disability. This lived experience should be what directs policy. It is people living with disabilities, or those who care for them, who know best what we need to change and how we can improve. I call on the Government to expand and invest in services. It is imperative we invest in disabilities at the same time as reforming how disability services are delivered.

As a former SNA, I stress how important it is to continue the roll-out of therapists in special schools and, furthermore, to expand it to mainstream schools also. This is perhaps the number-one ask from parents who have been in contact with my office. I call on the Government to remain fully focused on delivering on the commitments made in the programme for Government. As a backbench TD, I must continue to push for these measures as a priority for the constituents of Carlow-Kilkenny.

We urgently need to make much-needed reforms to the current assessment of need process. Children and families are waiting far too long, which is having knock-on consequences for their well-being and family life. Simply continuing to do the same thing and hoping to get a different result is not an acceptable option for me, nor should it be for the Government. The primary focus must be on identifying the delays and blockages which are causing these growing waiting lists for assessment of need. We need to find the most effective solution to these blockages. While that will take time, we must ensure any changes introduced are effective and can be sustained over time. This means that whenever an application for an assessment of need is submitted, it is dealt with promptly and within the statutory timeframes.

Every week I hear from far too many constituents across Carlow and Kilkenny who are waiting for an assessment of need. One parent in my community has been in touch with the CDNT in Carlow seeking support for her young daughter. She contacted the CDNT initially in September 2024. After waiting for five months, she received a response informing her that although her daughter needs an assessment of need, due to staff shortages, she would be waiting for four years for that assessment to happen. This is wholly unacceptable. We need to address our staffing issues. While I am conscious of the challenges and strains facing the health and social care sector when it comes to recruitment and retention, we must ensure our disability services are appropriately and adequately resourced and staffed to meet the needs of people with disabilities in Ireland.

I look forward to the development of the dedicated disability workforce strategy that has been referenced to meet the growing service demands and address recruitment and retention challenges across the specialist disability services. Even the increased capacity and enhanced service delivery in the disability service will not be possible, however, unless we ensure there are proper resources in place to service these ambitions. I welcome the €3.2 billion which has been allocated for the HSE disability services this year, which marks an 11.5% increase in funding on last year and an overall increase of €1.2 billion since 2020. While it is a significant increase in funding, there are nonetheless significant pressures facing the sector which need to be examined, understood and rectified. I would like to see collaborative efforts across the Departments for that to happen.

I welcome the news that the Department of disability will work closely with the Department of Health on resourcing disability; with the Department of Further and Higher Education, Research, Innovation and Science on expanding the pipeline for further therapists; and with the Department of Education and Youth on the development of the national therapy service in education. Having said all that, we also need to continue our focus on recruitment and retention strategies.

There is no doubt that addressing the problems within the assessment of need process is a challenging piece of work. It requires a well thought out and comprehensive plan to ensure all aspects of the system are examined and, where necessary, improved and fixed. We owe it to the children of Ireland and their families. They are relying on us to put in place a sustainable assessment of need system that works. I will be working for the constituents of Carlow-Kilkenny to ensure the commitments made in the programme for Government are fulfilled. We need to do better for parents and for our children.

Paul Donnelly (Dublin West, Sinn Fein)
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I listened to the Taoiseach today. I am always gobsmacked at how the Taoiseach can sound like he has only walked into the building and suddenly found himself in the position he is in. It is the same when I hear Fianna Fáil and Fine Gael TDs who have actually been in power. Some Fine Gael TDs have been in power for 14 years. That is 14 years of increasing waiting lists. I heard the shocking news today that the waiting list is potentially going to go up to more than 24,000 children.

Among those children is Cameron, who is four and a half and on a 72-month waiting list. He will finish primary school before he has access to any therapeutic interventions. Jaden, who is due to start school in September, needs a cognitive assessment before starting. While forms were submitted in December 2023, he is still waiting. His mother is getting really worried that he will not be able to start school. Similarly, two-year old Evie is on a waiting list. Her mother is dead right when she wrote that the Government’s lack of support is shaping her daughter’s future and that of thousands of other children. Nathan has no school place again this year. His parents have applied to 11 schools and are desperately trying to get him a school place. The irony is that if they refuse to send him to school, the education welfare officer has the legislation and the law behind him or her to bring them to court to either fine or jail them. What are the consequences for the Government? These are just a sample of the dozens of cases in my office. Each parent is desperately trying to get a service for their child.

This really should be enough to bring a Government down. It should be enough to call an emergency. When I spoke to Mark and Cara earlier today, I said that during the economic crash, Fianna Fáil spent, over a weekend, €72 billion of our money, and our children and grandchildren’s money, on the bondholders and bankers. In the Covid crisis, mountains were moved in an instant. Things were changed within weeks and days. What is the difference here? We have potentially 24,000 children whose lives will be, possibly, irreparably damaged because of a lack of access to the services they are entitled to. The law says they are entitled to them. This Government is breaking that law. I want the Government to call an emergency because that is what we are looking at in this regard. Call an emergency and take extraordinary measures to ensure each child has a service, a school place and therapeutic intervention when they need it. They are not big asks.

