We are now moving to statements on disability. I call the Minister, Deputy Foley, to make her opening statement under Standing Order 55.
Disability: Statements
Gabhaim buíochas leis an gCeann Comhairle as ucht an t-am agus an deis a thabhairt dom. A change of Government often brings with it a renewed sense of optimism, an opportunity to reassess our priorities and refocus our minds on the commitments and promises that have been made both here in this Chamber as well as on the doorsteps of homes across the country. Nowhere is this more urgent than for those living with disabilities, including their families, carers and those working in the sector who, for too long, have often feel unseen and unheard by society. I am, therefore, very pleased to have the opportunity to outline key priorities that will shape the work of my Department over the next number of years, fuelled by a renewed drive and ambition to improve and enhance the services that support individuals and their families living with a disability so that they may live safe and dignified lives.
The most recent census identified that a significant proportion of the Irish population experiences disability. Public services must, therefore, be planned, delivered and maintained in a way that responds to the needs of those who use them. Delivering robust and dynamic disability services for all users in the country does not exclusively lie within my Department, but rightly requires an all-of-government response if the needs of all service users are to be properly met.
Ensuring that all Departments are not simply aware of their commitments in this space but also act upon them in a meaningful and tangible way will be a key focus of mine, as Minister, and will guide my work in the coming years. I look forward to working with my Government colleagues to ensure we achieve this.
If an all-of-government approach to the improvement of disability services is a central commitment of this Administration, then the formation of a new disability unit in the Department of An Taoiseach is crucial to ensuring we achieve an all-of-government response to service improvement and delivery. This new unit represents a step change in how the Government will respond to the disability sector in the country as a whole, ensuring there is a central focus to support co-ordination across all Departments. As Minister, I will proactively work with and support this unit in order to ensure that the Government delivers on a co-ordinated basis for those in the country with disabilities.
Enhanced service delivery across the disability sector will not be possible unless the Government ensures that there are proper resource in place to serve this ambition. Therefore, a total of €3.2 billion has been allocated for HSE disability services in budget 2025. This amounts to an 11.5% increase in funding on last year and represents an overall increase of €1.2 billion since 2020. While this is a significant increase in funding, I appreciate that there are significant pressures facing the sector. I look forward to working with key stakeholders and Members to overcome the challenges in the years ahead.
The additional funding of €333 million allocated in budget 2025 represents the largest ever increase in the disability services budget. Some €290 million has been allocated in existing-level-of-service funding, which recognises those challenges that prevail in the sector, including the increased cost of service provision, pay cost pressures and service provider sustainability. In addition, the existing-level-of-service funding will provide for the full-year cost of a new service activity and, in a departure from previous years, this funding will also include provision for service expansion in line with demographic growth. A further €39 million has been allocated for new development measures to build on the service expansion achieved in 2024.
Funding has been provided for children's services, day services, residential services, respite, personal assistance and home support hours and other supports to assist people to continue living independently in their own homes. In addition, the capital allocation for disability services will increase by €4 million to €27 million this year to support much needed infrastructure, development across respite, day services and children's services.
The HSE's national plan for 2025 sets out in more detail the specific quantities of services to be provided through this additional allocation. While I am committed to ensuring appropriate funding is available and provided to voluntary organisations to enable them to deliver quality services on an equitable basis across the country, I acknowledge that many specialist disability service providers are experiencing funding, operational and governance challenges.
The financial challenges facing the voluntary sector are highly complex and arise from both historical issues relating to funding arrangements and existing and emerging challenges including - due to the changing profile of user need - higher safety and quality standards and general demographic and inflationary pressures.
As I previously stated, the total budget for specialist disability services in 2025 is €3.24 billion. The largest share, 72%, goes to voluntary service providers. Even with significant new year-on-year funding in recent years, there is a need to better understand and ultimately address the systemic sustainability and stability challenges being experienced by disability organisations across the sector. We need to work together to understand the cost of services and, more importantly, the factors driving the costs to ensure that we can make strong data-driven cases for increased investment in the sector. This can only be achieved as a shared agenda between the Department, the HSE, and the service providers themselves. In addition, innovations in service delivery must go hand in hand with all future investment in the sector.
In that regard, the Department is progressing a programme of work with the HSE to ensure systemic learnings from the sustainability impact assessment process can be shared and, more importantly, embedded. This work can contribute to better services by optimising person-centred outcomes from existing and future resources. We are committed to working with service providers in driving these innovations.
The Department and the HSE are committed to working with key stakeholders to identify, assess and address constraints to create a more effective and sustainable disability sector. Our priority is to provide equitable access to quality services for persons with disability in line with UN Convention on Convention on the Rights of People with Disabilities, UNCRPD, commitments, delivery of the disability action plan, and the progressing disability services roadmap. We want to ensure that we support progressive improvements in the sector. Partnership with the sector will be a significant focus to ensure that the Department and the Government deliver on commitments in 2025.
I am all too aware, as are Members, of the challenges and strains facing the sector when it comes to the recruitment and retention of staff. In outlining my priorities today as Minister, I am certain that a key focus for the Government will be to fill vacancies within the 93 children's disability network teams, CDNTs. I can confirm that progress is being made in this regard, with the workforce increasing by 17% from 2023 to 2024. This represents a significant growth of 272 whole-time-equivalent staff working across children's disability network teams. We are looking to build on this progress.
In budget 2025, €2.841 million in new development measure funding has been secured to provide for additional whole-time-equivalent staff in CDNTs. However, demand for services continues to grow beyond our capacity and significant challenges remain. I acknowledge that. Therefore, innovation is key here and the Government and I are committed to building on the momentum that has been achieved in 2024. In this context, a dedicated disability workforce strategy will be developed in 2025 to meet growing service demands and address recruitment and retention challenges across specialist disability services.
A number of measures are also being progressed that are designed to attract to and retain staff on CDNTs. This is being guided by the progressing disability services roadmap. Furthermore, a cross-departmental steering group with a focus on examining blockages in the system will be re-established during my term of office and this grouping will also focus on initiatives to increase staffing. Officials in the Department will seek opportunities for service providers to share their insights with and to contribute to the work of this forum in order that it best reflects the needs of the sector.
I acknowledge there are enormous challenges accessing assessments of need and the process itself. In this regard, the Minister of State, Deputy Naughton, and I will seek to address the unacceptable delays that children and parents face. The Government will also facilitate the continuation of the assessment of need waiting list initiative, enabling the procurement of private assessments for long-waiting families. Part of this effort to improve wait times is the allocation of €10 million in funding this year to deliver approximately 2,850 assessments of need. I am very conscious that a significant body of work needs to be done in this specific area.
The programme for Government commits to doubling the number of college places available for speech and language therapists, physiotherapists, occupational therapists, dieticians, psychologists, social workers and others within this field of work. These professionals are highly sought after both nationally and internationally, with an array of career opportunities available to them and the onus is on those of us in government to ensure that we do everything we can to encourage these talented professionals into the sector.
In July 2024, the Government approved the prioritisation of funding to support the expansion of training places in priority healthcare areas. These areas include speech and language therapy, occupational therapy and physiotherapy. As Minister, I will be keenly focused on encouraging and supporting students onto these courses, helping to incentivise careers in disability services right across the sector.
A key part of this effort will be to increase the number of graduate therapists each year, which is central to meeting the needs of the disability sector as a whole. In the spirit of Government co-operation, my focus will be to ensure that we engage with the relevant Departments to support this important work throughout 2025. Additionally, encouraging students to undertake placements in the disability services is vital to increasing the overall workforce of the disability sector. This will expose more and more students to challenging, yet equally rewarding career opportunities across the sector. It will encourage them to take up careers that really matter and which have enormous positive impacts on individuals and families living with disabilities.
I am pleased to say that significant work was undertaken during 2024 to increase these student placements in CDNTs. This work resulted in increasing practice education capacity by 50%. My focus now is to ensure that we not just continue this success but further build on this momentum to ensure that we can meet our commitments this year. The more opportunities we take to showcase to students the invaluable nature of this work, then the greater benefit it is in the long term.
The voluntary sector plays an important role in the delivery of disability services across the country. I know this and I know that the Deputies know this also. Workers in the voluntary sector need to feel that the Government supports them and that it is doing what it can to help to improve pay and conditions for those who work tirelessly to support people with disabilities. The programme for Government commits to working with the voluntary sector through industrial relations mechanisms, to progress pay issues that affect the delivery of disability services and the long-term viability of organisations in the sector.
I welcomed the agreement reached at the Workplace Relations Commission, WRC, in October 2023 that resulted in an 8% increase in pay for staff in disability organisations, funded under section 39 of the Health Act 2007. However, I recognise that there is need for additional investment for workers' pay in this sector. This will help support these organisations to recruit and retain staff to deliver services on behalf of the State. In line with the October 2023 agreement, and following approval of the public sector pay deal, relevant Departments, agencies, employer representatives and unions reconvened for talks at the WRC last year. Through this process, the Department made it clear to unions that funds are available for this purpose. The talks at the WRC were paused during the general election and the subsequent talks for the formation of Government. Recognising the urgency of the situation, I brought a memo to Government last week outlining my intention to seek a return to the WRC. I am confident that this is the mechanism through which all parties can meet around the table. I look forward to the process recommencing next week.
We all know that robust policy forms the bedrock for all that Government seeks to achieve. In this spirit, I am pleased to say that the national disability strategy is at an advanced stage and that publication is expected in a matter of months. At the heart of this strategy will be a focus on cross-government collaboration, to ensure that Ireland advances the rights of those living with disabilities in line with our commitments under the United Nations Convention on the Rights of Persons with Disabilities, UNCRPD. This spirit of co-operation and collaboration extends to our local authorities, which have an important role to play in helping to improve the lives of those living with disabilities. Through my engagements with members of Disability Federation Ireland, DFI, I know that some local authorities are modelling best practice for others to follow. This includes initiatives such as that in my home county, where a beach wheelchair service provides fully adaptable wheelchairs to locals and visitors alike. This affords users the same opportunities to access the beaches in the immediate vicinity. This practice should be replicated across the country. Through the ongoing development of the national disability strategy, the vital role that local authorities play in the disability sector has emerged as a consistent theme from all those I meet in the sector. As my Department leads the finalisation of this strategy over the coming months, I know that local authorities must be involved in the development, monitoring and implementation of actions. My officials have met key counterparts in the City and County Management Association to advance these objectives and to ensure that the strategy has sufficiently local focus. At the end of the day, we must focus on the local, because this is where people live and choose to work. While acknowledging the independence of local authorities as autonomous legal entities and the challenges inherent in co-ordination across jurisdictions, the national disability strategy will look at opportunities to enhance co-ordination and to showcase examples of best practice to advance the implementation of the UNCRPD at local level. The publication and funding of this new national disability strategy is critically important to advancing the rights and improving the lives of people with disabilities and this will be an clear and early priority for me as Minister. There is such untapped potential and talent for people with disabilities in terms of employment. I note that advocacy groups have pointed out that despite the obligation to make employment more inclusive for disabled people under Article 27 of the UNCRPD, in census 2022 only 49% of disabled people were employed, compared to 71% of people without a disability and of working age. The disability employment gap is greatest for those disabled to a great extent, which is 42%, versus those disabled to some extent, which is 12%. This is why employment will be a key consideration under the national disability strategy, an area in which I want to take ambitious action to ensure that disabled people are empowered to pursue meaningful careers.
