Dáil Éireann díospóireacht -
Thursday, 7 Mar 2024

Vol. 1051 No. 2

Report of the Joint Committee on Autism: Motion

Deputy Pauline Tully

I move:

That Dáil Éireann shall take note of the Report of the Joint Committee on Autism entitled "Final Report of the Joint Committee on Autism", copies of which were laid before Dáil Éireann on 14th June, 2023.

I will share my time with Senator Micheál Carrigy. I express my thanks to my fellow members of the former Joint Committee on Autism who worked diligently to produce this report. The collaborative and considered approach we took to our engagement is reflected in this report. In particular, I thank Senator Micheál Carrigy, the committee Cathaoirleach, for campaigning to establish the committee and for capably steering it throughout the course of its work.

It is important to acknowledge the contributions made by the many witnesses whose expertise and lived experience informed the committee's work, including teachers, psychologists, therapists and all the professionals who support the autistic community, the families and carers of autistic people and, most importantly, the autistic self-advocates who shared powerful insights with the committee in what was often a very challenging set of circumstances. I acknowledge the members of AsIAm, who are in the Gallery with us this evening and who were a wonderful support to the committee all through its existence and since. Their contributions have resulted in this comprehensive report and its recommendations. Before I move on, I also acknowledge the committee clerk and all the staff of the committee for their work and diligence.

The committee's final report features 109 recommendations, all of which must be implemented by the Government as soon as possible. I will focus on some key recommendations from the report. The first recommendation in the report is one of the most important. It calls on the Government to enact legislation which requires the State to publish an autism strategy every three years, establish a committee or monitoring group featuring autistic people to participate in drafting and monitoring the strategy, and require the Minister with responsibility for disabilities of the day to address both Houses of the Oireachtas annually to provide an update on its progress. While the publication of the initial draft of the autism innovation strategy is welcome, it is essential there is legislation in place to guarantee its implementation in the years to come. The autistic community in Ireland has been repeatedly let down by the State, and many autistic people and their families will wonder whether they can trust that services will ever improve. Legislation which will compel the Minister of the day to monitor and implement a national autism strategy would go some way towards rebuilding that trust and providing the services which are so desperately needed.

There is a particularly urgent need for properly resourced health services for the autistic community. The committee heard shocking evidence from self-advocates and healthcare professionals regarding the inadequate provision of healthcare and mental health supports to the autistic community. Dr. Mary Doherty, an autistic self-advocate and healthcare professional, told the committee that autistic adults have poor physical and mental health compared with the general population and that the life expectancy of autistic people is potentially reduced by 16 to 30 years. Additionally, Adam Harris told the committee that the risk of suicide among autistic people is seven times higher than that of the general population. These are stark figures which tell of the need for urgent action in respect of healthcare provision for the autistic community. Among the recommendations put forward in the report are the introduction of mandatory autism training for health and social care workers in the HSE and in section 38 and section 39 organisations, the provision of funding to health service providers to make their services more autism-friendly, and the creation of a pathway for multidisciplinary support, including mental health services for autistic children and adults. At present, disability services are among the least accessible services for autistic people in Ireland. Chronic under-resourcing under the PDS model has resulted in young autistic people facing extremely lengthy waiting times for assessment and therapies, ageing out into adulthood, where few services, if any, are available to them. They are forced to seek services in a private market which is expensive and where proper oversight and regulation cannot be guaranteed.

Nineteen of the report's recommendations concern disability services, and each of these recommendations seeks to remedy distinct issues which impact autistic children and adults trying to access vital disability services. The first of this suite of recommendations calls for the establishment of a single clear entry point to children's disability services and CAMHS. At present, autistic children are passed between services. The committee heard from several witnesses that CAMHS refuses work with children who have a primary diagnosis of autism on the basis that CAMHS services are unsuitable for them. However, no alternative services are accessible to autistic children. It is essential the HSE provides a single point of entry for autistic children where they may access disability services and mental health services in tandem.

Along with making disability and mental health services more accessible, we must also build capacity in these services to provide assessment and therapies to autistic young people. The committee heard from the HSE that the average national vacancy rate of positions in CDNTs is 34% - that was a year ago - with a vacancy rate as high as 43% in some CHOs. It is clear, therefore, that the challenges around staffing represent some of the main obstacles to providing high-quality and timely services to the autistic community. For this reason, the final report of the joint committee on autism makes a number of reasonable and achievable recommendations to address the staffing crisis in disability services. These recommendations include actions that will have an immediate impact on waiting lists for disability services as well as actions that are needed to build capacity in the long term. The report also recognises that there are no overnight solutions to the current staffing crisis. For this reason, the committee made a number of recommendations that, if implemented, would bear results in the future, among them maybe speaking to secondary school students and third-level students, bringing campaigns into those institutions, working with professional bodies of the various disciplines and developing opportunities for career progression within public disability services.

The disability capacity review to 2032 and the action plan for disability services are welcome, and it is positive to see that some of the recommendations of the final report have already helped to inform policy. The report reflects contributions from professionals who work directly with autistic children, including representatives from the Association of Occupational Therapists of Ireland, the Irish Association of Speech and Language Therapists and the Psychological Society of Ireland. These witnesses told the committee that little or no effort was made by the HSE to take their views into account when assigning the progressing disabilities services model. The report urges that the HSE learns from the challenges that have arisen from the roll-out of PDS and embeds a culture of collaboration and consultation with therapy, psychology and nursing staff as well as their representative bodies.

I am conscious of the time and want to allow Senator Carrigy in. The 109 recommendations featured in this report are the product of considerable engagement with the autistic community, their families and service providers. We have an opportunity to vastly improve the lives of autistic people in Ireland by implementing these recommendations, so I urge the Government to adopt this report and its recommendations.

Senator Micheál Carrigy

I am very grateful to the Dáil Business Committee for selecting the final report of the joint committee for debate this afternoon. I am also grateful for the opportunity to speak here as Chairperson of the former committee. I thank Deputy Tully for moving the motion and I thank all my fellow members of the joint committee, whose hard work is reflected in this very comprehensive report. I also thank my fellow members of the all-party parliamentary group, who have continued the work of the joint committee by advocating for the implementation of the final report. Both committees are a testament to the commitment of the Members across both Houses of the Oireachtas to improving the lives of autistic people and their families in Ireland. However, all this work will be of little importance unless we see the implementation of the report and a real, material improvement in the provision of services to the entire autistic community. For this reason, I echo the sentiments of Deputy Tully in identifying the report's first recommendation as one of its most important. It is to enact legislation which requires the State to publish an autism strategy every three years and which holds the Minister with responsibility for disabilities of the day accountable for its implementation.

