Maria Byrne (Fine Gael)
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I welcome the Minister of State, Deputy Finian McGrath, to discuss this important issue. My query relates to the number of autism spectrum disorder, ASD, assessments of need being carried out in the Limerick, Clare and Tipperary areas. I understand there is a significant backlog in this regard. I was recently contacted by a family in north Tipperary who, when they applied for a place for their child at a school's autism unit, were informed they needed a full ASD report for that child before their application would be considered. Unfortunately, the parents have now been told the facility is full. The child's assessment was to be done in August, which would have provided eligibility for enrolment in September, but because of the backlog and waiting list, they have been informed their child will not be assessed until Christmas.I spoke to the relevant people in the HSE and in the different Departments, to the school principal and to the family, and I have kept in regular contact with all of them. My understanding is that if people are out sick or on maternity leave they are not being replaced and this is causing a problem. I am not saying people cannot be out ill or for some other reason but in the context of these necessary appointments, people should be replaced to deal with these valid cases. The school principal told me there were six places in the school but they are now full. I was told this child will be accommodated for next year but that means the child has to wait for another year. I have dealt with a number of similar cases. There needs to be a review of what happens with assessments when a person in that unit is out on leave for the long term. Also, the lines of communication with the families need to be kept open. This family received a communication on the week in August they expected to be called for their child's assessment indicating that it would be Christmas before the child would be called. That is quite a long wait for the child. It is a serious issue for the families concerned. My understanding from my communication with the HSE is that there is an unprecedented number of applications this year with respect to autism spectrum disorder, ASD, seeking an assessment of need. I would like hear what the Minister has to say and any solutions he has for resolving this problem.

Finian McGrath (Dublin Bay North, Independent)
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I thank Senator Byrne for raising this matter. I have good deal to say on this issue and I share her concern about those particular cases. I will deal first with the broader issues involved and then respond to the issue she raised. I commend her on her work in area of disabilities, particularly in the Limerick and north Tipperary areas. I thank her for her support of the Irish Sign Language Bill taken earlier this week. I appreciate that.

There has been a steady annual increase in the number of applications since the commencement of the Act in 2009. The current number of applications received in 2017 in the mid-west is 342, and the number is 362 for all of 2016. Of this number, 66%, or 237, of the applications have had assessment reports completed on time - the figure is 52%, or 222 for all of 2016. However, the HSE is facing significant challenges in respect of meeting the statutory timeframes that apply to the assessment of need process, given the number and complexity of cases. Assessment of need applicants whose needs are deemed too complex for assessment at primary care level are seen for assessment by the mid-west children's disability network teams. These applicants can require a longer period of diagnostic assessment. This can often require assessment observation across a number of settings such as home, school and with a number of allied health care professionals to best identify the child’s health needs. As such, these complex cases cannot be always completed within the 12-week statutory timeframe. Some require ten to 15 sessions under the assessment of need process in order to complete a comprehensive assessment of their health needs.

It is also important to note that the HSE has recognised that early intervention services and services for school-aged children with disabilities need to be improved and organised more effectively and this process is well under way nationwide. That relates to the concerns the Senator raised regarding the delays and the child not getting a school place. To me, that is unacceptable because every child has a right to education, particularly children with disabilities.

The HSE is currently engaged in the reconfiguration of existing therapy resources under the national programme on progressing disability services for children and young people aged from zero up to 18 years. The aims of this programme are to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children and their families to disability services, regardless of where they live, what school the child attends or the nature of the individual child’s difficulties. The aforementioned reconfiguring of disability services for children is part of the progressing disability services for children and young people programme, as there is evidence that where integrated teams are operating, the assessment of need process runs more smoothly.

The HSE disability services have carried out substantial work on developing standardised operational procedures for assessment of need. These procedures are currently being finalised and will be implemented by the end of the year. I have just come from a meeting this morning with senior officials in the Department of Health in Hawkins House where we discussed disability issues and this issue also came up. I will convey to the Department of Health and to the senior Minister the concerns the Senator has raised.

Maria Byrne (Fine Gael)
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I thank the Minister for his interest in this issue and I aware of his commitment to the area of disabilities. His answer was grand and I know that matters are being reviewed but it does not resolve the plight of the parents whose children have not got a school place this year because the HSE has failed to meet its commitment within the timeframe. I understand there are complications but there needs to be a review of how these issues are being handled and that if people in the assessment unit are out on long-term leave, other people who are qualified need to be trained to carry out the assessments. I understand there may be a shortage of qualified people to carry out these assessments when people in the unit are out on long-term leave. Those are some suggestions I have for resolving this issue and I am sure the Minister of State will take them on board.

Finian McGrath (Dublin Bay North, Independent)
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Absolutely, First, I give a commitment that I will take them on board and, second, the important element, as I mentioned in my reply, is the availability of resources. As a group, Senators, Deputies and Ministers must ensure they push for the maximum resources. We did a good deal of work during the Estimates process recently. There is also an issue regarding speech and language therapy services. We have managed to get an extra €2 million for 2018 to deal with that particular issue.

Regrading the issue the Senator raised, it is unacceptable that children with a disability are not getting their constitutional rights. I am a little taken aback by this and that no other solution was found for those particular families. I do not buy the idea that it is acceptable that a child cannot start school because there is a delay in an assessment. I will seriously follow that up.

As for the Senator's point about a review, we have an issue - there is no point in ducking and diving about it - with people being out on long-term leave and their places remaining unfilled. There should be some creative mechanism, as the Senator suggested, to address the issue of people who are out on long-term leave. People are out of work for legitimate reason, that is a fact of life and I accept that. If they are not replaced and the list of assessments builds up, that is unacceptable. There is a shortage of psychologists, speech and language therapists and occupational therapists - those are the professionals I hear regularly mentioned.

During my Estimates discussions with the Department of Health, the HSE and the Minister, Deputy Donohoe, these were all issues that I raised with them and I will continue to raise. I acknowledge we got an increase of €75 million in the disability services budget, which I welcome. I was looking for more but that comes down to the negotiations and that is life. The bottom line is that in the meantime, while we are trying to invest in and reform the services, we need to be able to deal with these types of situations. Every now and then when I return to my office following a meeting, I am contacted about emergency respite cases or cases of families in crisis and we have to deal with those situations. The issue the Senator raised about children with a disability not being able to go to school because of a delay in assessment is not acceptable. We have to act on that and come up with a solution. I give a commitment that I will go back to the HSE and all the senior people, particularly in the Limerick and Tipperary areas, and I will do my best for the Senator.

Maria Byrne (Fine Gael)
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I thank the Minister for that.