Disability assessments for children
Deputy Seamus Healy alleges that the HSE is unlawfully delaying assessments of need for children with disabilities and says families are waiting up to two years. The Taoiseach rejects any breach of law, says disability has been prioritised, and points to increased funding, the Minister of State's role, and cross-sectoral work on assessments.
The HSE is deliberately and flagrantly breaking the law by denying children with disabilities their statutory entitlements to assessments of needs. The Disability Act 2005 provides for an assessment of the health and education needs of person with disabilities and provides for services to meet those needs. Section 9(5) provides that the executive shall cause an assessment of applicants to be commenced within three months of the date of receipt of an application. The background information and supporting documentation refer to the need for services to be provided early in life in order to ameliorate a disability. The Act provides that the assessments must be started within three months of the application and that the HSE must complete the assessment within three months. That is a legal requirement on the HSE as set out in the legislation. Unfortunately, that is not the situation that obtains nationwide. The legal entitlement of children with a disability is being breached routinely by the HSE. Children are not being assessed within the three-month period and there are huge delays in assessment. The service is broken and there must be an immediate solution to the problem.
The current situation for children in terms of assessment of needs is totally unacceptable and I will give a few examples. A child was referred for assessment on 8 September 2016 but a letter from the HSE states that the child is currently scheduled for assessment in September 2018. Another was referred for assessment on 19 January 2017 but the HSE letter indicates that the waiting time for assessment is approximately 24 months. A third child was referred in January 2017 and was told by the HSE that the assessment would commence in April 2019, a full 27 months away. This is simply not good enough. That child is now over three years old and will be over five years old in two years' time.
Early intervention is absolutely crucial in order to ensure that children with disabilities are properly looked after and have services provided for them. Vulnerable children with disabilities are being mistreated by the HSE and are being denied their legal rights. Does the Taoiseach condone the routine breach of the law by a State agency, namely, the HSE? What does he propose to do about it? Will he instruct the HSE to abide by the law and ensure that every child is assessed in accordance with the law?
Comment on this
This is an important subject. The Government has prioritised disability by appointing Deputy Finian McGrath as Minister of State at the Department of Health to sit at the Cabinet table and articulate the concerns and anxieties relating to this area on a regular basis. Disability funding has increased over the past year and early intervention services and services for school-age children with disabilities need to be improved and organised more effectively. This process is well under way and the HSE is engaged in reconfiguring its therapy resources into geographically-based teams for children aged from birth to 18. The objective of the new model of assessment and intervention is to provide a single, clear referral pathway for all children, irrespective of the disability they have, where they live or the school they attend, as evidence shows that is an important element of progress.
Some €8 million in additional funding was invested in 2014-2015 in order to provide 200 additional posts to support the implementation of that model. A further €4 million in additional funding was allocated in respect of 75 therapy posts in 2016 and it is expected that as this reconfiguration of services takes place it will have a significant impact on the HSE's ability to meet the needs of children and young people in a much more efficient, effective and equitable manner.
In 2013, 260 front-line primary care staff positions were approved.
That included 52 occupational therapists and 52 speech and language therapists. The aim is for that recruitment to continue which will lead to a reduction in waiting lists and times. A further €4 million was provided in that regard in 2014.
Since the June 2007 commencement of Part 2 of the Disability Act 2005, the HSE has endeavoured to meet its legislative requirements as specifically referred to by Deputy Healy. The number of applications for assessment under the Act has increased each year since it was introduced. It is anticipated that in excess of 6,000 applications will be received this year. It can take a significant period to determine accurately the nature of a disability which a child might have. Although there has been continual investment in this area, there are significant challenges in meeting the statutory timeframes which apply to the assessment of needs process. The Minister of State at the Department of Health, Deputy McGrath, is dealing with the delay in assessments. He is trying to resolve those delays by direct consultation. There is an ongoing recruitment campaign to combat the issue of staff shortage. The Minister of State is working with the HSE to deal with this in order that the requirements of the Act can be met by the HSE and there are no delays beyond the period for assessment and determination of a disability.
Comment on this
The Taoiseach has not answered the question. The HSE, which is a State agency, is breaking the law. I asked the Taoiseach if he condones that and if he will ensure that does not happen in the future. Unfortunately, since this Government has come to power and Deputy Finian McGrath has taken responsibility for the issue, the position has disimproved. We have gone from a situation where there was reasonable compliance with the law to one where we now have a waiting time of two years for the commencement of an assessment. The situation is being ignored. It has been raised in this House by several Deputies through parliamentary questions and as a Topical Issue matter. It has been ignored. The Taoiseach's answer indicates that it is still being ignored. The current situation is that where an assessment of need has not been completed, there are consequent delays in the provision of children's services such as speech and language therapy and the appointment of special needs assistants and resource teachers. The inaction of the HSE is unacceptable, deplorable and illegal. Does the Taoiseach condone that illegality and what he will do to ensure the HSE abides by the law?
Comment on this
It is not acceptable for any State agency to be outside the legal requirements of what it has to do. The Minister of State at the Department of Health, Deputy McGrath, who has special responsibility for disability issues, sits at the Cabinet table, has a substantial budget and is working assiduously to deal with this issue. If there are 6,000 assessments to be carried out this year, more than 100 must take place each week. Many of these assessments are quite complex and take a period of time to assess accurately.
Comment on this
I am concerned with assessments that have not been commenced. People have been waiting two years.
Comment on this
As the Deputy knows, parents have every right to know the nature and scale of the disability that their child or children may have to deal with. The Act itself-----
Comment on this
There has been much collaboration between the health and education sectors on the issue of children's disability. That is facilitated by the cross-sectoral team and the implementation of the Disability Act. That team comprises representatives of the Department of Health, the Department of Education and Skills, the Department of Children and Youth Affairs, the HSE executive, the National Council for Special Education and the National Educational Psychological Service. As Deputy Healy is aware, a detailed report was compiled by Mr. Eamon Stack, chairman of the National Council for Special Education, which sets out a progressive way of dealing with the issue. While waiting lists are unacceptable and should not exist, the Minister of State is at the forefront of dealing with the delays. In the near future, it is hoped the law in terms of assessment for children will be fully complied with, unlike the current situation where children have to wait for longer than they should.