I welcome the publication of the draft autism innovation strategy and look forward to the publication of the final strategy. I also appreciate the continuing work of the oversight group in steering this project and the work it has undertaken in ensuring the strategy's implementation. However, the committee heard evidence from many witnesses which would suggest that the issues affecting public services and which impact disproportionately the autistic community cannot be resolved in the lifetime of a single strategy. Many autistic self-advocates and their families will be asking themselves how they can trust that future governments will continue the work of the Minister of State, Deputy Rabbitte, and the innovation strategy oversight group. It must be borne in mind that much of the progress which has been achieved to date in respect of ensuring services for autistic people are on the agenda is due to the hard work of autistic self-advocates and the families of autistic young people. It will be bitterly disappointing for the community and their loved ones if we did not grasp the opportunity to give a statutory basis to the strategy to ensure the rights of autistic people are not neglected again in the future.

I acknowledge that in the lifetime of the Joint Committee on Autism and to date we have seen some progress in actioning a number of the recommendations. I thank the Ceann Comhairle, the Houses of the Oireachtas Commission, Róisín Deery, Breda Burke and Róisín Sweeney from the equality, diversity and inclusion team of the Oireachtas, the committee secretariat, the entire parliamentary community, and Zarah and the team from AsIAm - and I acknowledge that Michael, Adam and Niamh from AsIAm are in the Public Gallery - for their work with the EDI team and the training for the more than 1,000 members of the parliamentary community that undertook an autism awareness training programme. I thank them also for their work in making Leinster House the parliament with the highest standard in the world as an autism-friendly parliament. This achievement sends out a signal to all public service providers that inclusivity of autistic people is valuable and an achievable goal. I call on all Departments to follow the lead that has been shown by the Houses of the Oireachtas.

Deputy Tully referred to the Action Plan for Disability Services 2024-2026.

The action plan is a positive step in the right direction and reflects much of what the committee heard throughout the course of its engagements with the autistic community and with professionals in areas such as disability services and education and with carers and supporters of autistic people. I welcome many of the plan's commitments, some of which are reflected in the committee's final report, including sponsored third level courses in therapy with a commitment to working in disability services; to standardise assessments and clinical pathways; to improve transition planning for school-leavers; to review the available employment supports with a view to addressing the issue of unemployment of autistic and disabled people; and to provide clear information for autistic people regarding disability services and other supports. I hope future policy documents concerning autism and disability, including this strategy, when finalised, will take full account of the work and recommendations of our report.

On education, I note that aspects of the committee's interim report on the summer programme were implemented last year and we saw some improvements in that area. However, these improvements are not sufficient in the current context, with so many children in most need of the summer programme unable to access it. It is for this reason the committee's final report recommends a right-based approach to the summer programme be adopted by Government and an all in-school programme be deemed as an essential service. The reality that the summer programme is essential for autistic children and their families was made absolutely clear to the committee by the families who shared with us their experiences in recent years. Parents are heartbroken as they witness their children's behavioural, communicative and academic regression. They are exhausted as they try to manage extremely challenging circumstances brought about by this annual cessation of a much-needed routine for their autistic children. I call on all special schools to provide a summer programme in summer 2024.

I also welcome the commitment to implement measures regarding transition planning, which are referenced in the action plan for disability services. Planning and managing transition is crucial for many autistic people, particularly children and young people. It is vital that supports are put in place to assist schools in managing the transition of pupils from primary to secondary and secondary beyond into apprenticeship, higher education and work. At present, the unemployment rate among autistic people is 80%, according to AsIAm. Planning and managing transitions is the first step to making our schools, higher education institutes and workplaces more accessible to autistic people. However, it is vital that these settings are fully welcoming and supportive of the autistic community. As Adam Harris told the committee, one cannot create an inclusive educational system simply by permitting people to enter the building. To this end, the report makes a number of recommendations to Government on how to make education, higher education and employment more accessible and autism-friendly. These include providing funding and guidelines to schools and higher education institutes to build and modify their premises in line with the principles of universal design; providing autism training for prospective and qualified teaching staff; establishing a pathway to accessing alternative and augmentative communication devices and assistive technology; and establishing public employment services that build on good practice in disability employment, such as the Trinity Centre for People with Intellectual Disabilities. This service would link autistic people with employers and provide those employers with supports to ensure autistic people succeed in the workplace. By supporting the autistic community in accessing education, higher education and employment, we can address the issue of unemployment among the autistic community and reduce poverty. I wish to put on record my thanks to the Minister, Deputy Harris, who recently announced ten universities that are providing third level courses for young teenagers with intellectual disabilities and autism. I also recognise the announcement last week by the Minister of State, Deputy Rabbitte, of more than 500 devices which are being provided to families with support training through AsIAm for young children with speech and language difficulties.

Inaccessibility of public services to the autistic community has resulted in families relying on services provided by the private sector, which is also unable to meet demand. This has always been a major contributing factor to the exorbitantly high costs associated with disability and autism in particular. The committee was shocked to hear evidence from Dr. Áine Roddy that the average cost to families resulting from expenses associated with autism was €28,000 per child. These costs were accrued as a result of accessing private services but also loss of income and informal care. By contrast, the same study found the average State expenditure was €14,000. The most crucial step that must be taken is to address these costs for autistic people and their families. It is to build capacity in the public sector to provide services, including those I referenced earlier, along with respite services and more. The report also recommends the introduction of nine means-tested, targeted cost-of-disability payments for autistic people, disabled people and their carers, who have high levels of expenditure as a result of their diagnosis - specific, targeted supports for those with the highest additional costs due to disability or autism diagnosis.

I put on the record that I welcome the progress made thus far in reviewing current policies in line with the final report. However, we are only at the beginning of this process. I hope the recommendations of the final report will be implemented in full. I ask that the Government adopt and implement the recommendations of this report.

Minister of State at the Department of Health (Deputy Anne Rabbitte)

I thank Deputy Tully and the Oireachtas Joint Committee on Autism for sponsoring this evening's motion. I thank her, Senator Carrigy and all who participated in that valuable committee. I thank all of the participants who came before the committee, of whom there were many. I acknowledge the presence of AsIAm tonight and a lot of the families and participants who are watching this evening. I have noted the final report of the Oireachtas Joint Committee on Autism and wish to acknowledge the cross-party work of the committee and its efforts to identify, across 109 recommendations, areas where we can better support autistic people, their families and supporters. I genuinely want to acknowledge the work of the committee. It has enabled me in the work I do. Sometimes, it does not happen that there is a parallel process but at this stage there is, which the report is contributing to big time. Action on autism, as with action on disability more broadly, is advanced on a mainstream-first basis, with individual Departments and agencies supporting persons with disabilities within their areas of responsibility. My Department acts as a central co-ordination point to support these efforts. Within the mainstream-first approach, it is recognised that there are bespoke challenges facing autistic people and their families that need to be better addressed. It is for this reason I have prioritised the development of a new national strategy on autism, the autism innovation strategy. I was just looking at the diary. I hope to have it published within the month. Today is 7 March; I hope to have it done before 8 April.