Seán Crowe (Dublin South West, Sinn Fein)
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Children are entitled to an assessment of their health and educational needs within six months under the Disability Act. There are more than 15,000 children waiting right now. That number is expected to rise by more than 9,000 by the end of the year. To put those numbers in context, just 4,000 assessments were completed last year. In CHO 7, which incorporates Dublin South-West, some of the CDNTs are woefully understaffed.

CDNT 8, which is based in Chamber House in Tallaght, had a 53% staff vacancy rate at the start of April. CDNT 3 is based in a neighbouring constituency in Crumlin but it had a 68% vacancy rate. The CDNT in Ballyboden, which is part of my constituency, has pulled all speech and language therapy and there is no restoration in sight. There is no offer of alternative arrangements for the children, just a letter to say services have been ceased. What are the families to do? It is entirely unsustainable to run any branch of the health service when more than half of the posts are vacant. We are running healthcare professionals ragged trying to cover not only their duties but also those of another worker or maybe even two other workers. This leads to poor morale, poor working conditions and inevitable burnout, leading to the loss of yet another critical staff member.

For the sake of the tens of thousands of children, this Government must comply with its legal obligations to provide assessments within six months. We have to throw out the HSE pay and numbers strategy and deliver a long-term, sustainable solution that includes an urgent workforce plan to recruit, train and retain enough staff to finally end this breach of children’s rights once and for all. I agree with Deputy Ardagh on therapists in school. That is the model used in other countries. Children should have access to them in special schools. Unfortunately, in the special school in my constituency the children do not have access to therapists. It is about assessments, but it is also about those supports and they are not coming through. We all need to step up. I listened to everyone and we collectively agree on this issue, so let us see action coming from the Minister of State and her Department.

Paul Gogarty (Dublin Mid West, Independent)
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Services for people with disabilities are in disarray. There is an ongoing battle for disability services to be provided where needs have been assessed. The National Federation of Voluntary Service Providers, which represents a mixture of voluntary public services organisations and voluntary grant-aided bodies, has gone on record recently to state their ability to deliver existing services and meet the needs in their communities is seriously under threat. These organisations provide a lot more services than the HSE does directly.

The biggest issue relates to recruitment of staff, including occupational therapists, speech and language therapists, physiotherapists and other front-line and support staff. The Government is not making it easy to recruit and retain skilled professionals in this area. I have referred to how difficult it is to get a master's, to the fact that people have to go abroad and to the lack of a Dublin allowance for many jobs that are so valuable and needed. While healthcare is often a vocation, we will only encourage people to train here and stay here if they have a career pathway and adequate remuneration. Record amounts of money have been spent in this area, but we are only running to stand still because costs are rising, wages are rising, and funding is being delayed and not provided in a planned and consistent multiannual way, meaning providers are constantly firefighting. The Minister of State acknowledged that of the €333 million in additional funding provided in 2025, €290 million was allocated to maintain existing levels of service for people with disabilities, so where is the substantive funding for improvement?

In the context of all the pressure to make services available, we are faced with another crisis we are discussing now, namely, the delays in getting assessed in the first place, and in this respect the list keeps getting longer and longer. Under the Disability Act 2005, as everyone has referred to, assessments of need should be carried out within six months of the referral to the HSE. At the end of December 2024 there were 14,200 outstanding assessments of need and now we are past 15,000 with just over 4,000 assessments being carried out each year. It is likely to rise further. I read today that it could be 25,000 by the end of the year according to the HSE’s estimates. This is shocking stuff. The Government is outrageously in breach of its legal obligations, as every Deputy has referenced, and as of now I do not see evidence of a pathway being carved to sort out this mess. Why then has this not been declared an emergency for children, as campaigners like Cara Darmody have called for, and why has a time-limited task force not been set up? We acted during Covid, we responded to Brexit, we supported thousands of Ukrainians and we are mobilising a response to US tariffs – or at least we are in terms of what Ministers have said – so why can this not be declared an emergency and a target set to redress the balance? I acknowledge that even with the best will in the world and all the resources at our disposal being thrown at the problem, filling the vacancies, identifying additional needs and reversing growing assessment of needs waiting lists has a lead time, but does this Government have a six-month target, a 12-month target or a three-year target that can be realistically reached? Is there any way we can outsource assessments in the short term, a bit like the National Treatment Purchase Fund, to utilise the resources of other countries for a specific period or is this going to be tied up in the wider organisational mess that is the HSE?

We are a wealthy country. We do not have unlimited pools of money and there is a need to spend funding wisely in a targeted way, but even if the revenues continue to come in at current windfall levels we should never be talking about tax cuts when we are putting additional costs on families in other ways. We are not looking for miracle workers but a systemic, incremental, recordable progress to ensure the assessments and supports are available for those who need them.

