Aodhán Ó Ríordáin (Labour)
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I go door to door as often as I can and the other night in Raheny I came across two families with children in dire need of help from the Government. One family has a child in need of a psychological assessment in a school where there are 12 such children in need of a psychological assessment. Three of them will be able to get that assessment but this child is not one of them. The parent is now faced with the prospect of either going privately, at a cost of €650, or not having an assessment at all. What are the Government's plans to ensure every child who needs an assessment can obtain one in order that he or she can maximise his or her potential?

I came across another family where the situation was even more worrying and distressing, and the family has no problem with me naming them. Abigail, the daughter of Claire and Mark, was diagnosed with autism at the age of two. They also have two younger children and difficult enough it is to hear that type of news about the daughter they love dearly, they have fought a war since that diagnosis to get any sort of early intervention from the HSE to benefit their child. In recent days, they were told the earliest they will get help from the early intervention team in north Dublin is approximately six months' time. The child will be almost five years of age. She will finally get help almost three years after her diagnosis. She is approximately 150th on the list, but there are hundreds and hundreds of children on the list.

Unfortunately, in this country, not only must people deal with the difficulty of managing a child with autism, as well as every other aspect of family life such as looking after other children and doing their best for them, they must also embark on a war with the State. Unless people kick, shout, roar and scream, it appears they get nowhere, and it is utterly exhausting. I do not know of any other European country that has a waiting list of this nature for a child as vulnerable who needs this intervention. There may have been an argument a number of years ago, in the pit of an economic recession, that there was no money. We could have argued over and back about the priorities in budgets and so on. In the current circumstances, however, when it is clear there are resources, why must Abigail wait three years to get access to an early intervention team in order that she can begin the journey of maximising her potential as a little girl?

Jim Daly (Cork South West, Fine Gael)
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I thank the Senator for raising the issue of access to children's early intervention services and psychological assessment in north Dublin.

As the Senator is aware, there is a very high demand for early intervention services. Regrettably, there are now very significant waiting times in Dublin north city and county as well as other areas. There are a growing number of local factors driving this demand, including the increasing child population and growth in terms of the number of children presenting with complex needs.

The early intervention service for the area receives, on average, between 13 and 14 new referrals a month. A high level of requests for assessment of need are also received. These are typically carried out by therapists who also work in the early intervention service. From January to August of this year, 1,251 assessments of need were completed by the HSE disability service in north Dublin.

The HSE fully acknowledges the stress that delays in access to services and assessment can cause to families and is actively working to address the waiting times. The HSE disability service in Dublin north city and county has begun recruiting for five additional posts, one in each of the following services: psychology; occupational therapy; speech and language therapy; physiotherapy; and social work. These additional staff will further contribute to a reduction of waiting times for early intervention services across the area.

The local HSE disability service is currently engaged with the HSE nationally in the reconfiguration of services for children to deliver a new model of assessment and intervention that will provide a clear pathway for children aged zero to 18 years. The progressing disabilities services programme aims to achieve a national equitable approach in service provision for all children based on their individual need and regardless of their disability, where they live or where they go to school. The programme is doing this by forming partnerships between all of the disability organisations in an area and pooling their staff, who have expertise in the different types of disabilities, to form local children's disability network teams who will provide services for children with a significant disability, regardless of their disability. Evidence to date from areas where this has been rolled out shows that implementation of this programme will also have a positive impact on waiting lists both for assessments and therapies.

Senators will be aware that funding for an additional 100 therapy posts was secured as part of budget 2019. These additional posts, along with the reconfiguration of services and other initiatives, are expected to have a significant positive impact on waiting times for early intervention and assessment of need. It will also help meet the needs of children and young people in a more efficient, effective and equitable manner.

Paul Coghlan (Fine Gael)
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I thank the Minister of State.

Aodhán Ó Ríordáin (Labour)
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I acknowledge that the Minister of State is a compassionate individual who feels strongly about this issue. What time does he think is reasonable to wait from the diagnosis of a child just like Abigail to the beginning of intervention? What time does he aim for? What is his vision? Does he feel that three years is too long? I am sure that he does. What is a reasonable length of time for a family in this scenario to wait? I mean the families that have children like Abigail.

I do not think it is good enough for a family to be stressed over waiting for an intervention. They will have to deal with this diagnosis for many years to come as will other members of the family. Everybody around the family will be clued in to this issue. There is a constant state of conflict with agencies that are supposed to surround people with care and compassion. As happens in other jurisdictions when there is a diagnosis like this, one automatically feels as if there is a team of people working with the family and the child to improve his or her circumstances. The situation is completely different in Ireland where one feels almost completely abandoned and must work through this by oneself. The stress, as one can appreciate, is quite substantial. I ask the Minister of State the following again. What timescale does he think is appropriate from the time that a child gets a diagnosis to the time that the early intervention team can click into place? Are we working towards that timeframe? Then we can have a sense that we are all working together.

Jim Daly (Cork South West, Fine Gael)
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I understand what it is like for a child to be diagnosed with needs and for a child not to get services. I am a parent of a child with special needs. Like the Senator, I am a former school principal and understand the situation very well.

I also understand, as the Senator does as he formerly held my current ministerial position as a Minister of State, the challenges that exist within the system. In his opening speech he said that he understood a few years ago why every child did not get what he or she needed but now he cannot understand why every child does not get what he or she needs and inferred that there are plenty of resources available. I refute that inference and state that there are insufficient resources in the country. Despite having the largest health budget ever in the history of the State amounting to €17 billion next year we will not go anywhere near coping with the demand that is placed on that budget. Whether it is children with special needs or, like the previous Commencement matter, Alzheimer's disease, which affects the elderly, for whom the Senator cares a great deal, they are all competing needs. We also have acute sectors of hospitals and nursing homes. All sectors and all strands of society compete for funding.

To answer the Senator's question directly, it is immaterial what I think is a reasonable waiting time for a child.

Aodhán Ó Ríordáin (Labour)
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I cannot accept that.

Jim Daly (Cork South West, Fine Gael)
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I do not mind whether the Senator accepts what I say and I am making it a matter of absolute fact.

Aodhán Ó Ríordáin (Labour)
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The Minister of State must have a view.

Jim Daly (Cork South West, Fine Gael)
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It is completely immaterial what my opinion or belief is.

Aodhán Ó Ríordáin (Labour)
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The Deputy is a Minister of State in the Department of Health so he must have a view on what is an appropriate waiting time.

Jim Daly (Cork South West, Fine Gael)
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I do not mind what the Senator accepts or does not accept.

Paul Coghlan (Fine Gael)
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There is a procedure here.

Jim Daly (Cork South West, Fine Gael)
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It is completely immaterial what my opinion is. We are working on a finite budget. There are competing demands for that budget across a wide variety of sectors.

Aodhán Ó Ríordáin (Labour)
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That answer is absolutely unacceptable. I genuinely do not want to do this but it is unbelievable.

Paul Coghlan (Fine Gael)
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I cannot allow Senator Ó Ríordáin in again, unfortunately. I thank both the Minister of State and the Senator.

Jim Daly (Cork South West, Fine Gael)
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I assure Senator Ó Ríordáin that we have noted his concerns and interest in the area that he represents, and his desire to see those waiting lists dealt with. This is an area for the Minister of State at the Department of Health, Deputy Finian McGrath. We will continue to work with the HSE, which is the service delivery organisation, to reduce the waiting times and continue to invest in the issue, as resources allow.