Deputy Mary Lou McDonald- speech from 24 May 2023

Thank you so much, I would like to tell you about a little boy who lives here in Dublin. He will have his fourth birthday in a few weeks from now, and his mother wants what any other parent wants for her child, for him to be happy and to have all of the opportunities that life brings. But this little boy has complex needs. He had a preliminary team assessment for disability services nearly two years ago. He received no follow-up therapies, and his family has not been contacted by the HSE to receive a full and proper assessment of needs. So Taoiseach, as this little boy approaches his fourth birthday, he has spent half his life waiting for this assessment. He is non-verbal and he finds it difficult to sleep at night, and of course his mom is worried sick that without this assessment he will miss milestones and won't be supported to live his best life. He is worried, watching her son, who she loves so fiercely, slip through the cracks of a system that does not seem capable of meeting his needs. Taoiseach, this little boy is not unique in the appalling way that he has been treated. More than 10,000 children are currently waiting over a year for initial contact with their specialist children's disability network team. The very fact of that is a disgrace. In March of last year, the High Court ruled that the HSE was breaking the law in its provision of children's disability services. Under the Disability Act 2005, every child with a disability is entitled to an assessment of need. This is meant to be provided to them within three months of seeking it. But for thousands and thousands of children, that's not the case. According to the Till Geoff's Law, I am en Sa teat baaptshli from my university. I hope that there is an care, I am a woman from my state and has learned from my state. I have a mouthful, that can be found for the Toda. I have a человек, and I have a woman of ordentata. I am a person to meet, and this feels kind of a man of sports. These children deserve access to therapies, to develop their speech, to learn important skills and to access the education they are entitled to. Early intervention is essential to help them reach their potential, but sadly that crucial period is passing so many of them by. This in turn places an overwhelming burden on families who feel forced to pay privately for an assessment of need and for other therapies and services that they simply cannot afford. They have no recourse for reimbursement from the State, despite the fact that it is the Minister for Health's responsibility to ensure the children have these assessments and access to services. These children deserve better and well you know it. Families and children need a government that will get to grips with this. Not vague promises that do not materialise, not ad-hoc or piecemeal approaches, not platitudes, but a genuine change in children's lives. Thysha, can I ask you, when will the State honour its legal obligation to provide these services to children with disabilities, particularly a timely assessment of needs? When will families forced to go privately for assessment of needs be reimbursed? When will financial supports be provided for families forced to access services privately? Thysha, please. Thysha, please. Thysha, please. Thysha, please. Thysha, please. Thysha, please. I just want to thank the Deputy for raising this important issue and all of us will know from our experience from our beneficiary service or just from talking to parents out in the bed around the country that very many children are not getting the assessments that they need in due time and others are waiting far too long for the therapies that they need. Having said that, this is an area where government has shown huge commitment and has invested considerable resources in recent years. You will know, for example, that we have a dedicated minister now for special education in Minister Madigan, a budget of almost €2 billion. We have never had so many special needs assistance, never had so many special classes in our schools and we are setting up new special schools where necessary as well. I think we have seen in the past ten years an enormous transformation in the level of children who are able to access special education and we see the results of that, children doing much better than they would have done if they were born 10 or 20 or 30 years ago because of the enormous investment that has been made. I know it falls short in lots of different areas and that is particularly the case when it comes to therapies, when it comes to providing speech and language therapy, when it comes to providing OT and those services that children need. Of course, the sooner they get them, the better the outcomes and we acknowledge that. A huge amount of it is down to a shortage of staff, being able to find those staff, not a unique problem in Ireland, a problem that exists across the world given the shortage of qualified therapists. In the world, not just in Ireland, but we are not sitting on our hands about it. We are acting. The HSE is progressing several initiatives to improve the supply of therapists into disability services. Minister Rabbit and Minister O'Gorman are deeply engaged in this work. Indeed, they will be meeting with the HSE Board in the coming weeks on this matter and other matters. These include measures, a confined competition to fill vacant senior posts across all disciplines on CDNTs, targeted