Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Senator Conway for raising this very important issue. I totally acknowledge his own great work in pushing and campaigning for all children with disabilities and, in this debate, for children with Down's syndrome in particular. I thank him again for raising this very important issue. I absolutely agree with most of the sentiments he expressed. I accept the point that we need a plan, but we have a plan. I will deal with that in my response.

Timely access to speech and language therapy services is important and I understand that delays in accessing the service are a source of concern for patients, their parents and their families. The Government is committed to improving access to services through investment and improvements in how services are provided to enable children to reach their full potential. In 2019 we are going to spend €1.9 billion on disability services under the HSE service plan. That is an increase of 7.5%. Anybody who comes into this House to say that cuts are being made to services should look at the statistics and information and get his or her facts right.

The overarching principle governing the planning and delivery of health services and supports for adults and children with disabilities is that they should be integrated, as much as possible, with services and supports for the rest of the population. The Government’s agenda, and mine, in this regard is clearly set out in the national disability inclusion strategy, the steering group of which I chair. The strategy is based on a non-condition specific approach to the delivery of public services and the mainstreaming agenda. I take the Senator's point. I did a number of events myself on World Down's Syndrome Day. I spent a lot of time with parents and talking to children on that day.

As Senators will be aware, speech and language therapy is mainly provided through the HSE’s primary care service. Overall funding for primary care has increased in the HSE’s national service plan for 2019, with more than €50 million in additional funding being made available. An extra €50 million is being put in in 2019. This represents an increase of 6% on primary care for 2018. I make that point very strongly. Of course, we also have to look at individual cases. Each individual that presents to the HSE’s speech and language therapy service has an initial assessment to determine the individual’s presenting need and requirements for therapy. The therapist, in conjunction with the parents or carer, will then determine the severity of the individual’s difficulties and prioritise for therapy accordingly. The level of intervention is in line with clinical policy, age and presenting need according to diagnosis. The waiting period for intervention is dependent on the nature and severity of the disorder following assessment. The HSE aims to ensure that the resources available are used to best effect, in order to provide assessment and ongoing therapy to children and adults in line with their prioritised needs.

Speech and language therapy staffing levels in primary care have increased significantly in recent years with an additional 76 whole-time equivalents appointed between January 2015 and January 2019. Further increases are anticipated in line with funding in 2019. I accept the Senator's point; we need to increase and expand services further, but we have started. The HSE anticipates that almost 280,000 speech and language therapy patients will be treated in primary care in 2019. That is a lot of speech and language services. In addition to this increase in staff numbers, the HSE has established service improvement groups to develop new standardised models of service provision for speech and language therapy and other therapy services to support service delivery. We accept the point the Senator raised in his introduction. We are increasing staff numbers to expand this service. Measures under these models include providing structures, training and support to parents or carers so that they can work to help improve the individual’s speech and language. In addition, therapy is delivered in group settings where appropriate.

The HSE and I are committed to working in partnership with other service providers to achieve maximum benefits for children and adults requiring therapies and aim to ensure that the available resources are used in the most effective manner possible. On the Senator's general point, we have started the work and the reforms, but we have a fair distance to go yet. I accept that argument, but we have started, we have increased spending, and we are expanding the services. We have to make sure that every child with Down's syndrome has access to proper speech and language therapy. That is the objective of my plan under the national disability inclusion strategy.