I will also be working closely with the Minister of State for Disability, Deputy Hildegarde Naughton, on delivering on the ambition of the Action Plan for Disability Services 2024-2026. We have set ambitious targets in the plan to provide for unmet need and demographic change, and I believe this ambition is important to generate commitment to the vision we have for disability services in Ireland.
To date, the Government has supported the plan with approximately €113 million in new development funding - €74 million in 2024 and €39 million in 2025, with some funding from the existing level of service, ELS, allocation also funding service expansion through provision for demographic change. However, we know that there are significant barriers to delivery, and we are keen to work with our partners to add the extra capacity which is needed and to ensure that the enabling work is in place to help the plan to succeed. This involves addressing workforce and sustainability issues, improving data collection, seeking innovative policy and service delivery solutions and finding ways to enhance the delivery of residential services so that we grow this area in a more sustainable fashion.
Respite plays a crucial role in the overall disability sector, providing much needed support to families and carers. While I know that there is high demand for respite services, we also have to look at alternative respite including in-home respite; after-school and day respite programmes; host families and summer programmes; using existing overnight respite capacity to the maximum extent and providing additional overnight respite capacity. This is ambitious but we are fortunate that a comprehensive report on the cost of disability has been completed by INDECON on behalf of the Government. Regarding respite and alternative respite, this is the view of the disability organisations I have met. They agree that we need to think outside the box regarding respite and give particular attention to the notion of alternative respite, as I have outlined. Commissioned by the Department of Social Protection and published in 2021, the report found that there is no one cost of disability, but rather a spectrum of costs varying across a number of dimensions, including age, severity of disability and household type. One advocate explained very simply to me that if you are mobile, you are warmer in your house but if you are sitting in one spot all day, you need more heat and you have higher heating bills.
This should not be as big an issue in the newly designed near-zero energy homes. We must, however, think of and prioritise people with disabilities when it comes to the State's retrofitting programme, which is funded by carbon taxes.
At EU level there are a number of positive initiatives in development, including the European disability card. In one way, this will function as a European parking card, which will be very helpful for Irish people with disabilities who wish to park in disabled access spaces abroad and for tourists with disabilities who come to visit Ireland.
I am very proud that Ireland will hold the Presidency of the Council of the EU between July and December of 2026. Planning is ongoing with the disability division to identify areas of focus for the Presidency in the specific context of disability, aligning with Ireland's domestic priorities and the priorities contained in the EU strategy for the rights of persons with disabilities from 2021 to 2030.
It is clear a renewed ambition lies at the heart of the Government's plan and approach to the disability sector. From the setting up of a new and dedicated unit in the Department of An Taoiseach to enhancements to disability service provision, I am pleased to say that people with disabilities are front and centre of our agenda and must remain so for the duration of the Government. My priority as Minister is to ensure the Government works together in a collaborative way so the needs of users, their families and their carers are properly met and sustained. Collaboration and co-operation will be the hallmark of how the Government approaches the disability sector. I truly look forward to working with everyone, including Members, to achieve a step change for people with disabilities, their families, their carers and their support workers.
I congratulate the Minister on her appointment. As my party's spokesperson on children, I look forward to working with her.
Before I begin, I take this opportunity to mention an issue I have raised a number of times regarding the recent storm and its impact on people with electric wheelchairs and those who are reliant on electric beds and certain medical devices. Unfortunately, I feel I am hitting against a brick wall. Our most vulnerable people, who were on the vulnerable customers list, were left at sea during the storm. There was no priority. There was nothing for them. Their place on the list was, frankly, irrelevant. The ESB tells me to speak to the HSE and those responsible for disability in terms of my ask for generators for people reliant on medical devices. I appeal to the Government to look at this. We can never again have a situation in this State where our most vulnerable are left totally isolated and on their own. We will have more storms. In that context and on behalf of our most vulnerable citizens, I ask that the provision of generators to those reliant on medical devices be considered by the Government. Unfortunately, it will not be considered by the ESB.
I want to focus specifically on children with disabilities and those with additional needs. Sadly and for a long time, children with additional needs in the State are being failed each day, whether as a result of waiting lists for assessments of need, primary care or CDNTs. I have met parents whose children were getting a bit of a service from the Brothers of Charity previously, but the rug was pulled entirely from them when the CDNTs came into place. In my area, it has been a real struggle to staff the teams. This is still an issue. Children have been left with nothing. They had been getting little support but now they are getting nothing. Their parents have to watch them regress and see the impact it has on their development.
We know that for any child being on waiting list is detrimental to their development and to their well-being. We have more than 13,000 children on waiting lists. Children are waiting for first contact from CDNTs. More than 9,000 of them have been waiting for a year. Similarly, there are record levels with regard to waiting lists for assessments of need, with more than 14,000 children currently waiting. More and more parents are struggling. They are battling the State and taking legal action against it. This is totally avoidable. We need the Government to give serious priority to and to take action on reducing these waiting lists.
I want to raise a recent communication from the HSE that came to my attention last week. This was a communication to parents whose children are on the waiting list for assessments of need. This letter asked the parents to let the HSE know if they still want to remain on the waiting list and stated that if it did not hear from them by a certain date, they would be removed from it. Parents have enough to deal with, particularly when they have children with additional needs and when everything in the State is a battle, whether it is in the context of education, therapies or access to supports. I wrote to the Minister and to the Minister for Health asking them to make sure that no child is removed from the waiting list because a parent did not respond to a communication from the HSE. It would be great to see the HSE put effort into tackling the waiting lists rather than, as we have seen previously, trying to find ways around the legislation and the six-month requirement and, now, putting it back on parents by stating if it does not hear from them, they will be removed from the waiting list. It is not acceptable and it is not the way that parents should be treated.
Recently, I was made aware that child and adolescent mental health services, CAMHS, do not accept private assessments when it comes to accessing supports. I know of parents have paid for private assessments, even though they did not have the money, and who then went to CAMHS. In a particular case, a child was diagnosed with attention deficit hyperactivity disorder and CAMHS said that supports could not be provided because the diagnosis was made on the basis of a private assessment. When parents opt for private assessments, we have to have a bit of leniency and make sure they can get supports on the back of that those assessments, particularly where they have been waiting too long on the public list.
There are major issues more widely in counties Roscommon and Galway with regard to respite. I received an email from a parent on respite. The tagline was "respite plea". Parents are begging for support in terms of respite waiting lists in Roscommon and Galway. I would like to see moves on respite and care for parents.
Táim ag labhairt inniu chun an frustrachas agus an fearg domhanda a léiriú ar son teaghlaigh i gCill Dara Theas agus fud fad na tíre atá tréigthe ag an Rialtas seo maidir le leanaí le riachtanais bhreise. Faoi láthair i mo Dháilcheantar féin, tá tuismitheoirí trína chéile toisc nach féidir leo áit dá bpáistí a fháil i scoil speisialta nó fiú áit i rang speisialta i scoil príomhshrutha. Deirtear leo go gcuirfear ar liosta feithimh iad nó nach bhfuil aon spásanna nó acmhainní ar fáil, nó plean i bhfeidhm. Is cúis náire é seo.
Ní stopann sé ansin. Tá na mílte páistí i gCill Dara Theas sáite ar liostaí feithimh le haghaidh measúnú ar riachtanais AON atá de cheart acu faoin Acht um Míchumas, 2005. Ba mhaith liom a bheith an-soiléir; ní hamháin go bhfuil sé seo ina mhoill - is diúltiú ar chearta oideachais, tacaíochta agus todhchaí é seo.
Tá tuismitheoirí á n-íobairt lá i ndiaidh lae; ag scríobh litreacha, ag cur glaochanna agus ag impí ar an HSE, scoileanna agus na hAirí díreach chun oideachas oiriúnach a fháil dá bpáistí, rud atá de cheart acu agus atá na páistí i dteideal. Tá siad traochta. Mothaíonn siad gur lig an Rialtas síos iad. Cad atá le fáil ón Rialtas ach níos mó geallúintí folmha agus níos mó moill? Níl an t-am ag leanaí le riachtanais breise fanacht na blianta ar son tacaíocht. Tá cabhair agus seirbhísí de dhíth orthu anois.
Freisin, tá an íocaíocht de réir tástáil acmhainne don liúntas cúramóra míchothrom agus cruálach. Cuireann sé pionós ar dhaoine atá ag tabhairt suas gach rud chun aire a thabhairt dá mhuintir, ag sábháil na billiún don Stát chun tabhairt faoi droch-chás airgeadais agus téip dhearg. Táim tar éis labhairt le cúramóirí i gCill Dara Theas atá ag streachailt chun bia a chur ar an mbord atá ag troid chun gach euro atá acu a choimeád; go simplí toisc go bhfuil a chomhpháirtí ag tuilleamh díreach os cionn an teorainn. Seo iad na daoine atá ag obair 24-7 gan phá ag déanamh obair na seirbhísí sláinte, agus conas a déileálann an Rialtas leo? Le measúnú ar acmhainní míchothrom agus bacainní maidir le tacaíochta.
Tá Sinn Féin soiléir; ba cheart go mbeadh muid ag tacú le cúramóirí in ionad pionós a ghearradh orthu. Caithfear deireadh a chur leis an measúnú seo chun córas níos cothroma a chur i bhfeidhm. Is iad na daoine seo cnámh droma an phobail agus tá sé in am caitheamh i gceart leo; leis an dínit atá tuilte acu.
The means test for family carers is nothing short of cruel. It punishes those who give up everything to care for their loved ones, saving the State billions of euro only to be met with financial hardship and red tape. I have spoken to carers in Kildare South who are struggling to keep food on the table and who are forced to fight for every euro simply because their partners earn just above the threshold. These are the people working 24-7, unpaid, doing the work that our health service should be doing, and how does the Government repay them? With unfair means-testing and barriers to support. Sinn Féin is clear. Carers should be supported, not penalised. The means test must be scrapped, and a fairer system put in place. These people are the backbone of our communities, and it is time to treat them with the dignity they deserve.
The failures in disability services in providing supports and services and dignity for people with disabilities is Ireland's great shame. It is a shameful disgrace, and it is a disgrace that lies on the shoulders of successive Governments. I listened to a very powerful testimony from a couple from Dublin on the "Oliver Callan" show on Friday. They talked about how they were advised to get out of Ireland. I have personal family experience where that is exactly what they did - they went to Belgium. My nephew's mum is from Belgium. She fought with the system here. They lived in Waterford and fought for years until he was 12 or 13 years of age, then left and went to Belgium and overnight that child's - my nephew Dylan - experience was transformed. It is a shameful disgrace. It should not be this way. We can talk about policy, and we can talk about plans for the future, but the reality is that we should not be in this place to start with.
I can talk and produce figures. One feels incompetent and impotent as a public representative because all we are doing is tracking failure. Every six months, I can stand up in the Chamber and I can go on LMFM Radio and talk about how the promised posts are not filled, how 40% of CDNT posts in County Meath are not filled and how the waiting list is increasing to the point that 700 children in the county are waiting for a first CDNT appointment. Every one of those is a precious child with huge potential, and that potential is being stymied by the systemic failure of our Government and State agencies to provide for them. It is a damning indictment, and something has to be done. The Minister talked about a new Government and new potential and opportunity. Words count for nothing as far as I am concerned. What we need to see here is delivery. For my part and I am sure that of my party, we will do everything to fight this corner and make sure that progress is made. The Minister will have a willing partner if she is up for delivering that. Time will tell, however. There is a huge need for increasing capacity for additional training places, which she mentioned, as well as a job guarantee, which is something Sinn Féin has committed to, and pay parity. How are we still awaiting pay parity? I meet with representatives from Enable Ireland in Dunshaughlin, for example. It is immediately obvious that part of the reason they cannot get staff is, first, pay parity and, second, workers cannot afford houses in the area. It has to change. Many precious children are depending on it. I have not mentioned adults, but it is the same for them.