Michael Collins (Cork South-West, Independent Ireland Party)
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Our children with additional needs deserve our unwavering support and immediate action. Over 15,000 children are currently waiting for an assessment of needs, which is a crucial step in identifying their health and educational requirements as outlined in the Disability Act 2005. Our system is failing these children and their families. The HSE projects that without additional funding and resources this waiting list could swell to over 25,000 by the end of the year. This is unacceptable. I highlight the incredible efforts of Cara Darmody, a 14-year-old campaigner who has taken a stand for her brothers Neil and John and all children with disabilities. Cara has bravely initiated a 50-hour protest outside the Dáil and has been joined by Opposition leaders to demand that the Government fulfil its obligations.

The HSE is legally bound to complete a full assessment within six months of receiving an application but only 7% of these assessments are completed on time. This delay is not just a bureaucratic failure but a breach of trust and a violation of our commitment to these children. In west Cork the waiting time is over 27 months once assessed. Children then have to wait for services and this can take four to six months. The child is losing nearly three years between waiting for assessment and getting services. This is generally 25% to 50% of their lives spent waiting for vital services. That has a severe knock-on effect on the life of that child.

The Minister, Deputy Foley, has acknowledged the broken state of our system and called for an all-of-government approach to streamline the process. This includes a recruitment drive for psychologists and elimination of unnecessary red tape. We must ensure every Department stops recommending an assessment of needs is required to access services. Cara and her father Mark have rightly called for this situation to be treated as a national emergency. They remind us that laws are being systematically broken and it is our duty to rectify this. How can we expect our youth to respect the law when we as leaders fail to uphold it? We must act now. We must provide the necessary funding and resources to ensure every child receives the support they need.

While I am speaking about waiting times, according to research mental illness accounts for 45% of the overall burden of disease in individuals between the ages of ten and 24. The research also found that the need for mental health support in this age bracket had risen by 50% in the last 20 years. I was recently contacted by a west Cork mother whose 14-year-old daughter had been referred to CAMHS in August 2024. She did not receive any help and this led to serious consequences, including multiple suicide attempts and escalating intervention from emergency services. The lack of early intervention by CAMHS led to higher costs and worse outcomes for this child and the case is typical of the vast majority of young adolescents needing mental health support. In this case the costs of early intervention CAMHS assessment, therapy, etc., is over €4,901 over four to six months. This includes occupational therapy, speech therapy and psychotherapy. Each intervention is proven to be effective and helps to prevent escalation. When CAMHS is not available, the costs skyrocket. In this specific case there were six accident and emergency visits costing €4,800, three Garda interventions costing €1,350, a child and adolescent regional eating disorder services appointment costing €1,000, and inpatient care costing between €112,500 to €180,000 for a stay of 90 to 120 days in the Éist Linn CAMHS inpatient unit.

The total for crisis care was between €122,750 and €190,000. This is up to 25 times more expensive than early intervention. If we look at the bigger picture, nationally over 4,200 children are currently on CAMHS waiting lists. In west Cork, 40% of the children on waiting lists have been waiting for over a year. If 10% of these children are escalated to crisis care, we are looking at an additional cost of between €49 million and €80 million annually, as opposed to just €2 million to €3 million for early intervention. I ask the Minister of State to intervene. Cara has been outside the door for 50 hours. It would be good to go out and talk to her and show her the respect she deserves.

Paul Lawless (Mayo, Aontú)
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I welcome these statements. Aontú will be supporting the Opposition's motion later this evening. I met Cara Darmody today. What struck me most was how young she is. As I looked at her chocolate, her buns and her homework, it struck me just how young she is, yet she is forced into this campaign which is three years in the making. I commend Cara. I also commend the thousands of families and parents who like Cara are struggling immensely with a difficult situation at home and are forced also to be campaigners. It is one of the biggest issues in my constituency clinics.

I believe the Minister of State wants to solve this issue and hope she will listen to some of the suggestions. It is difficult to believe Cara has been outside for 50 hours and we have thousands of people waiting on assessments of need, yet we have trained so many psychologists who are abroad and cannot come back into the system. It is an incredible situation. Because of the lack of assistant psychologist places in Ireland, we are forcing people abroad who want to qualify into this profession and whom we so desperately need. When they go abroad, we tell them to stay abroad. There is no pathway for a psychologist to return to Ireland. It is absolutely shocking. I know of a number of senior psychologists who did their undergraduate studies in Ireland and went away to highly regarded universities in the UK and other places, and who have been waiting years in bureaucracy to get back and work in the HSE. This is a crisis and it is time the Government dealt with it. There are solutions to this crisis but we need a proactive Government to take the necessary steps to introduce simple, common-sense measures. I ask the Minister of State to deal with this issue of the lack of a pathway for psychologists coming back from the UK.

