Mark Daly (Fianna Fail)
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The next matter has been raised by Senator Wall. I welcome the Minister of State at the Department of Health, Deputy Butler, to the House and thank her for taking time out of her busy schedule to respond to this issue. This issue relates to professional therapists' waiting times and the list for children in south Kildare. The Member submitted it prior to the break and we are delighted the Minister of State is able to come in today to take this matter.

Mark Wall (Labour)
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I thank the Cathaoirleach for selecting this Commencement matter. I welcome the Minister of State to the House and thank her for coming in. Over the last number of months, I have received many representations from parents in south Kildare who are exhausted trying to get any level of assessment and help for their children. Their loved ones are being put on waiting lists that are getting out of control while the development and needs of these same children are not being addressed. It would seem that, on the back of prolonged delays in assessments of need for families in the area, the HSE decided to redeploy a number of staff to this much-needed resource but this has resulted in unacceptable delays for families whose children were dependent on seeing these specialists or, in the case of some families with whom I am dealing, whose children have moved along the age groups and are now waiting on specialist therapy. The result of these moves seems to be only heartache for families, forcing them to borrow money, if they can, and turn to private practices for assessments, if they can get them, given the importance of early intervention for their children about which everyone tells them. Many families have turned to online support groups where families in similar situations share their experiences and support one another as best they can. All the families I have spoken to do not blame the staff they deal with at the end of the phone or, if they are lucky enough, meet at a clinic. They recognise those still working in the system are doing their very best but cannot cover the gaps in the service that are all too evident for so many families in Kildare.

It is also important, as I think the Minister of State will agree, to allow these families to tell their story. I will take time to outline some of the heartache these families are facing as it is important to put their stories on the record of this House. Last week, I outlined the worries Samantha had for her daughter but today I will tell the House about Aileen. She tells me that at a young age they noticed things were a little different with their youngest daughter. Over time and after many attempts and calls, she received a phone call from a primary care doctor who said her daughter's needs could not be met by them and that the network disability team, NDT, would be needed as her loved one was non-verbal and showing signs that could indicate autism. She filled in and sent off every form required and still has not even been given an assessment officer. Her application was received on 16 November 2020. From the few people who have answered Aileen, she has heard she is facing a wait of 12 to 14 months, probably longer due to the impact of Covid-19. Meanwhile, she says, all her family can do is fumble along blindly, not knowing how to help her youngest child. She asked me if I had any idea how heartbreaking it is to watch one's young child struggle so much and not know how to help, not be able to communicate her needs and have a system that leaves her in the dark with no support or guidance. Aileen says she and her husband are sleep-deprived, heartbroken for their little one and seriously struggling to figure out ways to make her world adapt to her child. She said they need help, support and guidance.

Another lady I am dealing with, Nicola, says the HSE diagnosis for her daughter is that she needs intervention for occupational therapy, speech and language, psychology and physiotherapy. Her daughter has now been discharged from the early years team onto the school age team but she is still waiting for her custom and fitted shoes. The day her moulds were taken for them she received a phone call in the car park outside as she was strapping her daughter in to say they were discharging her to the school age team. She asked who would be her point of contact and was told there was none. She asked if she receive a letter about the transition from one team to the other and was told they do not do that and that she would not hear from the school age team unless she contacted it to tell it her daughter needed something. Her email to me read:

When your child has significant needs you think that being accepted by the likes of the NDT will be the turning point, you think it will be the beginning of the intervention your child needs so desperately and absolutely deserves. Well, I thought wrong, we are in this alone. We pay €80 for under an hour of Occupational Therapy as there's no choice but to do this.

She finished by saying that she did not have any fight left in her.

I am sure the Minister of State has been made aware of similar cases. I could give her many other examples of what families are facing and how they are desperate for answers for their loved ones. Solutions must be found. There is a generation of young children not getting early intervention. I hope the Minister of State can bring something to them that will make a difference and allow their families to breathe once again.

Mary Butler (Waterford, Fianna Fail)
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I wish to thank Senator Wall for raising these important issues today and for sharing the heartfelt pleas of Aileen and Nicola for support.

Both the Government and the HSE recognise the challenges in meeting the demand for children's disability services and are acutely conscious of how this impacts on children and their families in these most difficult and challenging times. Nationally, children's disability services are undergoing significant change as the HSE progresses towards the reconfiguration of services into children's disability network teams under the national programme, Progressing Disability Services for Children and Young People, for those aged up to 18 years. The key mission for this programme is to provide a clear pathway and fairer access to services for each child with a disability and his or her family based on his or her need and not on his or her diagnosis or where he or she lives or goes to school.

