Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank Senator Bacik for raising this issue. Before I begin reading my script, the Deputy is right. There is a wider conversation to be had which goes further than the one case she has brought to my attention. As she will hear throughout my speech, there is a need for really good collaboration between the two Departments to ensure all children have the right of access and are supported. I thank Senator Bacik for raising this issue. I begin by noting that the Senator's question relates in part to a particular child. It would not be appropriate for me to comment on that individual case and I have referred this to the HSE for more information and an update. I will share that information with the Senator as soon as it comes to hand.

As the Senator will hear, while there is some overlap with the Department of Health on this issue, as well as the fact that it relates to children with disabilities, the main policy issues involved fall under the remit of my colleague, Deputy Madigan, who is the Minister of State with responsibility for special education. Indeed, Deputy Madigan would probably have been the more appropriate Minister to attend this session today, although I will do my best to assist the Senator. I am also happy to pass on any further concerns to the Minister of State, Deputy Madigan, who is more appropriately placed to deal with these issues, for which the Department of Education and Skills is responsible.

In recent years, there have been developments in interventions for young children with complex conditions which have led to greater numbers of children with disabilities participating in school. In the past, these children either did not attend school or were in special centres or special schools managed by voluntary bodies, where nurses and care assistants were on-site as part of the overall staffing complement. Children with higher levels of need now often attend special schools and a small number of children are supported to attend mainstream schools.

High levels of ongoing support are required to enable this participation. At present, there is no national standardised process for the allocation of nursing supports in schools for children with complex needs. Current provision of nursing supports to schools is provided by the HSE or, on behalf of the HSE, through its funded service providers. Some nurses are also employed directly by schools and report to the school board of management. The provision of nursing supports has sometimes been dependent on the ability of an individual community health organisation, CHO, to fund such supports, leading to inequity of access for children in some special schools.

In 2018, the National Council for Special Education, NCSE, published its comprehensive review of the SNA scheme. The report included a finding that SNAs, who are not required to have any clinical training or qualifications, may nevertheless be expected to support students who require complex medical procedures. Following on from the review and its recommendations, the Department of Education and Skills is reviewing how nursing supports can best be provided in the education setting as part of their wider school inclusion model. The school inclusion model is designed to test a support model for schools which does not rely only on SNA support but which also provides for a range of additional supports, including therapy supports and services in schools. Currently, the school inclusion model is in a pilot programme in HSE area CHO 7.

A nursing group, a sub-group of the school inclusion model working group, has been established to progress the issue of nursing support for children with complex needs. This is a cross-departmental group which includes representation from my own Department. A paper is currently being developed to identify and prioritise the implementation of nursing supports for those children with the most complex needs. The school inclusion model budget is €4.75 million and the nursing provision will be funded through this programme.