While the autism innovation strategy was in development prior to the committee's report being finalised, the committee’s recommendations have been and continue to be carefully considered in the context of finalising the autism innovation strategy. The autism innovation strategy will provide a framework for cross-government action on autism by identifying and addressing areas where there are bespoke challenges and barriers facing autistic people and their families. In recognition of the need for timely and targeted action, the strategy will seek to identify clear actions that can be delivered within an 18-month period. I am pleased to say that development of the strategy is currently at an advanced stage and I expect to formally launch it, as I said, before 8 April.

A draft of the autism innovation strategy was published in early February as part of a further public consultation to seek the views of the autistic community, their families and supporters on the draft autism innovation strategy before it is finalised and launched. There has been a very positive response to the public consultation with more than 300 responses currently being collated and analysed. It is crucial that the autism innovation strategy responds to and reflects the lived experience of autistic people and those around them. For this reason, I have sought to ensure that the autistic community is involved in all stages of the development process of the strategy.

The draft autism innovation strategy was prepared based on feedback received as part of an initial public consultation in 2022. This formed the basis of engagements with Departments and agencies to agree actions under the strategy. My officials engaged with more than 15 Departments and agencies to reach an agreement on actions. As part of this process, Departments and agencies were asked to consider the recommendations of the Joint Committee on Autism, insofar as the recommendations pertained to their areas of responsibility.

The draft strategy was also informed by consultation with the autism innovation strategy oversight and advisory group. This gives me the opportunity to thank them for their time in their role. This group, which is majority neurodivergent, comprises autistic individuals, parents, professionals and organisations.

While the autism innovation strategy has not yet been finalised and is still in draft format, I anticipate that the strategy will address many of the committee’s recommendations for action on autism. For example, the final strategy will include a suite of actions designed to generate improved understanding of autism across the public system and society and to ensure that autistic people are better supported by mainstream public services and staff. Another important focus will be improving data and research around autism, and improving information and support for parents. The autism innovation strategy will also contain actions designed to deliver improvements in key areas such as health and social care, learning and education, further and higher education, training and employment, among others, where autistic people face unique barriers at present.

In addition, the strategy will contain actions to support and empower autistic people in a broad range of areas in the community. In this way, the autism innovation strategy aims to provide for a more holistic and co-ordinated approach to addressing the gaps in services and supports currently facing autistic people and their families over an 18-month period. Part of the strategy’s purpose will be to lay the foundations for the continuation of the work of the strategy as part of mainstream service delivery. It will not fix everything by itself, but it will deliver tangible results in the short to medium term and provide the building blocks for a more autism-friendly society in the longer term.

It is equally important to emphasise that in addressing bespoke challenges and barriers for autistic people, we must not run the risk of creating a perceived hierarchy of disabilities. Many of the issues highlighted in the committee’s report and that have been voiced in the consultation process affect not just autistic people but other persons with disabilities too. Where shared challenges arise we must provide mainstream solutions that work for everyone. There is a balance to be struck in responding to the bespoke and specific needs of the autistic community in a way that, as I said, does not create a perceived hierarchy. Equally, we cannot build services and interventions around overly-medicalised criteria or based on diagnosis-only criteria. The UNCRPD is very clear on this, where we are moving away from overly-medicalised interventions and supports. These shared challenges, some of which are reflected in the committee’s recommendations, are more effectively addressed via other policy frameworks that will deliver results for all persons with disabilities, including autistic people. In the context of my portfolio, these frameworks include the next national disability strategy, development of which is under way. It will be published later this year. The next national disability strategy will provide a blueprint for continued implementation of the UNCRPD in Ireland and further support the rights and inclusion of all disabled people, including autistic people.

On health and social care services, the Action Plan for Disability Services 2024-2026 is at the centre of renewed strategic reform efforts to deliver tangible service improvements for all people supported by disability services, including autistic people. Among other areas, the action plan makes provision for maximising the impact and reach of respite services, boosting the provision of community-based residential places and enhancing the provision of adult therapies. The action plan also includes targeted efforts to attract staff to key roles such as speech and language therapy and occupational therapy. In the context of children’s disability services, the progressing disability services roadmap seeks to address the significant challenges faced by children’s disability network teams, including waiting lists, staffing vacancies, growing demand for services as well as a growing demand for assessments of need. An important element of the roadmap is seeking to improve integrated service delivery, so primary care services, disability services and CAMHS work together to address blocks for children with disabilities in accessing supports. That is what Deputy Tully talked about. The HSE has its own plan called NAP, or the national access policy. That should be working. It should not be hit-and-miss between one CHO and another. I totally agree there should be one front door and when a person goes through it they should find their correct and right pathway, but that is up to the leadership within the HSE. At this juncture, I acknowledge the role the Department of Further and Higher Education, Research, Innovation and Science has played under the leadership of the Minister, Deputy Harris, in the creation of assistant therapist roles in the ETBs for speech and language, OT and physio. We have committed in the disability action plan to 250 spaces in that and the training and the framework is in operation. The Minister launched 125 last year for speech and language.

Efforts are also under way to address challenges in relation to recruitment and retention, including via international recruitment campaigns and the establishment of a steering group for the disabilities workforce, which I chair. The autism innovation strategy will complement and enhance these wider efforts and introduce measures to make sure the needs of autistic people are understood within these frameworks and can be progressed within them as part of sustainable mainstream service delivery. Across all these measures, my focus is on ensuring we advance a coherent and effective framework so we are addressing the needs of autistic people on a responsive, equal and evidence-informed basis that is sustainable into the future.

I also draw the House’s attention to the measures that have already been advanced in addressing some of the committee’s recommendations, while acknowledging that there is still a lot of further work to do. Within my Department and remit, both overnight respite and day respite services expanded in 2022 and 2023. In the context of budget 2024, new development funding of €15 million was secured specifically for respite to ensure provision continues to expand significantly. I secured €15 million in the budget, but in a full year it is €25 million. Additional funding has been secured to support the delivery of more assessments of need, including those procured from the private sector. Approximately €11 million was allocated to address waiting lists for clinical assessments identified through the assessment of need process in 2023. To support children with a disability while they await access to CDNT services, the HSE launched the children’s disability grant fund last October. There was a huge response, with 495 applications for funding. The HSE intends to issue letters to applicants before the end of the month and commence the process of engagement around the drawdown of the fund. I hope that will address some of the issues Deputy Tully and Senator Carrigy raised about Easter camps, summer camps and the various other supports required. On recruitment and retention, disability service employment levels grew significantly in 2023, with approximately 662 new whole-time equivalent staff recruited to HSE and section 38 disability services over the course of the year versus 231 whole-time equivalent staff recruited in the year prior. An agreement was also reached in October 2023, culminating in an 8% increase in funding for pay for section 39 and section 56 employees.

