Mark Wall (Labour)
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I thank the Minister of State, Deputy Rabbitte, for joining us.

Emer Currie (Fine Gael)
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I welcome the Minister of State. I hope she can catch her breath now.

In August, it was announced that a new multidisciplinary primary care assessment hub for children under the progressing disability services, PDS, programme was to open in Castleknock. That is very good news and is much welcomed. Obviously, it has prompted a lot more communication from parents to me about the children's disability network team, CDNT, waiting list in the area. I will give an overview of some examples I have received.

I have been contacted by a parent whose son is heading into secondary school. He has had one stage 1 desk-based interview. He has severe hearing loss, dyspraxia and, potentially, autism. His waiting time is 37 months for a stage 2 assessment of need clinical assessment.

I have been told about an eight-year-old who has been on the waiting list for an assessment of need for a year. This child, who has been referred to primary care services, is on a waiting list for child psychology but no time period has been indicated, and is facing a two-year wait for occupational therapy. This is in the Dublin 15 area.

Another parent has told me that since the switch to the CDNT system, in one year their child has seen the speech and language therapist, SLT, four times; the occupational therapist, OT, three times; and the physiotherapist twice. The SLT has left and there is no-one to replace her. Under the early intervention team, EIT, her son had one-to-one therapy at least every second week. That is in Blakestown.

In relation to transfers from the early intervention team in Blanchardstown, it seems that one person is manning the emails and the phones. I have been told by a few parents that they get the same text in response to emails. It reads:

We have received waiting lists of children from various services, HSE, CRC, DOC, school-age team and Beechpark Services. [They have amalgamated those multiple lists and are afraid to say that the waiting list is long.] The original date of referral for your child will be honoured. Currently I am unable to give you a timeframe when they will be seen by the team.

Another email said that the current waiting time is three years, and another said it is in excess of three years.

I would like to quote from correspondence from another parent:

When we were with early intervention we could access an OT, SLT and psychologist. They answered their phones and if they could not they would get back to you within 24 hours. On EIT we had regular phone support services with OT, psychologists, SLT, even though no diagnosis his needs were addressed and I felt empowered.

The question that she wants answered is: are they still doing that?

I am hoping the Minister of State can give me some clarity around the transfer to the EIT system and the CDNT system, with reference to the waiting lists for these parents and what is actually happening behind the scenes.They feel their basic needs are not being met. I know the Minister of State hears this all the time and is committed to changing it but the children and their families are exhausted.

This issue boils down to resources. Where are we with resources for CHO 9? Has there been a change to the HSE national panel of recruitment? I am consistently asked by psychologists if that issue is being addressed. These families are paying privately and they come from all walks of life and have different experiences and socioeconomic backgrounds. One family informed me their child will soon be seen because the HSE has outsourced the multidisciplinary assessment to a private company. Is that now happening?

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Senator Currie for giving me the opportunity to discuss CHO 9. I will just reverse a little, if the Senator does not mind. When we started the assessments of need in October 2020 one of our largest lists in the entire country was in CHO 9. This meant it was one of the last lists to be completed at that point in time. We were completing the assessment of need process, which was the old assessment of need rather than a preliminary team assessment or anything like that, and we got through it all. The Senator is right that we faltered at the end. We got stuck in approximately 33 cases due to the psychology and complexity involved in them. However, we got all the lists cleared.

While we were doing those assessments of need, the reform of progressing disabilities took place. This was challenging in the Senator's area for the simple reason that we pulled it all apart. The parents are probably telling the Senator that it was all pulled apart. Various teams were put in place. St. Michael's House, the Central Remedial Clinic, CRC, Avista and the HSE were the teams left in charge of the Senator's area.

There is no denying that since then, retention and recruitment in the area of children's disabilities has been incredibly difficult, particularly in Dublin. To that end, I compliment St. Michael's House, Avista and the CRC because they have addressed the issue. They are making their own arrangements for recruitment and have moved ahead of where we were on the PDS roadmap. They could not wait for the central office of the HSE to make a decision. Supported by Olive Hanley, they decided, because they were in a crisis, to start their international recruitment. They set a target to fill 96 posts across all the various levels, specifically speech and language therapy, occupational therapy and psychology. They are being supported by the HSE in that intensive recruitment drive, which has been ongoing since June. I see the fruits of it coming through in the teams.

