Dáil Éireann Debate, Thursday - 10 December 2020
79. Deputy David Cullinane asked the Minister for Health the average wait time for children requiring an assessment of needs in the context of the legal requirements on the HSE to commence such an assessment within three months and complete it within six months; and if he will make a statement on the matter. [42290/20]
View answerWe heard at a meeting of the Joint Committee on Children, Disability, Equality and Integration that the State is failing children in terms of assessments of need. The committee heard from parents and stakeholders. What is the average time a child is waiting for an assessment of need in the context of the legal requirement on the HSE to commence such an assessment within three months and complete it within six months and will the Minister make a statement on the matter?
I thank the Deputy for raising this question and giving me the opportunity to clarify the position. I have been observing the engagements of the Joint Committee on Children, Disability, Equality and Integration with the families, the Children's Ombudsman and other representatives.
The length of time to complete an assessment of need under the Disability Act will vary depending on the child’s complexity of need. The average time from receipt of application to the completion of an assessment of need report in 2019 for a child is just under 20 months nationally but there is considerable variation between and within the different community healthcare organisations, CHOs.
The Disability Act 2005 was commenced for children aged under five in 2007. The intention at the time was that the HSE would provide assessments of need under the Act for this group only while the Education for Persons with Special Educational Needs, EPSEN, Act 2004 would provide assessments for schoolgoing children. However, it is important to note that the relevant sections of the EPSEN Act were never commenced. As a result of a High Court ruling in December 2009, the effect of which was to open eligibility to all children born after 1 June 2002, the number of children aged five and over and, in addition, of schoolgoing age, has increased steadily as a percentage of applications received, increasing from 26% in 2011 to 55% in 2019.
This reflects that the assessment of need process is an accumulative one in terms of the numbers seeking access. The recent welcome allocation of €7.8 million through Sláintecare to address overdue assessments will further support the HSE and its funded service providers in ensuring children access the appropriate therapies as soon as possible. Assessment of need is a nut we need to crack. There is no denying that. The lengths of time families are waiting to access assessments has turned this into an industry.
I thank the Minister of State for acknowledging that because there are real people behind these different Acts and procedures. They are parents and children and this issue has a knock-on effect on the overall family structure, society in general and school. It is crucially important that these children receive intervention and assessment in order that there are no lost opportunities. That is what we are talking about here: lost opportunities for children. Parents face a dilemma when their children do not reach their developmental milestones. Some children are being left behind by their peers, are unable to perform tasks independently, or are totally reliant on the care of their parents or caregivers. We need to start doing something now, today, as soon as possible, to ease the access for parents seeking an assessment of need for their children, when and where they need it. What is being done to make this happen in a timely manner?
I again thank the Deputy for this opportunity to lay out exactly what my plans are and to share them with the House. The funding I received through Sláintecare is being adequately used to address that backlog at this moment in time. Next week, at the Joint Committee on Children, Disability, Equality and Integration, I plan to have all the figures to show exactly how the funding has been spent and how we are achieving that. I also plan to meet the Minister of State, Deputy Madigan, next week to address the issue regarding the EPSEN Act. When we originally brought in the assessment of need tools, they were intended to address early intervention. The Deputy spoke about real families. We should have all our assessments of needs done before a child enters the school setting, where appropriate and possible. I want to move away from assessments and get to intervention. That is the conversation I want to have. I have a plan and we are working hard on it.
I look forward to that conversation at the committee meeting next week. The committee heard from the Ombudsman for Children last week and he basically said it is an old fashioned three-card trick, that children are being moved from one list to another and their needs are not being met. I am glad the Minster of State mentioned intervention because that is another problem. When children get their assessment of need and what they need for their development going forward is outlined, the actual wrap-around services they need, such as speech and language therapy or occupational therapy, are not there. Those services must be put in place, in conjunction with getting the assessments of need.
I have an issue that was brought up by the Enough is Enough group at this week's committee meeting. The standard operating procedure is a desktop examination wherein parents fill out forms and assess their children's needs. Parents are not therapists and they have told me that they are terrified they will miss something that will delay their child's development. Does the Minister of State think this is an appropriate mechanism for assessing children in order that their developmental needs can be met?
The whole idea of the standard operating procedure, or SOP, was to gather information so we could put people on different pathways. However, that only ever got off the ground for approximately six weeks because Covid landed. Again, I am seeking funding from the Minister for Health and am using that funding appropriately to address the backlog. As a new Minister of State in my portfolio, this has given me the opportunity to address whether the SOP is fit for purpose. Will it address the needs of the families and get us the intervention we need in a timely fashion? I hope the Joint Committee on Children, Disability, Equality and Integration will bring in the other lead clinician, Dr. McKenna, to give the balance of the conversation. I am not a clinician and I want to hear from the experts. I hope the committee will also invite the HSE lead to discuss this matter.