I wish both the Leas-Cheann Comhairle and Minister all the best in their new respective roles.
In her opening remarks, the Minister referred to a renewed sense of optimism. That optimism really not shared by people with disabilities in my constituency because they are living with the consequences of the policies of the Government parties and their attitude to persons with disabilities. They tell me that they are close to losing hope. With the greatest of respect, the Minister's remarks are not going to do much to restore that hope for them. We have a situation whereby, effectively, the people themselves are not disabled; society disables them. They are disabled by the fact that they cannot live full lives. They cannot thrive or reach their potential because there are barriers in their way. There is one very small example, which I have raised several times, that really sums up the situation for me. A person living with a disability who lives along the train line in, say, north county Dublin, has to inform Irish Rail 24 hours in advance if he or she is a wheelchair user and wants to use the train. I mean, come on, Minister; it is 2025. If that is not infantilising behaviour, I do not know what is. People must know 24 hours in advance. How are people supposed to hold down a job? How are people supposed to respond to the needs of everyday living if they need to know 24 hours in advance if they are going to need to use the train? It is beyond ridiculous.
The Minister also spoke about the need to focus on recruitment for section 39 agencies, but she did not use the word "parity". She recognised that there is an issue with pay, but she did not use the word "parity". Before I came into the House, I was a full-time union organiser and I happened to be a member of the public services committee of the Irish Congress of Trade Unions, ICTU. When Brendan Howlin was Minister for Public Expenditure and Reform at the time and was absolutely decimating, and I mean seriously kicking the living daylights out of, the section 39 sector, we could see that unless there was a pathway back for those people to pay restoration, which was not forthcoming from the Government - I can tell the Minister that because I was in those rooms - they would fall behind and they have. Therefore, the mistakes that were made by the Fine Gael-Labour Government are still being paid for now by people with disabilities. The Minister said that talks are ongoing at the WRC. I welcome that, but I have attended those talks so unless there are people from her Department at senior level who are empowered to take decisions, those talks will fail as talks have previously failed. They need finance. They need senior decision-makers. The unions are absolutely up for the negotiation. The people who depend on the services absolutely need it. What we need from the Minister and the Government is to give the negotiators the wherewithal to resolve this and a path to parity for section 39 and other workers.
I congratulate the Leas-Cheann Comhairle on his new role and wish him the very best. I also congratulate the Minister on her new role. As Labour Party spokesperson on children and disabilities, I look forward to working with her constructively during this term. I thank her for her engagement to date. Obviously, the waiting lists referred to in this debate are something we have to tackle, and that Government especially has to tackle because behind every one of those numbers on the waiting list is a family and somebody who needs help. They are the people who we have to help. As I said, I look forward to engaging with the Minister over the next period.
The first area I want to speak about today is employment, which the Minister referenced. As she said, according to the census of 2022, only 49% of people with disabilities of working age in Ireland are in employment. That is compared to almost 71% of those without disabilities. That is a shocking disability employment gap of 21.5%. Among disabled people, the unemployment rate is higher among people with an intellectual disability at almost 30%. I cannot begin to tell the Minister the number of times mothers and fathers of adult children have contacted me to highlight this, and I am sure it is the same in her office. She stated in her contribution that the new national disability strategy is an early priority for her and a key strategy as well. However, we are still talking about a matter of months before it will be published. We really need to see something as regards employment in that strategy. I look forward to engaging with the Minister on it. As she said, it will be a very important document, but it will be an important document for all those who need help at this stage regarding employment.
The second issue I want to raise relates to Sensational Kids, which is in my area of Kildare South. I recently met with the CEO of Sensational Kids, Ms Karen Leigh, who brought me around the national child development centre they propose to build in Kildare town, which is to be a state-of-the-art facility to support more than 300 children per week and provide 13,000 therapy sessions annually that children with additional needs so desperately need. That includes occupational therapy, OT, speech and language and psychological assessments.
There are already more than 2,000 children waiting for this new facility to open, 90% of whom are on HSE waiting lists. As the Minister knows, that is still in blocks in Kildare town, which is a disgrace. The development has come to an abrupt halt due to the withholding of funding from the Department of Justice through the immigrant investor programme. I ask the Minister to work with her colleagues to ensure this national child development centre is built as quickly as possible in Kildare town. I understand that a capital investment application has been made to the HSE. This project needs to get off the ground. The centre is needed by so many people, not just in Kildare South but throughout the State. I ask the Minister and her colleagues, on behalf of the children and families who need their help most, that they provide this help in the quickest possible time.
In the Seanad, I raised the issue of assessment of need in my own area of CHO 7 time and time again. There are currently 4,272 children waiting for an assessment of need for more than one year while 1,103 are waiting between six and 12 months. As if children are not waiting long enough, the average time for the CDNT waiting list is more than three years in CHO 7. The term used time and time again regarding these children is “early intervention”. By not providing early intervention, we are missing a key opportunity to support children during their development, risking further developmental issues and indeed pain for their family. We have all heard of families paying massive amounts for private assessment and therapies. The programme for Government provides a commitment for a children’s therapies grant fund for evidence-based therapies. Is this something that parents can apply for to fund private therapies? It would be a very welcome measure for many families. It will have come too late for some but would be very welcome for others, given the many thousands of euro that many families are committed to paying already.
I also wanted to touch on transport. It is an issue other colleagues have raised. There are ongoing issues in accessing transport for people who have disabilities. One of the biggest barriers is to those in rural areas. I welcome the fact that Rural Link services are making a difference. We need to see more of them. In Suncroft, County Kildare, a new Rural Link route is being proposed to deliver six services a day. I am dealing with people with disabilities for whom this would be life changing because they could access the bigger towns like Newbridge, the train stations and so on. The issues of rural transport are connected with disability issues. I hope the Minister will work with us to ensure that these services can happen for those who need them most.
I spoke the last day about special schools, which have been mentioned today. In Kildare South we have an issue around a special school that was promised by the Minister when she was Minister for Education. She said it would be located in the constituency during a Seanad debate. It is currently located in Naas in Kildare North. There are ambitions for that school to be located in Kildare South. When I questioned the Minister on it, she stated that the need was actually in Kildare South rather than in Naas where the school is currently located. I ask her to work with me once again to ensure that the school can be located in Kildare South. It is already full and is doing great work. I wish the management and staff well. However, we need a school that is functioning and has places in Kildare South, where, as the Minister identified when she was Minister for Education, there is a need for a special school.
The Minister mentioned the voluntary sector and the section 39 workers. We all know in this House that without section 39 workers, the disability sector would fall down. I welcome the fact that she has mentioned additional pay for those workers and look forward to engaging with her to ensure that section 39 workers get the pay they deserve. Finally, as a member of the Oireachtas autism committee, the cost of disability was something we discussed time and time again. There are varying costs associated with disability, as the Minister said. It is something we need to get hold of and the Government needs to address. I will discuss it with the Minister over the coming months and years to ensure the cost of disability is recognised by Government and those who need payments actually get the payments they deserve.
I wish the Minister well in her new role. When it comes to children with additional needs in this country, the word that appears in almost every single conversation is “wait”. There are waiting lists to be assessed of three to four years in my own area; waiting lists then for the therapies and supports of another three years; and waiting for a place in a school because God forbid there would be a straightforward system in place to match children with additional needs with the places that exist. When the children do get a place, there is a further wait to have the health services and education system talk to each other so basic services like assistive technology can be put in place. I am aware of one case of a 13-year-old boy who had to wait approximately 15 months for assistive technology in his secondary school, even though the health service and the education services had known since the boy was three about the extent of his needs.
For the thousands of families out there who are going through this daily torture of having to fight tooth and nail for their child, they do not want to hear sympathy from us; they want action. Some 18 months ago, the Government announced six regional assessment teams to try to bring down the huge numbers waiting for assessment of need, in light of the breach of the six-month legislative requirement for the assessment. We were told these would be publicly funded, not privately funded, and that they would be run by the HSE. By now we were to have 60 AON hubs. I am hearing that in my own area, in IHA Dublin north county and Dublin north city and west, there is no longer any HSE assessment of need team. We know that the figures in that area are going up, not down. There are 2,890 waiting for first contact from a disability team, which is up from the previous figures of 2,779. What is happening? We know the figures right across the country are going up, not down. I welcome what the Minister said about plans relating to graduate recruitment. However, we are hearing nothing about retention, which is the critical issue within our CDNTs across the country. Staff in CDNTs tell me that the teams cannot recruit directly, the national panel does not work and they cannot access flexible or part-time work arrangements. Many of them are burned out because of the chilling effect of the pay and numbers strategy. Too many are telling me of the enormous strain and toll of knowing that far too many children are waiting. We all know that weeks and months matter in a child’s life.
I am particularly pleased to a former Minister for Education is now in this role as Minister with responsibility for children and disability. When she was Minister for Education, the Department oversaw a situation where schools with preschools were forced to end their licences to make way for special classes. We all welcome special classes, but the impact was that children who were in receipt of AIMS support overnight had nothing. There was no communication between the Department of Education and the Department of children. That has to change. That is my appeal to the Minister today.
As it is my first time speaking in the Chamber, I ask the Ceann Comhairle to indulge me a moment as I thank the people of Togher, Dunleer, Ardee, Drogheda, Dundalk, Termonfeckin, the peninsula up in the north side of the county, and of course the constituents in east Meath for the faith they have placed in me and their trust that I will represent them to the best of my ability. I would like to reassure them for the time that I am in this Dáil that I will always represent them as true as I possibly can. I will be proud and always very, very Louth.
As the Minister knows, Louth is the most densely populated county in the country after Dublin. We have a dire lack of OT services. The queues and waiting times for speech and language therapy, have gone from months into years, as many of colleagues have said. I recently spoke to a mother of a son with ASD and a series of complex issues. She is spending between €500 and €600 each month on the various therapies that she requires for him. That is before the cost of petrol, time off and any of the additional things she needs for her son. It is also before she tends to the care of her other two children. This is nothing new and we are well aware of it. I welcome the Minister's statements and the plan for Government to address these issues. Funnily enough, the biggest question this mother has as she is running from pillar to post is: "What happens if something happens to me?" What happens when she is gone? While we have very long waiting times and while in County Louth, we need a whole series of additional services, what strikes me is the lack of community services for when these young children become young adults and fully fledged adults in later life.
I recently visited Rehab with the Minister of State, Deputy Naughton, and we spoke to many of the users there. I would invite anyone to go down and visit at any stage because they really put a pep in your step and fill your hearts with joy. The fact of the matter is without these community services we cannot guarantee that these people will not inappropriately or prematurely end up in nursing homes. Can we ensure that these people will never finish up inappropriately in nursing homes?
I welcome the opportunity to examine the disability policy and support for people living with disabilities and their families. Improving the rights of and support for people living with a disability is a priority for me and the new Government. I wish the Minister, Deputy Norma Foley, well in her role; I worked closely with her in her role as Minister for Education. I know at first-hand her commitment and dedication to improving the lives of others, particularly vulnerable citizens. I look forward to the finalisation and publication of the new national disability strategy, which will set out Government priorities up to 2030. I welcome the Minister’s commitment to a whole-of-government approach to advance the long overdue implementation of the optional protocol to the UN Convention on the Rights of Persons with Disabilities.
