Disability Services

81. Deputy Brian Brennan asked the Minister for Children, Disability and Equality the measures she is overseeing to ensure the recruitment of therapists for children with a disability who require an assessment or have an identified need but cannot access a service due to staffing issues. [77997/26]

I thank Deputy Brennan for affording me the opportunity to ask the Minister of State about recruitment and retention in child and adolescent mental health services, CAMHS, the National Educational Psychological Service, NEPS, and children's disability network teams, CDNTs, and of special educational needs organiser, SENOs. We seem to have a persistent problem with regard to getting posts filled and keeping them filled.

The Deputy mentioned a number of issues not referenced in this question that are not the responsibility of my Department. CAMHS, for example, is under the Department of Health, while NEPS and SENOs are within the remit of the Department of Education and Youth. However, I certainly can provide an update on recruitment and retention of therapists working with children with disabilities within the CDNTs. Most children with disabilities can have their needs met through primary care and mainstream services across a range of Departments and agencies. However, children with complex needs may require access to the health and social care supports and services delivered by the 93 CDNTs across the country. The most recent HSE data provided to the Department reports that CDNTs are providing supports to more than 46,000 children and young people with complex needs nationwide. Challenges remain, with preliminary data for June showing there are waiting lists to access those services. Despite sustained pressure, waiting lists were reduced by 28% in 2025. In the national service plan for this year, the HSE has committed to a further reduction of 25%. I am pleased to report that there has been a lot of progress again this year. However, it is clear that more needs to be done to address waiting times and improve access to services. The Government has provided funding for additional posts to enhance the capacity of the CDNTs. This includes €8 million this year to fund 150 posts to support children with disabilities. A total of 80 of those posts have been filled and recruitment is ongoing for the remaining vacancies. The HSE has informed me it is confident of hitting the target of 150 by the end of the year. Budget 2027 increases the investment in this area, with €6.3 million allocated to recruit a further 150 posts for children's services. Recruitment and retention of staff remain a challenge in the sector. I will talk about what we are doing to address that at my next turn.

I am glad the Minister of State referenced the crossover between education and health. One of the issues that arises constantly is the question of what category applies when a child needs an assessment. There is sometimes ambiguity in that regard. In the context of children progressing in school, it is paramount that there be a co-ordinated approach to resolving these issues. All too often, we hear about parents being left in limbo as they wait for a clear roadmap to help them do what is best for their child. I was bewildered to hear the Ombudsman for Children tell us at the education committee the week before last that because the 70 national CAMHS teams are not populated properly, we really only have, in effect, 40 teams. I realise this may not be the Minister of State's area but my point is that we have a massive issue with recruitment and retention.

To be clear, my Department works with the HSE on the CDNTs. I will provide an update on recruitment and retention for those teams, after which I will deal with the Deputy's point regarding the confusion and difficulty for parents in navigating what is a very large and sprawling system. The HSE continues to drive intensive domestic and international recruitment efforts as well as workforce initiatives. Progress is being made, with the HSE reporting a 31% increase in staffing levels nationwide from October 2022 to June 2026. This equates to an additional 480 whole-time equivalent staff, including approximately 350 health and social care professionals. That is really important because they are often the people on the front line dealing with children and, indeed, adults. Clinical placement opportunities are strongly associated with future employment decisions by students. I am pleased to say that placement activity within CDNTs has expanded significantly. There were 472 placements last year, with further expansion this year a major focus for the Department. Other measures include a CDNT graduate sponsorship scheme, student engagement and career promotion initiatives, expansion of apprenticeship pathways and development of alternative entry routes into disability services.

I regret if I put the Minister of State on the spot this morning with my questions but they are very relevant in the context of the debates we had this week and the week before last on childcare, mental health provision in schools, assessments of need and the provision of clear roadmaps to supports for children with disabilities. I really would like to see some analysis and reporting on what we are good at and where we are failing in terms of recruiting appropriate numbers of staff to deal with these issues. Children need early intervention and easy access to supports at their critical stage of life.

I absolutely agree. I hope the Deputy will be pleased to hear that the HSE has commenced a national CDNT retention research programme, which aims to better understand the factors influencing attraction to work and likelihood to remain in the industry. A dedicated disability workforce strategy is being developed, which will be published by the HSE this year. Its findings will inform future workforce policy and workforce planning decisions. The Deputy mentioned how difficult it can be for families to know which door to go through and which service to access. We have CDNTs, primary care services and CAMHS. I take this opportunity to update him on the HSE's single point of access initiative, which seeks to ensure there will in future be no wrong door. I often hear from parents who wait a long time to get to the top of a list only to be told, when they finally get to speak to a healthcare professional, that they are in the wrong queue and must go to the bottom of another list. That should not and cannot be allowed to happen and we are working to change it. That is what the single point of access reforms will do right across every level of the HSE.