Desk-based HSE administrators, who potentially have no clinical experience, will now have greater powers to decide if children seeking health and educational services are disabled.
Concerns were raised at an Oireachtas committee on disability matters about the lack of clinical qualifications for assessment of needs officers. The fact that the overwhelming majority of administrators will decide if a child is disabled or not, having never met or spoken to them, also prompted concern.
On Wednesday, the Joint Committee on Disability Matters was considering a new law, which plans to overhaul the way that assessments of need are carried out in Ireland.
Late last year, the Government announced it was introducing sweeping reforms to try to cut long waits for assessments of need.
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In December, 18,000 people – the majority of them children – were on a waiting list for an assessment of need, and the State is consistently falling foul of a disability law that should ensure the professional assessment is done within six months. It was expected the waiting list for assessments of need would reach 22,000 by the end of 2025.
Under the proposed new law, an official will be required to make a determination of a disability first before a child is referred on for other services. This means that a child may only have access to a professional like an educational psychologist if or when an official has agreed that they have a disability. The Department of Children said 29 per cent of assessments of need carried out in 2025 resulted in a diagnosis of “no disability”.
Officials from the Department of Children confirmed to the committee that the assessment of needs officers, which will now have the power to decide if a child does or does not have a disability, will not necessarily have any clinical training.
“I think what’s important to know is that the assessment officer role currently an administrative role,” Nicole Dyrssen, of the disability children’s services unit at the department, said.
Dyrssen explained that the assessment officer is “really the co-ordinator and evaluator of the evidence ... So their job is to collate, get and gather all the evidence that they can from various sources”.
She said while the officers have the ability to meet a person whose application they are considering if they need to, that is “done less frequently” and the process is largely a “desktop exercise”.
“So they’re not operating in a clinical capacity,” she said.
Mark Considine, an official from the same unit at the Department of Children, said the Government had asked the HSE to look at “the training, the support and the qualifications of the assessment officers”. But he said “it’s not a kind of a linear process that if these people are clinicians, it will somehow improve the system,” and that there were a “whole collection” of issues with the system.
Kiera Keogh, a Fine Gael TD and a therapist who works with neurodivergent children, asked if the Department of Children had sought advice from the Attorney General “as to whether this will hold up in the High Court. Because ... it doesn’t sound like it would hold up in the High Court if we’re potentially referring people away from a full assessment, if there hasn’t been eyes on a child”.
Considine said the department had “engaged extensively” with the Attorney General. “Obviously we can’t say whether something would be successful or not, or challenged or not in that situation, but we tried to design it so that it meets the requirements as we understand it.”
Assessment of needs officer roles are not advertised with any requirements for health and educational qualifications. A survey by the National Clinical Programme for People with Disability (NCPPD) of 22 assessment officers found that 59 per cent had a clinical background, with 36 per cent saying their background was in nursing.
Currently, an assessment of need can take up to 30 hours and therapists have said they are spending one third of their time carrying on these rather than providing therapy to children. The Government had said it wanted to cut the time taking up by assessments because therapists were facing a “moral dilemma” about how long they were spending assessing children rather than offering them therapies.