I turn to my constituency of Dún Laoghaire. I acknowledge the great work being done by people working for service providers such as St. John of God and also everyone working in school communities across my area. However, greater supports need to be provided to these front-line workers. We also need to see movement on waiting lists for assessments and therapies. They are far too long and this is having an impact on children and their families.
Finally, I would like to raise the need to increase capital budgets to provide more dedicated residential care settings. The problem is particularly acute in south County Dublin because there is a cluster of families living in the close confines of service providers.
I wish the Minister and her officials well as they go about their important work over the coming term.
I congratulate the Minister on her new post. Like Deputy Devlin, I worked with her for many years when she was in charge of education. I just hope she can bring some of the energy and hard work she showed there. She was not afraid to make hard decisions when they needed to be made. I hope she brings that to this Department because it is very much needed.
I listened to the Minister's opening statement in my office. She spoke about workforce strategies and how she would try to tackle the recruitment problems. Fundamentally we need to reflect on why we are failing to attract staff into HSE disability services in particular and why we are struggling to retain them. A period of reflection is required to ask those pertinent questions when the Minister goes about the work of trying to fill those gaps. In the last estimate, my CHO had a vacancy rate of between 50% and 60%, which is intolerable.
My second point is on service level agreements. In the majority of large providers particularly in Cork - this is probably true in the rest of the country - SLAs have not been signed for 2025. How can particularly the larger providers recruit? As Deputy Devlin mentioned, how do they plan for capital projects if SLAs have not been signed for 2025? It is nearly March. It is critical for the Minister to take that away from this evening's statements. She needs to speak to her officials to progress those SLAs and get them signed.
My third point is on waiting lists. Other Deputies have mentioned OTs and SLTs. I recently received a response to a parliamentary question on psychology waiting lists for children and adolescents. In my CHO, in the area of Cork north Lee 435 children and adolescents were on the waiting list in 2020. We had 1,905 in 2024. We can attend all the public meetings we want, we can deal with parents at our clinics and we can deal with the special schools in particular, but fundamentally we are clearly going in the wrong direction. I genuinely hope in the term ahead the Minister can at least halt that increase in waiting lists.
I am not sure if she visited the Rainbow Club in the past. When Senator Rabbitte was Minister of State with responsibility for disabilities, she visited it on a number of occasions. It provides autism support for more than 1,300 children. Cork City Council recently disposed of a former HSE building and provided it to the club on a short-term lease with a view to extending it in the future. We are now looking to make it the Rainbow Club's home. It will require massive capital investment. Capital investment has been provided to other providers. The Minister might sit down with the Rainbow Club in the near future to discuss those plans.
I want to raise the issue that is central to this problem, which is the bureaucracy of the three sectors: the HSE, the disability sector and housing. That is preventing initiatives from being taken and preventing staff from being employed. Kilkenny SOS provides a fantastic service. It is at the cutting edge of developments in this area. It has been left short €500,000 since 2013-14. It was given its figure for 2025 and it is forecast to be short by €1.5 million by the end of the year. Kilkenny SOS cannot get the HSE to proactively work with it because even though it is proactive, the HSE seems to be just reactive. It is not giving the priority 1 and priority 2 cases to this organisation to allow them to take up independent living in their own houses.
I ask for an intervention that would bring together housing, the HSE and the disability sector with a budget and a decision-making role so that with those initiatives that are being taken, the group could make an allocation of money and could make a decision on what is being asked for, and could take the word of the service providers, which are at their wits' end because of what is going on and because of the delays in question. It appears that the HSE is almost afraid to make a decision on the staffing of some of these homes and that has to change. Whatever our grand plan for the future is, it will be impossible to implement it if all of the actors representing the State do not come together and deliver to those service providers that are recognised and are doing the job properly.
There is a house in The Sycamores in Kilkenny prepared and ready for respite, run by Kilkenny SOS. As yet, there is no agreement on how that might proceed. There is a huge problem here. I wish the Minister well in what she is doing. It is a job in which she can introduce much reform that would benefit everyone. I urge her to do it sooner rather than later.
I want to raise with Minister two cases of two autistic boys from Waterford, one is six years of age and one is five years of age. Tiernan Power Murphy is a six-year-old boy from Waterford who urgently needs dental surgery. Tiernan is autistic, has been experiencing severe pain and needs three teeth removed. Given Tiernan's specific needs, the procedure must be carried out under general anaesthetic which, as the Minister knows, is not unusual for autistic children. Tiernan's parents have been told that the waiting list is approximately ten years. The family's only alternative is to find private treatment, which could cost them €2,500. This is unacceptable for any family not least a family with an autistic child. The family are already facing significant stress and they are being asked to fork out thousands of euro for a health service that should be available from the HSE or leave their little boy in pain for months if not years.
This situation highlights just one of the many challenges that families of children with autism face when it comes to securing timely basic urgent healthcare. I am appealing to the Minister; I wrote directly to the head of the HSE and the Minister for Health for Tiernan's case to be prioritised. More than that, a proper solution needs to be put in place for the children so they can get access to timely care without upfront costs.
Today I received an email from the parent of a child called Jodie who will turn five in September. He was diagnosed with autism a few months ago. His mother submitted applications to every school in the Tramore, Waterford city and Kilmeaden area - ten schools in total. They received their final rejection letter last week.
Jodie's mother Becky said:
To say that I am heartbroken would be an understatement. This should be a joyous time for our family as we prepare for Jodie's transition into junior infants. Instead, we are devasted and heartbroken that our son has no place for September, which is his constitutional right. This situation is taking a significant emotional toll on me in particular, and the entire family.
Jodie is thriving due to the support his parents have provided, with little help, they say, from the State. They are paying privately for his therapies. This places a considerable financial strain on the family. Like many others, they have not even had initial contact from Jodie's children's disability network team for speech and language or occupational therapy. Becky says that she is “at a loss as to what steps to take next”. She says Jodie is a lovely and happy child attending a mainstream class but an SNA is not a viable option. His autism report strongly recommends a special class. There are numerous reports of children regressing if they are not placed in the appropriate setting. As Members know, we moved a motion on this issue last week which the Government rejected.
I thank the Deputy. Before moving on to the next slot, I am sure Deputy Cullinane has permission from the parents to use the names of minors. It is important to be cautious where minors are concerned. That remark is for everybody to note.
I call Deputy Liam Quaid who is sharing time with Deputy Aidan Farrelly.
I raise the human rights issue of adults under 65 with an intellectual disability or acquired brain injury who end up living in nursing homes or who find themselves stranded in psychiatric wards due to a lack of community-based supports. This is a desperately sad situation and another example of how much distance is opening up between our economic prosperity, on one hand, and the vindication of our disabled citizens' basic rights, on the other.
In May last year, there were in excess of 1,200 with disabilities living in nursing homes. The Ombudsman, Ger Deering, has warned that Ireland will look back with regret at how it treated these citizens. His office has authored a report on their plight, poignantly titled Wasted Lives. Mr. Deering has appealed to the new Government to include improved funding for the HSE to relocate these young people. He said he is "deeply unhappy" with the funding allocated in budget 2025, warning that a huge amount of work implementing the recommendations of the Wasted Lives report may now be in jeopardy. He noted that there needs to be a separate budget to help to relocate people who have been misplaced in nursing homes.
The findings from a 2018 study by the Disability Federation of Ireland showed that some younger people with disabilities were being placed in nursing homes as a result of the breakdown in family care arrangements. This might, for instance, involve an ageing parent or the decline in the health of a family carer, rather than because of the disability itself. When a community-based rehabilitation and residential placement becomes fragmented, underdeveloped or under-resourced, nursing home care may be the only option for some younger people with disabilities. It was clear from this study that several of the applicants would have preferred to return home. Others expressed a preference for living in more supportive accommodation or moving to an independent-living, community-based placement. Nursing homes were also being used for temporary care for people awaiting a placement in the National Rehabilitation Hospital.
I had the good fortune of working with the Peter Bradley Foundation, now known as Acquired Brain Injury Ireland, in Glenageary in my 20s. The organisation provides community living and rehabilitation for people with an acquired brain injury who would otherwise have ended up in nursing homes. It has transformed the lives of many service users throughout the country. Yet, so many people referred to ABI Ireland have to be told that their residential placements are massively oversubscribed and they have no prospect of being placed in one.
Adults diagnosed with a mild intellectual disability who also experience mental health difficulties are further neglected within our system. Those who are most in need of intensive support and residential care often fall between services and can spend prolonged or even indefinite periods of time misplaced in psychiatric settings. In this context, their psychological state and behaviours can deteriorate. In the absence of tailored supports, they may be over-medicated as a means of managing their distress and unsettled behaviour. There can be an intensive concentration of staff supports during the psychiatric admissions. However, because the setting is unsuitable a lack of improvement or even a sharp deterioration in the person's psychological state occurs and nursing homes may become the only placement option. This is a psychological and social dead end for people who may be quite young with considerable potential for rehabilitation.
People with an intellectual disability who are living in the community without family supports can be extremely vulnerable, at risk of sexual and financial exploitation and associated health consequences. They are sometimes linked with mental health teams that are ill-equipped to protect them from predatory behaviour. They should be able to avail of long-term specialised residential care in the community. They should be able to live somewhere they can call home, where they can feel safe, form healthy relationships and pursue meaningful goals. They should be fully supported to take part in their local community. If the UNCRPD is to mean anything, we need to see the kind of investment commitment that can put an end to this shameful situation.
I will come back to the Minister on the following area in more detail at a later stage but I want to mention the importance of recognising foetal alcohol spectrum disorders as a disability and to progress with standard criteria for diagnosis and supports. Foetal alcohol spectrum disorders are estimated to affect up to 7.4% of the population and are associated with lasting physical, mental, educational, social and behavioural difficulties. They are a serious neurodevelopmental condition and there is a great deal of work to be done in prevention, diagnosis, treatment and supports. The former Minister of State, Deputy Anne Rabbitte, committed to supporting the aims of FASD Ireland and I hope the current Government will honour that.
I wish the Minister well in her new brief. It has been a privilege to sit here and listen to input from Deputies from across the Chamber this evening. I do not think that will come as a surprise to any us. We have learned enough in recent years to have a good understanding of the lived experience of people with disabilities in the main. What people with disabilities do not in fact need is Members pretending here that we are about to take action when we are not seeing ample action. People with disabilities have incredible agency and ability to talk, advocate, self-advocate and live self-determined lives, if only the systems of the State could facilitate that. That is why I am glad of the opportunity to contribute.
I was a social care worker in some wonderful organisations in counties Kildare and Dublin for many years. The last one was the Walkinstown Association for People with an Intellectual Disability, WALK, where I got a chance to share in some of those self-determined lives with people who were phenomenal. Whether it is children, young people or adults, the themes are resilience, fighting spirit and an ability to contest some of the social norms and practices they probably should not have to contest. They find themselves in situations where they or their families have to fight for some of those basic services and requirements.
The Minister, Deputy Foley, has inherited a monumental task. We sincerely wish her the best in achieving that because the state of play right now is unacceptable when it comes to the intersectionality of the issues facing people with disabilities. If there is a housing crisis, we can be sure that the housing crisis facing people with disabilities is even worse. If there is an education crisis, again that can be expected to manifest itself in a very challenging way for people with disabilities. We know that for every crisis we have in society, such as transport and employment, it has double the impact on people with disabilities. In electoral politics we have seen recently published research which shows that the challenges facing candidates with disabilities are even worse than for those without disabilities.
