Nessa Cosgrove (Labour) | Oireachtas source

Cuirim fáilte roimh an Aire Stáit. Go n-éirí an t-ádh léi ina post nua. As other people have said, we really hope she succeeds, for people with disabilities, their families and their caregivers most importantly.

I wish to talk about the specific issue of triage for young adults with additional needs in emergency departments. I will give an example. Lauren is a young adult from Leitrim with Down's syndrome. Like many young adults with Down's syndrome, Lauren occasionally suffers from episodes requiring medical assessment beyond the scope of that which can be provided by her GP. Since becoming an adult, on two occasions last year Lauren's GP advised her family to bring her to the emergency department, once in Mullingar and once in Cavan, to determine whether treatment was required. Before she was 18, Lauren had always been assessed as a child. As those of us who have had children attend an ED know, children are assessed and they are moved on either to the paediatric ward or at least to a more comfortable environment, much more promptly than adults who are waiting.

In her two admissions last year, however, Lauren was an adult and was treated as such by the staff as she passed through the triage system to determine the urgency of the case. The prolonged nature of this experience has had a profound and negative experience on Lauren. I commend Lauren's mother, Maura, whom I know very well and who has been a very strong advocate on behalf of her daughter. For 12 hours late at night, Lauren sat in the emergency department until her parents were able to gain permission from a nurse to go home for the evening and return the next morning without losing her place in the queue. During that time, Lauren was exposed to aspects of life she was unequipped to process or deal with. Some people with Down's syndrome are hypersensitive to what is going on around ,them and Lauren is one such individual. She is both caring and sensitive. This caring, sensitive young adult saw people who themselves were in great distress and in pain. She witnessed scenes which left her with a sense of disorder. She witnessed some very unwell people, including some people who were under the influence of intoxicants and some people who were handcuffed by the Garda. Lauren was very clearly distressed by this and, as she was leaving, a very kind hospital staff member apologised that she was exposed to these scenes but they made it clear they were severely limited in what they could do to lessen the experience.

Nearly six months on, Lauren has not fully recovered from this incident. She experiences panic attacks and has difficulties sleeping, two unwelcome developments that Lauren did not suffer from before this experience. I ask the Minister of State to work with the HSE and to have a wide review of how adults with learning difficulties or additional needs are triaged. Triage is defined as a preliminary assessment of patients or casualties to determine the urgency of their need for treatment and the nature of treatment required. The capacity of individuals to deal with the immediate environment clearly impacts the urgency of their needs and therefore should form part of the triage assessment.

It is not appropriate that adults with additional needs are treated in the same way as other adults while awaiting assessment. It is also clearly not appropriate that they are treated as children; they are not children. Failure to acknowledge and act upon these two realities demonstrates the way in which we as a society do not always look beyond meeting the needs of the majority. It does not benefit anybody to treat everybody exactly the same. It does not benefit the adult with additional needs who may become distressed and disruptive while waiting and it does not benefit the adults with no additional needs who are also exposed to and absorb that distress.

Equality does not need identical treatment. Equality means giving everyone what they need to reach the same destination, in this case, satisfactory access to treatment and discharge. Equality demands that adults with additional needs have those needs met. That can be as simple as a staff member going around the emergency department from time to time to assess the mood and needs of those present. While I know we are often limited, it may mean providing a more homely area or room where those with additional needs and their families may be able to wait in a more suitable environment. There can be failure to access through ignorance. Often this does not come up because people with Down's syndrome are often not able to say and so we rely on their advocates, caregivers and parents to be their voices.

Now that we have raised the issue, I hope the Minister of State will take this on board. Since Lauren's mother brought this to my attention, the parents of other children with Down's syndrome and additional needs have brought this to my attention. It is a simple thing that could be done very effectively.