I propose to take Questions Nos. 608 to 613, inclusive, together.
Disability health services for children are organised and delivered very differently across the country because of the way they have been initiated and developed over many years. Some organisations provide services for a specific group of children who have a particular kind of disability, or they only operate in one part of the country. This means that there is considerable variation in children's access to services within regions and across the country.
The Health Service Executive has recognised that the current system lacks equity and acknowledges that there is a need to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities are delivered. To this end it is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0-18 years) as part of the National Programme on Progressing Disability Services for Children and Young People (0-18 years). This Programme aims to achieve a national unified approach to the delivery of disability services, so that there is a clear pathway for all children to the services they need regardless of where they live, what school they go to or the nature of their disability or developmental delay.
The Programme is based on the recommendations of the Report of the National Reference Group on Multi-disciplinary Services for Children aged 5-18 Years. Importantly, while the Programme supports the principle of providing access to mainstream education where appropriate, it also recognises the continuing role of special schools. It is worth noting that therapy services in the HSE Mid-West region are already delivered through the structure of geographically based multi-disciplinary teams and that this has enabled two Special Schools to access multi-disciplinary supports which had previously not been available. It is common across Europe and elsewhere to have children seen by their local early intervention and school age services whatever the nature of their disability or developmental delay, for example in Bavaria or in the UK.
The Programme is being led by the HSE in partnership with the non-statutory disability organisations, the Department of Health, the Department of Education and Skills and associated agencies. It is supported by a National Co-ordinating Group which has representatives from the Department of Health, the Department of Education and Skills, the HSE, voluntary service providers and parents through their umbrella organisations. At regional level there are Regional Leads for the Programme in each of the four HSE Regions. Decisions regarding any local re-organisation of services are the responsibility of Local Implementation Groups. These include stakeholders such as representatives of the service providers involved, parents and the educational sector representatives.
The active engagement of stakeholders is a critical element of any change process and implementation of the Programme will involve broad consultation. No individual or agency representative will have a veto in this regard. Information on the Programme has been made available widely through the HSE website, bulletins, workshops, and presentations. The National Advocacy Unit of the HSE has developed guidelines for the reimbursement of expenses for service users participating in the design, development and delivery of services. These guidelines apply to the participation of parents in the development of this Programme.
Detailed local area action plans are being developed by the Local Implementation Groups with the following objectives:
- One clear pathway to services for all children with disabilities according to need;
- Resources used to the greatest benefit for all children and families;
- Health and education working together to support children to achieve their potential.
The Local Implementation Groups will make informed decisions on the optimum use of existing resources, based on local information about resources and the needs of children in their area. Children will get access to services within existing resources according to their needs regardless of where they go to school. It is the Local Implementation Groups that will decide how best to phase in the changes in accordance with local conditions. Significant progress has been made since the Programme was established in 2010. The HSE envisages that full implementation of the Programme nationally will take two to three years to complete.
