2026-07-08

I highlight the serious case of a ten-year-old called Poppy, whose experience is a compelling example of a wider service failure for children in my constituency of Wicklow-Wexford, which covers south Wicklow and north Wexford. Poppy has complex feeding difficulties and has been referred between the child and adolescent mental health services, CAMHS, the children's disability network team, or CDNT, primary care and the complex feeding clinic for over three years. Despite CAMHS advice that Poppy needs specialist dietary input, north Wexford CDNT has not had a dietician for the past five years. This is shocking and it means Poppy does not get the type of support she needs. Her condition has deteriorated to the point where anti-anxiety medication and possible PEG tube placement or force-feeding have been discussed. The family have funded assessments and therapies privately due to the lack public services. Poppy's case highlights the lack of such services for children in south Wicklow and north Wexford. There are many long-term vacancies in the north Wexford CDNT, there is no current occupational therapy service and only limited physiotherapy is available. Families are experiencing significant delays, there is poor communication and unclear referral pathways and parents are reporting extensive waiting lists. I want to know what is going to be done about it.

In raising the issues with CDNT services across the south east, in Waterford in particular, I am really concerned about the situation in Dungarvan. The service there is down two whole-time equivalent speech and language therapists, and that is on top of a low base. I am very concerned about waiting lists. There are six children on a waiting list for CDNT services in Dungarvan for over 12 months. The situation is not much better in the Clonmel and Waterford CDNTs which cater to parts of County Waterford. This comes on top of the latest figures I have - though there may have been some movement since I got them - showing an 18% vacancy rate in CDNTs across the State. This means children are being left behind. I am thinking of a young boy in west Waterford who was really coming on with speech and language therapy but who has been left in the lurch. Since I mentioned locally that I would be raising the issue this week, I have been inundated with messages and emails, most of which have already been passed on to the relevant offices as representations. It just shows the issues that exist, despite the best efforts of the people working in the CDNTS, who are really diligent, dedicated and excellent. This is putting huge pressure on families and holding children back in their development and also their wellness.

I acknowledge Kilkenny city has bucked the trend and is operating a full staff complement, which is great to see. However, it is a completely different story in south Kilkenny. The team serving Ferrybank, south Kilkenny and Waterford north city has a vacancy rate of 52%. Over half its posts remain unfilled. That is a massive failing for children across these communities. To make matters worse, the planned closure of Carlow College, which provided so many social care courses in the area, is another serious blow to the sector and the region. In Carlow the vacancy rate for the CDNT stands at a staggering 42%. While some areas have made real progress, others have been completely neglected. Will the Department introduce targeted measures for teams like those in Waterford north city and Carlow to tackle the high vacancy rates? I know from working with adults with disabilities that if some of the people I supported had received services when they required them, they would be in employment now and leading much different lives. It is too late for them. We need to look after the children now and see more staff in these places.

