Assessment of need delays
Deputy O'Callaghan raised Cara Darmody’s protest and the Government’s failure to resolve long delays in assessments of need for children. The Taoiseach said the issue was recognised, argued solutions rather than excuses were being pursued, and cited increased assessment numbers while insisting clinicians should have the final say after the High Court decision.
Cara Darmody is continuing her protest outside the Dáil today because nothing she has heard from the Government has convinced her to end it. Asked repeatedly yesterday if the Government would stop breaking the law, the Taoiseach could not even give that assurance. The Government does not seem to see the problem with this. It has access to State resources, can direct policy and can authorise hiring. It can fix this, yet despite having all these tools and resources at the Government's disposal, all the Taoiseach could offer yesterday was the same old tired excuses. I want to examine some of those excuses now.
The Taoiseach said yesterday that, fundamentally, we need to change the legislation when it comes to assessment of need. When exactly did he arrive at this decision? The High Court struck down the accelerated assessment procedure more than three years ago. The Government has had all of that time to act but it did not. The procedure was struck down for a good reason. It consisted of one hour of observed playtime and a 30-minute discussion with a parent. Children were then diagnosed as having a disability but not told which disability they had. It was a completely inadequate, box-ticking exercise. Is the Taoiseach telling us that this is the system to which the Government will return or is its plan to get rid of assessment of need altogether?
The Taoiseach also said yesterday that he was in the process of setting up a disability unit in his Department. It is now nearly six months since the election. How far along in this process is he? What is the delay in setting it up? If the issue is really a priority, why was it not done on day one? The reality is that successive Governments have claimed disability is a priority. Endless waiting lists for assessment of need and vital services tell a very different story. Parents know that early intervention can make a world of difference to their child. It could be the difference between learning how to speak or getting left behind. Imagine what it is like to see your child placed on an endless waiting list as they miss key milestones.
As Cara has learned, when it comes to this Government, talk is cheap. Last year, when she met the Taoiseach's colleague Simon Harris, he made commitments to her. Instead of keeping those promises, they were broken. Cara has said it does not matter what age someone is; anyone who makes a promise should keep it and if they do not, their credibility will be gone. The credibility of this Government is already in tatters, with a list of broken promises, but there is an opportunity now for the Government to rebuild it. Following the Taoiseach's meeting with Cara this morning, will he now tell us when the Government is going to stop breaking the law?
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I disagree fundamentally with the Deputy's sentiments when he says we do not see the problem. Of course we see the problem and we have made it very clear that we see the issue here regarding assessment of need. I am not making any excuses; I am just focused on solutions. I have heard precious little from anybody here on the Opposition side in terms of a solution-driven approach.
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You have been in government for five years.
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You are breaking the law.
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Equally, the Deputy referenced the High Court decision. I have no intention of going back on the standing operating procedures, but I believe that when the High Court makes a decision, it is clinicians who should ultimately decide on the nature and type of provision of therapy, medicine or anything. The last Government did not follow through for different reasons. There was not agreement in respect of it after the High Court decision.
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That was you. You were in the previous government.
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This Government is adamant it will deal with that aspect. It is only one aspect, one strand of it. It needs to be looked at because there needs to be a framework that allows therapists to intervene more quickly in providing services to children. An assessment of need, by the way, is not a static thing nor should it be. As a child develops, the child needs ongoing review. That is why the Government has already taken a decision to have a national in-school therapy service, something I campaigned for during the election and said would be a red line for me in the programme for Government. Our partners in government, the Fine Gael Party and the Independents, are fully aligned to that objective and the Minister for education, Deputy Helen McEntee, has initiated that process for a national in-school therapy service starting in the special schools, which is absolutely essential.
We are increasing the level of assessments but we need more than the approximately 20% increase that happened last year. We need to recruit more therapists and we will also do that. We need to engage with CORU on faster recognition of qualifications for those who come in from overseas to work in our services as therapists. Far more flexibility is required there to supplement and add to the therapists who will come through our colleges. We will also increase the places in third level colleges, but all of that takes some time and we will be procuring additional capacity from the private sector.
There is a fundamental point about ensuring there is early intervention with children by therapists, and then a problem arises. If every therapist is going to spend 90 hours assessing children, there will be precious little resource for actual intervention. We need to get that balance right. That is something on which the Government is focusing and something we need to work on in respect of the legislative provision. We have asked for ideas and proposals around that.
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The Health Service Executive has been highlighting the court decision for quite some time. That is the answer to the Deputy's question on that.
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That is an astonishing answer. The High Court judgment was more than three years ago and the Taoiseach has just now told us that the reason it has not been acted on or that the Government has not got its act together on this is that the previous Government could not agree on what to do. Is that the case? We have more than 15,000 children waiting for an assessment of need that they desperately need, beyond the six-month limit, and the Government is breaking the law because for the past three years, the Taoiseach and his Government colleagues have not been able to get their act together and agree on what to do. Is that the case? What we need from the Government now is detail on how it is going to fix this. It has been talking around changing the law and hiring more people but when will it actually stop breaking the law? It is not acceptable if the Taoiseach and his Government colleagues have been breaking the law for more than three years and letting down children and their families who desperately need access to services and assessment of need simply because they could not agree among themselves what to do.
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The Deputy is not correct in that at all. He asked specifically about the law and I gave him a straight answer that this Government will deal with that aspect of it. However, the outgoing Government dealt with a whole load of other issues pertaining to this. For example, 4,162 assessments were completed in 2024, a 30% increase on 2023, and that upward trend is continuing with the assessments that were completed in the first three months of this year. There was a 65% increase in the first quarter of this year compared with the same period last year. It is not as if nothing is being done or the issue is being ignored. That is just a deliberate distortion by the Deputy's good self. He also needs to look at the reality and see what he is saying we should do about the balance between assessment and direct intervention with the therapists we have, be they those in the private or the public sector. There is a finite capacity. Maybe we can get more out of the entirety of that capacity of therapists in the country, be it private or public, but the Deputy needs to come clean as well and not just take the comfortable position of saying that whatever we produce on this side of the House, he will simply condemn and have a go at it.