recruitment for the CDNTs, targeted international recruitment for CDNTs with an agreed relocation allowance for people who are willing to come in from abroad, a sponsorship program for therapy grades. In addition to that, they are looking at other options to bring in an apprentice program for therapy grades. We have done that in other areas, saying that there should be more ways to enter profession. It does not have to be through the degree system or the universities to perhaps have an apprenticeship in this area. The employment of graduates as graduate therapists while they are awaiting registration, so we do not have people awaiting registration that could work in the system and are told that they cannot. Also, an expansion of therapy assistance in the system, with the HSE supporting individuals to return to education to qualify as therapists. Also, an increase in the number of clinical placements on the CDNTs. Despite the recruitment challenges, the HSE and the Department remain commissioned to progress in these efforts to increase the workforce and to improve services to children and families. I know that listing recruitment initiatives can seem somewhat removed from the very real pressures that parents and ultimately their children are facing, but I really cannot emphasise enough how the challenges in our CDNTs are primarily driven by a shortage of staff, and how we are doing all that we can to increase the number of staff, to bring in staff from abroad, to increase the number of people who are trained here. Mark of the HSEC, W MacDonald. The HSEC, you have been in government 12 years. What you have read into the records of the Dáil, there just reflects a litany of failure, of inefficiency, a lack of priority given to this area and to these children. One of my colleagues, Martin Brown, another TIP deputy, got word saved. A one-year-old child with autism from TIP, got word from the HSEC that the first services available to that child will be in 2028. 2028. And there are other children waiting for services or assessment of needs who are being told that they will wait for that length of time. That is not acceptable. And I have to say, a person, an individual who is in government for 12 years, to stand up and to try and pretend that it is all rosy and that there is not a fundamental issue here in terms of political purpose and funding. And support for the minister, who is Minister Rabbit in this area, is just not acceptable. We should not be standing up here citing one-year-olds and two-year-olds and four-year-olds left in this situation. 17,000 children are waiting for first contact with their specialist children disability network team. 10,000 of those are waiting over a year. And you actually stood up and talked to me about SNAs, which is an important issue, but a separate issue. So do not try to dodge here. You said you are planning that you are doing the dividend all to get more staff and therapists. Your counter motion said the following, and let me finish on this. Discussions are ongoing between the Department of Health and Department of Further Education, Research, Innovation and Science regarding the expansion of students. I mean, you are still at the point of discussing this. Are you serious? Are you actually serious? And can you answer my question? Will the State reimburse those who have to go privately for assessment of needs and for services and therapies? Will you open the purse strings and support those families? I have been in government for 12 years, and in those 12 years, this country has made enormous progress. Just look at the figures that came out this morning from the CSO. 2.6 million people at work. Unemployment falling to 4.1 per cent. Compare that to where we were 12 years ago. And, Deputy, you do not like to talk about this, but let us not forget that your party has been in government for most of the last 20 years north of the border. I know you do not want to talk about it, but it is a fact. And I will be happy any time to compare the record of my party in government here with yours north of the border. But doing so is pointless, because it will not do anything for parents who are concerned about their children not getting therapies. But if you want to bring up my record in government, do not think it is any surprise that I should bring up yours, because I am happy to compare it any time, point for point. And if you bring it up again, I will bring it up again. In the issue of assessments of need, we have a real challenge here. Assessments of need are a legal entitlement, but have become a barrier to children getting the therapies that they need. We shortened the assessment of need. That helped for a period of time, reduced the waiting lists. A court decision meant that we had to reverse that. And now that has created a problem. And that is sometimes what happens when you put things in law for a good intention, it can backfire on you. In relation to the issue of reimbursement, that is something we are going to give consideration. Minister Gorman and Minister Rabbit, in response to Deputy Kelly, already indicated that. But when you do those things, you have to do it right. And it is not unusual for us to reimburse. We do it with respected DPs, we do it in dentistry, we do it in pharmacy. So yes, we are open to considering that over the next couple of months when it comes to therapy. But you have to do it right. Because if you do it wrong, it can backfire as well. Thank you. Deputy Bacic.