The Social Democrats put forward policy positions. We have all done so at different points, as has the programme for Government. The new strategy presents the opportunity to fulfil some of those issues but it goes back to my opening point. We do not speak on behalf of people with disabilities. It can start with a meaningful listening exercise to understand, hear from and empower people with disabilities to ensure they are treated with dignity and respect. We want to ensure that in every facet of life they can live fulfilled and self-determined lives. I sincerely wish the Minister the best in that.
The Minister will be aware that there is an enormous need for carers to look after our senior citizens, children and disabled people in the home. Being subject to a means test is an obstacle to bringing carers into the system. Does the Minister agree that a means test in this situation serves no purpose and should be dispensed with as soon as possible?
I am aware that doing so is included in the programme for Government. That is very welcome.
Carers are an invaluable resource to the State and therefore need to be protected and encouraged. Can we ensure that this protection and support and encouragement are provided to carers with the dropping of the means test? In conjunction with our carers, are we committed to employing many more district nurses, for which there are many vacancies in north, south, east and west Kerry? Home carers, district nurses, home helps and respite care are all vital parts of having our health service delivered partly at home. We must finance provision of these services as this system suits patients being at home where they want to be. It is also cheaper and easier to deliver for the State.
We should also drop means testing for disabled person's grants and mobility aid grants. I welcome and acknowledge the recent improvements in this area. I can confirm, for example, that in County Kerry there were only four cases that were over the income threshold last year. I am aware of a case in Killarney whereby a family was shot down for a stairlift. Under the recent changes, they qualified for a grant of €2,150 or approximately 40% of the total cost of the stairlift. The family in question informed me that it was the first time ever they had received any assistance. They have been fighting for services and equipment for their son all their lives. People in such circumstances deserve assistance and getting rid of means testing will be one small way of helping them.
I thank the Ministers of State for being in attendance. I wish them both well in their briefs. I also wish the Minister, Deputy Foley, well in her brief. One of the things I urge all three of them to do is to listen to parents of disabled children, engage with parent support groups in every constituency and listen to their lived experience. One of the big issues we see throughout the country is that what the CDNT service says it is delivering and how the parents of the children receiving those services feel they are getting are miles apart. For the Taoiseach to make the statement he made the other day that the CDNT is a service that is not working is a significant statement to make. One of the requests I have of the Minister and Ministers of State is to inquire whether the HSE will carry out a root-and-branch review of every CDNT service in the country to hear from parents who are lucky enough that their children are in the service. We all know the challenges for the parents of children who are awaiting the outcome of the assessment of need to get into the service. If a child gets into the service, regrettably the child in many cases does not get the kind of service he or she needs to progress in life developmentally. That is one request I have.
If I think of my own constituency, Neurodiversity Ireland largely covers the Sandymount area, Involve Autism covers Dublin 6W and the Terenure-Rathgar area while Irishtown, Ringsend and Pearse Street are covered by the neurodiversity, NIRP, group. When one engages with parent support groups, what one learns from speaking to them is that they are banding together to support parents of children with a disability. Often, the services these groups offer in getting access to occupational therapists and speech and language therapy supports at schools are superior to the services that people are getting through the CDNT service. This school-led approach is a very good one. I support it, but we need significant changes in the CDNTs. I hope the Government will request that of the HSE.
I wish the Minister, Deputy Foley, well in her new portfolio. I thank the Ministers of State for coming to the Chamber today.
Tackling the deficiencies in disability services is a significant challenge. It is imperative that all of us, as elected representatives, collaborate with the Minister and Ministers of State to bring about much-needed transformation in disability services. In the short time I have, I will focus on my constituency of Dublin Fingal West, which falls under CHO 9. I highlight that the two CDNTs which my constituents are referred to, Balbriggan and Swords, have, by some distance, the longest waiting lists in CHO 9, with a combined figure of 1,045 children awaiting assessment. As their TD, I feel a profound duty to advocate, not only for the children who are awaiting assessment, but also for their families and those working in the Balbriggan and Swords CDNTs. Children and their families have been waiting for up to four years for an initial assessment, with no indication as to when they might receive the essential supports and therapies that they so desperately need. This delay not only exacerbates the children's issues due to a lack of timely intervention but also creates extreme stress and worry for their families, as well as leading to a challenging environment for the dedicated professionals working in both the Balbriggan and Swords CDNTs. Without access to a CDNT, families are being forced to search for private supports and therapies. This can compound the stress and anxiety felt by parents who are trying to support their disabled child, not to mention the financial impact it has on their family.
Balbriggan is the youngest large town in Ireland, and Fingal West is rapidly growing. The demand for CDNT services will continue to intensify as the population increases. Balbriggan and Swords CDNTs need to be prioritised, the open vacancies fully filled and the waiting list reduced. Families and children have endured systemic failures for far too long. The time for change is now. I welcome any opportunity to support the Ministers to deliver the disability services which are needed.
I, too, wish the Ministers of State well in their roles. It is not an easy task, as I think we all accept.
The Taoiseach is on record as saying that disability services will be the defining issue for this Government. I think it will be. We all faced a general election recently, and I would not say I was surprised by the extent to which the issue of disabilities, services and lack thereof came up but it was certainly striking. Many of the stories we heard were heartbreaking in terms of individual families and the battles they have faced in trying to get some degree of service for their loved ones. They are battling to get assessments, initially, and then, once assessments are done, battling to get supports and services, school places, school transport and so on. It is a constant battle and fight for many families. This simply is not good enough.
I know the issue of respite was raised earlier. I fully support that. Many families are at their wits' end trying to care for their loved ones. They need a break. Respite services are simply not adequate. We need to radically improve them and provide the resources necessary in order that families can have a break from the care and love they give their loved ones.
Deputy Michael Cahill raised the issue of adaptation grants. Having been a councillor for many years, I worked with and assisted families in securing these grants and advising them on making applications. The issue of the means test needs to be looked at. It places an unnecessary burden on families with the application process. I would like to see an estimate of how much it would cost the State to abolish the means test. It would be a good investment and one we should look at.
Successive Governments have failed on the issue of disabilities by simply not providing enough resources or supports to families and individuals. We need short-term strategies to address the deficit but we also need a long-term plan. We do not want to find ourselves here debating the same issues in five or ten years. We need a clear, long-term plan to address this issue. It is obvious to me that the training and places available for training therapists and other professionals in this area need to be looked at and radically increased.
I wish the Minister of State and the Minister, Deputy Foley, the best in their new roles.
I listened to the Minister's opening speech a while ago and to many of the Deputies. I will cut straight to the chase, hoping that one of them might be able to assist me. I have been working with someone who is now a young woman, but was a child when we started this.
Her mother wrote to me and said:
I am a mum to an 18 year old lady with cerebral palsy. She also has a dysplastic hip, retroverted pelvis, twisted femur and autism...Katie has a dysplastic hip since she was 4 years old and we brought her to the Paley institute in Poland to meet Dr. Dror Paley, who following his examination told us that Katie's pelvis is retroverted and the ball that should be in the socket is now 50% [dislocated].
She goes on to say that Katie had spinal surgery in 2014 which released the spasticity from her body that had her in pain every day and allowed her to walk independently for the first time in her life when she was seven years old. We have been working on this for a long time. We are in a situation where Katie has gone through the whole child system, since she was four years of age. She is now 17, nearly 18. She has been waiting for surgery for 14 or 15 years. We have been in constant contact with services and we have been told by the HSE that there are surgeons in Ireland who are available to do this surgery, but this has been going on for 14 years. There is a lack of responsibility or accountability or someone does not want to take on the responsibility of doing this operation. I would be delighted to give the Minister of State all the information. I will use polite language. This girl has been waiting for 14 years for surgery and all she has been getting is excuses, that she is too weak and will not make it and so forth.
Now that Katie is an adult she is in limbo. She does not get any services from the Brothers of Charity where she was transferred with the progressing disability services three years ago. Her physiotherapist is on maternity leave. She does not have full-time physiotherapy. She got a break and got a six week block in 2014 and has had nothing since. Her situation is deteriorating. We are talking about disability services. It must be heartbreaking for the family and individual - I have sat with them - to be told that it can be done. All of the specialists said they could do it until they looked at the person and then they said they cannot. We have reports from other parts of the country and from the United States that these surgeries can be done and this girl could walk, but unfortunately she has regressed now and has gone back into a wheelchair. I wanted to highlight the fact that we are talking about disability services here and we have amazing people within them. I appeal to the Minister of State or Minister, Deputy Foley, - if I could give it to her I would - to sit down with me to discuss this case to try to solve it.
The disability service is not fit for purpose. Everyone in this House knows that. Every Deputy here, like me, is contacted by parents almost every day of the week who are at their wits' end, totally frustrated fighting every inch of the way for services for their child, whether that be a young child or an adult child. We have to stop fighting parents. A parent in my constituency had to go to the steps of the High Court last year to get a place for her child. She was fought every inch of the way by the Government. That is simply absolutely unacceptable.
The second thing we must do is accept that the Government is breaking the law. Every child is entitled by law to an assessment of needs within six months of referral and that law is being broken every day of the week by this Government and has been broken by previous Governments. It has been raised in this House on numerous occasions. I raised it here with the current Tánaiste about ten years ago, so everyone knows about it and it is time to stop breaking the law. If a member of the public broke the law, they would be prosecuted so when will the Minister be prosecuted for breaking the law? The first thing we must do is accept that the service is not fit for purpose and second, we must stop breaking the law, partner with parents and not fight against them in future. There are huge issues, such as school places, parents getting four, five and six letters of refusal for appropriate places for their children in September.
A group of 54 parents of children with special needs will be outside the Department of Education at 1 p.m. this Friday to fight for their children's right, which the Government is failing to vindicate, to have a school place with the special education resources and supports they need. It is bad enough to have to fight for the right of one's children to have a school place which the Government is failing to vindicate, but parents have all the additional stresses that relate to fighting for children with special needs. They will now be doing a 24-hour sleep-out around the clock outside the Department of Education next Friday. That is what the Government has forced them to do. Such is their frustration, such is the failure of the Government agencies and Departments that are supposed to vindicate the rights of children to respond to these parents that they have been forced to take this step. It is an absolute disgrace. Even now, the Government should be forestalling the need for those parents to take that action this Friday by guaranteeing their children the supports and school places they need.
The second issue I will raise in the brief time available to me is the people who work providing supports and services for people with special needs or disability in section 39 organisations. It is an absolute disgrace that the people who provide these vital supports and services, simply because they happen to work for a charitable organisation to which the Government has outsourced a public service, are paid less, have worse pay and conditions, do not get pay increases in some cases for years and do not have pay parity with those in the public service. That issue must be addressed as a matter of absolute urgency.
I am tempted to talk about child school places, but I want to talk about adult disabled people because it has been almost one year since the care referendum this Government lost because disabled people got organised online and actively and defeated the care referendum whether we like it or not. They then went on to defeat the Green Paper which was another Thatcherite plan of the previous Government to force people into work. Can the Minister of State name anything that has been positive for disabled people that happened in the past year since they sent that message to the rest of society about their plight?
I do not have much time. This is likely to be the worst country in Europe to be a disabled person. Disabled people are twice as likely to be homeless, twice as likely to leave school early and very likely to be unemployed because of our very high unemployment rate. Something disabled people discovered during the pandemic was that an able-bodied working person was thought to need €350 per week to live. That was the pandemic payment. Yet, disabled people were getting and still get €240 per week. Actually people who are disabled need much more money because of all the additional costs in their lives, such as transport, heating and many other things.
Will the Government please do something about the housing situation for disabled people as well? I have had to help to pay for occupational therapy assessments to be done to help people to get onto the housing waiting lists. That is illegal. Councils should be doing that. Laws are being broken continually when it comes to people who have a disability. Will the Government learn the lesson from last year and do something for disabled people?
