Cuirim fáilte roimh an Aire Stáit. Last Friday morning, I attended a protest in Cavan town. It happened to be all mothers who were there. It was organised by mothers of children with additional needs. They were pointing out that they are not getting the supports and therapies they require from the children's disability network team, CDNT, based in Cavan. The longer children go without supports, the more complex their difficulties become. Families are finding it difficult to engage without supports and schools are finding it difficult because they are not getting the supports either. They are struggling as they try to provide the best form of education for these young people. This is the fourth protest the group has held in a year. Parents are just trying to highlight what is happening. They do not have the time or energy for this. They should not have to fight for their children all the time but they are forced to.

These parents tell me that 578 assessments of need, AON, reports are overdue in Cavan-Monaghan, 511 of which have been overdue for more than three months. Only 12 AONs were carried out in the first quarter of 2026. Thousands are on the waiting list for AONs across the country and Cavan-Monaghan is no different. As the group has pointed out, delayed assessment wastes time when children should be accessing vital supports. Even those children who do have these assessments are not getting the therapies and supports they require. These children deserve support not waiting lists.

The group has said that, while staff numbers within the CDNT were dismal a few years ago, they have improved majorly in the last few years. That is welcome but these parents are not seeing that in the interactions on the ground. One parent told me that she had a meeting last week with two psychologists employed in the CDNT, who hold less than one whole-time equivalent position between them. She met with the two and asked them why they were meeting with her and not with her child. It turns out that one of those psychologists has never had any meetings or support sessions with a child. The meetings with parents and training courses are important. Parents are willing to participate in those so that they are in the best position to help their children. However, that is all they are getting. Children are not getting the one-to-one therapy they require. The parents are told that if they do not undertake the next training session, which may be one they have already undertaken, their children will be removed from the list or moved down the list.

There is this sort of threat over them. As I said, parents are happy to do what they need to do, but they are not trained psychologists, speech and language therapists, occupational therapists or whichever professional the child may require.

Some services are being outsourced, and this is causing a problem in itself. Some of the therapists are leaving the service and going private because it is more profitable for them. Parents are trying to access the supports privately, which is putting a huge financial burden on them. However, they have to do it because they realise that early intervention for their child is so important. If children are missing these important interventions, they will not be able to progress in life as they should.

Parents have also told me there are huge problems accessing CAMHS. Children may have an autism assessment, but they may also have suspected ADHD. They need the diagnosis to get treatment but CAMHS is refusing to see them. Some parents have had six refusals before finally getting an appointment for an assessment for ADHD. I know CAMHS is different but there was supposed to be a single point of access between the CDNT and private care, and that does not seem to be happening yet. Perhaps I could have an update on that. It is unfortunate that CAMHS is not intervening.

Parents are exhausted. Some of the children are a flight risk and parents have to watch them all the time. The children are awake at 4 a.m. so parents are not getting the sleep they need to be able to give the child the care they need. Some are at breaking point. What can be done to address this? It is not just about increasing staff. Even if we had a full complement of staff at the CDNT, they would not be in a position to deal with the backlog of needs.

I thank the Senator for raising this important issue, for all of her advocacy on this issue and for her determination to ensure that things improve. I assure her that this is also my determination.

The Government fully recognises the importance of providing adequate supports at the right time for children with disabilities throughout the country, including those in County Cavan. As she said, parents are exhausted and need support. That is why the HSE children’s disability services have undergone significant reform and restructuring over the past few years to provide more accessible, family-centred services for children with complex needs. Progress is being made, although I appreciate it is not being made fast enough. At the end of March 2026, 45,472 children with complex needs were receiving supports from the children’s disability network teams. This progress is also reflected in reductions in waiting lists, which fell by 28% in 2025. While this shows movement in the right direction, it is important to acknowledge that significant work remains to address waiting times and unmet needs.

In the national service plan for this year, the HSE has committed to a further 25% reduction in waiting times because at the centre of this remains a clear goal, which is to ensure that no child will wait longer than 12 months for the service they need, while also recognising that, over time, we must go even further. At the moment, many children registered with children’s disability network teams, including those on waiting lists and on open caseloads, are still waiting for some aspects of the support or services they need.

