Dáil debates
Thursday, 18 December 2025
Ceisteanna Eile - Other Questions
Disability Services
2:35 am
Maurice Quinlivan (Limerick City, Sinn Fein)
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9. To ask the Minister for Children, Disability and Equality her plans to address the waiting time for assessments of needs, considering there are in excess of 18,000 children waiting for such an assessment; and if she will make a statement on the matter. [73106/25]
Maurice Quinlivan (Limerick City, Sinn Fein)
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More than 18,000 children are currently waiting for an assessment of need and this figure is expected to increase to between 22,000 and 25,000 by the end of the year. These are children whose lives are suspended. They are waiting for assessments so they can receive the medical and educational supports necessary for their continued development. As the Minister of State will be aware, early intervention is crucial and that intervention is being denied to many children. The long waiting lists affect development as they cannot access the supports they need. How will the changes the Minister proposed last week assist in rectifying this breach of the law?
Emer Higgins (Dublin Mid West, Fine Gael)
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I thank the Deputy for giving me the opportunity to address this on the floor of the House. The delivery of an effective, efficient assessment of need system is a priority for the Government. There has been intensive work by the Department of Health and the HSE. Demand for assessments of need has increased significantly in recent years. Applications may be in excess of 11,000 this year compared with 4,700 in 2020. That represents a doubling in five years. This reflects both the increase in population and the number of families exploring all options to access services for their child. The impact of this increased demand has contributed to more than 18,000 applications being overdue for completion nationwide at the end of September. We will have figures for the end of this year shortly. In September, there was a 42% increase on this time last year.
More positively, there has been continual improvement in the number of completed assessment of need reports. Over 4,500 reports were completed in the first nine months of this year, a 57% increase compared with the same period last year. This improvement has been bolstered by significant investment by the Department in the targeted waitlist initiative, which focuses on the families waiting longest for assessments of need. More than 6,300 clinical assessments have been commissioned from private providers under the initiative since it started in June 2024. Budget 2026 provides for the continuation of this initiative next year, with €20 million provided for the delivery of some 6,000 clinical assessments.
Last week, the Government announced a series of reforms to the assessment of need process that will make the process more effective and efficient for children and their families. Over time, this should lead to a reduction in the waiting time to receive an assessment. This reform includes changes to Part 2 of the Disability Act 2005, which provides for assessments of need. I will elaborate further.
Maurice Quinlivan (Limerick City, Sinn Fein)
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My concern about the changes announced last week are that they risk deepening the chaos already prevalent in special education and that we are placing an additional administration burden on educators. In Limerick, for instance, 259 children are waiting for an assessment of need and none of them was met within the statutory timeline so the Government is failing those children with zero of 259 children having been met. The fact remains that the Government is in daily breach of the law by not honouring the requirement to provide an assessment of need within six months.
I urge the Minister to initiate a new campaign to recruit people to services, to advertise it properly - unfortunately, that was not done the last time - and, if sufficient applications are not received, to expand the drive internationally if we need to do so. The removal of the need for a formal diagnosis to access a special class or special school placement and its replacement raises concerns, not only with me, but with the teachers' unions which said they were not consulted in advance of last week's announcement, which is disappointing to say the least. It is not acceptable for this responsibility to be pushed onto educators without them even being consulted. Decisions on the necessary supports should remain the responsibility of qualified educational and disability professionals.
Ruairí Ó Murchú (Louth, Sinn Fein)
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It goes without saying that the issue of assessments of need has been a disaster for a considerable time. There is much unease about the proposals that were put forward. One of the issues with the proposals is that they are only an indication of a proposal. We had an engagement earlier in the week and if we are talking about removing the need for assessments of need in schools, it is a fact that we are talking about something that is a few months away from being completed. Will the Minister of State give an indication of how she and the Department of education will come up with a process and by which means children will be assessed for the appropriate class, special class or mainstream education with supports? That is vital.
The Minister of State has said previously that there is not always a need for an assessment of need to access the child and adolescent mental health services, CAMHS, or primary care but we all know the issues. Children get bounced back and there is a real need to deal with that. The problem with primary care is that the service that was once there is not there at the moment.