South Kildare, in conjunction with the rest of County Kildare and west Wicklow, was reconfigured under this programme in 2014. Consideration is now being given to realigning the Kildare-west Wicklow children's disability network teams with the community healthcare networks which were not in place at the time of the reconfiguration in 2014. The remainder of CHO 7, where south Kildare is based, should be reconfigured by the end of June 2021. This reconfiguration will improve access to services and waiting times for intervention.

The vision for children's disability services going forward is to have easy access to the services children require, fairness in providing services and families and health services and schools working together to support children in developing their potential. This will result in consistency and equity in delivering disability services for children and young people.

Significant additional resources have already been redirected to the assessment of need process in CHO 7 to work through the backlog of applications. This project is addressing the backlog to deliver assessments to each child as quickly as possible. There are a number of disciplines working on the backlog, including psychology, speech and language therapy and occupational therapy, enabling assessments to be fully completed as quickly as possible. It is expected that all diagnostic assessments will be completed by the teams by the end of May 2021. The Minister of State, Deputy Rabbitte, has put a huge amount of time and effort into trying to deal with the waiting list for the assessments of need. Huge progress has been made. It is expected that all diagnostic assessments will have been completed by the teams by the end of May 2021.

Clearing the assessment of need backlog is important because it will ensure that resources can be targeted to provide the appropriate therapeutic interventions children and young people need. Funding for an additional 100 new therapy posts was allocated as part of budget 2021. Some of these posts are allocated to CHO 7 and it is expected that a number of them will be in place by the end of quarter 2. This will also help to strengthen service provision in the region.

I trust that this clarifies the issue raised by the Senator. I know that my colleague has also raised the same issue with the Minister of State, Deputy Rabbitte. It is an issue about which we are all concerned and we all hear about it in our constituency offices. I hope this has given the Senator some clarity.

Mark Wall (Labour)
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I thank the Minister of State for outlining that. However, the issue at hand is the length of waiting times. The Minister of State said that investment has been made, and that is most welcome. She mentioned colleagues. I am sure her colleagues in this House today and throughout county Kildare and the State will be aware of the issues being raised in our offices and the problems people are facing. People are at the end of their tether. Aileen and her family have mentioned sleep deprivation. That issue is replicated in the cases of many others I am aware of at the moment.

The Minister of State mentioned the assessments of need and the reduction of waiting times for them. I received an email over the weekend from a person in Dublin, who told me they had received a letter in January telling them that the waiting time for such an assessment is 36 months. If the Minister of State is telling us today that waiting times for these assessments are to be reduced, I would appreciate it if the HSE could send new letters out to those affected. They received letters in January telling them there was a 36-month waiting list. The Minister of State has told us today that waiting list will be reduced over the next few months. If new letters were issued to the families affected, it would help them and, most importantly, the children.

Mary Butler (Waterford, Fianna Fail)
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As I outlined in my opening statement, the challenges in meeting the demand for children's disability services are well recognised, in addition to the impact of these challenges on children and their families.I hope the Senators are reassured by what I said on the commitment of the Minister of State, Deputy Rabbitte, and the Government to improving access for children with special needs to specialist therapies, such as occupational therapy and speech and language therapy. These service improvements, which I referred to in my earlier contribution, will ensure better access to services for all children who need supports. I know from working closely with the Minister of State, Deputy Rabbitte, in the Department of Health that she meets each area lead on disability services in each CHO on a regular basis. Two CHOs have already met their target of seeing all children who are waiting for an assessment of needs. The Minister of State expects, notwithstanding the difficulties with Covid and face-to-face interactions, that all should be met by the end of May. I have no doubt that with the 100 extra therapists put in place, this should happen.

The critical need for and importance of disability supports for people and their families at this unique time in our history are acknowledged. The impact of Covid on people's lives continues to be significant. The primary objectives of the Minister of State, Deputy Rabbitte, the Minister, Deputy Donnelly, and the Government as a whole are to restore face-to-face services and ensure continuity of services in a safe way for children and adults. The common goal of families, health services, schools, public representatives and society is to work together to support and empower children in developing their full potential. It is also important to point out, because the issue got a lot of traction in the news in recent weeks, that the Minister of State, Deputy Rabbitte, has agreed with the HSE to pause the removal of therapists from all special schools who deliver on-site therapy while further engagement takes place. I should note, on behalf of the Minister of State, that this work has been done. I will bring the Senators' comments on the letters back to the Minister and I thank them for their time.