Martin Daly criticises CAMS access after years-long waits

Thank you to Dr Burke and to Ms McArdle and the witnesses for coming here today. I have to be honest, I simply don't recognise the service that you're describing. I will pay tribute to many fine people who are working in the CAMS service, but the access to CAMS is simply unacceptable. And, you know, some of the commentary, it's difficult not to be frustrated. I don't know if your reports really reflect the amount of anger, frustration, pain and suffering that there are families in situations where they live 365 days a year, seven days a week, and for years to get access to a CAMS assessment. It is the only service in the health service where an experienced GP makes a referral and it is rejected without seeing the patient. It is simply not good enough. I'm going to give two pathways here very quickly because time is short. A 15-year-old boy, his family were in with me during the week. Essentially, it's going on since he was three years of age. Sorry, he's 11 years old. His issues in school, there's a question of ADHD. I'm not going to go into the details, that's my job. Possible autism, does all the family support stuff, goes to the primary care OTs who say this is ADHD or perhaps there's symptoms of autism. A referral was made to CAMS three years ago, sorry, five years ago. They say this elements of autism here needs assessment, eventually gets to see the psychologist in the primary care team who makes an assessment in May 2025. We're now six years on. He's assessed him as not having autism based on insufficient evidence of autism but feels he has complex ADHD, says he needs to be seen by CAMS. Referral again by the GP to CAMS. CAMS sent out a form. Now, they haven't seen this boy yet. No one has seen this boy in CAMS service. Fill out a form. It's an SRS2 form. The family have to fill out the form. It's an observational form. And then it goes back to CAMS. And guess what CAMS say after all of this? We feel he has autism. He needs to go back to the psychologist for a reassessment. I mean, this is absolutely ridiculous. There is a mother crying in front of you. Five years in, they want their son to have an assessment in case he has this complex ADHD. I'm not an expert in this. But, I mean, this to me is chaos. This is goalkeeping. This is not problem solving. These are families who are at the end of this type of service. By the way, they paid for an educational psychologist who has come up with a diagnosis of ADHD. 500 euros. They were lucky to get it so inexpensively. So, there's professions. And OTs are saying this in the service. And they can't. I'm conscious of time here. But I just need to get this off my chest. Another family, a 15-year-old, referred to CAMS two years ago, has autism. So, I don't recognise, Dr. Burke, what you're saying about CAMS refusing autism. It's clear to me, and it's consistent amongst deputies here, amongst GPs I know, and amongst families I meet, that if autism is introduced, it's like a goalkeeping situation. CAMS say, no, hand up. We're not even seeing you. We're not assessing you. So, a 15-year-old with autism. And the other thing is sending out these patronising letters. What's this here? Common sense parenting programmes for children with really difficult issues. I mean, gaslighting parents. So, two years ago, referred with depressive symptoms. I'm not going to go through all the other referrals that had to go to CAMS in that area. Eventually seen in October 2025, two years into it, a number of engagements with CAMS in Roscommon. Then referred on for an additional assessment into Galway. Parents feeling that they were being told these were parenting issues. Turns up in Portioncola Hospital in February, suicidal. Kept overnight in Portioncola Hospital. Sent home without a CAMS assessment. Then seen by CAMS again. Then the father, these are very, very reasonable parents, finds a detailed suicide note. Then admitted to CAMS. Ten days in CAMS in Merlin Park Hospital. These are the pathways that are reality for parents and children. Not what's in this report. And, you know, we see the waiting list here. 4,462 children. How many referrals? Does that include referrals that have been declined by CAMS? It doesn't. In Roscommon, I know we were having 60% of GPs' letters being declined without seeing the patient. It doesn't. In Roscommon, I know we were having 60% of GPs' letters being declined without seeing the patient. So, here's the questions I suppose I want to ask. Because, you know, it's difficult not to feel frustrated. And I understand the other deputies and senators here. Because these families are coming into our offices non-stop. And then as a GP, I'm seeing it also. Is the referral criteria for CAMS too narrow? I suppose, first of all, I want to say, we agree with you. We need that more needs to be done. Okay? And we can tell you how we're going to do it. But can I just interrupt here? The culture isn't... I would accept this. If CAMS in Galway said, we do not have the capacity, in Roscommon, we do not have the capacity. You know what happened to this child on the border? CAMS Roscommon see him, goes into a unit in Galway. He needs an assessment of needs. They won't let the Roscommon assessment of needs officer do it, because he's in County Galway on the border. There's no assessment of needs officer in County. He's an inpatient. Now you're purchasing one in the private sector in Mullingar. He's going to drive through Roscommon to get to Mullingar. It's... I don't mean to... I'm not making this personal. It's simply, if you recognise the problem, the parents on the ground and the children feel the volume and the significance and the size of this problem is not being adequately recognised. And that if someone in CAMS turned around and said to a GP, we don't have the capacity to see this child, that's fine. But don't tell me, as a senior GP, go to Jigsaw, go to Family Support, go everywhere else. And many of these services just simply aren't available. And can I tell you what we're doing about it? Because I agree with you. It's unacceptable that it's sent back to you. OK. So what we're doing about it is, is through the single point of access, right, you will make the referral. If CAMS thinks they need also to be seen by the CD&T or by somebody else, it does not go back to you. It goes through the clinical triage form, right, to... It's accepted by the other agency, right? And then you will receive a letter to say exactly what we're doing with your patient, right? And then should they need further intervention? Again, it comes back to the clinical triage form and it's discussed and that is provided. So it never goes back to the primary referral again. For example, you have a psychologist who's a HSE primary care psychologist who says that this child is complex, ADHD, this needs to be seen by CAMS. Now, this is five years into this process. This isn't in two or three months. Back to CAMS. I have all the rejection letters from CAMS here. They're patronising, to say the least. And then CAMS say, no, not on seeing the patient, based on an assessment of form that they won't see them, you need to go back to the... And there's no choice, by the way. There's only one psychologist in the service. Thanks, Deputy. And just to remind deputies, if we do want to get answers from the witnesses we've invited here, we need to allow them time to answer their questions as well. And we need to give adequate space. In the interest of fairness... I agree with that, but I think they understand exactly what I'm talking about. I'm just saying, Deputy, in the interest of fairness, we've invited people here and we need to give them time to adequately answer the questions.