I will preface my remarks by saying that if the Government is seriously interested in helping to empower people with disabilities, it would abolish the means tests for carers immediately and it would bring in a cost of disability payment immediately.
I will pick up where my colleague left off when she spoke about breaking the law. The Government is blatantly breaking the law. Twenty years ago - 20 - we brought in the Disability Act to give rights to people in a very limited way that an assessment would be carried out within six months of referral. Not only has the Government failed to do that, but it brought in an appalling discriminatory approach called the standard operating procedure. Again, families had to go to court and again the Government was caught and told it was not compliant with the Act of 2005.
I am not personalising anything, but the Minister of State, Deputy Naughton, is sitting across the Chamber. It is impossible to stand over this system. It is broken. I will give the figures and I will then come back to Radie Peat, who encapsulated this issue. There are 91 CDNTs in nine CHOs. I put it to the Minister of State that our CHO distinguishes itself by having a vacancy rate of approximately 30%. I have all the figures in respect of the failure to employ physiotherapists, occupational therapists and speech therapists, but my time is limited. In December 2024, there were 12,920 children on the waiting list for the CDNT. There are 14,200 children waiting for assessments of needs. Those figures are just astronomical.
This was best captured recently Oliver Callan's radio show and in a newspaper article, when Lankum singer and multi-instrumentalist Radie Peat took her courage in her hands and agreed to be interviewed. She said it was not for herself because it was too late for her and her child. She spoke for all those other mothers who are sitting waiting and whose children have no service. Radie Peat was told it would be 2028 before her child would be seen. The family's GP, Dr. Austin O'Carroll, said in the newspaper article that the system is broken and needs to be addressed at a political level. In the same article, Dr. Anna Beug, an inner-city GP and medical educator said that staffing shortages are causing the system to collapse. We are breaking the law. We are standing over a system that is collapsing, and here we are having statements on disability.
I wish the Minister, Deputy Foley, and the Minister of State, Deputy Naughton, the very best in their hugely important roles. They have a massive responsibility, with thousands of people across this country relying on their success. We have made some progress in the provision of disability services. I commend the Minister of State's predecessor, Senator Anne Rabbitte, on her work and on her dedication to people with disabilities during her term in office.
This is a whole-of-government problem and a whole-of-society issue . Every Department and public body must abide by the law and fulfil its public sector duty to ensure that people are not discriminated against. Unfortunately, day in and day out, people are disabled not by their condition but by the restrictions put on them by the State, by society and by our built environments. There is a cruelty to it. Often, because people have a disability they are curtailed by our State and put into a poverty cycle of health inequality. It often feels as if the State does not want people with disabilities to have ambition. I know this not to be true, but it is the effect of many of our State policies.
There are many issues I will take up with the Minister of State's ministerial colleagues over the next four years. With regard to her brief, however, I make no qualms about saying that things are not good with disability services at present. Like many other counties, Louth has huge waiting lists. More than 600 children are on the list for assessments of need. That is not to mention the waiting list for those who had assessments and who are not receiving any therapies. Louth services have a vacancy rate of about 50%, with more than 32 of the positions involved across the north and south of the county. The torture and heartache families are put through is just agonising.
Children with disabilities are suffering while waiting to access therapies and assessments of need. This not only affects their present, it also has lifetime consequences. We cannot fail here. We must address this issue head on. These children deserve equal opportunities. They deserve to thrive and they deserve to reach their full potential like every other child. Many speakers referred to how services are being stretched and how many children are waiting for assessments of need. Consider what we have achieved over the past year, with more than 14,000 children waiting and 2,400 on waiting lists.
Tá an-áthas orm labhairt ar an ábhar seo sa Teach anocht. In recent years, it has become very apparent that the State has failed many neurodivergent children. Many have been left languishing for years waiting not just for assessments but also for timely early interventions. It is often stated by the HSE and its representatives, and by the child experts, that early interventions are key to helping neurodivergent children achieve the maximum that they can achieve and reach their full potential. Unfortunately, it is rare that a child who needs an early intervention actually gets it. Many concerned parents are forced to go to expensive private providers only to find themselves out of the public system thereafter. Assessments cost in the order of €2,000. In many cases, this is simply not affordable. It is also worth noting that public representatives are dismissed by the HSE with the excuse that there are large numbers of children waiting and that it is doing its best. When the statutory waiting period of six months passes and a letter is sent by a solicitor's firm to the HSE, the children involved get the services they need. The threat of proceedings against the HSE seems to do the trick. This leads to inequity in the system. Unfortunately, that is not the end of the matter. When assessments are carried out, many parents are told that their children need physiotherapy, occupational therapy or speech and language therapy. The number of therapists is wholly insufficient and this leads to more waiting times and, accordingly, less chance of the all-important early intervention. The HSE says it is trying to recruit additional therapists but that this is proving difficult. I welcome the fact that the programme for Government will lead to increased staffing, increased support for families who need funding for private assessments and increased numbers of regional assessment hubs. I also welcome that important legislative changes will be made in this area.
I strongly urge the Minister of State to move every might and main to ensure that these children in particular are picked up early and that the key phrase of "early intervention" is actually delivered upon. We need the policy changes and resources delivered at the earliest possible moment so as not to leave these children behind who have so much to offer our society. It is imperative that we deliver on the rights of these children without any delay and that all the measures needed be front-loaded at the earliest opportunity but certainly within the lifetime of this Government. Caithfimid an rud ceart agus cóir a dhéanamh i leith na bpáistí tábhachtacha seo.
One of the commitments in the programme for Government relates to the delivery of a step change in disability services. This is a very welcome and ambitious objective. Should it come to fruition in five years' time, we would be able to reflect positively on it. This Government would leave a legacy of change in this area should it come to pass, and we all hope that it will. My professional career coincided with an era when children with diverse needs began to enrol in mainstream school settings. We saw with this the appointment of additional resource and supply teachers and the introduction of special needs assistants in schools throughout the country. We must pay tribute to the Taoiseach for the role he played in developing and introducing that system. As a result of its introduction, teachers have become great advocates for children with special educational needs. The system has extended the role of teachers beyond the classroom in advocating with service providers for their pupils and for those to whom they provide tuition. I have been fortunate in my teaching career to work with many special needs assistants. The special needs assistant has the opportunity to have the greatest impact on a child with special needs. I have seen that time and again. I welcome very much in the programme for Government commitment to continue to extend and increase the number of special needs assistants within our schools, both mainstream and special schools.
A number of people mentioned CDNTs. While we are all frustrated by the lack of services being provided through the teams at the moment, I believe there is something about the model that we should try to build upon. Of course, the model is not unidisciplinary; it provides multidisciplinary support to all the children within the team. If we can build on that model and properly resource it with the appropriate personnel we could have a successful model for the support and for the therapeutic intervention for children with special needs.
I will give some insight into how the numbers can be different across the CDNTs. In County Galway, there are six CDNTs. In one of those teams, as of last March when I asked a question at the regional health forum, there were no children waiting for initial assessments, which was very noteworthy. I sought further information as to the position and, sure enough, when I looked at the staffing cohort of the six teams ,the team that had no children waiting for initial assessments was the best staffed. It had the highest number of speech and language therapists, occupational therapists and psychologists, all the way down to social workers, preschool liaison staff and other support workers. There lies the answer.
I found preparing for this debate extremely difficult because for me disability advocacy is not just a policy area. For me, it is deeply personal. For the past 19 years I have worked within the disability sector. I have been specialising in supporting children who are neurodiverse and their families and their schools. It is very difficult to fit 19 years of passion and knowledge into just a few short minutes when there is so much to say.
I must point out that I was in private practice and was not working within the HSE; my counterparts in the HSE had huge caseloads and very little job satisfaction where I was able to keep my caseload extremely low and was able to see students on a weekly basis and, therefore, see great results.
I know first-hand the struggles facing those with disabilities and their families. For example these are endless waiting lists, lack of respite hours, sacrifices made by full-time carers and bureaucratic hurdles just to access grants such as the housing adaptation grant, for example. These are not just abstract issues but are everyday realities for so many. I acknowledge the appointment of the Minister of State with responsibility for disability and I wish her well. I also want to thank her for for meeting so many of us so swiftly to hear and discuss our concerns. I also want to wish the senior Minister, Deputy Foley and the Minister of State, Deputy Moynihan, the very best of luck in their briefs as we know that everybody is counting on us to deliver.
The establishment of a new disability unit in the Department of the Taoiseach is also a step forward and now we can see that there is a sharp all-of-government focus on disability. Now is the time to drive action and to deliver this step change we know is needed. I personally feel that a culture shift is needed on how we view disability. Yes, we have to provide care, support and services but the drive and our focus should be on accessibility, access to society, access to independence and access to opportunities. When viewed through the lens of accessibility, we would not make someone walk from one side to the other to prove that they need a medical certificate. We would not make a disabled person give 24 hours to use a rail service and we would not place young people with disabilities under the age of 65 into nursing homes. When we provide people with disabilities with the proper supports and access, they will reach their full potential and when they reach their full potential, all of society will thrive.
I have only a few minutes to speak on what is a huge issue. I will start by mentioning the public health nurses in my own area and this is an issue right across the country. There is only one such nurse in the Drimnagh area and last year that person was transferred to the nearby area so there was no service. One might ask why this is an issue in this debate. Many young parents start to panic when they cannot measure whether their child is reaching their milestones or whether there are issues involved.
Recently, an elderly constituent had to have very complex dressings done quite regularly and no public health nurses called to the house. The woman is disabled and had to struggle to get a taxi to a local clinic even in bad weather, as was recently the case. She has been hospitalised because of the consequences of being out in the rain. She has had pneumonia and is about to be released only this week with no guarantees still that public health nurses would call to her house. Those are the consequences of what falls upon those who have a disability or who struggle with one.
This is not to ignore the many parents who are also struggling. I have heard people talk about the children's disability network teams, CDNTs, and how great they could be. Yes, they could be great but they are no good if they are not fully serviced because they add to the frustrations of many where if one is promised a service and it is not delivered upon, one can see the child becoming frustrated.
I got a letter from the Dublin 12 Campaign 4 Autism Inclusion only last week expressing huge frustration once again. As the letter said, it is 2025 and we are still in need of autism classes and special school places. It is time for this to be sorted once and for all. This is a group of parents who do have places for the children next September. Each family has been with the National Council for Special Education, NCSE, but again there are no places. Something has to be done for Dublin 12 and it is beyond a joke, as the group has said.
Then one sees cases where complaints have to be made to ensure that assessments of needs are completed or when the assessment of need is done, no services are provided. In the particular case of a young boy of five that occurred in 2022, it was suggested that he needed all of the assessments which were listed but these had not been done by November of 2024. This is a huge area.
I wish all of the Ministers well and whatever help we can give from the side of the House, we will, because at the end of the day we have to deliver these services.
I have short enough speaking time but I welcome that the Minister of State has mentioned there has been some progress on graduates in the special section of the Department of the Taoiseach. There are also quite a number of areas, however, that require urgent re-examination. Reference is made to 60% of people with disability working. If one looks, however, at people who are termed disabled to a great extent, it is only 27.3%. That is an area which needs to be focused upon.
We need to look at the issue of housing for persons with disabilities, given that disabled individuals make up 25% of homeless people, which is hugely disproportionate. We need better accessible transport, affordable childcare, improved education, improved employment and adequate personal assistant services.
