Tuesday, 26 November 2019

Ceisteanna (48)

Margaret Murphy O'Mahony


48. Deputy Margaret Murphy O'Mahony asked the Minister for Health the action being taken to reduce the number of overdue assessments of need under the Disability Act 2005; and if he will make a statement on the matter. [48760/19]

Amharc ar fhreagra

Freagraí ó Béal (7 píosaí cainte) (Ceist ar Health)

What measures are being taken to reduce the large numbers waiting for assessments of need under the Disability Act 2005?

I thank Deputy Murphy O'Mahony for raising this very important issue.

The Disability Act 2005 provides for assessments of need for people with disabilities. Any child thought to have a disability born on or after 1 June 2002 is eligible to apply for an assessment of need, which will detail his or her health needs arising from any disability. Since the Act's commencement in 2007, there have been significant year-on-year increases in the number of children applying for both assessments of need and disability services generally. Regrettably, these increases have led to the extended waiting periods experienced by children and their families.

In order to improve the assessment of need process and ensure that children receive interventions as soon as possible, the HSE has developed a new standard operating procedure for the assessment of need process. This measure will ensure that children with disabilities and their families access appropriate assessment and intervention as soon as possible while at the same time bringing consistency to the assessment of need process across all community healthcare organisations of the HSE. It is intended that the procedure will be implemented from quarter 1 of 2020.

In addition, the HSE disability services are currently engaged in a major reconfiguration of their existing therapy resources for children with disabilities into multidisciplinary geographically based teams. This is part of the HSE's national programme on progressing disability services for children and young people from birth to 18 years of age.

The key objective of this programme is to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities and their families to services, regardless of where they live, what school they go to or the nature of the individual child's difficulties. Evidence to date from areas where this has been rolled out shows that implementation of this programme will also have a positive impact on waiting lists for both assessments of need and therapy provision.

An increase in the number of therapy posts has been identified as a priority requirement to meet current unmet need and projected future needs in children's disability services nationally. In this regard, last year's budget provided for the recruitment of an additional 100 therapy posts to help reduce the long waiting times for assessment and to support interventions for children who need them. The recruitment process for these posts is well under way. There were 63 in post by the end of the first week in November, and the remaining 37 are expected to be in post before the end of the year.

As the Minister of State knows, under the Act the assessment is supposed to start within three months of application and to be completed within another three months. This is not happening. Right across west Cork and indeed nationally I have heard of many cases in which the parents, who obviously know their children best, know what is wrong with their children but just need this official assessment done and an official diagnosis. Many people can afford to go private; many more cannot. Even for those who can, this diagnosis is often not accepted. It is therefore imperative that this list is cleared in order that parents get these official diagnoses. The diagnosis opens many doors, including those that will allow children access to special needs assessment, SNAs, so it is very important. The Minister of State will be aware that overdue assessments under the Act rose from 3,568 at the end of March to 3,768 at the end of June of this year. I recently received figures for the end of September showing 4,100 now overdue, so we have seen an increase of 15%. This is not acceptable, with respect.

I am conscious that timely access to assessments and therapies is imperative in a child's development. I fully understand that delays in accessing services are a source of great concern for children and their families. While not addressing all needs, it is important that the process has begun. I accept the Deputy's point that it is very important we get in early when it comes to these young children with disabilities. What are we doing? As I mentioned in my response, the recruitment process is under way. There were delays with trade union issues within the HSE. As I said earlier, however, 63 were in post by the end of the first week of November and we have been told that the remaining 37 are expected to be in post before the year end. This new resource will result in additional new therapy posts ranging from speech and language therapy to occupational therapy, physiotherapy, social workers and psychologists. I am confident that the initiatives I have outlined will have a significant positive impact on reducing waiting times for assessment of need over the course of the next year.

What the Minister of State is trying to do is obviously not working. If there has been an increase in the number of overdue assessments in the past six months, there is something wrong. I acknowledge that the numbers went down in 2018, but this year they are increasing, and that is just not good enough. The Minister of State spoke of the importance of early intervention, and it is hugely important, but without this diagnosis people cannot get early intervention. This is cruel and if there is no early intervention, it can have a detrimental effect on the child as he or she grows up. I ask the Minister of State to put something in place for these children and their parents. We must remember that behind every child affected are parents and siblings who are all going through this torture together. I therefore ask the Minister of State to do something to reduce the numbers on this list.

I take this issue very seriously and take on board the point the Deputy makes. It is essential we put these early intervention services in place. As I said, though, the key issue is that the staff numbers have increased dramatically. We are trying to deal with this. We have also set up the health service reform programme, which seeks to have health and social care networks in place. The HSE is also establishing a total of 96 children's disability networks across each of the nine CHO areas. These networks comprise special multidisciplinary teams to work with complex disability needs. Each network will have a children's disability network manager with specialised expertise in providing clinical disability services.

The appointment of these network managers can now proceed following the recent Labour Court ruling. I am optimistic that this will improve the services. I accept the point that we must act and hope to have these 37 new posts filled before Christmas.

Question No. 49 replied to with Written Answers.

It has been agreed that Deputy Murphy O'Mahony will ask Question No. 50 on behalf of Deputy Michael McGrath.