2025-12-18

Before I raise my issue, I wish the Ceann Comhaire and her team, including Jill Gray, and every person who works in the Oireachtas a happy Christmas. We are incredibly well looked after. Sometimes it is a bit lost on us how well served we are. This is a very decent place to work because of the men and women who keep it going. I hope everybody gets a chance to spend a bit of quality time with their family, because they have all more than earned it. I hope the Ceann Comhairle gets a rest. It has indeed been a very busy year. I thank the Minister of State for being here to take my topical issue, which relates to the length of time children in my constituency, in particular, must wait for an assessment of need, AON. It would be remiss of me not to raise the volume of representations I have received, even in the past two or three hours, on what is being referred to as the Government's decision, quietly embedded in a press release, on the AON process. They come from teachers, people working in the area of special education and, crucially, parents. They say diagnosis matters. It is not a bureaucratic hurdle. It provides children with an understanding of their own identity, strengths and challenges and it equips teachers to provide informed and effective supports. They want to know who will conduct these educational assessments. Will teachers be expected to take this on? What training, what capacity and what safeguards will exist? How can educational assessment conducted without diagnostic expertise determine appropriate placement in complex cases? There are real concerns. I received a deluge of lobbying before I came down here. They have a simple request. They want the Minister to publish in full the proposed criteria and decision-making process. They want clarity on the future status of special education designations. They want this paused to facilitate the discussions, which I feel are important. This Topical Issue specifically relates to my area, but my area is part of the wider picture. I represent one of the youngest and most rapidly expanding areas of Dublin, but the children in my area who require an assessment of need appear to be left waiting. I think they are the longest waiters in the State - 3% of children in Fingal received an assessment of need within the legal minimum timeframe compared with a national average of 10%. A national average of 10% is an absolute disgrace but 3% is even worse. I represent the youngest town in Ireland. If ever there was a need for additional resources to be targeted, it would be in my area. Parents watch their kids wait and wait for assessments of need. If the Minister of State wants an estimation of just how bad things are, it was reported in The Times Ireland weekend edition that there is now a buy-now-pay-later service being offered for therapies. I have spoken to parents who are so desperate to get the assessments of need for their kids that they will actually go private when they do not have the money. It is grand for those who are loaded, but most people are not. They might borrow from a family member, get a credit union loan or do a few shifts of overtime if there are any going, but very often, there are not. Then they find themselves in debt but they still have to keep paying for therapies. The Minister of State might acquaint herself with this buy-now-pay-later, BNPL, service because I fully intend to raise this every single time. It is disgusting that people would be forced to get into debt for what their children have a legal entitlement to. These companies have the neck to advertise this stuff because they know how desperate parents are. They know that parents desperately need these assessments for their kids. This BNPL service is evidence of a failure on the part of the Government.

Before I deal with the Topical Issue, I wish a merry Christmas to Deputy O'Reilly and her family, as well as to the Ceann Comhairle, her team and everybody who keeps this place running day in and day out. I hope they all enjoy the break. I thank Deputy O’Reilly for raising this issue and for offering me the opportunity to speak about it on the floor of the House. The Government recognises that there are unacceptable delays in accessing assessments of need, not just in the Deputy's constituency, but at a national level also. The Department and the HSE are committed to addressing these delays and ensuring that the assessment of need system is more efficient and effective. There has been a continued growth in demand for assessments of need in the north Dublin local health office, which spans a significant area within Dublin Fingal West. In the first nine months of this year, 808 applications were received compared with 655 in the same period last year. This marks a 23% year-on-year increase in demand for assessments of need in the north Dublin local health office area. Nationally, demand for assessments of need has doubled in five years. Significant efforts have been made to increase the completion rates of assessments of need throughout the country, including the north Dublin local health office area. This is reflected in the Deputy's constituency in the completion of 770 assessment reports in the first nine months of this year, a 58% year-on-year increase when compared with the same period last year. These efforts have had a positive effect in reducing the number of applications that were overdue for completion in north Dublin by almost 3% in the last year but obviously there is a long way to go on this. At the end of September, there were 1,841 applications overdue for completion in north Dublin compared with 1,893 at the same time last year. While there is a positive trend evident, I entirely accept that we need to do a lot more, not just in the Deputy's constituency, but at a national level, to ensure that assessments of need are completed as soon as possible. This is why the Government announced on 9 December a series of reforms to the assessment of need process that will make the process more effective and efficient for children and families. These reforms include changes to Part 2 of the Disability Act 2005, which provides for assessments of need. These changes will not remove any rights for parents to apply for an assessment of need for their child, nor will they alter the statutory six-month timeline set out in the Disability Act. In addition to these legislative reforms, there are a series of operational actions that are being progressed as a matter of priority. These include the development of statutory guidelines to ensure that assessments of need focus on identifying a child’s needs, engaging in more intensive assessments only where required to identify need. This should help reduce delays and allow therapists to spend more time delivering services. The HSE will establish 11 new in-reach teams, initially, to support HSE assessment processes, including assessments of need and also the HSE's new specific autism protocol and assessment process. Each team will include a psychologist, a speech and language therapist, an occupational therapist and an administrator, providing clinical guidance throughout the process. The administrator is being provided for that team on foot of feedback we are receiving from families that they feel they need and deserve better communication from our teams. The Government recognises the need for urgency in addressing delays in the assessment of need system and that is why we announced these reforms last week to be brought in in the coming months. We are absolutely committed to addressing these for the benefit of children and their families.