Beyond the work of my Department, there are a range of actions being undertaken by my colleagues across Government to better support autistic people and their families, including in the areas highlighted in the committee’s report. In 2023, the Department of Education spent over €2.6 billion on special education and further progress will be made this year as an additional €113 million will be dedicated to providing supports for children with special educational needs.

The progressive realisation of an inclusive education system is a common theme between the committee 's report and the recently-published NCSE policy advice. A lot has been done across a range of policy areas that will assist in achieving a more inclusive education system, including the adoption of the principles of universal design for learning in school building programmes and in curriculum design, efforts to build teacher capacity and strengthening approaches to ensure that learner and parent voice is central. With regard to higher education, the Department of Further and Higher Education, Research, Innovation and Science has invested a total of over €4.8 million to enhance universal design across higher education institutes to benefit all students, but especially autistic students and students with intellectual disabilities. It is important to acknowledge it was €8.6 million the Minister, Deputy Harris, launched in the last ten days on top of the €4.8 million. Work is also being done by my colleague, the Minister of State, Deputy Butler, to better meet the mental health needs of autistic people. A new child and youth mental health lead has been established in the HSE. A focus for the new office will be an improved approach to service access and integration. To this end, the HSE is currently piloting a central referral mechanism, which is referred to as “No wrong door”.

I welcome these developments and reiterate the Government’s commitment to delivering for autistic people, their families and their supporters, both within the forthcoming autism innovation strategy and across the breadth of mainstream service provision. I will continue to prioritise the autism innovation strategy and will continue to drive progress on the broader challenges for people with disabilities and continue to engage with my colleagues across Government in the context of my portfolio. I look forward to working across Government and with the Members present to deliver tangible improvements for autistic people and their families.

An Cathaoirleach Gníomhach (Deputy Bernard J. Durkan)

We are endeavouring to get everybody in, as this is a very important subject from the point of view of sufferers and families. As we will do so, that means we have to curtail the time a little in each case from here on. I call Deputy Martin Kenny.

Deputy Martin Kenny

I commend the committee on the work that has been done. It affects every public representative in this House and beyond. We continually deal with families who have issues and difficulties with a child awaiting a diagnosis or having difficulty accessing services. Trying to struggle and manage all of that has caused huge stress and anxiety for mothers and parents throughout the country. We continually have to deal with this issue where we find that when they go to the service to seek help, it is difficult to access it. They find it difficult to get the assessments done and they find it difficult, when it comes to schools, to get proper provisions there. There is a whole range of areas where we have these situations. A person in north Leitrim wrote to me recently about their son and the difficulty they had moving from the children's disability network to CAMHS, back out of there and over and back in a roundabout way. The most recent experience of this particular child was on 3 January this year, they received a letter from the children's disability network advising that it was discharging the child and handing the file over to primary care and that they should go to the discharge team, which does not exist. This happens continually. Deputy McDonald raised the issue here recently of a child in south Leitrim whereby the child was told to move out of CAMHS and go to the intellectual disability team. There is no intellectual disability team to go to. They are left in an abyss. This seems to be happening quite regularly, unfortunately. It is causing great angst and difficulty for many families.

I also wish to acknowledge some good work is happening. I recently spoke to a parent who for several years had been going through huge difficulty where their child had been struggling both in school and outside of school. Once they got the correct support and the correct intervention and had the team built around them, the father described it me as being as though a door opened and a different child, who they did not know, came out. We need to be able to do that everywhere. We have the resources. We have the ability to do that. Unfortunately, we do not seem to be doing it right or doing it in an appropriate manner.

The report and the recommendations, as happens with many reports in this State, are put on a shelf and not looked at again. The key issue here is that they are implemented, that every three years through this House progress has to be seen to be made and that regardless of what Minister is in office, that this is going to happen. That has to be the difference between this report and previous reports.

I attended an event in the audiovisual room recently. It was quite horrific to hear of how some children were being treated in our schools. Autistic children need special attention. They need to be looked after properly. There needs to be a mechanism there, that they have the correct resources. We heard stories of children being locked in a room, which is totally inappropriate. This is not something that happened a century ago or a couple of decades ago. It happened recently. The people from AsIAm were at that as well. We cannot have a society that treats our children like that. That is what we need to change. All of us concur that this has to change. We have that society here and now. This is not something that is historic, this is present. That is the difference.

I appeal to the Minister of State, and to the Government, to take the recommendations of this report and to run hard with them and deliver on them. That is the only way we can ensure that all the children of our nation, and adults and everybody else, and families who struggle so much because of the situation in which they find themselves, will be treated properly and adequately. It is not enough to treat the children of the nation equally, we have to treat them adequately as well, and that has been the failure up till now. I will leave it at that.

Deputy Ruairí Ó Murchú

I will add my voice to what has been said, in the sense that a spectacular piece of work has been done by the Oireachtas committee. I thank Senator Carrigy, Deputy Tully and everybody who worked on the committee, of which I was not a member but I sort of inveigled myself in. I have a tendency to do that. The Minister of State will not be shocked, exactly. We dealt with a huge number of people, officials, organisations, advocates and beyond that, families and individuals. That is the bit that was absolutely vital. As you cannot have a conversation without talking about disability services and CDNTs, we also spoke to those who represented speech and language therapists, occupational therapists, psychologists and all those others. I appreciate what the Minister of State said in regard to the autism innovation strategy. Nobody is too worried any more as to what the name of the organisation, the working group or the interdepartmental group is, we just need to make sure we deliver a fit-for-purpose service that provides cradle-to-grave services. It is across the board for those with autism. We know that we have to do our bit in regard to changing everything, from the health service through to educational institutions and all the rest of it. There are some welcome pieces of work being done. It is the old saying that "I would not start from here if I were you, but here is where we are." We need to make sure we get that done. It goes without saying that it will involve universal design and reasonable accommodation but beyond that, when we are talking with families and autistic people there has to be early intervention. We throw that term out there and then we do not always deliver the service that is required. It has to be that single point of access. No matter what it is called, it has to be that single point of access with no wrong door. When we talk about the medical system, at times it is medical and health versus education and that has to change. We need to see the school inclusion model. We need to put those therapies where they are needed, while at the same time there will be a need in respect of other people who will require CDNTs, primary care and whatever else. It should work relatively seamlessly. That is where we want to get to but that is not where we are at this point in time. It is a matter of how to make this happen. How do we make these 109 recommendations happen? How do we make the autism innovation strategy, whenever it is finalised, happen? How do we provide the service that is required?