I also want to raise the lack of spaces available. In order to have continuity and a healthy sector with psychologists coming through, we need to address the lack of places for junior and assistant psychologists. I am told that for every junior or assistant psychologist in this country, there are 20 others waiting to get onto the panel. There are forums online which the Minister of State can see if she wishes. People attend my clinics as I am sure they attend hers who actually want to become assistant psychologists but cannot do so. They go abroad and then we tell them to stay away. They cannot come back and work in the HSE because we are going to flood them with bureaucracy. This is one simple measure we could address. The Minister of State needs to take a proactive, solution-focused approach to this issue.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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No one wants to see Cara Darmody outside of this House. I join with Deputy Alan Kelly when he said that the last thing we would expect in a democracy like ours, with an economy that is doing well, is a 14-year-old outside Leinster House campaigning not just for her own family members but to highlight what is going on right around the country. It is not right. The Minister or some senior official should be outside talking to her, to bring about a resolution not just to her family's problem but to the overall issues.

I believe in the goodwill of the Minister. I know everyone in this House wants to do the right thing by those who are disabled, marginalised or in this system looking for an assessment of need for their child who may have autism or other issues. Do not tell me the management of the HSE did not see this coming. It is shocking that they actually ignored it for years. I would point to 2010 and 2011 as the years when the numbers began to increase rapidly in terms of those who could not access services for their children who may have had autism, whether an assessment or therapies. The numbers grew from that time. We do not need a consultant's report to look at what went on. All we need do is look at the parliamentary questions that were being asked during that period and right up to today regarding those who cannot get assessments or the professional supports they need so urgently. Oral questions here in the House over that period show us the same trend.

The Governments from 2011 up to now have absolutely failed. We should start the debate by acknowledging our failure and acknowledging that in spite of the money being put into the system, the services are not being delivered. We have to ask why that is the case. Where is the system failing? I think we will find it is failing in terms of management, which should see the problem and recruit to deal with it. We have a complete collapse of that system and it is extremely unfair and damaging to the young children who are affected by this. We need a rapid response, lots of money and lots of personnel within the HSE who are qualified. We need to be searching abroad to bring them home if that is necessary. We certainly need to do a lot more to reduce the lists and employ OTs, speech and language therapists, psychologists and physiotherapists.

We need to engage with the parents. The recent changes in the HSE have seen professionals within the system instructing parents as to how they should deal with their child, or how they should cope with the child. Assessments are needed to deal with the issue. The local authority will always ask for an assessment if the family wants to get a particular type of accommodation. All of that has to be fast-tracked and dealt with. The waiting times are extraordinary. I do not know how much money or time it is going to take to resolve it. The problems for these families are here and now. The Minister should really bring in the senior managers in the HSE to determine how they are going to deal with it, how they are going to spend the extra money the Minister says will be available to them, how they are going to focus on all the appointments that are needed, and how they are going to fix a really broken system. That is the question. The parents are looking for answers today because they are affected every single day. When this debate is over, we will probably talk about something else. That probably should not be allowed to happen either.

Séamus McGrath (Cork South-Central, Fianna Fail)
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I thank the Minister of State for facilitating this debate, which we badly need to have. I do not want to repeat everything that has been said. The position is stark with 15,000 children waiting for assessments and very poor figures for those who get assessments within the six months. The overwhelming majority do not get assessments within the six months, which is a requirement under the 2005 Act.

As we all know as constituency TDs, families have to fight for everything. We are talking about assessments of need in the House this evening. The same debate could be had about supports and services following assessments, school places and, of course, school transport and so on. It is a broken system at present and it needs radical change to bring about the kind of improvements that are necessary in the system.

Within that broken system, however, there are positives. What organisations like Rainbow Club Cork - I know the Minister of State is very familiar with that organisation - do in providing services is absolutely astounding. That is an organisation that grew from the voluntary sector through the outstanding work Karen O'Mahony and her team are doing there. We have to look at that model in the context of the assessments and see how we can learn from it because they are doing Trojan work in providing the actual services and supports that are required.

In the Dáil earlier today, the Taoiseach stated that 30% of those assessments result in no actual diagnosis. That is a very high figure and we need to drill down into it because the system clearly does not have the capacity to deal with assessments that are not necessarily required in the first place. It is also unfair on children to go through those assessments. Of course, there will always be a percentage that result in no diagnosis and that is right and proper but 30% is a very high figure. We need to investigate that properly to see what is behind the figure. As I said, the system simply cannot cater for those numbers of assessments.

There are things to welcome from the Government. I know there is a real commitment to this area. There is a significant increase in funding, which is very welcome, and the Minister recently announced an assessment will no longer be required to access the domiciliary care allowance and so on. That is positive. We need to look at social housing and the interaction between assessments and social housing. There are families out there whose social housing application is stalled while they are waiting for an assessment, and that is not fair. The whole interaction between assessments and access to services from other State agencies is something that needs to be looked at very carefully as well.

The introduction of therapists in schools is very welcome and something that should have happened a long time ago, so there are positives. Of course, we now have a Minister at the Cabinet table who will work alongside the Minister of State to try to drive change in this area. That is welcome.

