Mark Wall (Kildare South, Labour)
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13. To ask the Minister for Children, Disability and Equality her plans for introducing a reimbursement scheme for families who have had to pay for private therapies for their child due to long waiting lists for public services. [50027/25]

Mark Wall (Kildare South, Labour)
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We are all aware - and it has been discussed already tonight - of the length of waiting lists of families waiting for therapies in this country. I ask the Minister of State to address the House tonight on any plans she may have for a reimbursement scheme for families who have had to pay privately for their child due to these long waiting lists.

Hildegarde Naughton (Galway West, Fine Gael)
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The Government and I recognise the importance of early intervention, and the programme for Government, as the Deputy knows, commits to ensuring children and their families get that early intervention and therapy input, and that they can access that support in a timely way.

A key response to this issue is the recruitment and retention of health and social care professionals, and I alluded to that in my last response. Substantial effort and investment has been made in this regard. Our CDNTs support almost 45,000 children with complex needs. HSE data from April of this year shows there has been an increase of 26% in CDNT staffing levels since October 2023 and the vacancy rate has reduced from 29% in 2023 to 18% in 2025, an 11% reduction.

I acknowledge that some families, as the Deputy said, are still facing unacceptable delays. Access to therapies for a child should not depend on whether their family can afford it. Rather than diverting funding to reimburse individuals for private therapy, we should utilise public funding to invest in our public system and to enhance the capacity to deliver these therapies free of charge. This is an issue of equity and it also speaks to our focus on building a sustainable service for children with disabilities. Notwithstanding this, individual health regions may procure private providers to provide therapies and interventions on a case-by-case basis. However, this is usually only in exceptional circumstances. This is about improving the pipeline of required therapies and a continued focus on recruitment and retention. We also need to develop that pipeline of future therapists through our third level education system, which we are doing.

In June, the Government approved an expansion in training places from September 2025 in disciplines critical to disability, health and education services. Additionally, alternative pathways into health and social care professions are being developed to widen access to critical skills areas. That includes apprenticeships, tertiary programmes, graduate conversion and mature entry.

Mark Wall (Kildare South, Labour)
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I thank the Minister of State. I am all for public services and I welcome the fact the Minister of State is chasing down the maximum number of public services we can and increasing the number of consultants and clinicians we have in that area. Unfortunately, too many families are waiting too long for those much-needed services for speech and language, OT, physiotherapy or whatever their child might need. I know we spoke already about Cara Darmody and the €10 million fund that was created for private assessments of need, and I welcomed that at the time. It was discussed in this House.

In supporting any public development, the question around case-by-case basis emergencies remains. Does the Minister of State have any idea how many CDNTs have used that facility of using private services for case-by-case basis emergencies? The number of people coming to my office are probably not aware of that but they are definitely not using that particular emergency service.

Hildegarde Naughton (Galway West, Fine Gael)
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I do not have the figures for that but I can tell the Deputy that the focus of Government, and my focus and that of the Minister, Deputy Foley, is to make sure we are increasing the number of speech and language therapists and occupational therapists so that they are actually going out there providing the therapies. As the Deputy knows with regard to the backlog of assessment of need, a lot of them are carrying out the assessments. What many people want and what parents send their children to get these assessments for is to get access to the therapies, which is a huge part of this. That is the drive we are working on through the legislation around the assessment of need process to make it more efficient and effective, and to meet the needs of our children who really need these services. That is our sole focus. Yes, we provided €10 million to try to address the assessment of need backlog, for example, and we will continue to work our way through that. People do have a right to an assessment of need but we need to make sure that we are looking at our third level institutions, recruitment abroad and speeding up the registration process for those coming back from abroad through CORU but also looking at bursaries. If the Deputy has other suggestions, my door is open with regard to recruitment and retention of these therapists.

Mark Wall (Kildare South, Labour)
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I always welcome the Minister of State finishing with a question like that. I am going to use the opportunity once again to raise Sensational Kids, a new building in Kildare town. I am sure the Minister of State is aware of this particular building. It remains unbuilt since November 2024. This building could have allowed up to 300 children per week in the greater Kildare and Leinster area to receive those services I mentioned but also training for those therapists in speech and language, OT and physiotherapy. That was a proposal that was part of Sensational Kids. I understand that proposal is with the HSE now but it would make a difference for so many families in Leinster. I still state that as much as I support public services, families are crying out for that early intervention and those emergency services. Maybe if the Minister of State or her Department get the chance, they might come back to me on how many have availed of those emergency services, and they might also look at that Sensational Kids proposal, which would be so beneficial to so many people in the area I am from.

Hildegarde Naughton (Galway West, Fine Gael)
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I thank the Deputy, and I will come back to him if I have those figures available to me. He raised an important point around early intervention. I refer to the earliest milestones, and a child not reaching them.

What is happening now is a lot of these pressures are coming into the education system. Where a need is identified we need to be flagging it much earlier and providing the services much earlier. That is where that single point of access to the HSE will be so important as well as us dealing with the assessment of need process, recruiting and retaining our therapists at home and abroad but also getting that earlier intervention through the primary care setting, for example. Just one area is not going to resolve this. This is a whole-of-government approach but the HSE, the Department of Education and Youth and my Department will also ensure we are reaching those at an earlier level and allowing CDNTs to deal with those with the most complex needs.