I was at two committees this week. The education committee was dealing with the issue regarding special education teacher allocation hours. We know the mess we are dealing with there. It needs to be addressed by being scrapped and revisited. I am not too worried about what consultation has happened, the net result is not necessarily good for a great number of the students out there. Like every other representative in here, I have been contacted by any number of teachers, principals and schools. That is something we need to deal with. It did not take very long until it got into the subject of CDNTs. Alongside that committee, there was the committee on disability matters, which was dealing with the HSE. There was complete acceptance in regard to a single point of access and what we need, while accepting we do not have the service we require at the minute within the CDNT.

I spoke about my own wee lad, Turlough. He has been in Ó Fiaich. I can only say great things about the school in Dundalk. The primary care psychologist did a huge element of work and dealt with the school dealt and with Annemarie, my wife and our son, Turlough, but now wants to put him back to the CDNT. She is worried about that. He does not need to be stuck on a waiting list for two years. He is 15 years of age. That is the sort of situation we are dealing with. I have parents with a child with autism who is violent. They have particular issues with the child.

The wider issue for this kid is that he had a diagnosis of autism and is now presenting with what psychologists and others who are not within the system would say is ADHD, but they need some form of assessment. They are trying to get to CAMHS but all they are really looking for is an assessment to provide delivery. I am aware of a case where CAMHS was willing to look at a young girl with autism who had previously been referred to CAMHS but did not get access to the service. It now looks like that is happening, however.

Bernard O'Regan frightened me yesterday when he said he thought Bernard Gloster told him the autism protocol was in play, but that he was hearing it is only in play in four CHOs. He made the point that we need to make sure that happens across the board or get some sort of clarity. That is what he said yesterday. My apologies to the Cathaoirleach Gníomhach for going over time.

An Cathaoirleach Gníomhach (Deputy Bernard J. Durkan)

I am loath to interrupt but we have to try to get everybody in.

Deputy Ruairí Ó Murchú

I have a tendency to go over my time.

An Cathaoirleach Gníomhach (Deputy Bernard J. Durkan)

We know that, but the Deputy has knowledge of this serious subject. We try to accommodate everybody insofar as possible. We will now try to accommodate Deputy Buckley.

Deputy Pat Buckley

I thank the Minister of State for being here. The report contains 109 recommendations, but the committee probably could have made more. A great deal of work went into the report, which is a blueprint for how the services should be run. It tells the true life stories of the witnesses who appeared before the committee, provides details of the expert reviews and so on. This was probably the best committee of which I have been a member. Every member of the committee was passionate about the issue. We never fought or had a disagreement. I thank the Cathaoirleach, Senator Carrigy, Deputy Tully, the other members, the staff and the secretariat. They were amazing. I have previously prepared reports that have, unfortunately, been shelved, but I am very optimistic about this one. This Parliament is the first in the world to be autism friendly. That was achieved in an incredibly short time. More than 1,000 people completed the training. I do not want to name names; they know who they are. Some of them are present in the Gallery. As the old saying goes, where there is a will, there is a way. This time, the will was there and it worked and we moved things very quickly.

There are many different aspects to this issue. I will address a few of them. Where there is an action, there is an instant reaction. When people are not getting the services they are supposed or expected to get, that has a knock-on effect on the family members. It is a downward spiral. If people are getting the assistance, however, and the system is working, they will not knock it. It is very fragmented, however.

The Minister of State covered a great deal. She stated:

My officials engaged with more than 15 Departments and agencies to reach an agreement on actions. As part of this process, Departments and agencies were asked to consider the recommendations of the Joint Committee on Autism, insofar as the recommendations pertained to their areas of responsibility.

That last word, "responsibility", is the one that keyed me up. Everybody has a part to play in this.

A good friend of mine named Margaret Trundle ran summer schools for more than 25 years. I think she is still running them. She started off as a volunteer. There were fewer than 20 children there back then. Nine or ten years ago, when my children were teenagers in transition year, they volunteered for the summer. At that stage, there were more than 200 kids and more than 400 volunteers. It was all done voluntarily. It was amazing what that summer provision accomplished. The number of families affected and the amount of respite they got was frightening. It was probably the best thing to ground children and make them realise what they had, rather than taking it for granted. There were tears on both sides when I told my kids that their transition year was over, that they were going into the leaving certificate cycle and that they would not be able to return to the summer school the following year to help. Every year, my kids were there. It was one of the most amazing experiences I have witnessed. That is a credit to the people involved in Midleton and elsewhere in east Cork, particularly Margaret Trundle, who did this off her own bat for many years. What we are discussing is the provision of supports in order that people do not have to carry the whole weight themselves.

Members referred to mental health and so on. It is worrying and, of course, very stressful. I was on a disability committee in the previous Dáil term along with former Deputy Caoimhghín Ó Caoláin. My God, the harrowing stories we heard about families who were out of options. One family had in their kitchen an Alsatian cage into which they put the child when that child kicked. That was their only option to ensure the safety of the child, but also of the family. Thankfully, I have not heard any such stories for a long time. I do not ever want to hear stories like them again.

This was one of the best committees. We all worked together. What is in this report is very doable. We need the Minister of State to engage with all the Departments and agencies. I have faith in her. I know she can crack the whip. I and others on this side of the House will support her in whatever way we can. This is about doing the right thing. This report gives voice to people's true life stories. The committee just reflected those stories and put them down on paper. We now have to move from paper to actual results. We in this House will do whatever we can to push it on. The door is wide open; let us push it forward.

Deputy Marc Ó Cathasaigh

I echo Deputy Buckley's point that the committee worked very hard and in a collegiate fashion. Much of that is down to the Cathaoirleach, Senator Carrigy, who deserves great praise. We were very much supported by AsIAm in that work. We had an initial private session with Adam Harris at which we said all the things we were afraid to say in public session. We got to road test them and to discuss how we were going to talk sensitively and properly about this subject. It was great. When it came to the public sessions, we were on a firm footing because we already had that pattern established. It was a valuable exercise.

Probably the most powerful session we had was when the autistic self-advocates came and sat in the Seanad Chamber. It was a long and split session. We heard from people personally and that helped us travel a long way along the road to an autism-friendly Parliament. The apparatus of the Parliament had to prepare for the session. It stopped being theoretical. We said it was going to happen and asked what steps we needed to take. That was a useful and powerful session. I again congratulate Senator Carrigy on doing a good deal of the spade work in that regard. It was not an easy session to bring together. The entire secretariat did massive work, as did people across the Oireachtas.

