Mark Wall (Labour)
Link to this: Individually | In context | Oireachtas source

I too welcome the Minister of State to the House and thank the Cathaoirleach for selecting this very important matter. It was in February of this year that I raised this matter previously with Deputy Collins's colleague, the Minister of State, Deputy Rabbitte. The issue is the need to find out what the waiting times for assessments of need are in the community healthcare organisation, CHO, 7 area, the area where I live, and to reduce them. On the day in question, I was presented with figures from the HSE which included a figure of 1,320 individuals and their families who were waiting on an assessment of need. In fairness to Deputy Rabbitte, she was very honest in her contribution on the day. I will recall what she said at that time because it is very important. She stated:

It is important for me to be honest and transparent with the Senator. [...] The Senator is after getting a script but I need to correct something on it. It states "CHO 7 currently reports 1,320". Thankfully, Noel in my office kept digging until ... [he got the correct figure, which was 2,665, a lot more than the figure provided by the HSE] ... That is the number of families in CHO 7 awaiting an assessment of need.

She went on to describe the situation as "Groundhog Day" and said:

That is as bad as it can get. To be honest, the HSE has not kept pace with the growth in population as shown in the census returns. Funding has not kept pace with the disability sector and the growing population. It is important to say that.

In subsequent conversations I have had with the Minister of State, Deputy Rabbitte, in this House and in conversations she has had in the Dáil, she has mentioned that she is in the process of setting up six regional hubs to tackle the delays on waiting lists once and for all. However, in the reply to a recent parliamentary question put by my colleague, Deputy Sherlock, Bernard O'Regan, head of operations in the HSE's disability services, gave a figure of 1,986 families in my area who are waiting on an assessment of need. Some 1,596 of these families have been waiting for longer than three months. The reply went on to describe an assessment of need administrative hub being set up being set up in CHO areas 1, 4, 5, 7 and 8 and stated that assessment hubs have been established in CHO areas 3, 6 and 9. I would appreciate it if, in his reply today, the Minister of State could outline the difference between an administrative hub and an assessment hub. In my own area, CHO 7, are we disadvantaged by only having an administrative hub rather than the assessment hub other CHO areas have? In his reply, the Minister of State might also confirm the correct number of families waiting on an assessment of need in CHO 7.Has the figure that was given to me by the Minister of State, Deputy Rabbitte, reduced from 2,665 to 1,986 or has the figure the HSE provided on the day risen from 1,320 to the figure quoted in the recent parliamentary question response of 1,986?

The reason that has been put down again is that behind those figures there are families. I know the Minister of State, Deputy Rabbitte, knows that but unfortunately I am not sure if everybody in the HSE realises it. A family I mentioned on that day, last February, from my home town of Athy, has still not heard anything about an assessment of need. The last time one was carried out for their young son was in 2012. They were offered a preliminary team assessment in 2021 and the High Court has overruled that, yet this family is still trying to get an assessment of need for their son. I mention that piece of paper, as I have described it before, that all families need, even though the HSE and the Minister of State on the day told us it was not needed. Everywhere I talk to families they are asked for their assessment of need first.

Campaigners like young Cara Dermody, who I met today, have highlighted the waiting lists time and again. I am sure that not a week goes by that the Minister of State and all colleagues in this House do not get a call from a family or families on assessments of need and on trying to improve their waiting times. I look forward to the Minister of State's reply and I hope he can explain some of the issues in that parliamentary question response.

Niall Collins (Limerick County, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank Senator Wall for raising this important issue for discussion in the House. I want to be completely clear that the development of any child with a disability to reach his or her full potential remains a matter of utmost importance for this Government. I am aware that the provision of a timely and effective assessment process that works for children and families is an area of ongoing focus for my colleague, the Minister of State, Deputy Rabbitte, the Department of Children, Equality, Disability, Integration and Youth and the Health Service Executive.

The principle of early intervention is recognised by both the Minister of State, Deputy Rabbitte, and the HSE, particularly in the context of the services and supports it provides to children with disabilities and their families. In line with this, the HSE focus has been to develop a strategy for services that is reflective of the best national and international practice. The backlog for assessments of need has been caused by a number of factors, including rising numbers of applications due to general population increases; staffing shortages being experienced by children's development network teams, CDNTs, across the country; and the impact of the High Court judgment of March 2022, which directed that the standard operating procedure used to address backlogs did not fulfil the requirements of the Disability Act 2005. Assessments of need are being progressed in line with the revised clinical guidance developed on foot of the High Court judgment, which has been clinically approved and allows for clinicians to exercise their professional judgment on the scope and extent of each assessment. Accordingly, assessments can range in duration, having regard to the complexity of the child's presenting needs.