The Taoiseach also mentioned in the Dáil today that there is a finite number of therapists and professionals out there. We all know that. That is the bottom line here. For me, this is not necessarily a resource issue. Rather, it is a capacity issue. It is a challenge for the system to provide the assessments that are necessary but we need to do everything that is necessary to bring about the number of professionals we need to get through the assessments that are in the system. It is a catastrophic failure on the part of the HSE that it was not able to plan in a greater way for the workforce that is required to provide these assessments and services. That is undoubted. This should have been foreseen. There were plenty of flags along the way to show there would be a very high number of assessments. Of course, we hear that figure could grow by the end of the year but let us deal with the facts before us. We have 15,000 who are awaiting assessments and that figure itself is very sizeable.

We need to do what is required to bring about a change in the number of professionals working within the system. Obviously, we have to look at bringing back those who have left these shores to work abroad. We have to urgently bring them back to work within the system, provide the resources and provide the imagination and the changes that are required to bring them back. They can then get stuck in to what is required here in terms of getting through the backlog of assessments so that families can see some light at the end of the tunnel for this major problem.

Peter Roche (Galway East, Fine Gael)
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It is a remarkably decent and generous thing that Cara Darmody has done for this island in terms of bringing this to a level where nothing else has been discussed today, and rightly so. When I was campaigning in my municipal authority of Tuam in the run-up to the local elections last year there were lots of issues discussed, such as housing, homelessness, migration and childcare, and, of course, early years intervention was one of the priorities. Then at the back end of last year when we had the general election campaign the same issues were raised, only this time it was within the constituency of Galway East. I found it staggering when I spoke to the many parents who were desperate to get answers and find a pathway for their child who badly needed that intervention. To be brutally honest, I found it very distressing. Obviously, every parent wants the best for their child.

In turn, I wanted to bring what I believed to be the priorities of the people of east Galway to my own parliamentary party. Hand on heart and to be fair about it, it certainly has been and continues to be one of our priorities. I am heartened by our leader and the emphasis he has put on that sector, notwithstanding some of the commentary I have heard about how there would be very little talk about this if not for the events of today.

That is not to say the issues out there are not chronic. In my own constituency of Galway East I encountered a young chap in sixth class who was granted assistive technology to support him with speech and language. Of course, that fell into the special education section within the Department of education. That happened a year ago. You can imagine the frustration and the deep desperation felt by that family because all of a sudden, he will be out of national school and that is a deficit that is not right for him.

Any delay to a child getting an assessment is a real disadvantage. Families are then forced to take the private route but that sector, too, is exhausted. The importance of early years intervention is always outlined to parents and the parents want the best but they suddenly find that the support and intervention services to match that are not really there. The assessment of need process will only function as intended when the people delivering that service are supported, trained and, of course, valued.

There is huge focus on children with autism regarding supports for schools and services but we must not forget for one second those children with Down's syndrome. That community also requires the same level of supports. Of course, it is only right and fair to think that anyone who falls into any of the categories deserves the best there is in society. The urgency for both should be the exact same. We owe it to the families and we owe it to the professionals who serve them. We need to act in a sustainable and ethical way to bring about the necessary change.

Of course, all of the commentary that has been uttered here today is absolutely right. I would not like anyone on the Opposition benches to think for one second that we are not on the same page as them. We are all in this together. There was an acknowledgement today by the Taoiseach and there is always an acknowledgement from the Tánaiste that this is an area where greater investment and greater focus are needed. The relevant Ministers are dealing with it and I have no doubt that their empathy, compassion and support will improve things going forward. That is what I wish for and, of course, if that is not the case I, like others, will continue to be a champion for a better service and for better supports.

Joanna Byrne (Louth, Sinn Fein)
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I commence tonight by mentioning and paying tribute to 14-year-old disability rights campaigner Cara Darmody, who began her 50 hour sleep-out protest outside Leinster House this morning. She is here to battle for her two brothers who have autism and profound intellectual disabilities and for the thousands more children like them whom this Government is failing. Despite its denials, it is failing them. It is an indictment of this Government that a 14-year-old who should be studying for her exams and looking forward to her summer break from school should have to engage in such a protest.

The failure to assess autistic children within six months in 93% of cases means the Disability Act is being systematically broken by Fianna Fáil and Fine Gael.

Parents and guardians have contacted my constituency office in Louth in their droves, asking for help, as their children are on the ever-growing waiting list for an assessment of need. In mid-2025, Louth assessments of need, AON, service is currently only processing applications from late 2023. The statutory timeframes are not being met due to limited staff resources and an unprecedented increase in applications and workload, which has significantly affected wait times. There are limited staff resources when this Government is flagging a budget surplus this year. Currently, the Louth AON service is outsourcing the vast majority of assessments to HSE-approved private providers, as primary care does not carry out assessments for Louth. Two out of three CDNTs covering north and south Louth, north Meath and Ardee are at capacity for carrying out assessments of need.