As with other areas, disability services within the Cavan-Monaghan integrated health area, IHA, are continuing to experience significant recruitment challenges, as the Senator said. We have a clear need for more qualified healthcare staff nationally and internationally. There are two CDNTs in the Cavan-Monaghan IHA. In Cavan, the HSE is the lead agency, while Enable Ireland leads the CDNT in Monaghan. At the end of May, the team in Cavan had a vacancy rate of 32%, with a total number of staff of 19.35 whole-time equivalents. At the end of May, 226 children were waitlisted for services from the CDNT, with 394 children on an open caseload. Some 264 children, and in many instances their families, received an intervention during May, with 1,003 direct and indirect supports provided to children and their families during the month. The Senator mentioned that in some cases, people were going through a course they had been on previously. I have received that feedback and I am taking it on board.

Using the available funding, the Cavan CDNT has put a number of measures in place to help manage waiting lists. That includes outsourcing assessments, where possible. As the Senator said, it includes engaging private providers in crisis cases where there are vacancies in disciplines and making temporary staffing adjustments, such as in senior or staff grade and therapy assistant roles, to maintain capacity.

I am concerned to hear the Senator describe what sounds like inefficiencies. I ask that the Senator follow up with me directly in relation to the particular example she gave. I will seek some information and clarity on that.

As the Senator said in her contribution, staffing levels have improved over the past year, allowing the team to begin to work through the longest waiters now. Recruitment remains ongoing. Agencies and local advertising are being used where needed. There are plans to re-establish student placements as capacity allows. More generally, there is a strong focus across Government on filling vacant posts across the 93 CDNTs as quickly as possible.

Additional funding has been put in place to build capacity and to reduce wait times, including the €8 million in this budget to fund a further 150 posts. This is starting to have an impact, with the HSE reporting a 28% increase in staffing nationwide between October 2023 and October 2025. That would equate to an additional 448 whole-time equivalents, and 321 of those are additional health and social care professionals. Recruitment is continuing both at home and internationally alongside wider workforce initiatives to support the long-term growth of the children’s disability network teams. The HSE will also be developing a dedicated disability workforce strategy this year to help tackle ongoing recruitment and retention challenges such as those the Senator has described. While we recognise there is more to do, there is very clear momentum, not just across the HSE but also across the Government and the HSE's funded agencies to strengthen services, grow the workforce and improve access for the children who really need it.

The Minister of State mentioned that over 45,000 children are receiving support through the CDNTs but parents have said to me that when they have been told that their child has received X number of interventions, and they know their child has not, the CDNT is counting interaction with parents. They are counting phone calls, meetings, letters.and emails. That is not intervention. I do not know who they are trying to fool by that. The parents know that the child is not getting intervention that he or she requires. While all of the interaction is required, it should not be counted as an intervention. Yes, parent training is an intervention that will help the child but other than that, it should not be the only thing. There should be more one-to-one interventions.

Another issue I want to raise is the hydrotherapy pool in the CDNT space in Enable Ireland in Cavan. It is not open to the children who are using the service. It has not been open to the children for years. I appreciate that some work was required last summer but it is now being rented out to private organisations because they have their trained attendant who can come and ensure safety at the pool. Parents have no issue with it being rented out to different groups where children need it, and it is a money raiser, but it is not open to the children because the management maintains that it does not have an attendant. When I engaged with the manager more than six months ago, she told me that the HSE had approved a business plan to employ someone but there is still no one employed. I do not how what is happening there but it really is an issue of frustration to them.

They need the one-on-one therapies for the children and they need the use of the pool. The CDNTs need to stop trying to fool people into thinking that there is more intervention with children than there is.

I thank the Senator. Perhaps the Senator will follow up with me directly in relation to the hydrotherapy and the pool. I will seek an update from HSE as to where that is at. If, as the Senator said, a business case has been approved, I will ask where recruitment is on that particular issue.

I reiterate that the Government’s commitment to strengthening services in order that adults and children with disabilities in Ireland are better supported is clear and is backed up by sustained investment in the disabilities sector. It remains a clear priority with €3.9 billion allocated to the HSE's disability services in this year’s budget. That was a €628 million increase, or a 20% increase, on funding from last year. This level of record investment recognises both the growing demand for services and the complexity of the needs being met and that need to be met. It builds on significant year-on-year investment in recent years, with overall funding for disability services having increased by 91% since 2020. Alongside this funding there is also a strong focus on people, and building and sustaining a workforce that can deliver the supports that families rely on. That is why we are preparing this year’s workforce strategy for disability services.