On CHO 7, the HSE advises that there are 1,935 children waiting and assessments of need outstanding as of late summer 2023. A more recent figure is not available due to the ongoing industrial action within the HSE affecting administrative and managerial grades. I am aware that the Minister of State, Deputy Rabbitte, has ongoing engagement with national and local HSE management and as a result of the launch of the progressing disability services roadmap last month, there are planned measures to alleviate the backlog, including outsourcing assessments to private clinicians to improve capacity. Funding of €11.5 million was allocated in 2023 to procure diagnostic assessments from the private sector. However, this sector is also experiencing staff supply issues. The measures also include the establishment of the regional assessment hubs, which will assist each CHO in the reduction of waiting times. At present, all assessment of need referrals are managed centrally by the regional team based in Naas. The measures also include an extensive recruitment programme to enhance CDNT's capacities so that any assessments of need and therapy interventions can be delivered. The building of the CDNT's capacity is a critical component for the HSE to achieve its objectives for children's services.

Among the many initiatives being pursued in the recruitment space, the HSE advises of the launch of a targeted initiative to recruit Irish health and social care professional, HSCP, graduates who have gone overseas. A competitive relocation package has been launched to facilitate overseas recruitment and all 2023 HSCP graduates who are successful at interview are being offered multiple permanent opportunities.These measures, among others, are part of a national campaign and are intended to benefit all CHO areas.

I assure the House that the Minister of State, Deputy Rabbitte, continues to work closely with the Department and the HSE to address the issue of delays in assessments of need via the roadmap drive to make progress on the challenges to ensure the fundamental requirements of children with disabilities and their families are met in a timely manner.

Mark Wall (Labour)
Link to this: Individually | In context | Oireachtas source

Unfortunately, the reply does not differentiate between an administrative hub and an assessment hub. I ask the Minister of State to raise with the Minister of State, Deputy Rabbitte, the need to differentiate between the two. It seems an administrative hub gathers information, while an assessment hub carries out assessments. We do not have an assessment hub in CHO 7. The figure of 1,935 provided is 20 or so short of the figure provided in answer to a parliamentary question tabled a couple of weeks ago, notwithstanding the industrial action mentioned in the reply.

In a debate in Dáil Éireann, the Minister of State, Deputy Rabbitte, promised she would use private resources to reduce waiting times. Unfortunately, the figures in front of me show that times are not reducing for families, including the family I mentioned and many other families in my area. Are private resources being used? The Minister of State's reply refers to but does not go into detail on what is needed for many families who are unfortunately still waiting on an assessment of need. They have not received the update they are waiting on.

Niall Collins (Limerick County, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Senator for providing me with this opportunity to speak on this very important issue. I fully agree, and I know it is a view shared across government, that children who are seeking assessments of need must receive them in a timely manner. Funding has been provided to the HSE for additional posts in recent years to enhance the capacity of the children's disability network teams, CDNTs, and shorten waiting times. The overall funding in recent years provides for nearly 800 whole-time equivalent posts, including approximately 175 therapy assistance posts approved in budget 2024. The current delays in accessing therapy services are directly related to vacancies across the CDNT network. Work by the HSE is ongoing to maximise the capacity of each of the CDNTs via recruitment campaigns and other measures. These measures include sourcing therapy assessments and interventions via private service providers, along with the standing-up of regional assessment hubs.

My colleague, the Minister of State, Deputy Rabbitte, is fully engaged with the HSE on the matter of recruitment. In addition to those mentioned earlier, there are specific measures being employed by the HSE to improve capacity. These include 227 additional training places that have been developed for health and social care professionals, which commenced in September, 147 of which are in the Republic of Ireland and 80 of which have been secured in Northern Ireland. In addition, the number of trainee psychologist posts increased by 45 posts per annum for the next three years and all final-year students who applied to national campaigns have been interviewed and placed on recruitment panels. These measures have been developed at a national level to address the needs of all CHOs and target the provision of timely service for both assessments of need and therapeutic interventions.

It is important to state that despite the challenges, significant work is ongoing, with over 45,000 children currently supported by the CDNTs across the country. It is acknowledged that there is yet more work to be done but the Minister of State firmly believes that the recently launched progressing disability services, PDS, roadmap will be the key to addressing this challenge. I thank the Senator again for raising this matter.