Thomas Byrne (Fianna Fail)
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With no disrespect to the Minister of State, Deputy Tom Hayes, I am grateful for his presence in the Chamber, but I am disappointed that not one of the substantial number of Ministers in the Department of Health is available to take this matter.

I am grateful to the Cathaoirleach for giving me the opportunity to raise the matter of the provision of special needs assistants, SNAs, for preschool children in County Meath. Each county appears to have a different system for the provision of SNAs for preschool children. In County Meath there has been some provision in the past 20 years, while other counties have had no provision and others have had some supports available. In County Meath an ad hocapproach was taken every year. However, this year there has been a battle to secure some funding to maintain existing services. This is despite the fact that the Minister for Health with responsibility for the area has boasted of an increase in the health budget and that the cuts are over. They are not over in the provision of preschool SNAs in County Meath. Up to €197,000 has been allocated for special needs assistants next year, but this will not be enough to maintain the current level of services, particularly with the number of children coming into the system who will require assistance. There is also the possibility of assessment being introduced. I do not know how this will impact on the provision of SNAs.

The most concerning aspect of this issue is that the funding of €197,000 will come from home care packages. This is becoming more of a feature of funding announcements by the Health Service Executive, HSE, and the Department of Health in recent months. It is just like the story of John Duggan and the provision of the drug Soliris. If he is to be given it, someone else will have to suffer. Special needs children and their parents in County Meath have been told that someone else will suffer for them. It used to be a case of suffer little children, but now it will probably be elderly people who will have to suffer. The HSE is making this very clear, which is very unfair.

What are the Government’s exact plans for the service? The parents need clarity on the issue. They are meeting tonight to come up with ideas on how the budget should be allocated. That is an awesome responsibility that the HSE seems to have passed on to them. That is now typical of it because it has lost control of its budget, meaning that it does not have responsibility for money anymore and washes its hands of the matter. If Fianna Fáil returns to power, we will give control back to the HSE because it needs to make the decisions while listening to people at the same time.

The fact that the Department of Health is involved in this area is an anomaly. It is responsible for preschool SNAs, while the Department of Children and Youth Affairs is responsible for children and the Department of Education and Skills the curriculum in preschools. Tusla and Pobal are also involved, resulting in a multitude of agencies engaged in the provision of preschool education. This is wrong as we need a joined-up approach. Parents need certainty and information on the provision of SNAs as a substantial number of children will need help next year. We must ensure the Government maximises resources and allocates them fairly to enable those children to have the best possible start.

Tom Hayes (Tipperary South, Fine Gael)
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I thank the Senator for raising this matter to which I am replying on behalf of the Minister of State at the Department of Health with responsibility for primary and social care, Deputy Kathleen Lynch.

The participation of children with a disability in preschools is a cross-cutting issue involving several stakeholders, including the Departments of Children and Youth Affairs, Health, and Education and Skills, as well as the HSE. The free preschool year is provided through the early childhood care and education programme, ECCE, which is the responsibility of my colleague, the Minister for Children and Youth Affairs. The objective of this scheme is to make early learning in a formal setting available to eligible children in the year before they commence primary school.

While the HSE has no statutory obligation to provide supports for children with special needs wishing to avail of the free preschool year, it works at local level and in partnership with the relevant disability service providers to address individual needs as they arise. This is done in a number of ways, such as funding special preschools that cater specifically for children with disabilities.

In some limited cases at local level, HSE disability services have also facilitated children with disabilities to attend mainstream preschools by providing funding for preschool assistant supports where possible. In this context, I understand that the HSE's Meath disability services provide a preschool assistance subsidy in co-operation with Enable Ireland's Meath early services. This subsidy assists towards the cost of obtaining a preschool assistant for a child with a disability. I am advised by the HSE that current demand for this subsidy exceeds available resources.

As the Senator will appreciate, the HSE is obliged to continually review all its existing funding arrangements to ensure that services are provided within available resources. The HSE Meath disability services has confirmed that it will provide finding for the preschool support service for the academic year 2015-2016 from within its approved budget. With the growing number of children availing of this service in recent years, the HSE has been examining how these supports are allocated in order to ensure that the approved level of funding is used to best effect and on the basis of need.

The executive has indicated that a revised process, involving the payment of a subsidy, will be put in place in respect of 2015-16. The objective of this will be to prioritise children based on their identified needs and to maximise the number who can be supported. This may, for example, involve a preschool assistant supporting two children attending the same preschool where this is feasible and in line with their assessed need.

The HSE is currently involved in a major re-configuration of its therapy resources for children and young people with disabilities as part of its national programme on progressing disability services for children and young people up to eight years of age. When fully implemented, this programme should mean greater equity in accessing therapy services based on need, clearer referral pathways, and improved collaboration between the sectors.

An additional €4 million, equating to approximately 80 additional therapy posts, was specifically allocated in 2014 to drive the implementation of the programme. A further additional investment of €4 million will be made into the programme in 2015. This equates to €6 million in a full year. This programming is already well advanced in Meath.

At national level, the Departments of Children and Youth Affairs, Education and Skills, and Health are actively looking at the issue of the integration of children with disabilities into mainstream preschool settings, informed by work undertaken by the cross-sectoral team on children's disability issues.