I agree with Deputy Tully that recommendation 1 is front and centre. I would like to see an autism strategy that is updated every three years, because there is a worry. We got the report down off the shelf for this evening and I am glad that the Business Committee selected this report and has given it an outing. However, we want it to be a practical document. We want it to be dog-eared. We want it to be scribbled all over, just like the copy in front of me.

The second recommendation to which I want to draw attention is recommendation 6, to ratify the optional protocol of the United Nations Convention on the Rights of Persons with Disabilities without delay. The Minister, Deputy O'Gorman, is committed to doing that within the lifetime of the Government. Let us get on with it. I want to see it done.

In the context of disability services, recommendation 11 is pivotal. We have talked about there being no wrong door. For people with autism, however, it feels at times like there is no right door. Half of them are locked in the first place. The lack of clarity and joined-up thinking in respect of CAMHS and CDNTs is putting people in awful situations. We know that many autistic people also suffer with mental health issues. To say that we have decided which box people fit in and, therefore, deny them access to certain supports is not tenable. I do not think we can continue along those lines.

As a former primary school teacher, I homed in on the education aspect. There has been reference to children on reduced hours or children who have to be put into rooms. Not a single educator or school leader wants to be in that position.

When educators are forced down that road, it means they do not have the training or the resources to do what it is that they decided they wanted to do with their life, which is to educate and provide for children. While it is no fault of the teacher training courses, when I came out of teacher training I was not prepared to teach an autistic person, particularly in the real-life context of having 29 other children to reach in a given day. The reality is that I had to go through that process to really learn how to do that. We need to support teachers who find themselves in that situation. We need to make sure the training and resources are available because it is a difficult transition and a balance has to be struck between the needs of each individual child in a class and the needs of the classroom as a whole.

I also want to talk about recommendation No. 47, although time is short. This recommendation relates to the summer programme. We took this issue so seriously that we issued an interim report. It is critical for the children who need to maintain a sense of regularity of the summer period and for their parents. We have to work harder to ensure that continuity of service over the summer, accepting the need for teachers to have downtime. Of course, people need time away from the classroom but we need that continuity of care.

I could talk for many more minutes but the time has elapsed. I again thank Senator Carrigy and all of the members of the committee, which has produced a very valuable report.

Deputy Robert Troy

I welcome the opportunity to contribute to this debate. I welcome my constituency colleague to the Lower House. I am not sure whether his party colleague would do so, but I certainly do. I compliment him on the good work he has done in the area of autism. I know he is personally involved and he brought that personal commitment to this report. I congratulate him and his colleagues on publishing a very worthy report in the context of the rising rates of autism globally. It really is timely that we debate the issue here this evening.

As we know, autism is very different for everybody and the needs are unique to each individual person. The point has been made a couple of times this evening that, now that we have a report and now that the committee has done the good work and published the recommendations, it is important that Government implements those recommendations. I welcome the Minister of State, Deputy Rabbitte, to the Chamber this evening. She is very committed to her role and to her work as Minister of State in this area. However, the matter is not unique to the Minister of State. It will require commitment and dedication across a number of Departments.

I will use this opportunity to highlight some of the challenges and issues I have seen in my engagement at the constituency level. There are delays in accessing assessments of need. That is particularly problematic, as I have mentioned before, in respect of the Springfield Centre in Mullingar where long waiting lists result in young children's access to necessary supports being delayed at a crucial time in their formative years.

There is also poor access to services. I have privately raised the issue of respite services with the Minister of State before. There can be a need for respite services depending on where one is on the spectrum. I previously raised with the Minister of State the respite services being run by the Muiríosa Foundation. The foundation had ceased providing weekend cover. I appreciate the Minister of State's intervention. The foundation wrote to parents a number of weeks ago saying:

We are pleased to inform you that Mullingar Respite has received the funding to operate two weekends a month from March 2024. These weekends [will] be allocated equally between adults and children.

In order to provide an equitable share of weekends for all that use our respite, we are unfortunately not in a position to accept requests for specific weekends.

We would like to take this opportunity to thank you for all your support and thank you for your cooperation in this matter.

The Minister of State will know people who need that service. We have invested in our infrastructure. The infrastructure and the building are there. It is not good enough that it is not operational 24-7. It is not good enough that families who need this intervention at a critical time cannot even book in for a holiday, a wedding or some other life event they need support for. Currently, they are not able to do that in that service in Mullingar. The Minister of State intervened a number of weeks ago. I need her to intervene again. Extra money was provided for respite services in budget 2024. I would like to see that service being rolled out every single weekend all year round.

Another issue that has been mentioned is the lack of inclusivity in education. Again, this is not the responsibility of the Minister of State but I am going to take the opportunity to raise the matter this evening. Taghmon National School, which is a number of kilometres outside of Mullingar, was requested by the Department of Education to put in for not one, but two additional classrooms for special educational needs. Having put in that request and submitted all of the documentation and paperwork, it was then told it only needed one, despite the fact that there is a waiting list to get in. The school originally applied for one but was requested to apply for two. The Department is now telling the school it is looking for too much. It is bizarre stuff. This is a school with a waiting list for children with autism to get into the special education class and it is being frustrated, running the risk that children who need the service will not have it in September. I ask the Minister of State to utilise her good offices to raise that point.

One of the points that has been made related to the lack of employment supports. Earlier today, I visited the National Learning Network in Mullingar. It is a fabulous service that is doing really good work. More than 90 people utilise it for a variety of reasons. Not all have autism, although some do. I was struck by the fact that there is now a waiting list to get into that service because of the good work it is doing with children and young adults experiencing different challenges. It was a pleasure to visit that service today. As I am speaking in the House this evening, I will take the opportunity to compliment the good work it is doing. Those in the service requested to come visit the Dáil. We will honour that request. When we do, perhaps the Minister of State will come out to meet them.

Minister of State at the Department of Health (Deputy Anne Rabbitte)

I thank everybody who participated in this evening's debate. I do not think it was a debate. To be quite honest, I think we are all on the same page. That is very important.

When you have met one autistic person, you have met one autistic person. Let us understand the line. That is the baseline here. Perhaps every Department other than my own needs to understand that. When you have met one autistic person, you have met one autistic person.

Before I go on, I will acknowledge the work of Niall Brunell in the Department, who has worked really hard on the strategy with me. I also acknowledge the work of Noel Byrne. Their teams have done a great deal of work. They have worked with everybody and fed into the various reports. They have worked with AsIAm, with the various organisations and steering groups and with the people who participate in them.

I am not going to stick to the script because I want to address a few issues. I will start with the issue of AAC devices. While it is not for me to make announcements on the floor of the Dáil, I will say that is my ambition that AAC devices will become a permanent fixture and will not be a one-off.

