Donna McGettigan (Clare, Sinn Fein)
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Throughout the State, more than 15,000 children are currently overdue an assessment of needs. Under the Disability Act 2005, children are entitled to assessment of their educational and health needs within six months of being on the waiting list, so each of these 15,000 children represent a breach of law by the Government. In my constituency in Clare, parents who are at their wits' end are contacting me. They are watching helplessly as the childhood of their son or daughter passes by year after year with no intervention to improve their quality of life. It is shameful that these parents have to fight every day to try to get the services their children badly need and deserve.

I have been helping a mother whose child was originally screened at the age of seven and referred to CAMHS. That was more than ten years ago. In the meantime, the child has developed further symptoms and complications and is struggling with their mental health because they cannot understand why they are so different from everyone else and have difficulty with everyday interactions. The family's GP has been very supportive but can do little more. The child is now on antidepressants and receiving some counselling from Pieta House. That mother has been pushed from pillar to post. She is constantly having to fight, even to talk to someone about the possibility of her child receiving an assessment. In more recent years, she became concerned her child would be considered an adult and have to start again on a new waiting list. In response to inquiries I made on her behalf, the HSE acknowledged the child was referred to primary care services and was on the primary care register. However, we were also told that an assessment service is not currently provided by primary care services. A private provider was commissioned to provide the service but later found it could not recruit the people it needed and this arrangement was scrapped.

We were not told, however, how much time had elapsed between the beginning and end of that process. How long was wasted waiting for a private provider to reach the conclusion it could not provide the service for which it had been commissioned? I was told by one parent that it took two years to realise the process would not work. We were also told that in an effort to address the unacceptable waiting times for children on the primary care register, the HSE was engaging with private providers to outsource multidisciplinary assessments. Will the Minister of State explain why the previous process involving private providers failed but this one is expected to succeed? As the process has just commenced, we could not even get an expected date for when the service will be provided. Can the Minister of State provide a target start date for the service? The nearest thing we got to reassurance was being told the child would remain on the waiting list and would be seen in chronological order regardless of how long they would have to wait. This is simply unacceptable. Their childhood is wasting away and they will never get that time back.

Another parent of a nine-year-old child described the enormous strain it places on her and her family who are struggling to help the child. They have been waiting for three years for an assessment and without it, the child has not received the supports they need. This mother received much the same response as we did to our inquiries, that a private provider was unable to recruit the necessary staff, a different provider is in the process of attempting to recruit staff and the HSE is awaiting results of its efforts. What is the point of repeating the same failed strategy? Parents should not have to spend their lives fighting to get the services their children are entitled to.

The Government's failure to implement the Education for Persons with Special Educational Needs Act 2004 has resulted in the education system and the National Council for Special Education, NCSE, not being able to deliver for children in school environments. This places additional burdens on already overburdened specialist services. Can the Government provide a date for the full implementation of the 2004 Act? Can the Minister of State provide a target date for when the Government will be compliant with the six-month rule set out in the Disability Act 2005?

Jerry Buttimer (Cork South-Central, Fine Gael)
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I thank the Deputy for raising this important matter. I apologise that the Minister is not here and that I do not have a copy of the speech for the Deputy. I will get it to her as soon as possible.

Like her, I deal with parents and children every day and every week and she is right that there is frustration. We all need to work collaboratively to ensure access to services is improved and that parents and children who deserve to receive them do so. The Government is fully committed to addressing the challenge of the growing demand for assessments of needs. It is important to know that children do not require an assessment of needs to access health services, including those provided by primary care, children's disability network teams, CDNTs, or mental health services. However, demand for assessments of needs continues to grow beyond the current capacity of the system to meet it.

It is a stated priority of the Government to ensure a sustainable solution is put in place to address waiting times and waiting lists for assessments of needs. Officials in the Department of Children, Disability and Equality are working to identify the delays and blockages that are resulting in children waiting too long for an assessment of need and to find the most effective means of addressing them. This is likely to involve operational changes, increased staffing resources, better IT systems or outsourcing to the private sector where appropriate. In addition, officials are working with HSE senior management and experienced clinicians to identify legislative changes to improve effectiveness and efficiency within the assessment of needs process. It is important to note that any proposed changes will not affect the statutory right of any person to access an assessment of needs. Work is under way to deliver existing actions and address new ones to address the backlog.