This is of little comfort for the families who have emailed Senator Currie asking her specific questions. On the question as to whether early intervention is still happening, the answer is "No" because they are now all part of one team. Early intervention teams used to be a separate piece but are now part of the wider CDNT team. However, the skill set is still there and early intervention is still the priority. It was the one piece of the jigsaw that worked very well in the HSE and the various organisations. While people may not have got an assessment, they got the early intervention and were listened to and communicated with.

A lot of work is taking place, as the Senator has said, in providing responses by email or telephone and telling parents when they can expect to get a call back and that they have not been forgotten about. In last year's budget, money was set aside to ensure every single CDNT team had proper administration to answer emails and phone calls. Those administrative positions are being filled or have been filled in the Senator's area to support the teams. We do not want clinicians to be answering phones or writing emails. We want them to be face-to-face with children. To be fair, from what I can see on the ground, this is turning around. CHO 9 has been the most challenging of all the CHOs but they are working together as a collective rather than in isolation. It is not a matter of, for example, Blakestown being in one team and another area having another team. They are sharing resources and skill sets and the recruitment drive in CHO 9. I can see that transitioning down.

To be honest with the Senator, I get uncomfortable when someone is told it will be three years before someone is seen. The teams cannot say it will be three years for the simple reason that we are working with teams that are 74% populated. Some of the teams in the Senator's area had recruitment figures as low as 50%. That is starting to increase slowly but surely. If that figure was to come down to what I could identify as an acceptable level of clinical risk, we would be in a comfortable position. There is a challenge regarding the 96 posts. The target is to fill them within eight months and we are getting through them by working together and knowing what disciplines are needed from one team to the other. The teams have taken ownership of this and I and the HSE are supporting them with whatever they need. Senior managers in Avista, CRC and St. Michael's House have been able to recruit and I can see the difference this has made. This is of little comfort to the parent the Senator quoted but in six months' time, we will have a pathway towards good skill sets. I will discuss this with the Senator shortly.

Emer Currie (Fine Gael)
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I would like to see the progress the Minister of State is seeing. I do not know how I will get to see that by tabling a parliamentary question to the Minister every month. I need to see it so that I can tell the parents who are in contact with me. The communications they are receiving indicate it will be three years. They are not getting the communication they used to have and need and want. The Minister of State spoke of targets of eight months and six months and I will hold her to those.

I will ask her again about the panel of recruitment. How does that fit into what is happening? What is happening as regards the therapists who were to be brought back into special schools? I have heard there has been an intervention by Fórsa in that regard and we are not seeing those therapists back in the schools. Will the Minister of State comment on that? Is recruitment for those specific roles necessary? Is that the approach that will be taken or will these therapists come from the CDNTs?

Anne Rabbitte (Galway East, Fianna Fail)
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The other evening I referred in my speech to Fórsa. It is amazing what happens on the floor of the Dáil because since Tuesday evening, the HSE and Fórsa have met twice and I hear that progress is being made. I also spoke to John Kearney of the National Council for Special Education, NCSE, this morning and I will issue communications to all the special schools. I am waiting for the head of disabilities, Bernard O'Regan, to tell me the outcome of this. I assume everybody wants to see children getting an intervention and being supported. I have no doubt the union wants that as well. I do not want to assume but I am hopeful a common sense approach will be taken and we will see therapists going into the schools. I have allocated €13.5 million to recruit 133 staff to go back on to the teams. While we are taking them from the teams, they are still part of the team and just happen to be spending a certain number of hours supporting the school side.

We have blown the panels open completely because I needed to get as many people as possible into the CDNT teams to support the schools. We abandoned the panels.To be fair to Damien McCallion in the HSE, he went in there and said they had to tear it apart and blow it open to ensure that we can get everybody off panels and into either the CDNTs or back into the schools. I think I have answered both questions.