Emer Higgins (Dublin Mid West, Fine Gael)
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I thank both Deputies. I was delighted to engage with the cross-party group on autism about this issue the day before yesterday. The direct question about the education plans was how the process will be formulated, and the answer is through consultation. The Department of Education and Youth has indicated to us that it is willing to explore how to get to a point where it can remove an assessment of need as a requirement for entry to special schools and special classes. It will now consult on how best to do that with relevant stakeholders and officials and will come back to the Taoiseach through the Cabinet committee on disability in the first quarter of next year with a proposal for how and by when it can make it happen.
On people being bounced from list to list, one of the things announced this week was the single point of access, which is the HSE's new system to ensure there is no wrong door and that when children get to the top of a list, they are not pushed to the bottom of another list. This is a service-based and needs-based approach the HSE is implementing in collaboration with our Department.
Maurice Quinlivan (Limerick City, Sinn Fein)
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Last week's announcement was an attempt to shift responsibility to schools and mask the failure overseen by this and previous Governments.
However, I do note that each team will include a psychologist, a speech and language therapist, an occupational therapist and an administrator. Where will they come from? Is it not a better approach to have a proper recruitment campaign and try to access the resources that exist that we have not been able to harness so far? The change will not remove any rights for parents to apply for an assessment of need for their children nor will it alter their statutory six month-timeframe in the Disability Act. It does not explain how the Government will achieve this legal obligation of accessing an assessment of need within a six-month period. Will the Minister of State advise how this change will assist these children who are waiting for 27 months or more for an assessment? These children need their assessments and they need to have them completed within the six-month period. What we and the children need to see is an urgent workforce plan to recruit and, more importantly, to retain the staff we have already to deliver this important service without breaching the rights of these children. Every month and every single day that an assessment is delayed impacts children.
2:45 am
Ruairí Ó Murchú (Louth, Sinn Fein)
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We all support the idea of a single point of access. My understanding is there will be 11 teams delivered in 2026 and then nine teams in 2027. That all sounds grand but I would follow up on what Deputy Quinlivan said. At this point I imagine, because we cannot always get the updated figures, we are looking at 300 or so positions unfilled in the CDNTs. I would like if that figure was lower but how do we recruit the OTs, SLTs and psychologists to those teams? How do we recruit to these new teams? How will these new teams work? We are all supportive of therapies within schools and involving the schools, the parents and everyone involved in the child's life. Assistive technology is absolutely important at that point. How do we get that recruitment process done while we are recruiting to all these bodies at the same time because many advocates have said there are difficulties in relation to this?
John McGuinness (Carlow-Kilkenny, Fianna Fail)
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On the same line of questioning, if we reduce the waiting list so quickly then the next waiting list is for the therapy, so there will still be a huge number of children waiting for therapies, particularly speech and language. I referenced in the Dáil this week the children with Down's syndrome who are waiting. What happens when all of those children are added to the list?
Emer Higgins (Dublin Mid West, Fine Gael)
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I thank the Deputies. Can I be really clear? Last week's announcement was about children with disabilities who require therapies and that is exactly what we are setting out to achieve - the delivery of therapies regardless of children's disability. There is a six-pronged approach here. The heads of Bill have now been published. They will go through pre-legislative scrutiny at the Joint Committee on Disability Matters. We have committed to informing parents earlier about when a decision is arrived at as to whether or not their child has a disability. We have the HSE's new model of having a single point of access which we have discussed and which will be supported by additional recruitment. Between that and the autism assessment process and protocol, which is also a huge part of this, they will be supported by 11 inreach teams next year and 20 inreach teams by the end of the following year. We are also recruiting within our own teams - the CDNTs. We have had a 27% increase in staffing in the 18 months up to April of this year. We have 45,000 children now receiving therapies through our CDNTs and I would like to thank our staff and our clinicians who are delivering those. We are also supplementing our assessment of need process by outsourcing. We will outsource 6,000 of those next year. That frees up therapists to work with children to deliver the therapies they need.