I thank the Deputy for giving me the opportunity to address this on the floor of the House. The delivery of an effective, efficient assessment of need system is a priority for the Government. There has been intensive work by the Department of Health and the HSE. Demand for assessments of need has increased significantly in recent years. Applications may be in excess of 11,000 this year compared with 4,700 in 2020. That represents a doubling in five years. This reflects both the increase in population and the number of families exploring all options to access services for their child. The impact of this increased demand has contributed to more than 18,000 applications being overdue for completion nationwide at the end of September. We will have figures for the end of this year shortly. In September, there was a 42% increase on this time last year. More positively, there has been continual improvement in the number of completed assessment of need reports. Over 4,500 reports were completed in the first nine months of this year, a 57% increase compared with the same period last year. This improvement has been bolstered by significant investment by the Department in the targeted waitlist initiative, which focuses on the families waiting longest for assessments of need. More than 6,300 clinical assessments have been commissioned from private providers under the initiative since it started in June 2024. Budget 2026 provides for the continuation of this initiative next year, with €20 million provided for the delivery of some 6,000 clinical assessments. Last week, the Government announced a series of reforms to the assessment of need process that will make the process more effective and efficient for children and their families. Over time, this should lead to a reduction in the waiting time to receive an assessment. This reform includes changes to Part 2 of the Disability Act 2005, which provides for assessments of need. I will elaborate further.
Sentiment score: 0.26
I thank both Deputies. I was delighted to engage with the cross-party group on autism about this issue the day before yesterday. The direct question about the education plans was how the process will be formulated, and the answer is through consultation. The Department of Education and Youth has indicated to us that it is willing to explore how to get to a point where it can remove an assessment of need as a requirement for entry to special schools and special classes. It will now consult on how best to do that with relevant stakeholders and officials and will come back to the Taoiseach through the Cabinet committee on disability in the first quarter of next year with a proposal for how and by when it can make it happen. On people being bounced from list to list, one of the things announced this week was the single point of access, which is the HSE's new system to ensure there is no wrong door and that when children get to the top of a list, they are not pushed to the bottom of another list. This is a service-based and needs-based approach the HSE is implementing in collaboration with our Department.
Sentiment score: 0.30
I thank the Deputies. Can I be really clear? Last week's announcement was about children with disabilities who require therapies and that is exactly what we are setting out to achieve - the delivery of therapies regardless of children's disability. There is a six-pronged approach here. The heads of Bill have now been published. They will go through pre-legislative scrutiny at the Joint Committee on Disability Matters. We have committed to informing parents earlier about when a decision is arrived at as to whether or not their child has a disability. We have the HSE's new model of having a single point of access which we have discussed and which will be supported by additional recruitment. Between that and the autism assessment process and protocol, which is also a huge part of this, they will be supported by 11 inreach teams next year and 20 inreach teams by the end of the following year. We are also recruiting within our own teams - the CDNTs. We have had a 27% increase in staffing in the 18 months up to April of this year. We have 45,000 children now receiving therapies through our CDNTs and I would like to thank our staff and our clinicians who are delivering those. We are also supplementing our assessment of need process by outsourcing. We will outsource 6,000 of those next year. That frees up therapists to work with children to deliver the therapies they need.
Sentiment score: 0.21
As Minister for State with special responsibility for disabilities, I am committed to delivering a step-change in supports and services for people with disabilities and their families, ensuring they are enabled to live full lives of their own choosing and on an equitable basis with everyone else in society. The Department has been working closely with the HSE to deliver on this ambition and improve disability services for all who use them. The Deputy will be aware that services are provided on the basis of need and funding is provided now through the regional health areas, RHAs. The Deputy has asked about the improvements being made to disability services in Kerry, which falls within the HSE South West RHA. As part of a broader programme of work, the HSE, with the support of the Department, has progressed a range of service improvements in the Kerry area. As previously stated, the programme for Government includes a commitment to the continued expansion of all types of respite services, building on additional investment and progress over the past few years. The HSE South West disability service operates separate children and adult regional respite forums. Each forum manages the referral and respite service provision for the population of the region to ensure equitable access to respite services, consistent with each person's assessed need and preference. Service provider representatives and HSE South West disability service personnel comprise the membership of the regional respite forum. The HSE South West disability services provide a range of respite models for children and adults and these include: residential overnight respite centres, after-school clubs for children and young people, in-home support, outreach support and holiday breaks for adults. These options ensure that respite is provided in the manner which best meets the needs of the people and their families and carers. RHA HSE South West, which extends to the Cork and Kerry areas, provided 17,181 respite overnights in 2024, 2,833 day-only respite sessions and supported 760 people with a disability. Kerry residential respite services for children aged between 6 and 18 years of age are delivered by St. John of God Services. There are two residential respite houses, one in north Kerry and one in south Kerry. Each house has four respite beds and operates seven days per week, with planned closures this equates to approximately 2,800 respite beds for children.
