2026-06-23

24. Deputy Ruairí Ó Murchú asked the Minister for Children, Disability and Equality the number of children currently waiting on assessment of needs over the statutory waiting time, in each RHA area, in tabular form; and if she will make a statement on the matter. [47426/26]

Well, we actually did make it to this question. I requested information on the number of children currently waiting on assessments of need for longer than the statutory waiting time in each regional health area in tabular form. I want to get a notion of where we are. We spoke about the new autism protocol earlier but the fact is that this figure is far too big. We need to deal with this. Parents are not getting assessments and therapies for their children.

The Deputy is absolutely correct. The delivery of an effective and efficient assessment of need system is a priority for the Government. The Department and the HSE are working intensively to address delays in the provision of assessments of need to children and their families. It is important to reiterate that children do not require an assessment of need report to access health services, such as primary care, children’s disability network teams or mental health services, or education supports. Demand for assessments of need has increased significantly in recent years. This reflects both the increase in population and the increase in the number of families exploring all options to access services for their child. Over 13,000 applications for assessments of need were received last year, with over 3,800 applications made in the first three months of this year. This demand is absolutely outpacing the capacity of the system to respond. As a result, 21,782 applications were overdue for completion at the end of March. I gave the Deputy that figure earlier. To break that figure down by regional health area: the figure in HSE Dublin and North East is 6,608; in HSE Dublin and Midlands, it is 7,772; in HSE Dublin and South East, it is 3,204; in HSE South West, it is 2,004; in HSE Mid West, it is 595; and in HSE West and North West, it is 1,599. These numbers are really stark. It is really important to remember that behind every number is a child or young person. It is not acceptable that children and families have to wait so long for assessment of need applications to be processed. This Government, the Minister, Deputy Foley, and I have made it very clear that change is needed. There has been progress in the past two years with a noticeable increase in the number of completed applications. Over 5,900 assessment of need reports were completed in 2025, which is a 43% increase on the previous year and an 85% increase on the year previous to that. This progress has been and will continue to be assisted by the assessment of need targeted waitlist initiative, which funds the procurement of clinical assessments from private providers to inform the assessment of need process.

It goes without saying that the figure of 21,782 should be shocking. Unfortunately, it is not. The figure in my own area, HSE Dublin and North East, is 6,608. As the Minister of State has said, behind each of these figures is a child and a family. None of this is good enough. We sometimes come in here and talk about CDNTs and the number of unfilled positions. I will work on the basis that the number of vacancies is still in the high 300s. Even if we had double that number, I am not sure the CDNTs would be able to deal with the need that is out there. We have had many interactions in relation to this recently. Many people have bought into the idea of putting the resources where they are needed, which is to say, in school therapies. It is going to be very difficult if we do not look at the whole gamut from assessments right through to therapies. We are constantly trying to change little bits rather than looking at the overall picture and putting in place a framework that delivers for the children and families out there.

The Deputy is right; the demand is increasing year on year. It has increased quite exponentially in the last five years. As a result, it has been difficult for us to keep up with demand. Our CDNTs around the country do absolutely incredible work not just with regard to assessments of need, but also, importantly, in the delivery of therapies. It is those interventions that parents and children want. In response to an earlier question of the Deputy's, we spoke about the new autism intervention and pathways protocol. That is another Government investment to ensure we provide access to more timely assessments and more targeted interventions for children and young people across Ireland.

We have the figures. None of them are good enough. Unfortunately, despite all the initiatives that have been taken, we have not drastically dealt with that figure. That is the frightening part. It is the one right that parents have. It is sometimes the only right they can vindicate through the courts and there is therefore huge emphasis on it. However, as we all know, it does not provide you with the therapies, which are absolutely necessary. I am going back to the idea of putting a system in place across the board. I am worried that, even if we were to recruit all the occupational therapists, speech and language therapists, and psychologists for which there are unfilled positions in the CDNTs, in primary care and in the in-reach teams, which is probably not possible to do without a huge increase in workforce planning, we would still not be able to deliver on the need that is out there. We have to look at this in a far more comprehensive way that relates to how we deal with disabilities across the board. At the UN conference, we discussed the idea of mainstreaming, making reasonable accommodations and allowing full participation for those with disabilities. We need to stop this failure.

The Government is absolutely committed to ensuring that this is dealt with in a comprehensive way. Part of our response will be a series of improvements to the assessment of need process to make it more efficient and effective for children and families. Over time, this will lead to a reduction in the waiting time to receive an assessment of need. I thank the Deputy for his work on the Committee on Disability Matters. From that work, he will know that the general scheme of the disability (amendment) Bill has been published on the Department's website. The Deputy's committee has published a report following pre-legislative scrutiny of the Bill. The Department is now considering the recommendations. I thank everybody who was involved in those committee hearings and in pulling together that report. A series of recommendations were made and we are now working on these to improve the proposed legislation. A document addressing frequently asked questions has also been published. Legislation is only part of our response. We also need to enhance the processes, to improve training and to increase administrative support for our HSE assessment officers, who are responsible for the production of the assessment reports. The Department is working really closely with the HSE and with the working groups that are in place to ensure this happens. As the Deputy has said, we need to address the wider issues. That is exactly what was set out in this year's HSE national services plan.

Do we have any idea of the timeline for the legislation?