121. Deputy Liam Quaide asked the Minister for Children, Disability and Equality the number of staff assigned to each regional single point of access referral pathway for children's disability and mental health services, including primary care; the number of single point of access units established to date per health region; the disciplines represented on each; and the governance arrangements in place to adjudicate contested cases. [29469/26]

Sentiment score: 0.20

The Taoiseach told us this week that the single point of access initiative is being rolled out across child and adolescent mental health services, CAMHS, children's disability network teams, CDNTs, and primary care so that young people are not languishing on one waiting list after another. There is serious concern, however, within the services that buy-in to the single point of access is not consistent across all parts of the system, including psychiatry, and that there is an absence of a clear adjudication mechanism for contested cases. What procedures are in place in each region to make this work on the ground?

Sentiment score: 0.27

The single point of access is a sound concept and I fully support it. Young people are, as the Minister of State said, getting passed from one waiting list to the next and that is happening mainly because services have been understaffed for years and they respond to this by becoming more rigid in their gatekeeping of referrals. There is also an issue of power imbalances that we need to focus on. For instance, it is very difficult for a basic grade speech and language therapist or a basic grade occupational therapist to hold the line with, for instance, a consultant psychiatrist, that CAMHS is a more suitable service for a young person even when, objectively, that is clearly the case. I am hearing of concerns within services that psychiatry has not fully bought into the single point of access model in each region. I ask the Minister of State again whether there is an ongoing dispute between CAMHS, primary care and CDNTs about which service best fits a young person's needs. Who has the authority to make a final decision in that instance? Is there a named adjudicator? Is there a formal escalation pathway? Is there a timeframe for determination?

Sentiment score: 0.14

The HSE has repeatedly told committees in the Oireachtas that the single point of access will stop children from being moved around the system, between primary care, CDNTs and CAMHS. It is still far from clear how this is meant to work when services fundamentally disagree. That disagreement continues about responsibility for a young person and that is the real test of this reform. Will the Minister of State now set out whether the Department or the HSE has formally engaged with the College of Psychiatrists on the single point of access, whether the college has indicated full support for the model and whether it has expressed reservations, particularly around disputed referrals or contested cases, and whether she will publish the governance and adjudication arrangements that are meant to operate when these disputes arise? It is not realistic to expect a basic grade occupational therapist to make a referral to the regional executive officer. Without that clarity this risks becoming another reform that looks nice on paper but leaves clinicians arguing and families stuck in limbo. It is fair to say that all this is happening against a backdrop of services remaining severely compromised by a long-standing failure to engage in proper workforce planning and comprehensive recruitment to disability and mental health services.

Sentiment score: -0.13