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Dáil
‹ Ceisteanna ó Cheannairí - Leaders' Questions

Children's disability assessments

Summary

Deputy Doherty raised severe delays for children waiting for disability assessment and initial contact, saying the system and budget response are failing families. The Tánaiste accepted the delays, pointed to extra funding and ongoing work, and the exchange became increasingly partisan before the Chair moved on.

Agus muid ag labhairt anseo inniu, tá os cionn 17,000 páiste ag fanacht ar theagmháil tosaigh ó fhoireann mhíchumas leanaí. Tá an Rialtas ag fágáil na bpáistí seo ar leataobh de bharr córas nach bhfuil ábalta freastal ar a gcuid riachtanas. As we speak, there are 17,000 children waiting for initial contact with children's disability teams. There are 2,500 children who are waiting for and overdue an assessment of needs. As the Tánaiste knows, these are crucial assessments the families and the children involved are entitled to, but they are being failed by a system that is totally unable to meet their needs. The situation is dire. It is continuing to get worse year after year under the Government. The number of these assessments carried out by the HSE has plummeted. Thousands of children are being failed by the State and left in limbo while they wait for care they are entitled to.

I will tell the Tánaiste about one of those children. Uisneach turned 13 last month. He received his official diagnosis of autism in an assessment report this week. Uisneach is a lovely little boy who has a rare syndrome involving physical and intellectual disability. His mother first asked for an autism assessment when he was six years old and beginning primary school. He got that assessment this summer as he became a teenager, following seven long years of uncertainty and barely in time to make applications for secondary school. Due to this shocking delay, Uisneach did not receive the supports of home tuition or July provision he was entitled to. He had autism his entire life and should have been entitled to both these supports but because he did not have the formal assessment and diagnosis, he was excluded from these supports. It was only after this official assessment was completed - seven years after it was requested - that his parents were directed for the very first time to any supports tailored for neurodiverse children. Because everything is put on hold for the assessment to be completed, delayed assessments mean delayed access to supports. Uisneach will not get that time back and he will not get back all the missed supports he was entitled to for many long years. Neither will the 2,500 children who are waiting for assessments of needs that are overdue or the 17,000 waiting for initial contact.

These families are left in limbo after reaching out for support. They are being failed by the Government, and this is happening under its watch. Ministers were out this week with announcements in the budget that sound impressive on the glossy surface. When you scratch beneath the budgetary spin, however, it is clear the Government has not responded adequately to the situation. The vast majority of money announced this week is to stand still, not to speed up, the delivery or assessments, or the badly-needed services that should follow these assessments. The Government's disability capacity review made it clear the levels of funding that were required to meet the needs of children and adults across the State. The Government provided a fraction of what was required. In doing so, just like last year and the year before, the Government will fail these children and many others like them.

When will the Government will deliver the investment needed to support these children and their families? When will it provide the investment necessary to ensure that they get the fairness and respect they deserve in a timely manner, and not be obliged, like Uisneach and his family, to wait seven years to be given the supports they are entitled to from day one? Will the Government rethink the budget decision and provide the resources to meet the needs of these children and deliver on the recommendation in its disability capacity review to the effect that substantial additional funding is required?

Comment on this
Leo Varadkar The Tánaiste Fine Gael

I thank the Deputy for raising this issue. It is one that is of enormous importance to thousands of families across the country. I think all of us will know from our constituency services of cases of people and children who have had to wait a very long time for their assessment of need. I am sorry to hear of the case the Deputy raised and hope Uisneach is getting the support he needs now.

There are lots of delays in getting those assessments of need done for the children who need them. As I mentioned, this is something I am aware of from my constituency service. I met Avista, one of the providers in my constituency, on Friday last to discuss this and related issues. There are additional resources provided for in the budget that will be detailed in the HSE service plan.

