I ask the House to note I am not opposing the motion and I welcome the opportunity to debate this important issue. The Opposition put forward a similar motion in May of this year which we, as a Government, did not oppose either. This Government has continued to progress key measures to access assessments of need as well as therapies since that motion went unopposed and I welcome this opportunity for further debate. I also wish to take this opportunity to acknowledge the commitment and passion of Cara Darmody, who is accompanied by her father, Mark. I have met Cara on a number of occasions and I absolutely accept she is so passionate in her advocacy. I take the opportunity to reassure Cara, and all families waiting for an assessment of need, that the Government recognises and shares the concerns expressed through this motion. I know families have been enduring incredible stress and unacceptable delays in receiving AON reports and some existing AONs are taking up to 30 hours to complete, which is far too long. This is why this morning Cabinet approved the publication of the general scheme of the disability (amendment) Bill 2025 to bring in a faster and more efficient way of carrying out AON reports. In 2026 the HSE will set up and roll out 11 expert teams with four staff on each, including a psychologist, a speech and language therapist, an occupational therapist and an administrator. This will help to speed up the process because assessment officers will have the expert help they need at an earlier stage. There will be improved training for staff involved in the delivery of assessments of need and ensuring that assessment officers and liaison officers have sufficient administrative supports so they can focus on the production of assessment reports and service statements for children. We are all aware there has been substantial growth in the number of assessment of need applications in recent years. They increased from 2,500 in 2008 when the AON process began to 10,000 last year and over 12,000 applications are anticipated by the end of this year. By the end of September of this year, there were over 18,000 applications overdue for completion nationwide, which is 42% increase on this time last year. I am more than conscious that behind these numbers are children and families facing their own challenges every single day and relying on the State to help and support them. We want the AON process to be faster so therapists are freed up to provide therapy rather than writing endless reports. HSE clinical staff are spending up to one third of their time completing assessments for the AON process. The more time they spend on the completion of clinical assessments under the Act, the less time they have for the therapy interventions children need. It is a vicious circle and one the Government is determined to break. When clinicians were consulted about this by the national clinical programme for people with disabilities, they spoke about their "moral dilemma" in prioritising AON reports over children on CDNT waiting lists. We need therapists to be therapists and this reform is designed to achieve that. The targeted legislative reform of the Disability Act aims to improve the effectiveness and efficiency of the assessment of need process so children and families receive their assessment of need reports within the statutory timeframe. I want to be very clear the proposed legislation will not affect individuals’ statutory right to an assessment of need or change the time frames set out in the Act. The general scheme will be submitted to the Oireachtas Joint Committee on Disability Matters for pre-legislative scrutiny as soon as possible and will then progress through the Houses. I have no doubt it will be subject to much debate, which I welcome. We owe it to the children and families who affected by delays in the assessment of need process to make sure there is a system in place that works. The legislative reform will build on the work undertaken by the Department and the HSE to date in addressing the increasing demand for assessments of need. In 2024, over 4,100 assessments were completed, a welcome increase of 30% over the previous year. Recent HSE data shows that this upward trend is continuing, with over 4,500 assessments completed in the first nine months of this year, a 57% increase compared to the same period last year. This reflects the priority given by the Department and the HSE to address the backlog of applications. It is essential that we maintain this momentum and accelerate it. I know there have been calls to use more private therapists to tackle the AON backlog. Since May 2024, we have funded a targeted waiting list initiative where the HSE procures clinical assessments from approved private providers for those families who have been waiting the longest. There have been 6,300 clinical assessments commissioned from private providers for AON since June 2024 and there is €20 million in budget 2026 to pay for 6,000 more. However, we have to reform the system to tackle the root of the problem. If we rely on more and more private reports, it is not fixing the AON system. It is like pouring water into a bucket with a hole in the bottom of it or, as a person said to me earlier, it is like adding another lane to the M50. We cannot rely on the private sector indefinitely. We must ensure that the public system can meet the clearly growing demand. The Department will continue to prioritise actions to improve the capacity and effectiveness of the assessment of need system. However, there also needs to be a recognition that assessment of need sits within a wider system that has multiple challenges. Much more is required, beyond even the legislation that the Cabinet approved today. For example, autism was noted as the category of disability in 45% of all completed assessments of need in the first nine months of this year. We know that accessing assessments is a significant concern for parents in order that the services necessary to support their children can be identified as early as possible. There will be a new autism assessment process by the HSE next February, and it will be staffed by psychologists. This will provide a more consistent and efficient approach to autism assessments and establish a clearer pathway to children and their families on how to access these assessments within the healthcare system. It is important to stress, and has already been pointed out, that children do not require an assessment of need report to access health services. However, I know that many families feel they have no choice other than to rely on the assessment of need. They are faced with long waiting lists for services or cannot access the assessments they want for their children. With this in mind, there will be a new single point of access system from the HSE. This will be rolled out across the country to make it easier for families to be referred to the right service, whether that is a children’s disability network team, primary care or the child and adolescent mental health services. As a result, children will not be put on multiple waiting lists or passed from one service to another. Another important development is the new process on the way in education for admission to special classes and special schools. The Department is working to ensure that an assessment of need will not be required to access special classes or special schools. All of these changes will give families a faster way of getting the services they need for their children, rather than just relying on the AON process. The Department of Education and Youth is putting in place an education therapy service. This new service will commence in special schools with the intention that, over time, it will expand to schools with special classes and mainstream schools. It will complement existing therapeutic services provided by the HSE. The reform of the assessment of need process will only be effective if waiting lists for children’s services are reduced at the same time. It is no use having children move quickly through the assessment of need process only to join long waiting lists for services and therapeutic supports. An intensive focus by my Department on increasing the staffing of children’s disability network teams has seen a 26% increase in children’s disability network team staffing levels, notwithstanding the issue of vacancies, which I appreciate. There is funding for a further 150 staff for children’s disability network teams in budget 2026 to reduce waiting times further. There are a total of 460 new training places for the health and social care professions coming on stream to increase the pipeline of therapists to support the sustained growth of children’s disability network teams. That includes 310 new training places this year and a further 130 next year. As I have outlined, there are many actions required to reform the AON process. It is not fit for purpose as it stands, and I believe we all agree on that. I have personally described it as a broken system and, again, I believe we agree on that across the House. However, we in government are determined to fix it. The Minister of State, Deputy Higgins, and I are committed to working with our colleagues in government to take all the necessary actions, legislative and non-legislative, to improve the AON process for the people who matter most, the children and their families.

Sentiment score: 0.28