Instead of properly resourcing the HSE, this Government is again privatising aspects of our health system and it is not working because the waiting lists are getting longer. Even with this privatisation, Louth's assessment of need service has stated to us that it cannot guarantee statutory timeframes of when assessments of need will be met. Louth has a total of 902 children waiting for assessments of need to be processed. A total of 245 of these children have been waiting for over 12 months, 350 have been waiting for between six and 12 months, and 155 of these children have been waiting for between three and six months. Government ideologies are clearly failing the children of this nation and I urge the Government to put its politics aside and work with the combined Opposition's proposal set out before it later tonight to uphold children's rights and deliver the support that Cara and the 15,296 affected children like her are crying out for.

Louis O'Hara (Galway East, Sinn Fein)
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I am regularly contacted by parents in my constituency expressing their frustration and despair at the assessments of need process, the lengthy delays and the fact that parents have to fight every step of the way to get an appropriate assessment for their child. One mother told me how her daughter waited nearly three years for an assessment and received no supports in the meantime. She would have paid for one privately but the HSE would not tell her which providers were approved and she could not afford to waste €800 if the assessment was not accepted. The assessment was eventually outsourced and, had she known that the provider that her child was eventually sent to was an approved provider, she would have gone to it two years previously. She said that the whole experience of diagnosis was chaotic and disjointed, and she would not wish it on any family. Another mother told me that she had been forced to fund all of her child's assessments and therapies. She said, "Had I waited publicly, my child would never be in the correct educational setting." Another parent told me of how it took years of battles to be told her child was eligible for an assessment, even though she knew her child was autistic. As a result, they missed out on years of supports and not having any accommodations at school, and had to pay the additional costs for private services, with no domiciliary care allowance, no carer's leave, and battles to get parental leave at work. She said the emotional cost was huge.

These cases illustrate a system that is categorically failing children and their families. While the children in these cases have now received their assessments, Cara Darmody's 50-hour protest at the gates outside reminds us of the more than 15,000 children whose assessment is overdue. While Government will not oppose tonight's Opposition motion, it must not ignore it and we must see action. It is time to treat this crisis like the emergency it is and make funding available to Cara's Fund to clear the backlog and to set a specific target date by which the Government will comply with the established legal obligations, as well as developing an urgent workforce plan to train, recruit and retain enough staff. We also know that the assessment of need is only the start of yet another battle for supports and services. Many parents in my constituency are in touch with me about supports from the CDNT being almost non-existent. There are issues with special needs assistant, SNA, allocations for children with additional needs, which I have raised here previously. Many children continue to be failed even after receiving a diagnosis.

Michael Lowry (Tipperary North, Independent)
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Raising a child with additional needs is both challenging and rewarding. It is demanding and fulfilling. For parents, it becomes a labour of love in almost every possible sense. They want what is best for their son or daughter. They want their child to have the best possible start in life. They aim to set the best foundation possible to support their child throughout their life. Services for families dealing with autism and other additional needs are totally inadequate. This problem is years in the making. It is a problem that has been in full view and not addressed. As a result, children are being neglected and left undiagnosed for far too long. Even after assessment and diagnosis, very little support is available for parents. Successive Governments and Ministers have paid lip service to their needs.

Every other day, I meet parents who are encountering a broken system. Their feelings range from frustration to disillusionment, from anger to despair. Parents have to endure sustained mental anguish. The immense daily pressure is intolerable. The educational and political system has failed them. Parents have reached the limit of their endurance. For years, they have faced a heartbreaking battle for services for their children. They have come to believe, with good reason, that seeking what their children urgently need through the established channels is a fruitless exercise. They have been there and done that. In fact, most have done it many times without results. For years, there have been calls to reform and resource all areas of the additional needs sector. There have been some improvements, which are acknowledged. However, the reality is that we are merely touching the edge of an issue that is impacting vulnerable young people in our society. Parents' demands for assessment and diagnosis for their children is what every child in the country deserves. They are pleading for timely assessments for their children. This is the first hurdle on the journey for their child. This is what will guide future decisions. The reality is that this is the hardest, most painstaking and difficult hurdle to cross.

The most recent statistics make for sombre reading. They show that an alarming number of children across the country are waiting for assessments. This is a critical first step for early intervention. The outcome is crucial to establish the level and extent of support required. It is a sad reflection on Government, on Ireland as a country and on all of us as human beings that we are continuing to let down these children and their families. This is a legacy and current issue that should unite this Dáil into urgent, purposeful and meaningful action to address what is now a national crisis. During negotiations on the programme for Government, our Regional Independent Group made this issue a top priority. We will continue to press for fundamental change and action to ensure that the needs of these children are met in a timely manner.

Mattie McGrath (Tipperary South, Independent)
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The crisis surrounding the assessment of needs process for children with disabilities sees it not just under severe strain. It is a system in breach of its legal obligations, leaving thousands of children without access to vital supports which they are entitled to by law. This should be a national emergency. What we are doing to young children and families is criminal. The HSE has been allowed to breach the law for years with no repercussions. Under the Disability Act 2005, children are supposed to receive an assessment of needs within six months of application, yet we know this is not happening. Families wait for years, during which time their children miss vital windows for intervention, development and care. This is not just a delay. It is a denial of rights, of equal opportunity and of childhood in many cases. Parents are exhausted. They are forced to become full-time advocates, legal experts and indeed campaigners just to get their children what they are entitled to and what is owed to them.