I believe it was Deputy Martin Kenny who spoke about assessments of need. I have the regional assessments hubs set up in the six RHAs. I will have to talk to Bernard O'Regan about what Deputy Ó Murchú said. There has to be one front door and no wrong pathway. Expanding on the assessment hubs, we also need community information hubs. We need pathways that are not on a medical model or anything like that. The phrase "from the cradle to the grave" was used. Where do we access early years services? Where do we get education? What are the barriers? What are the questions we should ask teachers? What is going to be the transition from sixth class to first year?

How do we get through that really anxious period when ADHD presents when someone is getting ready for exams? How are we looking at integrating into higher education and further education? How do we actually work with our guidance counsellors to ensure we get the best opportunities for our young people? Parents need that support and they do not get such support with a good bedside manner within the HSE. They are there to deliver a particular style of service. We need community hubs in autism that will actually reflect the needs of the parent and the young people. It needs to be fit for purpose, accessible and universally designed for accommodating the young person who has autism. It is not so much just the young person; it can be the person who is transitioning into higher education or into employment because there can be those little speed bumps along the way when someone needs to come back again to be put on the right pathway.

It is way above my pay grade to have any sort of involvement in the school inclusion model but I absolutely believe it needs to happen. There is no denying that whatsoever. Sometimes when we ask why things do not happen, perhaps we need to talk about the unions. I will not go any further than that. We have fantastic teachers, special education teachers and SNAs but sometimes when we want to change the Titanic ever so slightly, we have to ask where are the barriers to change. Sometimes it has to be in relation to the unions. I will get shot for that later on. I cannot crack certain whips and that is the reality of it, but it is important to call out what they are. That is my job.

I met a fantastic group during the summer, as all of the Members also meet these groups. I met the young leadership group from AsIAm. That human leadership group taught me an awful lot in the one hour I was in the room with them. They taught me so much about how we need to actually listen to, understand the direction of, and hear the voices of young people. Maybe sometimes we do not have enough young people engaging with us. The AsIAm youth leadership programme is phenomenal. There needs to be more space for that in how we do policy and how we engage with younger people.

Reference was made to the autism strategy being updated every three years. I would love to see that happen and perhaps under my tenure, when we get the autism innovation strategy launched, that could be the next part of the conversation. I would like to think the work all of us have put in will not fall on deaf ears going forward, and that when governments change it continues to stay in play. It really has to. Members will be aware of the optional protocol and the release the Minister, Deputy O'Gorman, and I did earlier this week, along with the work that went to Cabinet. That is real. I really want to see the optional protocol enacted. The no wrong door approach is very important. As Deputy Ó Cathasaigh has said, sometimes parents feel there is actually no right door for them.

The summer programme is where we put families into a spin. We put families into crisis by not having summer programmes. "Not having the routine" is what I hear all the time, along with not having the stability of the structure. Coming to the second last week of August, before schools start to return, is when families are actually on their knees. We can prevent this and it is within our gift. To be fair to the HSE, I have seen some of the recommendations relating to the grant fund, although it is not finished out yet. As well as balancing it with not having enough therapists on our teams, it speaks to that point about routine. It is about that routine and ensuring that children have access to what they classify and like as their routine services.

A number years ago I visited a place called Liskinnett Farm, which is not too far from where Deputy Michael Moynihan comes from. They support 6,500 therapeutic interventions through equine therapy. These are children who go to the summer programme but actually go horse riding every day on the week they are on the summer programme. We need to be a little more agile in our approach to the summer programme. It does not need to be regimental within the classroom but the children need to get on the familiar bus to go to their familiar location to be supported with their familiar staff. That needs to happen but there is nothing to stop us bringing in our trainee occupational therapists and physios and nothing to stop us bringing in our trainee nurses or trainee teachers, or even our trainee gardaí. I again go back on this hobby horse of mine. We need everybody to understand autism and how to interact earlier in the season. We can bring these trainees into the school. Junior school does not finish up until the end of June and the colleges are out at the end of May. There is nothing stopping us. We can do the transition without putting the entire weight on the teaching body. We can lean on teaching support to work with our young professionals and our leaders of the future in education, our leaders of the future in health and social care, and our leaders of the future when it comes to crime prevention. We can use our mainstream and we can work with the children who need that support. It is not rocket science; it is about a change of culture and a willingness to participate. Let us be fair and acknowledge that this is happening in some schools. We need other schools to come on board. We need other Departments, including health, education, and equality, disability, integration and youth to all work together and stop being siloed. Meetings about meetings must stop. We need to actually say, "This is the pathway and this works". Maybe we need to give more autonomy back to the school principals. Maybe we need to give more autonomy back to the disability managers so they can work out their own local arrangements.

Deputy Troy raised the issue of ASD classes, where the response has been along the lines of, "You say you need two but we are only giving you one but actually we know that the prevalence of autism is growing." That approach does not make sense to me. He mentioned Mullingar. I can also talk about Castleknock in Dublin where there are 23 young children that I am aware of at this moment who are waiting to get into two national schools and there is no capacity for them. No young child should not know where he or she will go to school in September.

With regard to respite, I go back again to the point that it does not all have to be about a head on the pillow. We should consider alternative forms of respite, including Saturday clubs, weekend camps and Easter and summer camps. When funding is provided in a budget that ensures €15 million for respite care and €25 million in a full year, why we are doing every second weekend with a provider just blows my head completely. On day services where there are waiting lists, we know our school leavers because we are profiling. It was 1,700 one year and 1,800 another year, and nearly 2,000 this year. I have left aside €34 million in a full year for school leavers. It is beyond me why one cannot actually do the sums, make the provisions, map it out and have places sustained. I reiterate that I am in full support of an Cathaoirleach Gníomhach, Deputy Durkan, and all Deputies. My job is to secure the funding to ensure these can be operationalised to make sure the lives of our young people, and our not so young, are in a better place. I cannot go out and do it but by securing the funding we are paying the wages to ensure that people do their jobs and are accountable.

Deputy Pauline Tully

I thank all my colleagues for their contributions to this discussion. It is not really a debate; it is a discussion. I thank the Minister of State not just for being here and participating in this but for all the work she does in this area. I am really looking forward to the launch of the autism innovation strategy. It is great to hear it is just a few weeks away. She said it was initiated before the committee's final report but the two dovetail, and that makes sense.

The onus is on whoever is in Government in the next term, and the next term as we go forward, to continue this work so what was done in this Government term, with the report by the Minister of State and the committee's work, does not stop there. Many good reports are sitting on shelves and have never been implemented. We need legislation that ensures the strategy is reviewed and updated on a regular basis, and that a report is brought to this House on how this is being done and implemented.