It is not just a matter of money. We have seen a huge increase in spending on health and disability in recent years but money alone does not solve problems. You need to recruit and retain staff, which is a challenge here and everywhere around the world at the moment. You also need to be able to ensure your systems work well. Perhaps we need to consider a change of approach here. At the moment, you need to get your assessments of need before you get the therapies you need. However, I know people who work in the sector would state that it does not necessarily have to be that way. You could start providing therapies right away. It can be very clear that some children need therapy. The system we have at the moment where you wait for your assessment of need before you get the interventions is perhaps not the best option. Where it is obvious a child needs a particular intervention or therapy, why do we not provide that straight away? We need to provide additional resources, which is happening, and additional staff, which is a challenge. Perhaps we also need to look at the system and the approach we have taken to date and assess whether these can be improved.

Comment on this

What these parents want is a plan. Unfortunately, what the Government has is a Minister of State who is not forward-planning. One third of all positions in disability services are vacant yet there is no plan in the budget to deal with this. The Government was brought to court by these families and it was found the law was being broken in relation to assessments of need. That is how dire it has got, and the Tánaiste is now talking about how maybe we need a different approach. Of course we need a different approach. What we really need is a different Government that will put these children first and foremost. This cannot go on year after year. The situation is getting worse. There are 2,500 children whose assessments of need have been delayed. That is up 500. The number of assessments carried out last year compared with this year is a fraction of what the HSE was doing. The situation is getting worse.

The Government does not have a plan. People who are desperate, who do have the support they require and who have children like Uisneach who are going through their entire primary education without assessments of need and the support to which I refer are this week being given a booklet on what autism is. That is a disgrace. It is a disgrace that our Government is failing so many children in this way. These people are really vulnerable. This problem could be fixed with the right political will.

Comment on this
Leo Varadkar The Tánaiste Fine Gael

I absolutely guarantee that the Minister of State, Deputy Rabbitte, is leading the way on this and is committed to working with the Government as a whole to make improvements in this area. There are a lot of additional financial resources for disability. The total budget for the year coming is going to be €2.4 billion, with €11 million or €12 million being provided specifically to improve waiting times when it comes to an assessment of need. We accept that there is a problem and it is something we are working on. We are providing substantial additional financial resources. However, there are challenges, including those relating to recruiting and retaining staff, which the Deputy mentioned, and which are by no means unique to this country. There are also challenges with getting the systems right and ensuring that we get the therapies children need as soon as possible.

It is disappointing that the Deputy used his time to only come up with one solution to this problem, namely, his party being in government.

Comment on this

That is the only solution.

Comment on this
Leo Varadkar The Tánaiste Fine Gael

It is disappointing it seems to be the Deputy's approach to anything, rather than coming up with a solution or ideas and detailing them to set out what he would actually do.

Comment on this

We provided five times the amount of money that the Government did-----

Comment on this
Leo Varadkar The Tánaiste Fine Gael

Instead, the solution is just Sinn Féin.

Comment on this

-----in our alternative budget.

Comment on this
Catherine Connolly An Leas-Cheann Comhairle Independent

Go raibh maith agaibh.

Comment on this
Leo Varadkar The Tánaiste Fine Gael

It is pretty narcissistic.

Comment on this

The Tánaiste has been in government now for a decade-----

Comment on this

Sinn Féin's alternative budget was €153 million.

Comment on this

-----and these children have been left on the sideline.

Comment on this
Catherine Connolly An Leas-Cheann Comhairle Independent

Thank you.

Comment on this

Sinn Féin's alternative budget was €153 million.

Comment on this
Catherine Connolly An Leas-Cheann Comhairle Independent

Tá me ag bogadh ar aghaigh.

Comment on this

The Tánaiste has been in Government, he has been a Minister-----

Comment on this
Catherine Connolly An Leas-Cheann Comhairle Independent

Deputy-----

Comment on this

-----he has been the Minister for Health, he has been Taoiseach and he has been Tánaiste-----

Comment on this

Sinn Féin's alternative budget proposal is for €153 million.

Comment on this
Catherine Connolly An Leas-Cheann Comhairle Independent

Deputy-----

Comment on this

-----and these children wait and wait. That is the reality.

Comment on this

This is the usual bluster.

Comment on this
Catherine Connolly An Leas-Cheann Comhairle Independent

I am not going to impose the ultimate sanction. I ask for a little co-operation; just a small bit of respect for the Chair and what it represents, namely, the democratic process, please. Could we do the courtesy of listening and stop interrupting? We are moving on to the Social Democrats.

Comment on this