Sentiment score: 0.37
Just to advise the Deputy that our Department and the HSE are currently auditing respite services to have better visibility and to be able to plan better and make decisions based on the need. It is our intention to increase both overnight and day respite next year throughout the country. That will be part if the HSE's national services statement and national services plan and we will be making the decisions on that based on the level of current provision and the level of identified need in an area. I hope that is of benefit to the Deputy in terms of his own county.
Sentiment score: 0.43
Just to clarify, the NCSE is under the remit of the Department of education rather than our Department. I know this is something the Minister of State with responsibility for special education and the Minister for education are looking at. Together with the NCSE, they had set a date of 1 October for applications. That was to be able to give the parents better clarity, better security and early decision-making ahead of the coming academic year. I appreciate that there are parents who may have been in a position to provide information after this date. That is something I have raised directly with the Minister of State with responsibility for special education.
Sentiment score: 0.35
HSE Capital and Estates Dublin and North East and the disability services in the Cavan-Monaghan IHA service area have identified a premises for sale that is suitable for the purposes of renovation to develop a HSE respite centre for children. The purchase transaction has been approved and completed. The keys of the premises have been transferred to HSE Capital and Estates Dublin and North East. The premises are located at Drumbear, Ballybay Road, County Monaghan. Following the conclusion of the preliminary design stage with disability services in quarter 3 of 2025, the HSE Capital and Estates Dublin and North East office, through the appointed design team, has progressed with preparing a planning application for the proposed development, to be lodged no later than the end of January 2026. Subject to statutory approval of the planning application, it will be the HSE Capital and Estates Dublin and North East office’s intention to commence the preparation of tender documentation for the project. The HSE will then complete a capital project to prepare the property to deliver a five-bedroom residential respite facility. HSE Capital and Estates Dublin and North East has advised that, if all of those steps go according to the timeframe set out, this project should be completed in quarter 4 of 2026. The number of children who will avail of respite in this new centre will be dependent on the assessed individual needs of each child and his or her family. In order to legally operate as a registered residential respite centre, a facility will need to meet the required standards for a designated respite centre, which is assessed and determined by the Health Information and Quality Authority, HIQA. Cavan-Monaghan disability services secured a commitment for funding for an interim, two-year residential respite service for children in County Monaghan pending the development of the new HSE facility. The location of the interim children’s respite centre for Monaghan is at Urbalkirk, approximately 8 km from Monaghan town. The Talbot Group operates the service under a service arrangement with the HSE. The interim children’s respite centre, called Rainbow Lodge, became operational on 1 October 2024. Retention of this respite centre’s services will be contingent on future funding considerations. Cavan-Monaghan disability services helped prepare capital submission documents for the national HSE capital and property steering committee to seek approval and funding to provide a stand-alone respite centre for adults with an intellectual disability in County Cavan.
Sentiment score: 0.16
As the Deputy is aware, Rainbow Lodge is an interim children's respite centre. It came into operation on 1 October 2024. Retention of this respite centre service is contingent on future funding considerations. I take on board what the Deputy has said in relation to the new centre coming on board at the end of next year, and that there may perhaps be a gap. I take that feedback on board and will bring it back to my officials. Regarding respite services for adults and children in County Monaghan, I draw the Deputy's attention to the fact that there is also Annalee View Respite Centre. The HSE disability service in IHA Cavan Monaghan operates one respite centre directly in County Cavan, which is in the Deputy’s area. Steadfast House is an overnight respite centre in County Monaghan. It is a HSE-funded, section 39 provider, which is funded under a service agreement with the HSE to provide 1,500 respite nights per year. Following the submission and approval of additional funding in 2024, the number of respite nights increased from 840 per annum to the current level of 1,500. Mountain View Respite Centre, in County Cavan, provides services for adults with physical and sensory disabilities from both Monaghan and Cavan. It opened in November 2026.