The Minister of State mentioned that this Government is putting the disabilities issue front and centre of Government. If that were the case, then some of the Taoiseach's nominees would have been people at the forefront of the disabilities sector. I mention people like Joan Carthy, for example and Ann Marie Flanagan, both of whom have tremendous expertise in this area. It would have been a good idea if the Government had appointed both of them as Taoiseach's nominees to the Seanad. They would have addressed the gender balance deficit but they are also experts in their own right in the field of disability. I hope that somehow, through whatever sector, their contribution can be encouraged and recognised.
Last week it was reported that more than 14,000 children are waiting for an assessment of need. As is the same with everybody else I am sure, one of our constituents has a son who was diagnosed with a moderate intellectual disability and had an assessment of needs conducted in 2016. The family was informed he required psychological, speech and language, and occupational therapy but he has never received these services. It appears that the HSE is conducting assessments but is failing to deliver the required services. This situation is unacceptable and needs urgent attention to ensure that children receive the support they need.
Also, for children with disabilities who have to travel to special needs schools, the lack of adequate drivers and vehicles and the lack of communication with the parents on when they will receive their transport is nothing short of shameful. This seems to happen at the start of every single school year and in some cases it continues on during the year. Parents cannot kick up for fear that they may lose their transport completely.
With regard to people with disabilities, I want to reiterate that Independent Ireland firmly believes that the carer's means test needs to be abolished. I have consistently emphasised that point in the Dáil. It is a fundamental issue. These individuals are providing care to the most vulnerable in our society and they should at least receive the basic carer's allowance. The Ministers of State know the stories and they must hear these themselves all of the time. Now is the time to change things. We need to put the most vulnerable in our society at the top of the list and perhaps spend less of our time on the worries around the world; we need to have a little more time to take care of our own here.
Somebody on the Government benches spoke about the medical certificate and I would like to talk about it also. It reminds me of how many constituents come to me who want a medical certificate for a vehicle or an adapted vehicle and are being refused. These are people in wheelchairs and we have consistently said that we will ensure that that law changes and that these people will be looked after. If one went in with no legs or no hands, one will come out without a cert. Who is making these decisions? There was a court case about this and the decision was to bring change within government and it has not happened so people still cannot get the medical cert. Respect must be shown to people with disabilities. I am worn out from people coming into me and I presume it is happening to all Deputies as I am not the only TD to whom people come in to express the frustration they feel when they have to drag their family out, get people out of bed and are still refused.
I take this opportunity to wish the Ceann Comhairle the very best in her new role.
My comments today are on accountability for the delivery of services. At the end of the day, the Government will be accountable but I am asking now for it to make changes within Departments so that people who do not deliver for people with disabilities in their Departments are made accountable. In other words they must make their Departments better and ensure that if somebody does not do the work we are asking them to do and that the Government itself wants to have done, there is accountability. If a person cannot do the job, out they go and somebody else new is brought into the Department to do it.
When it comes to changing legislation to allow people to work in schools, there must be equal opportunities for people with disabilities. In the workplace, there must be equal opportunities. We can see by the Government contracts being given out, that it is all only going to one sector. What I want to see from the Minister - and I do wish her well in her position - is accountability across the board. If someone cannot do the job, they should move over and let somebody else deliver the services.
We could go on here forever about this matter. If people look back on the record of the Dáil or at television recordings, they will come across statements that were made five, ten and 15 years ago. In those statements, people made all the same promises but there has been no change. Also, people in various positions have not been made accountable for failing to deliver services. This is where I am coming from.
I want the Minister and the Minister of State to run the Department like a business. If someone cannot deliver for the Department, which means they cannot deliver for the Government or the people of Ireland, they should move over and let somebody in who is ambitious enough to take it on and deliver for the Government, for everyone in this House and for everyone with a disability who needs work done for them. That is what I am asking.
I am going to take a different approach to the Government on this occasion. I will give whatever help I can to assist it, but I want to make sure that those in government ensure that the people who are supposed to be delivering for the State do so. If they do not, then they should get out and we should make sure that someone who can deliver for the vulnerable replaces them.
There is no point in discussing disabilities unless we can address the core issues relating to the disability sector. The core and fundamental issue is recruitment and retention. The CEO of the Disability Federation of Ireland stated that this issue is having a catastrophic impact. The reason that it is having such an impact and that there are so many difficulties is because two thirds of disability services are delivered by the voluntary sector. This Government has utterly failed the voluntary sector. Section 39 and section 56 workers have been led up the garden path by the Government. It made firm commitments to the great people in Western Care, Cheshire Ireland, Ability West and the Wheelchair Association of Ireland. It made commitments on delivering pay increases and on pay parity. However, it forgot about those commitments.
It is interesting that commitments were made in the lead-up to the election but that these do not appear in the programme for Government. All the people in the organisations are seeking is equal pay for equal work. There is not a Minister in this Chamber who would accept an inferior pay scale for delivering the same work of his or her counterpart. That is what the Government is asking these great people to do.
I will make a plea to the Minister of State on behalf of the hundreds of thousands of people who work in the voluntary sector. These people want to continue to deliver the service but they are finding it incredibility difficult. Unless the Government delivers on its promises, we will have strike action. Nobody in the disability sector wants that. The section 39 and section 56 workers want to provide the service to the most vulnerable people our communities. I ask the Minister of State to avert this unnecessary problem and give those who care for the most vulnerable people the respect, recognition and pay they deserve.
I am delighted to contribute to this debate. In recent years, I gained huge experience as Chair of the disability committee. That committee worked extremely well on a cross-party basis in the previous Dáil to ensure that the voices of disabled citizens, their families and their communities would be heard. I understand that another iteration of this committee will be set up for this Dáil, which is extremely important.
From the evidence that was given to that committee over a four-and-a-half year period, it is quite clear that Departments and Government agencies are working in silos. A unit has been set up in the Department of the Taoiseach to try to bring uniformity and a sense of purpose to Government in order to ensure that disability services are worked through. It is hugely important we break down all the barriers and that the information that is gathered at a very early age in terms of the access and inclusion model, AIM, or the domiciliary care programme is shared across the system in order that we know the challenges that exist.
As other Deputies stated, we need to meet the challenges that exist every day of the week. By means of lived experience, I have seen the major challenges families are facing right across the spectrum. A number of agencies were set up - voluntarily, as was said - 50 to 60 years ago. They tried to provide a service, as they set out, from the cradle to the grave. That is what the State needs to do, namely provide a full service right across the system.
There are challenges at the very early stages of a child's life. These last right through to primary school and secondary school. Since I took up this role, I have brought as much energy as I possibly can to it. I certainly have an understanding of the challenges that are faced by families on a daily basis. We have been working with the Department officials and the NCSE to ensure there are places available for children starting this year and into second level as well. We will work might and main to try to ensure we deliver that in a timely fashion.
Families need certainty. They also need understanding when it comes to the places that are available for their children. They do not need it April, May and June of the school year; they need it prior to Christmas. That is one of the things I will look at in order to try to make sure that we respect both families and children who need additional help in school and that we intervene in a timely fashion. The latter is not happening at present. We all know the challenges every parent faces, and those challenges exist right through their lives as well.
More than 20 years ago, the service providers were very good. They embraced the voluntary housing bodies and they built houses by using funds that were provided by the relevant Departments. We have, however, tied that up in red tape in relation to HIQA and everything else. We have to look at streamlining that and making sure that funding is put in place and that there are residential places for families, not just on the respite side but also for the many parents who are into their 70s and 80s and who are caring for adult children. Those people do not know what the future holds. We meet them every day of the week. The State needs to accept this.
The new unit that is being set up in the Department of the Taoiseach will be judged on the basis of delivery. It will be judged on how we make the lives of people with disabilities and those of their families and their communities better. We have to work might and main in this regard. This is one of the issues I intend to take this on full belt. I know the Minister of State, Deputy Naughton, and other Ministers will be working as hard as that on it as well. I give a commitment that I will work every day to make the lives of people with disabilities better.
Every town, every street and every public service should be built for everyone. For too many people in east Galway who are living with disabilities, that simply is not the case. We have all heard the stories of parents fighting tooth and nail to get basic supports for children who have been waiting years for essential therapies. Adults struggling to access home care are left to rely on family or to go without. People in wheelchairs are forced to take long detours because a footpath is broken, a shop has a step too high or a train station is not fully accessible. These are not rare cases; this is everyday life for thousands of people, and it is not good enough.
Look at our towns. I think of Athenry, Gort, Tuam, Loughrea, Headford and Portumna; are they truly accessible? Try pushing a wheelchair down some of our footpaths. Try finding a disabled parking space that is not already taken. Try getting on a train without having to ring ahead and hope a ramp will be available. The reality is that many of our streets and services were not designed with everyone in mind. When that happens, it sends a clear message to the effect that this place is not for you.
Disability rights are human rights. Accessibility is not an afterthought, it is a necessity.
If a town is not accessible, it is excluding people. If services are not available, we are failing people. Therefore, what do we do? First, we invest properly in disability services. That means shorter waiting lists, real supports and funding that meets demand. Second, we rethink our public spaces because if a footpath, a building or a bus is not accessible for everyone, it is not good enough. Third, we listen. We listen to the people living with disabilities, their families and the organisations that understand what needs to change. This is not about policy; this is about dignity and about ensuring that every person in east Galway and across Ireland can live, work and move freely in their own community.
I wish the Ministers of State, Deputies Naughton and Moynihan, well in their new roles. The opportunity to make this statement is timely. I am moved to refer to the heart-breaking interview on the "Oliver Callan" show last Friday of Radie Peat and Dan Lambert about their daughter who has non-verbal autism. They eloquently articulated the horrendous difficulty parents and their children with special needs face in seeking early diagnosis and intervention. As a GP, their story is the reality for many parents. Theirs is a constant battle to obtain services that should be a right. Every day lost to early intervention is an irretrievable cost. Those with the least resources suffer the most. Radie and Dan waited 18 months for an assessment in 2023 only to be placed on a five-year waiting list for intervention. They reflected the frustration and anger that thousands of parents feel. We have ageing parents who have dedicated their lives to caring for their children with special needs, yet they are unable to plan for their children's future. Minimal planning is available. I recall a mother who cared for her son with severe intellectual disability for 48 years. At 80 years of age she sought residential care for her son. After years of requests, she was told it would be sorted out when she was gone. When she died suddenly from complications following a hip fracture, his long-term care was arranged within ten days. A lifetime of struggle should not have ended that way.
Disabilities can take on diverse forms, some easily recognisable while others remain hidden from view. Each person's journey is distinct and deserves to be understood on its own terms. I welcome the programme for Government's renewed focus on disability committing to the UNCRPD and prioritising a national disability strategy with a vision for 2030. I also welcome the establishment of the disability unit in the Department of the Taoiseach, which will give weight and focus to delivery. The strategy must be underwritten by principles of equality, accessibility, the right to live independently, the right to education, adequate healthcare, employment and the right to participate in daily life. I welcome the recognition of carers in the programme for Government. In the context of an existing €6.5 billion spend, we must ensure funding is directed to the most vulnerable. If reform is required, we should embrace it. Ireland has lagged behind EU counterparts in supporting people with disabilities. We must move forward proactively. I know the Minister's personal commitment and that of the Taoiseach to this issue. To quote St. Francis of Assisi: "Start by doing what is necessary, then what is possible, and suddenly you are doing the impossible."
