Ruairí Ó Murchú (Louth, Sinn Fein)
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79. To ask the Minister for Children, Disability and Equality the reasons her Department accredits for the lengthy waiting lists for assessment of needs; the progress being made in developing legislation in this area; and if she will make a statement on the matter. [61490/25]

Ruairí Ó Murchú (Louth, Sinn Fein)
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Will the Minister provide the reasons her Department accredits with the lengthy waiting lists for assessment of need? There has been much discussion on this in the last while. There has also been talk of developing legislation in this area. Will the Minister make a statement on the matter? From my last parliamentary question, the number of people on the waiting list is somewhere between 17,000 and 18,000; therefore, there is a lot to be done.

Norma Foley (Kerry, Fianna Fail)
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The Government recognises that there are unacceptable delays in accessing assessment of need. The Department and the HSE are committed to addressing these delays.

The delivery of an effective and efficient assessment of need system continues to be a priority for the Government. Intensive work has been under way to deliver actions to achieve this. It is important to note that children do not require an assessment of need to access health services, whether primary care, children’s disability network teams or mental health services. However, as the Deputy has pointed out, demand for assessment of need has increased significantly in recent years. This reflects both the increase in population and the number of families exploring all options to access services for their children. The number of applications has increased significantly since 2020, rising from 4,700 applications to over 10,000 applications in 2024. It is expected that the number will increase further this year. The reasons for this growth are complex and reflect the changing needs and awareness of disability in our society as a whole. Capacity constraints have meant that the system has struggled to respond to the substantial increase in demand. In this regard, the Department is working with the HSE to identify opportunities to enhance processes, improve training and increase administrative supports. It is important to highlight that there has been a noted improvement in the number of completed assessments. Over 4,100 were completed in 2024, an increase of 30% compared to 2023. HSE data shows this trend is continuing this year and there has been a 57% year-on-year increase in completed assessments in the first nine months of the year. This improvement has been achieved by a number of measures, including the assessment of need targeted wait-list initiative. Under this initiative, the HSE procures clinical assessments from approved private providers. Over 6,300 clinical assessments have been commissioned from private providers since the initiative commenced in June 2024.

Ruairí Ó Murchú (Louth, Sinn Fein)
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We all know the issue. The Minister is stating that the reason is the increase in population. We all accept that on some level. However, she is also stating that parents are trying to explore all options available to them. They are doing this out of frustration. I have heard that people who previously would have been able to get a service in primary care in other sets of circumstances are all being put on the assessment of need list. Therefore, can we have an assessment of the assessment of need list in relation to what needs to be done from a legislative point of view but also in relation to how we are actually going to deal with this issue? If we are still talking about it at the end of the year, I suggest that the number waiting over six months will have reached between 24,000 and 25,000. The State is in breach of the law in this regard. We really cannot have this ongoing conversation. We need to find a real solution.

Norma Foley (Kerry, Fianna Fail)
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I thank the Deputy. Again, I acknowledge the points he makes. Parents are right to access every opportunity they can for a child. I would do it. They are right to do it but we need to find better ways to progress the assessment of need. As I have said, over 6,300 assessments have been done privately. Some €10 million was made available but it is likely that between €18 million and €20 million will be spent this year.

I acknowledge that other measures have been attributed to the increase as well. Despite the fact that AON is not required to access health services, primary care, CDNTs or mental health services, it is still a route that is chosen.

Specifically in relation to the legislation the Deputy referred to, work is under way to identify relevant legislative changes relating to Part 2 of the Disability Act, which addresses assessment of need. This aims to support the effective and efficient delivery of assessment of need. It is intended to bring forward the legislation before the year end. It will not affect the statutory right of any individual to access an assessment of need or the statutory timeframe set out in the Act. The provision of an effective and efficient assessment of need system continues to be a priority.

Ruairí Ó Murchú (Louth, Sinn Fein)
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I welcome the fact that we are not talking about removing that one right parents have to the six months. I have no particular issue with looking at the best means of offering assessments and therapies - we have had that conversation before - but, as the Minister herself has stated, we have issues in the system itself as to where referrals are going onto the assessment of need list. I am back to the operation of the AON administrative hubs, the Cara's fund money and the use of private practitioners. Have we maxed out the number of private practitioners who are available or is there more capacity there? We are still looking at, as I said, 17,000 or 18,000, and at the end of the year I assume we will still be looking at 24,000 or 25,000 who will be over the six months in which they should have had an assessment. None of this is good enough. Obviously, there is frustration. When will we get a handle on this? We cannot just continue having this conversation.

Norma Foley (Kerry, Fianna Fail)
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Specifically in relation to the private capacity, €10 million was made available last year. I did say that if at any point more were required and if there were capacity to do more, more funding would be made available. It is our estimate that between €18 million and €20 million will have been spent, and a further €20 million has been secured in budget 2026. If more is required again in 2026, we will not be found wanting.

We need to look at other measures as well. For example, the HSE is looking at a single point of access model, which I think will be very helpful. It will mean that children will be referred to the right supports and not be placed on a number of different waiting lists. That will be a significant step forward. The HSE is also introducing an autism protocol, which will mean that there will be a specific autism assessment. It is important to remember that 45% of assessments of need in the third quarter of this year alone led to an autism diagnosis. Looking at all levers, whether it is the change in legislation, the private capacity-----

Ruairí Ó Murchú (Louth, Sinn Fein)
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What will that look like?

Norma Foley (Kerry, Fianna Fail)
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Pardon?

Ruairí Ó Murchú (Louth, Sinn Fein)
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The change in legislation.

Norma Foley (Kerry, Fianna Fail)
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We will present that before the end of this year.