Sentiment score: 0.12
The Deputy described a deficiency in respite care in Monaghan. I assure him that the Department and the HSE are currently auditing respite services to give us better visibility of the full picture regarding the provision but also, more importantly, the need. We have additional funding next year that we sought through budget negotiations. That will be part of the HSE's national services plan that is to be published. To clarify, we will be making the decisions as to where the funding goes based on the current level of provision locally but also based on need. The Deputy has clearly outlined a case for why Monaghan needs further investment. If the HSE figures add up on that, we will absolutely be looking at it.
Sentiment score: 0.23
The Government absolutely recognises there are unacceptable delays in accessing assessments of need. My Department and the HSE are committed to addressing these delays. Under the Disability Act, an assessment of need is an assessment process carried out by the HSE where a person is of the opinion that he or she may have a disability for anyone born after 1 June 2002. It first establishes whether the person has a disability as defined within the Act and then identifies the health and education needs of the person with the disability and the service required to meet those needs. As the Deputy said, last week the Government announced a series of reforms to the assessment of need process which will make the process more effective and efficient for children and families, and will move towards more assessments being delivered within the six-month statutory timeframe. These reforms include changes to Part 2 of the Disability Act, which provides for assessments of need. The general scheme of the disability (amendment) Bill 2025 was approved by the Government on 9 December and will be published on the Department’s website shortly. It is important to say these changes will not remove any rights for parents to apply for an assessment of need for their child, nor will they alter the statutory six-month timeline set out in the Disability Act. Turning to access to treatment and therapies, I must emphasise that children do not require an assessment of need to access health services including primary care, children’s disability network teams, CDNTs, or mental health services. However, it is recognised that there can be delays for children and families in getting access to the treatments and therapies they need. Children can be on a number of different waiting lists which can cause confusion for families. In 2026 the HSE will introduce a single point of access system, which will make it easier for families to be referred to the right service whether that is a CDNT, primary care, or a child and adolescent mental health team. The recruitment of staff across the disability sector continues to be a key priority in ensuring children can access therapies in a timely manner. An intensive focus of my Department has been on increasing the staffing of CDNTs that deliver supports and services to children with complex needs. My Department has been in discussions with the Department of education on the need to phase out the requirement for an assessment of need to access special education class or school.
Sentiment score: 0.21
That statistic that 45% of children who go through the assessment of need process receive a diagnosis of autism is absolutely correct. For that reason the HSE is standing up a new autism assessment and protocol process in order to be able to respond to emerging need in this area. We hope that from January, but definitely from the first quarter of next year, children who are displaying autistic traits will be referred into the new HSE autism protocol and assessment process. That will absolutely help. It will provide them with specific interventions that will be most appropriate to them. That is a really welcome development. I thank the HSE for its hard work and its engagement with my Department on this. Part of what was announced last week was a six-pronged approach. We have the heads of the Bill. Decisions are being communicated earlier to parents. There is a single point of access. There is the autism protocol and assessment. We also have recruitment in our own CDNTs. We are recruiting at the moment and will be recruiting another 150 staff next year. Throughout the disability service we will recruit 1,000 people next year and we are also outsourcing assessments of need. Education is the other element of that. The Minister for education will come back to the Cabinet committee on disability in the first quarter of next year with formulated proposals on that issue.
Sentiment score: 0.13
Taking cognisance of the Chair I will give a short response. Our in-reach teams will support the HSE's new model and will work to ensure there is more joined-up thinking between primary care, CAMHS and our CDNTs. Each team will consist of a psychologist, a speech and language therapist, an occupational therapist and an administration person. Part of the reason we have an administration person is because some of the feedback we have received from parents is around communication. This person will assist with that from a caseload management perspective. We will be standing up 11 teams in 2026 and a further nine teams in 2027. That will be 20 teams, which will be one team per regional health organisation.
Sentiment score: 0.12