In Tipperary, the situation is particularly dire. As of March this year, there were 233 children and young people awaiting an autism assessment, while the wait time for assessments for a new referral is currently 48 months. That is four years. It is shocking. On top of this stress, the Government has spent €8 million on legal proceedings against parents seeking assessments for their children. This is a misallocation of resources that could have been better spent on providing the necessary assessments and supports. We have had report after report and commitment after commitment, yet the situation continues to deteriorate.

I commend Cara Darmody and her father and mother. She is a young girl from Ardfinnan, just beside me, in Tipperary, who has spoken with so many and has started a sleepover outside Leinster House. She was given commitments, as were countless other families, but promises mean nothing without delivery. It is time for the Government to act decisively and establish a mandatory fund as proposed in the joint Opposition motion to clear the existing backlog. It should set a definite timeline for compliance with legal obligations under the Disability Act. It should invest in sustainable solutions, including the recruitment and training of additional staff to meet current and future needs.

Indeed, we owe it to these children and their families to uphold their rights and provide the support they need. These rights are enshrined in the Constitution. We need urgent reform, we need accountability and above all we need to put our children and not bureaucracy at the centre of this system.

Carol Nolan (Offaly, Independent)
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I begin my brief remarks by commending the parents and the disability advocates who are highlighting this issue. I also commend and applaud all of those therapists who are demoralised, forced to work in a system that is just not fit for purpose and against a level of demand that is simply unprecedented. There seems to be very little point in standing up here yet again and simply repeating that the assessment of needs system is broken. We all know that. We all know there are thousands of children and families whose entire lives are put on hold because of it. What we need to focus on is pragmatic solutions and one such solution is to hire private therapists to clear the backlog. There is a serious backlog in many areas. CHO 8 Laois-Offaly in particular is very bad and has been for many years. That is where the focus needs to be. We need to bring in the private therapists and continue with the recruitment. In my constituency there are 530 children waiting on an assessment of need. If the two CDNTs that cover Offaly and north Laois, east Offaly is included, the figure is 530. Why is it that emergencies like this go on for so long? Why is it that there is a lack of urgency and that the HSE cannot hire therapists? What is it about the culture of the HSE and indeed the political culture that seems almost immune to effective action? There is something profoundly wrong at a fundamental level that goes way beyond the organisational and the structural. We have the will but despite all the apparent best efforts of Government the crisis goes on and on and so many children are failed and left behind. Why are so many of our children in need of complex disability interventions? What has happened to generate this level of demand? We must listen to therapists working in the field. We must respect them and support them. We must trust their judgment as to what it will take to deliver real change. There can be no more top-down approaches to this crisis. We need a revolution in our understanding of service-----

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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Thank you, Deputy. You are out of time.

Carol Nolan (Offaly, Independent)
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-----delivery if we are to have any chance of-----

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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Deputy, you are out of time.

Carol Nolan (Offaly, Independent)
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-----honouring the rights of children to timely assessments of need.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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You are now 20 seconds over time.

Carol Nolan (Offaly, Independent)
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I am finishing a sentence.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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You are now 20 seconds over time.

Carol Nolan (Offaly, Independent)
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Calm down Chair, I am finishing a sentence.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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Do not tell me to calm down. Please, Deputy.

Carol Nolan (Offaly, Independent)
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You do need to calm down.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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Have a small bit of respect. I appreciate you do not have any respect for me but have respect for the Chair.

Carol Nolan (Offaly, Independent)
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You are the one blowing it out of proportion. There is no need for the drama.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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Have respect for the Chair. Everybody prepares and makes their speech in the time they are allotted.

Carol Nolan (Offaly, Independent)
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You are creating too much drama.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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You have been a Member of this House long enough to know those rules.

Carol Nolan (Offaly, Independent)
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The Gaiety is around the corner. We do not need the drama.

Hildegarde Naughton (Galway West, Fine Gael)
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The challenges and problems associated with the assessment of need process and the provision of services for disabled children, adults and their families have been illustrated in stark detail in this Chamber today. It is not acceptable that vulnerable people clearly in need of State support are left wanting. It is not acceptable that families are stressed and frustrated, and despair that the State appears to have ignored their pleas for help. It is not acceptable that any person feels they must stage a public protest to draw attention to this issue.

As Minister of State with responsibility for disability, I believe there are three fundamental issues which Government must address to deliver the step change in disability services as promised in the programme for Government. The first is tackling the long and growing waiting lists for assessments of needs. Our primary focus must be on the assessment of need process, identifying the delays and blockages which are causing the growing waiting list. We then need to find the most effective solution to these blockages. This may require legislative change, while being clear that no one will lose his or her statutory right to an assessment of need. It will likely involve operational changes, increased staffing resources, better IT systems or outsourcing to the private sector where appropriate. It will also involve ensuring nobody is asked to undergo an assessment of needs to access State services unnecessarily. This work is already under way with officials from the Department of Children, Disability and Equality working intensively with the HSE to deliver existing actions, including those set out in the roadmap for service improvement, and to develop new ones.