I almost feel that we are on a hamster wheel having these discussions on disability. I get that everyone across the board is aware from the issues that are raised in their constituency offices, from canvassing doors and even from familial connections, of the huge want and need that is out there and the huge amount of frustration we are addressing with families, even if we only deal with the issue regarding autism services. I have heard a number of the speeches that have been made and they are very similar to speeches made last week, the week before and even for the entire period of the previous Government. We often implore here but I really do implore the Minister. We really have to get down to brass tacks. Even today, when we are talking about disabilities across the board. We have had the issue regarding the HIQA report into Sunbeam House Services. We need to ensure that whatever service we provide is above par and that we are providing the service that is required for some of our citizens out there who need the most help altogether. I have also had calls in the past while and heard about the huge worries in the disabilities sector regarding the pay-in-hours strategy and the fear that what has happened - whether we are talking about hospitals, section 39 workers and others who are dealing with issues like mental health services, with the cuts that have happened with staff. The fear in the disability sector is around all the issues of underfunding and the issues as regards section 39s. The fact is that we have to deal with those workers' issues so we can at least help in the retention of the workforce. We are talking here about people who will put up with a hell of a lot on the basis that they are utterly committed to those citizens to whom they want to give care and whom they facilitate.
An issue I have spoken to the Minister, Deputy Lawless, about and have dealt with the two previous Ministers about is higher education, personal assistants and personal assistant hours in further education. In my own constituency, I refer to the Drogheda Institute of Further Education, DIFE, and the Ó Fiach Institute of Further Education. While some room for manoeuvre provided regarding an increased pay rate, a 52-week contract is still not provided. We are failing those workers but we are also failing those whom they are helping and facilitating to stay in further education. We are talking about accessibility across the board. We need to ensure it happens. This is a cradle to the grave issue. I am hoping I will table a question regarding CDNTs. I will say it again about the school inclusion model: we need to put the service where the need is.
Go n-éirí leis an Aire ina post nua. Ba mhaith liom labhairt faoi rud éigint atá i mbéal an phobail faoi láthair agus is é sin assessments of needs. Chuir mé ceist isteach faoi the steps that the Minister was going to outline for assessment of needs in her new post. The reply I got from the HSE stated that 10.4% of assessments of needs were completed within the timeframe set by the HSE, which is within six months. It is with cautious optimism that I support the programme for Government but this is something by which we will be defined as a Government. It is something that I hope gets addressed in five years. I really will support the Minister the whole way through if she can tackle this issue. There are too many people, go háirithe i mBaile Átha Cliath Thuaidh, nach bhfuil sé seo ann dóibh.
I congratulate the three Ministers and wish them well. Disability services in south Tipperary are quite simply non-existent and not fit for purpose. The CDNT teams, despite the efforts of the therapists working in them, are simply not fit for purpose with huge vacancies and even longer waiting lists. Children are crying out for autism assessments, psychology services and speech and language and occupational therapies, and the services are simply not there to meet demand. On top of that, there is a severe shortage of appropriate school places. Again, parents are scrambling for schools. They are going around to dozens of schools in some cases for a place next September. At the same time, I have schools offering ASD units and they are meeting delays and brick walls from the Department. I have young children like Michael Barrett and Oisin Carroll who deserve an education and cannot get places. Others are currently waiting without a school place. We have Scoil Aonghusa, a wonderful institution, which is bursting at the seams waiting for additional accommodation. Yet again, the Department is letting us down and not helping them out there. We have a severe issue and we have to grasp the nettle and do something serious about it.
I with the Minister well in her role and look forward to collaborating with her on many issues. In County Offaly, 525 children are waiting on assessments of need. Two CDNTs, networks 10 and 11 cover the county. I am very concerned about this. I am also concerned about the fact that there are no preschool places in Edenderry for children with autism. I actually met a parent this morning who told me that. I was shocked. I knew it was an issue at primary and a secondary level but not at preschool level. I hope that can be addressed. The issue of therapists and the shortage in Offaly is nothing short of a national scandal at this stage. I have a child who had an amputation some years ago who cannot get an occupational therapist. In this day and age, that is absolutely disgraceful and appalling. I call on the Minister to please ensure that Offaly gets urgent intervention in terms of therapists and assessments of need.
I wish to raise the issue of many parents in County Kerry whose children have been diagnosed with autism, ADHD and other intellectual disabilities. While the numbers continue to increase, the services are not readily available. Waiting times for assessments and diagnoses are taking way too long. There is a huge shortage of speech and language therapists. Many parents have to go down the route of private assessments for their children. This is a huge burden on families and many cannot afford it. Applications for domiciliary care and disability allowances for children are taking way too long. We have no respite places; hardly any at all. The St. Mary of the Angels centre, which was given over voluntarily and put in place by many volunteers, including parents, back over the years is being closed by stealth. I want the Ministers to address this issue. It is not fair that children with disabilities have to go up to County Meath, up against the Border with the Six Counties.
Teachta Healy-Rae, we need to move on.
That is not fair for people in County Kerry.
Gabhaim buíochas leis an Cheann Comhairle. I wish the Minister of State and her team the best of luck on this issue on which there is great unity across the House. In essence, we must listen to the voices, the lived experiences and the needs of children and adults with intellectual, sensory and physical disabilities. We must enact and implement personalised budgets that are person-centred and family-driven and that will enable the achievement of the unique ability of each child and adult. The evaluation phase of the homecare platform and SLAs must actually be implemented as soon as possible. This must be balanced with improved respite services. The Ministers must confer with Mr. Gloster of the HSE to ensure there is a root-and-branch examination of the HSE's disability services to ensure the appropriate resourcing of competencies to those charged with providing the services.
I thank Members for their contributions on what is a very important topic. The Government is absolutely committed to ensuring that people with disabilities can live full lives with the same rights and access to services, education, transport, sport, culture, careers and means to live independently as all other citizens enjoy. Since being appointed the Minister of State with special responsibility for disability last month, I have made it a priority to visit services, meet people with disabilities and sit down with advocacy groups to hear their views on what is working well and what needs to be improved. There are wonderful examples of services that help to transform lives. There are also examples of services that need additional support and bolstering. There is no shortage of good ideas concerning what can and must be done. Only by tapping into the lived experience of people with disabilities will we understand what is happening on the ground, which will help us to deliver the reforms needed to improve services and deliver on our ambition.
I want to deliver change that will have a real impact, as well as helping to oversee reform in this sector. For example, we must ensure that a person using a wheelchair who uses public transport can travel seamlessly from their home to a bus stop or a train station. I have asked my officials to develop a plan to audit our public spaces to ensure people are not inhibited from travelling because of cluttered streets and an inability to cross the road safely. That will help to guide investment decisions. I want to look at expanding the role of access officers in the public sector to ensure services such as libraries are accessible and people with disabilities are not prevented from attending and enjoying concerts and festivals. I wish to create a mechanism to allow public bodies to share best practices and I want to help people with disabilities to get into employment. My Government colleagues and I are absolutely committed to ensuring that each Department and the local authority sector work together to address the various barriers that prevent people with disabilities from fully engaging in society.
A demonstration of this commitment is the fact that I as the Minister of State with special responsibility for disability sit at the Cabinet table, where I join my colleague the Minister, Deputy Norma Foley. This will ensure that the voices of disabled people will be across every Government decision. We are both committed to delivering change in tandem with colleagues across other Departments. It is important to note that the Cabinet committee on disability will be retained by this Government. A new disability unit will be established in the Department of the Taoiseach and both these actions will form the basis of a whole-of-government step change in its approach to service improvement and delivery. By putting disability at the centre of Government, we will expand and reform services to maximise people's independence and help to support disabled people. Census 2022 told us that 22% of the population or approximately 1.1 million people, have a disability. Most are supported via mainstream health and social care services. My Department funds, via the HSE, specialist, community-based disability services, which are designed for the 60,000 people with a significant intellectual disability, autism or a complex physical disability. These services include multidisciplinary therapies for children or adults, adult day services, personal assistants, home support, respite and residential services. Some €3.2 billion has been allocated for HSE disability services in budget 2025. This is up 11.5% compared to 2024 and represents an increase of €333 million, the largest ever increase in the disability services budget. While the overall budget has increased by €1.2 billion since 2020, we appreciate that much more is needed. We must invest more in services, personal assistants, home support hours and other supports to assist people to continue living independently in their own homes. Our capital spending must increase and, crucially, we must provide more therapists and access to services.
The programme for Government commits to doubling the number of college places for speech and language therapists, physiotherapists, occupational therapists, dieticians, psychologists and social workers. An additional 150 places were provided last September as a first step in this process. These professionals are highly sought after nationally and internationally, with an array of career opportunities available to them. In July 2024, the Government approved the prioritisation of funding to support the expansion of training places in priority healthcare areas, including speech and language therapy, occupational therapy and physiotherapy. Increasing the number of graduate therapists year-on-year will be key to meeting the demands of the disability sector and we will engage with the relevant Departments to support this work in 2025. Additionally, encouraging students to undertake placements in disability services is vital to increasing the disabilities workforce. This will expose more students to the challenging, impactful and rewarding nature of work in the disability services sector and encourage them to take up full-time positions upon graduation. The recruitment and retention of staff is a challenge across the sector overall and a significant priority for the Government continues to be filling vacancies within the 93 CDNTs. Clear progress is being made in this regard, with the workforce having increased by 17% between 2023 and 2024. This represents significant growth of an additional 372 whole-time-equivalent staff working across the CDNTs. We are building on this progress. In budget 2025, more than €2.8 million in new development measure funding was secured to provide for additional whole-time equivalents in the teams. This includes 40 health and social care professionals, 20 health and social care professional assistants and 15 clinical psychology trainee placements. The Government will also facilitate the continuation of the assessment of need waiting list initiative, enabling the procurement of private assessments for long-waiting families, with €10 million in funding allocated for 2025 to deliver 2,850 assessments of needs.
Among the most important pieces of work under way is the development of the national disability strategy. The development of this strategy is at a very advanced stage, with publication expected in the coming months. The next national disability strategy will operate as a framework for the co-ordination of disability policy right across government, ensuring a whole-of-government approach to the advancement of the UNCRPD and collaboration on cross-cutting issues. Advocacy groups have been extensively involved in the development of the strategy and officials from a range of Departments and stakeholders, including disabled people's organisations, DPOs, met in my Department last week to discuss the next steps.
In working across government, including with colleagues in the Departments of An Taoiseach and Housing, Local Government and Heritage, to develop our commitments on the development of the national disability strategy, the role of local authority decision-making has emerged as a consistent theme. As my Department leads on the finalisation phase of development, it will be critical that local government is involved in the development of monitoring and implementing the actions. While acknowledging the independence of local authorities as autonomous legal entities and therefore the challenges inherent in co-ordination across jurisdictions, the national disability strategy will examine opportunities to enhance co-ordination and to showcase examples of best practice to advance the implementation of the UNCRPD at local level.
I assure Members that we will progress the action plan for disability services. We have set ambitious targets in the plan to provide for unmet need and demographic change. This ambition is important to generate commitment to the vision we have for disability services in Ireland. To date, the Government has supported the plan with approximately €113 million in new development funding - €74 million in 2024 and €39 million in 2025 - which has led to service expansion. I fully appreciate that more is needed and I will work with colleagues during the Estimates process to secure funding to provide the services we need.
I have listened carefully today to the contributions of Members and I will take them away for consideration. There is no monopoly on good ideas. I am fully committed to listening and taking advice from any quarter, whether it is colleagues across Leinster House, advocacy groups, DPOs, families, individuals with lived experience or experts in the field. It is only by understanding the needs of people with disabilities that we can deliver the step change in disability services as per the commitment in the programme for Government that this sector needs.