One such important action is the targeted waiting list initiative, which funds the procurement of capacity from private providers to deliver assessments of need, targeting those families waiting longest. HSE data show that more than 3,600 assessments were commissioned from private providers between June 2024 and the end of March this year under this initiative, which will continue to run for the rest of the year. However, we cannot rely on the private sector indefinitely and we need to support the public system to meet demand. Efforts are continuing to improve staffing in the public system through recruitment and retention actions. Looking at the CDNTs in particular, there has been clear progress with recent HSE data showing a decrease in CDNT vacancy rates from 29% in October 2023 to 18% in April of this year. The positive impact of these initiatives is becoming visible as regards the number of assessments of need completed. There was a 30% increase in the number of completed assessments last year compared with 2023, and in the first three months of this year, more than 1,400 assessments were completed nationally. That is a 65% increase compared with the same period last year. We recognise there have been improvements, but there is more to be done. I accept the points the Deputy made. If she would like to give me the case studies she spoke about this morning, I will gladly bring them back to the Department for her.

There is still a significant backlog with almost 15,300 assessment of need applications overdue for completion nationwide at the end of March. This is an 8% increase on the number overdue at the end of 2024 and clearly shows the scale of the challenge. However, looking at the figures for HSE Mid West in particular, some progress can be seen. Although 434 applications were overdue at the end of March of this year, this is a decrease of 1.8% compared with the number overdue at the end of December. Although it is a small change, it is as step in the right direction. It does not meet the needs of the parents the Deputy mentioned this morning. I accept that.

Addressing the delays in accessing assessments of need and the growing backlog of applications is a challenging and complex issue. The Government is absolutely committed to addressing this to ensure that children who require an assessments of need receive it as soon as is practically possible.

Donna McGettigan (Clare, Sinn Fein)
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I already gave these cases to the Government and they were referred to the HSE, which is where we got the answers that reliance on the private sector is not working in the HSE Mid West region. While I appreciate that there are difficulties in the system, especially around the need for robust regulation of psychologists, just 7% of assessments were completed within the six-month timeframe required by law.

CORU was established under the Health and Social Care Professionals Act 2005, and part of its remit was the regulation of psychologists. This problem has been rumbling on for years now and far too little action has been taken by Government to date. We in Sinn Féin want to see the building up of strong public services accessible to all on the basis of need. That requires action from the Government to ensure that the proper regulatory framework is introduced for psychologists. However, this is an emergency so in the short term the use of private assessment with reimbursement for parents must be expanded dramatically and as quickly as possible. I understand that even without the required regulatory framework, there is an informal list of reliable psychologists with a proven track record. Since 2021, the waiting list for assessment has gone from 500 to over 15,000. That is a shocking indictment of Government inaction. Judging by the responses I have received to representations made on behalf of constituents, it is likely to get worse. The lack of intervention to meet the needs of children is nothing short of scandalous. I ask the Minister of State to provide some hope to parents struggling daily to cope without the services they so badly need. Can he outline how this appalling state of affairs can be ended and the waiting list backlog cleared quickly? I remind him that there is a legal obligation on him to do so and plans should have been put in place long ago to recruit and train the staff required to do this. I also ask the Minister of State to ensure that clearing the backlog of assessments will not simply move the bottleneck further along, and that an adequate number of school places for children with special needs, suitable services and supports required by them will be available when they have had their assessment of need.

Jerry Buttimer (Cork South-Central, Fine Gael)
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I thank the Deputy again for raising this very important matter, which is a priority for the Minister and the Government. This is reflected in the current programme for Government, which includes a clear commitment to support families who are waiting for assessments of need and to ensure children and their families can access the supports they need. The Minister understands the scale of the challenge but is encouraged by the activity under way. This is delivering results in the increased number of completed assessments and ongoing efforts to enhance the capacity in the public system to deliver assessments of need. The Minister also knows that there is a lot more to be done, as the Deputy outlined. She has tasked officials within her Department to delve deeper and identify issues within the assessment of need system that are causing delays. She has also asked them to consider those large system-wide factors where parents feel their only option is to seek an assessment of need for their child. In addition, officials in her Department are working with HSE senior management and experienced clinicians to identify legislative changes to improve the effectiveness and efficiency within the assessment of need process. It is important to note that any proposed changes will not affect the statutory right of any person to access an assessment of need. The Minister can assure the Deputy that the matter will continue to receive the most urgent attention and Government will continue to work intensively and collaboratively to put in place an effective and efficient assessment of need system to deliver the service that children and their families need.