I thank all three Deputies for raising this really important issue and giving me the opportunity to respond. As the Minister of State with responsibility for disability, I, along with the Minister, Deputy Foley, and the Government, fully recognise the importance of providing timely and appropriate supports for people with disabilities and their families. We are committed to improving access to these services across the country, including for children and families in Waterford and the south east. The HSE children's disability services team has undergone significant reform and restructuring over the past few years. The core focus of these changes has been to ensure children with complex needs and their families receive an appropriate and accessible family-centred service. HSE preliminary data for March 2026 indicates our CDNTs are providing services and supports nationally for 45,472 children and strategies and supports for wait-listed children with urgent needs, where staffing resources allow. These are encouraging in terms of the numbers of children receiving support but there has also been encouraging progress in the numbers on our waiting lists reducing. In that same period, the national CDNT waiting list has reduced by 50% from 16,522 children in 2023 to 8,200 children at the end of March this year. In the national services plan for this year, the HSE is committed to a further 25% reduction in the numbers on our waiting lists. The HSE preliminary data to the end of March this year indicates that for Dublin and the south-east health region, which is the region all three Deputies represent, 6,834 children are on open CDNT caseloads or are receiving services, and a waiting list of 2,078 children remains. The children's disability network team in Waterford and the south east continues to provide services and supports for children from birth to 18 years of age. I would like to pay tribute to all the staff working in our CDNT teams, not just in that region but across Ireland. Like many areas across the country, they continue to face recruitment and retention challenges across a range of health and social care professions. As Deputy Ó Súilleabháin pointed out, in the north west and in south Wicklow, there is a particular issue with dietitians; as Deputy McGuinness pointed out, in Dungarvan, there is a particular issue in terms of speech and language therapists; and as Deputy Newsome Drennan pointed out, while in south Kilkenny there are high vacancy rates, in Kilkenny, there are not. There are areas where vacancy rates are higher and we will be prioritising the teams with the highest vacancy rates when it comes to allocation of additional resources. Services are operating under significant pressure. That is as a result of those vacancy rates and also the demand. While teams continue to work hard to meet the needs of the children and families, workforce shortages can impact the capacity to provide assessments therapies and interventions. This can slow things down and, ultimately, everybody wants that sped up. Unfortunately, children on the CDNT register, whether they are on waiting lists or on an open caseload, are likely to be waiting some time in terms of intervention. That is a direct result of those issues, which we are determined to overcome. I acknowledge the frustration this can cause for children and their families. The HSE and CDNT lead agencies are continuing to work actively and collaboratively to recruit into funded posts to strengthen workforce capacity and support staff retention across the sector. We have provided funding for additional posts in recent years to enhance the capacity of teams and reduce waiting lists. Most recently, €8 million was secured in this year's budget to support the recruitment of 150 additional posts for CDNT teams. As I said, priority will be given to the teams with which there are the highest vacancy waiting lists.

In north Wexford and south Wicklow, if a child needs specialist care, say, in the area of physiotherapy, occupational therapy, OT, speech and language, psychology or with a dietitian, if they are in desperate need, what procedures are in place if the necessary specialist intervention is not available due to staffing shortages? Does the HSE consider it acceptable that children remain without these services? If they are unavailable, is there an emergency plan B to deal with desperate cases like these? There are many of them. I know of so many people who cannot access any service, so what is plan B?

I thank the Minister of State for the response. Like her, I want to pay tribute to those who are working in the services. They have, in many cases with one hand tied behind their backs, managed to clear backlogs arising out of the pandemic and they do their work to a really excellent standard. As we know, however, there are ongoing issues in terms of recruitment and retention, with retention being a key issue. That is not to say there is not capacity elsewhere, however, and for those children whose development and ability to live their lives fully is being held back, Government needs to look, in the interim at the very least, at private provision or provision in areas outside of where they live, so that at least they can access some modicum of service in the short term.

I thank the Minister of State for her response. While I welcome that there is progress being made, the harsh reality of this is that much of the progress is moving at a snail's pace. Over 2,100 children across the region I live in are on a CDNT waiting list. Almost 1,600 of those children having been on a waiting list for over 12 months. This number just compounds how slow progress is being made. Every day that a child in need is missing out on vital care is causing harm. It is as simple as that, so we need to see faster progress.

I thank the Deputies very much. I fully appreciate not just their frustrations but those of the parents and children they are here representing. I am pleased to be able to say that we are making progress when it comes to recruitment. The HSE reported a 28% increase in staffing levels nationwide from October 2023 to October 2025. That equates to 448 whole-time equivalents now working in HSE disability services. That includes an additional 321 who are specifically health and social care professionals. We are doing a lot of work to increase that pipeline to be able to hire from. One example of this is the student sponsorship programme, which we launched in April of last year. That has already resulted in more than 40 graduates taking up roles in our CDNTs nationally. This includes six student sponsorships across integrated healthcare area, IHA, Carlow, Kilkenny and south Tipperary and IHA Wexford and Waterford. Therefore, the Deputies will see even in their own areas that this is an initiative that is working to help support their constituents. In addition, a dedicated disability workforce strategy is being developed by the HSE this year to meet growing service demands and address recruitment and retention challenges. While challenges do remain, both the Government, the HSE and our funded service providers - our section 38 and section 39 organisations - remain absolutely committed to improving access to disability services, strengthening workforce capacity and ensuring that children with disabilities and their families receive the supports they need.