A number of Members spoke about summer provision, which is very important. I acknowledge again the work done in recent years by the Department of Education on increasing the numbers year on year. The committee put a spotlight on it. Senator Carrigy did a large amount of work on this. I echo his call that all special schools should provide summer provision. It can be provided in different ways. It does not have to be students sitting in a classroom. In fact, it should not be students sitting in a classroom. It should be students engaging in various activities that are appropriate to them. Students go to the Gaeltacht to learn Irish and they do not necessarily sit in a classroom to do it. They do it through activities, and learning by doing is much more beneficial.

There has been a lot of talk on moving towards a more inclusive education system and the NCSE has come up with some guidelines on this. It is not, as Derval McDonagh of Inclusion Ireland said, about a child fitting into the education system. It should be that the education system is broad and changes to suit a child. There are many ways to do this. Our schools have to become much more universally designed and appropriate for all our children. Children can then access education in their local area. This is a while away and it will take time. It will take time to build up the confidence of parents to send their child to the local school and be assured their child will get an appropriate education there and will be supported. This can only happen through engagement with parents and engagement with the education sector and ensuring that supports are put in place.

Many important points have been made. This is an excellent report and it needs to be implemented. The Minister of State is on the road to doing this and I appreciate it. It is everybody's responsibility to ensure it continues. I reiterate my thanks to the autistic community in particular, whose powerful self-advocacy has culminated in this comprehensive report. I also thank all of the witnesses, whose contributions are reflected in the committee's recommendations. I also reiterate my call on the Government to implement all of the recommendations in the report.

Senator Micheál Carrigy

I thank all of the Deputies for their contributions this evening in what is an important debate. Deputy Martin Kenny mentioned reports being left on the shelf. One commitment I have given, as have the members of the committee, which is why we have an all-party parliamentary group on autism, is that so long as all of us are in these Houses the report will not sit on a shelf. I have to work towards it but I want to stay here to make sure this is fully implemented. It needs to happen.

I want to put on record my thanks to the Minister of State. She is passionate in this area and I know she will leave no stone unturned in ensuring the best services possible that the State can give will be given. I give a commitment to work with her and to support her on this. I thank her for the work she has done to date.

The Minister of State mentioned one-stop shops. I look forward to the pilot model being rolled out in 2024. Ultimately, in the years to come, I look forward to it becoming far more widespread throughout the country. It is important for parents. I am one of those parents and when you are told initially it is gut-wrenching. We did not know where to go or where to get information. Luckily we now have the advice line, which is funded through AsIAm. It is important that we have a place for parents and families to go to get the support that the child needs and that parents need.

I look forward to the day when every child in every family will have assistive technology devices. I know they can work and they can help a child with their speech. It is important that it is budgeted for in 2025 and that we see far more of them made available.

The Minister of State mentioned the significant number of special classes, with 1,300 special classes and seven special schools. The transition from primary school to secondary school is an issue and we need to identify more places in post-primary schools.

I support Deputy Troy on having all-round services, rather than having just two a month as there is in Muiríosa in Mullingar. I highlight the respite services in Longford. I know the Minister of State has put funding in place for them but they are not in place as of yet. I ask that this be implemented immediately. I know the money was made available by the Minister of State and she visited us in Longford. I thank her for this and I want to highlight that these services need to be put in place immediately.

We met three weeks ago as a group to discuss the draft strategy. We found that a significant number of the report's recommendations were not contained in the initial draft. We have made a very short submission to the Department on this. It supports the submission made by AsIAm with regard to all of the recommendations made in the report being considered. The all-party committee has made a submission supporting the submission that AsIAm has made. It needs to be taken on board for the final draft of the report and I look forward to seeing it in early April.

SET has been mentioned, and has been very topical in recent weeks. I met the Minister of State, Deputy Madigan, on this to express concerns. An appeal mechanism is being put in place for schools for September if they feel they have a shortage of hours. We need to make sure the funding is in place for the hours required for those appeals that are successful. We do not want a situation where a school knows in September but has to wait until January. The funding for these hours needs to be put in place and the commitment needs to be given now by the Government to make sure the funding is in place.

I am grateful to the other members of the committee. Deputies Buckley and Tully and everyone mentioned that we work very well together. We put in a significant amount of work. We had 26 public session meetings and more than 30 private session meetings. We also had a number of trips, including to the Middletown Centre for Autism and Ballyowen Meadows primary school in Dublin. Last October Senator Wall, Deputies Tully and Buckley and I visited the health minister in Scotland and Scottish Autism. This is where we met the group of young advocates on the Lived Experience Advisory Panel, who are involved in drafting the legislation for Scotland. The Minister of State mentioned this and it is key. She met with the youth group in AsIAm. We need to work with young people here to make sure they are inputting into the policies we make in the years ahead.

I thank the witnesses who contributed greatly to the report and all of the organisations that support the autistic community with passion and commitment in what are difficult challenges and difficult circumstances for many people. On the day of the debate in the Seanad, which was mentioned by a number of people this evening, a very powerful statement was set out in these Houses. To have that debate in one of the Chambers of the Oireachtas gave people an opportunity to speak and advocate on behalf of the autistic community. It was very powerful. It is something that all of us will remember for the rest of our lives.

It was a privilege for me to work so closely with the community on the report. I am grateful for the continuing co-operation of those people in the community and the organisations. I mentioned Adam, Michael and Niamh, who are here. I look forward to working with them and supporting them as they continue to advocate on behalf of the autistic community.

On my behalf and on behalf of the all-party joint committee, I thank the community and its supporters for their resilience, their patience and their efforts to promote inclusion of their society. I support Deputy Tully's call on the Government to take on board the report in its entirety, to implement it as part of the autism innovation strategy and to legislate for that strategy in order that regardless of what government is in place in the years ahead, it is a rolling report to be reviewed every three years whereby the Minister of the day will come to both Houses of the Oireachtas to update the Members on behalf of the people.

An Cathaoirleach Gníomhach (Deputy Bernard J. Durkan)

I compliment all involved on a very interesting and sensitive debate, which was needed. I also compliment them on the manner in which it was dealt with. I recognise the efforts made by all of the people involved to identify and empathise with the families and the sufferers themselves.

Incidentally, somebody made reference to the Upper House and the Lower House. This is the Upper House. We are not in the United States, where the other House is the Upper House.

Deputy Pauline Tully

The Seanad is the Upper House.

Question put and agreed to.

Cuireadh an Dáil ar athló ar 7 p.m. go dtí 2 p.m., Dé Céadaoin, an 20 Márta 2024.

The Dáil adjourned at 7 p.m. until 2 p.m. on Wednesday, 20 March 2024.