I thank the Deputy for this question. On 26 May, the Minister for Children, Disability and Equality, Deputy Foley and I, along with the Minister for Health, Deputy Carroll MacNeill, and the HSE were pleased to launch the new autism assessment and intervention pathway protocol - the autism protocol. The new protocol represents an important step in ensuring that children and adults have access to appropriate and timely autism assessment processes. The new protocol will, for the very first time, provide a standardised assessment process across children's disability network teams, primary care and mental health services. Evidence tells us that some presentations of autism are easier to identify than others. Informed by this evidence, the HSE has designed a protocol that will introduce a three-tiered approach to autism assessment. It will match the intensity of assessment to the complexity of the presentation, as decided by the assessing clinicians. It is a pathway designed specifically for autism assessment, and this includes differential assessment and diagnosis, as required, as well as the development of a formulation to provide clearer understanding of the person's lived experience and the services and supports they may require. The autism protocol has been developed over a period of five years, with input from people with lived experience, civil society and all clinical disciplines involved in assessments as well as managers and service leaders across disability, primary care and mental health services. To support the implementation of this, my Department secured funding in this year's budget for the development of inreach teams. These will consist of a psychologist, a speech and language therapist, an occupational therapist and a case worker. These teams will work with the health areas to support and to build capacity within community services, including mental health and primary care teams as well as our CDNTs. Implementation planning for the protocol within the regions will commence in quarter 3 of this year and will include relative briefing and training within the regional healthcare areas. We are providing training in the meantime, until that point.
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Sure. I understand.
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To be clear on the timelines, since the Deputy specifically asked, this is now launched. It will be rolled out in quarter 3 of this year. Right now, we are working with teams across the country to upskill and to train them on this new system of autism protocol and pathways. It is expected that when it is fully rolled out, each of the 20 integrated health areas will have one established inreach team. This year we will recruit 11 inreach teams. The final design and respective roles of the teams are being finalised. Recruitment for those inreach teams will commence in quarter 3 and quarter 4 of this year and they will be, as the Deputy referred to them in his remarks, the backup for the system. While it is not possible to quantify the exact impact at this stage in terms of assessments, it is anticipated that the successful implementation of the autism protocol will help to reduce demand for assessment of need, which the Deputy also mentioned. It will do that through the provision of a more direct and a clearer path to autism assessment for children and their families. To be clear, however, this does not in any way impact anybody's statutory right to an assessment of need. It is just a clearer access pathway through existing services such as primary care, our children's disability network teams and CAMHS, should people with an appropriate route to an assessment require one.
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I agree with much of what the Deputy says. This is an attempt to provide alternative means for assessments. There will be three tiers in this autism assessment and intervention pathway protocol. Tier 1 is for an assessment with clear presentations of autism, tier 2 is a more detailed assessment for unclear causes using structured tools and input from multiple professionals, and tier 3 is an assessment for more complex presentations involving additional specialists and further reports. I know the Deputy has a further parliamentary question. I think it is No. 19. The updated figure we have is that there are 21,782 applications overdue for completion. That was as at the end of March. The figures we have are on a quarterly basis, so that is the most up-to-date figure we have this quarter.
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The Government is committed to ensuring that children with disabilities and their families who need early intervention and therapy input can access that support in a timely way. That commitment is reflected in the sizeable investment in disability services. In this year's budget alone, more than €3.8 billion has been allocated for disability services, which is an increase of €1.8 billion since 2020. As part of the budget process, funding was also secured for additional posts in children's disability network teams, with further investment to fund 150 posts for teams across the country. That investment builds on a 28% increase in staffing levels nationwide from October 2023 to October 2025. Services in the Dublin north county integrated healthcare area, which is the Deputy's area, are delivered through the two CDNTs she mentioned, both of which are under the Central Remedial Clinic, CRC. To support service development and respond to increasing demand, additional staffing resources have been allocated by the HSE in recent years to the CRC. In 2026, the CRC received approval for development posts across both CDNTs, comprising 1.5 posts for Balbriggan and two posts for Swords. Two of those posts been allocated to behaviour support services, with the remaining posts allocated to speech and language therapy. The CRC was also allocated two full-time assistant therapy posts last year to support therapists and enhance service delivery across both teams. The Deputy consistently advocates for the Fingal area. It is a fast-growing and young community. To drive further improvements, not just in Fingal but across the country, a dedicated disability workforce strategy is being worked on by the HSE and will be published this year. The strategy will help to meet growing service demands and address recruitment and retention challenges across specialist disability services, including CDNTs such as those in the Deputy's area.
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In Balbriggan, 81% of posts are filled but the figure for Swords is only 52%. That is why we are doing so much work on our recruitment and retention strategies. I pay tribute to the staff in both CDNTs for the huge progress they have made. In recent years, there has been a significant increase in the total number of CDNTs across the HSE Dublin and North East region, which includes north-west Dublin, north Dublin, Cavan, Monaghan and Louth. There has been a huge increase in the number of children on open caseloads, that is, the children being seen by our CDNTs. There also has been a reduction in the number of children on CDNT waiting lists. At the end of March, across the region, that number was down substantially from the previous year, from 3,672 to 1,908. The number of children waiting over 12 months on CDNT waiting lists is also reducing. We are focusing on delivering much-needed therapies to children in Fingal and across the region.
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Now that we have a single point of access for the HSE, that will have a huge impact and it will mean that there will be no wrong door. If a child goes to primary care and should be on a CDNT list or vice versa, they will not be put back to the start of the list again. That is a whole-of-HSE approach. The strategy we are working on at the moment is our HSE resourcing strategy. This will be about making sure we are putting the right resources in the right places. It has been very positive for the Deputy’s area in that 3.5 new roles have been created this year alone. That builds on the two new roles allocated last year. This year we have funding to deliver 150 new posts across the country in our CDNT teams and we are in discussions at the moment in terms of the Estimates for next year and we hope to be able to build on that.
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