As the Deputy will be aware, on 26 May, the HSE launched the new autism assessment and intervention pathway protocol, or the autism protocol. Once implemented, it will apply to all HSE and HSE-funded providers, as well as private providers. I am delighted that extensive collaboration by Government underpinned the development of the autism protocol. My Department and I remain committed to ongoing engagement with autistic individuals, families and representative organisations to continue to improve access to services. The protocol introduces a three-tiered approach to autism assessment, reflecting the evidence and lived experience that some presentations are easier to identify than others. It matches the level of assessment to the complexity of each case, as determined by clinicians. The pathway is specific to autism assessment and includes differential diagnosis where necessary, along with developing a formulation to better understand the person’s lived experience and the support they require. The autism protocol was developed over five years. It was developed with input from people with lived experience, civil society, clinicians across multiple disciplines and service leaders from the disability, primary care and mental health sectors. The service improvement programme board for the autistic community is a national HSE governance body that provides oversight, leadership and accountability for autism assessment and intervention services, including the autism protocol. When the service improvement programme board for the autistic community was established, a national expression of interest ensured representation from individuals with lived experience, including young people, adults and family members. The board included senior operational and clinical decision-makers, academic support and representatives with lived experience as equal contributors. As the programme progressed, two working groups were created. The assessment and pathways working group, which reports to the service improvement programme board for the autistic community, included three representatives with lived experience and clinicians from psychology, occupational therapy, speech and language therapy, public health nursing and social work. It also included senior managers, family members and leaders, and they helped shape it.

Sentiment score: 0.40

Absolutely. I am completely happy to say that to the Deputy. As she said in her opening remarks, the success of this depends on people's lived experience. That is exactly what we have used to help shape it. We also had expert input from a clinical advisory group as well as that assessment and pathways working group within the service improvement programme board for the autistic community. That was to ensure there was also a clinical perspective on this. The assessment and pathways working group produced a comprehensive report. It was over 250 pages long and it outlined the new assessment approach. There were two versions of that protocol that were shared through workshops and webinars. Two consultation sessions took place in March with civil society, advocacy groups and people with lived experience. Feedback was provided to participants. To be really clear, our approach, that of the Minister, Deputy Foley and I, and of our Department and the HSE, is to include people with lived experience. "Nothing about us without us" is something we are very proud to stand over.

Sentiment score: 0.32

Absolutely. This process is all about families, children and ensuring that we have appropriate and faster access to the most appropriate clinical decisions. This is also in response to the fact that 40% of assessments, of children who are going through assessments of need, are being diagnosed as autistic. As a result of that, through five years of collaboration, hard work and clinical expertise, this protocol has been designed as part of the response to that. That is not just in Ireland. The OECD finds that there has been, overall, almost a 10% increase in autistic presentations. This is to support that but to clarify, it is totally different, distinct and independent from the assessments of need process and there is no change to anybody's statutory right to an assessment of need. What we are trying to do here is provide a quicker and clearer access pathway through our existing services, whether it is primary care, CDNTs or CAMHS teams, for people who are presenting as potentially autistic. We have three tiers as part of that protocol.

Sentiment score: 0.08

The Deputy is absolutely correct. The delivery of an effective and efficient assessment of need system is a priority for the Government. The Department and the HSE are working intensively to address delays in the provision of assessments of need to children and their families. It is important to reiterate that children do not require an assessment of need report to access health services, such as primary care, children’s disability network teams or mental health services, or education supports. Demand for assessments of need has increased significantly in recent years. This reflects both the increase in population and the increase in the number of families exploring all options to access services for their child. Over 13,000 applications for assessments of need were received last year, with over 3,800 applications made in the first three months of this year. This demand is absolutely outpacing the capacity of the system to respond. As a result, 21,782 applications were overdue for completion at the end of March. I gave the Deputy that figure earlier. To break that figure down by regional health area: the figure in HSE Dublin and North East is 6,608; in HSE Dublin and Midlands, it is 7,772; in HSE Dublin and South East, it is 3,204; in HSE South West, it is 2,004; in HSE Mid West, it is 595; and in HSE West and North West, it is 1,599. These numbers are really stark. It is really important to remember that behind every number is a child or young person. It is not acceptable that children and families have to wait so long for assessment of need applications to be processed. This Government, the Minister, Deputy Foley, and I have made it very clear that change is needed. There has been progress in the past two years with a noticeable increase in the number of completed applications. Over 5,900 assessment of need reports were completed in 2025, which is a 43% increase on the previous year and an 85% increase on the year previous to that. This progress has been and will continue to be assisted by the assessment of need targeted waitlist initiative, which funds the procurement of clinical assessments from private providers to inform the assessment of need process.

Sentiment score: 0.24

The Deputy is right; the demand is increasing year on year. It has increased quite exponentially in the last five years. As a result, it has been difficult for us to keep up with demand. Our CDNTs around the country do absolutely incredible work not just with regard to assessments of need, but also, importantly, in the delivery of therapies. It is those interventions that parents and children want. In response to an earlier question of the Deputy's, we spoke about the new autism intervention and pathways protocol. That is another Government investment to ensure we provide access to more timely assessments and more targeted interventions for children and young people across Ireland.

Sentiment score: 0.09

The Government is absolutely committed to ensuring that this is dealt with in a comprehensive way. Part of our response will be a series of improvements to the assessment of need process to make it more efficient and effective for children and families. Over time, this will lead to a reduction in the waiting time to receive an assessment of need. I thank the Deputy for his work on the Committee on Disability Matters. From that work, he will know that the general scheme of the disability (amendment) Bill has been published on the Department's website. The Deputy's committee has published a report following pre-legislative scrutiny of the Bill. The Department is now considering the recommendations. I thank everybody who was involved in those committee hearings and in pulling together that report. A series of recommendations were made and we are now working on these to improve the proposed legislation. A document addressing frequently asked questions has also been published. Legislation is only part of our response. We also need to enhance the processes, to improve training and to increase administrative support for our HSE assessment officers, who are responsible for the production of the assessment reports. The Department is working really closely with the HSE and with the working groups that are in place to ensure this happens. As the Deputy has said, we need to address the wider issues. That is exactly what was set out in this year's HSE national services plan.

Sentiment score: 0.26