I suppose the Minister of State's recognition of the scale of the problem is welcome. I know she was not making a massive deal out of it, but going from 1,893 to 1,841 is nothing to be proud of really. She should probably be a bit mortified. That figure of 1,841 children in my area represents families that are just left waiting. They feel very much abandoned. On the establishment of 11 new teams, the Minister of State might indicate in her second reply how many additional staff that will provide. Will they be joined up with the children's disability network teams, CDNTs? Will they be joined up with community healthcare organisations, CHOs, local health offices, LHOs, and the network? Will they be a stand-alone network of their own? She might explain to me how that will work. She might address the use of BNPL offers. It is debt built up by people who cannot afford to pay out of their own pocket for a service that the State is legally mandated to provide for their kids. They are getting themselves into debt for a service that they have a lawful entitlement to. That is a fairly damning indictment. I appreciate the Minister of State is not long in the job but her party has been more than 14 years in government. The evidence of kids being failed, specifically the 1,841 in north Dublin, is all around us. I have already outlined teachers' serious concerns over what was in the Government's press statement. Teachers in this area, with the interests of the kids at heart, do not trust that what the Government is saying will work. There is no clarity there and I hope the Minister of State will be able to put some clarity on it.

I will. The reforms announced last week are basically a six-pronged approach. First is the statutory element and we published the heads of the Bill, which will go to the disability matters committee for pre-legislative scrutiny and for further consultation. That is aimed at standardising and streamlining the assessment of need process to make sure that every child, no matter where they are in the State, gets the same approach. The second thing we have done is made the decision - this will be part of the statutory guidelines - that decisions will be communicated earlier to parents. When a decision is arrived at as to whether or not a child has a disability that decision should and must be communicated to parents at the point at which it is made. That does not currently seem to be the case. We are now providing that for parents. Single point of access is coming in through the HSE. That is the process by which there will be no wrong door. The Deputy spoke about primary care and the different elements of the health service. Unfortunately some people’s experience is that they wait on the waiting list, they get to the top and they are told they are in the wrong queue and have to go to the bottom of another waiting list. This will be the end of that approach. This is a single point of access to make sure we are supporting parents and families through the right channel for them. On top of that the HSE is initiating a new autism protocol and assessment process specifically for children who are displaying autistic traits. At the moment 45% of children who go through our AON process get a diagnosis of autism. This is responding to that need which is developing and evolving. On the in-reach teams, there will be 11 in-reach teams next year and a further nine the following year, bringing it to 20 and there are 20 REO areas. That is the rationale for how they are being recruited and where they will be based. There will be 44 people hired next year for those in-reach teams of four per team. They will be there to support both single point of access and also the autism protocol and assessment process. We are also hiring more into our CDNTs. We are outsourcing more assessments of need. We will outsource 6,000 assessments of need next year and there is also the education element which the Deputy raised. The Minister for education has confirmed she is committed to putting together a proposal that will phase out the requirement of an assessment of need for a special class or special school and to formulate that proposal in consultation with key stakeholders including unions in quarter 1 and bring that proposal to the Taoiseach and the Cabinet committee on disability.

I thank the Minister of State and Deputy O’Reilly. I wish them both happy Christmas.

Happy Christmas.