Martin Daly demands action on children's neuro-rehab gaps

Minister, I just want to ask you about your plans for community neuro-rehabilitation teams for children with neurological conditions, and if you would make a statement on the matter. Minister, I wish to draw your attention to the lack of policy framework and service infrastructure for rehabilitation supports for children with a neurological condition. You will be aware that the national neuro-rehabilitation strategy only applies to people over 18 years of age, and there is no equivalent of community neuro-rehabilitation teams for children. That means that there is extremely limited access to therapeutic supports. Thank you. The Government and I recognise the need for all children to receive the right services at the right time, and we are committed to improving services for all children with disabilities and have and will continue to do so. There are currently 93 CDNT teams across the country, and these teams provide services and supports for children from birth to 18 years of age, and children with neurological conditions receive supports through these teams as well as through other community services. Almost 45,000 children and their families are being supported by children's disability network teams, and with the number of children waiting to access the CDNT teams, it has been decreasing by 15 per cent in the first half of this year. HSE data from April 2025 shows that there has been a nationwide increase of 26 per cent in CDNT staffing levels since October 2023. Most significantly, the CDNT national vacancy rate has reduced from 29 per cent in 2023 to 18 per cent this year. That is a reduction of 11 per cent points, and we will continue to improve that. The model of service for all CDNTs is family-centred and based on the needs of the child, and it is centred on the objectives of empowering and supporting parents and others who are with the child on a daily basis to facilitate that child's development needs. The programme for Government includes a commitment for advancing neuro rehabilitation services nationally, including the completion of the national rollout of HSE community and neuro rehab teams. And to date, the Government has provided funding for community neuro rehab teams in four regional health areas, HSE Galway, Roscommon and Mayo, HSE South West, HSE Dublin South and Wicklow, and HSE Dublin South West, South City and West and Kildare West Wicklow. I know your issue is in relation to children in particular, we will be increasing the focus on children's neuro rehabilitation going forward, and the HSE is progressing plans to examine the demand for paediatric neuro rehab services for children in Ireland. As you know, Minister, in Ireland 450 children suffer a moderate traumatic brain injury each year, yet the CNDT teams do not have the capacity to provide neuro rehabilitation. However, the children network disability teams cannot cater for children with complex neurological disability, in areas such as spasticity management, orthotics, gait analysis, feeding issues, assistive technology, seating neuro rehabilitation vision and hearing assessment. The national model of care for paediatric healthcare recommends development of neuro rehabilitation services in the community for children with neurological conditions. Could you just give me an update on that? Thank you Minister. Thank you Deputy. So, as I was saying, we will be increasing our focus on the children's neuro rehab. So the HSE is progressing plans to examine the demand for those rehab services for children in Ireland with acquired disability, and to examine the current capacity rehab services, as well as designing a service delivery model for children with acquired disability in line with national strategies for children with disabilities. So consideration of the children's disability services and the funding requirements for budget 2026 is ongoing. The Department has been actively engaging with the Department of Public Expenditure and Reform and Digitalisation and the HSE throughout this process. As the budget has not yet been announced, confirmation regarding funding in specific regions can't yet be provided following confirmation of 2026 funding, the HSE will publish their national 2026 national service plan, which will set out the expected activity for 2026. I welcome the additional services in the community, and I suppose we need to point out that there are gaps in the current system. Children are discharged from paediatric neurology and neuro disability in hospital at 16 years of age. Adult disability services, including day services, accept clients from 18 years and over, so there's a gap there. And there's also clear lack of care coordination for children with neurological conditions, acquired neurological conditions, there's a critical need for case management and key worker support for children with complex neurological and neurodevelopmental conditions. And I suppose it's like everything in the community, we need just more coordination, we need deeper capacity, and we certainly need services for, most especially for children who have acquired brain injury. Thank you. Thank you, Deputy, for your contribution here today, and I think it is important, you're correct, that we do address those gaps. As I travel the country and I've met with those who look after people who get or acquire a brain injury, mostly adults, but issues around that gap between ages of 16 to 18, for example, these would be issues that would be raised with me. So I, I suppose, appreciate you raising it here tonight, and it is something that we will have to look at to make sure that we're rolling out these hubs, as is happening for adults across the country, but also looking at gaps in the surface as well. Thank you. Thank you.