The second fundamental issue which must be addressed is providing speech and language therapy, occupational therapy, physiotherapist, psychology and other supports to everyone who needs them. That involves providing more places at third level, more work placements and upskilling. It means continuing with the recruitment drives which have helped deliver an additional 272 staff in our CDNT network last year alone. It also involves measures being put in place to retain existing staff in the system and attracting new entrants. This is of particular importance for the children’s disability network teams which provide specialised community-based services for children with complex needs and that do not yet have the full staff complement they need to deliver their services.

The third fundamental reform that I, my colleague, the Minister, Deputy Foley, and Government is committed to introducing is providing clarity to families and individuals on how to navigate our overly-bureaucratic health system in order to secure the services they need. That involves making sure there is no wrong door, that a child is directed to the appropriate service regardless of how they enter the system, whether through the primary care system, CDNTs, CAMHS or any other avenue.

This is an emotive topic, one that affects many children and families right across the country, causing anxiety and stress for parents who are seeking the supports their children need. The State needs to communicate better. It needs to map out a pathway through services and deliver those services in a timely manner. The challenges associated with the assessment of need process and the wider system are significant and they require a proportionate response from Government. Since taking office, both the Taoiseach and the Tánaiste have consistently highlighted that disability services, in particular disability services for children, are a key priority for this Government. The priority is reflected in the fact that both the Minister, Deputy Foley, and I sit at the Cabinet table where disability matters are in sharp focus. A Cabinet committee with a specific focus on disability has also been created to ensure there is a whole-of-government response to issues affecting children with disabilities, whether through fixing the broken assessment of needs process, providing appropriate education supports and, crucially, access to therapy services. A dedicated unit in the Department of the Taoiseach is also being created to drive change and hold Departments and State agencies to account.

Specifically around the assessment of needs process, the Minister, Deputy Foley, has been very clear about the stark nature of this challenge. There are almost 15,300 assessment of need applications overdue for completion. In 2021, the figure stood at 3,500. Over 10,600 new applications were received last year with some 4,100 completed assessments in 2024. Those numbers do not work for anyone and it is clear that demand is greatly outstripping the capacity of the system to meet it. The introduction of the targeted waiting list by Government last May is without doubt helping, with over 3,600 assessments commissioned from private providers between June 2024 and the end of March this year. I am also encouraged by the 30% increase in assessments completed last year compared to 2023 and the 65% increase in completed assessments in the first three months of this year compared to the same period last year. These figures show we are moving in the right direction but we need to do much more, much faster. However, it is not enough to clear the current backlog and think that the job is done. We need to ensure another backlog does not grow to take its place. This will not be a quick fix. The problem is complex. Parents rightfully want access to services and supports for their children. In many cases, when they seek that support from primary care, CAMHS or children's disability network teams, they are told that they have been added to a long waiting list. This leads many people to apply for an assessment of need, a statutory right set out in the Disability Act. They may believe that this will give them early or accelerated access to services only to find that, even if they are provided with an assessment report, it leads only to another waiting list. Some parents feel they have no option but to turn to the legal system to ensure their statutory rights enshrined in the Act are met.

The Minister, Deputy Foley, called this situation "untenable" and I agree. We can and should do better.

We must ensure that any changes introduced are effective and can be sustained over time. This will mean that whenever an application for an assessment of need is submitted, it is dealt with promptly and within the statutory timeframes. While this work is under way, we need to look at the wider system to identify the blockages that are resulting in long waiting lists for children who need to access HSE services and supports, whether these are in primary care, CAMHS or the children's disability network teams. We are all aware of the many demands on our healthcare system, but we must ensure that our disability services are appropriately and adequately resourced and staffed to meet the needs of people with disabilities in Ireland.

In this regard, I look forward to the development of a dedicated disability workforce strategy this year, to meet growing service demands and address recruitment and retention challenges across the specialist disability services. However, it is important to emphasise that increased capacity and enhanced service delivery in the disability sector will not be possible unless we, as a Government, ensure there are proper resources in place to service this ambition. A total of €3.2 billion has been allocated for HSE disability services this year. That is an 11.5% increase in funding on last year and an overall increase of €1.2 billion since 2020. This is a significant increase in funding, but I appreciate that significant pressures are facing the sector.

Collaborative working across Departments will be vital over the coming period. For example, we will work closely with the Department of Health on the resourcing of disability services, with the Department of Further and Higher Education, Research, Innovation and Science on expanding the pipeline of future therapists, and with the Department of Education and Youth on the development of the national therapy service in education.

There is no doubt that addressing the problems with the assessment of need process is a challenging piece of work. It requires a well thought-out, comprehensive plan to ensure all aspects of the system are examined and, where necessary, improved or fixed. It is a priority for the Government. We owe it to the children of Ireland and their families who are relying on the State to put in place a sustainable assessment of need system that works.