Government to change law in bid to speed up autism and disability assessments

The Government has signalled that it will change the law to make assessments of need for disability and autism services quicker in order to cut waiting lists.

The plan comes as the Government faces fierce pressure on disability services with 14-year-old disability rights activist Cara Darmody continuing her 50-hour protest outside Leinster House, while a series of debates took up most of the Dáil’s time on Tuesday. Ms Darmody and her father Mark were in the visitors’ gallery as the issue was debated.

Sinn Féin leader Mary Lou McDonald told Taoiseach Micheál Martin that “the problem is not the law – it’s a good law ... the issue is Government inaction. The issue is Government failure”.

“Rather than changing the law – comply with the law,” Ms McDonald said.

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The Taoiseach said, however, that “The HSE is not in a position to fulfil the law right now”.

Mr Martin promised a number of actions, several of which were also outlined by the Minister for Children and Disabilities Norma Foley at a post-Cabinet press conference, at which she also promised that money would not be a barrier to reforming the system.

Both Mr Martin and Ms Foley said that the Government would seek to train more therapists, recruit more of them from overseas, and also ensure that existing therapists spent less time on assessments of need and more time delivering therapy services for children with autism and disabilities.

Under disability legislation, children are entitled to an assessment of need, a formal process which evaluates their condition and what services they require, within six months of applying for it.

All sides admit the system is currently overwhelmed and unable to deliver the services or assessments required by children.

On Monday, The Irish Times reported that more than 15,000 children are now waiting for longer than six months for an assessment of need, but that number is expected to grow to 25,000 by the end of the year.

Asked if this number would be reduced by the actions the Government is now promising, Ms Foley said she hoped that would be the case, but avoided making any concrete promises.

Reducing the time spent on each assessment is a key part of the package being assembled by the Government. At present, some assessments can take up to 90 hours of work by therapists. However, a shorter version of the assessment process used by the HSE was found by the High Court not to be in compliance with the legislation.

Government sources admit that fixing the system – and cutting the waiting lists – is going to be a lengthy process.

The Taoiseach insisted the law needed to be changed amid trenchant Opposition criticism over the failure to meet the legal obligation to provide assessments for children within six months.

Disability and special needs are a key Government priority, he said. “I want to get this sorted, but that would mean taking decisions which I anticipate would run into opposition here,” Mr Martin said.

He told Ms McDonald, Labour leader Ivana Bacik and Social Democrats deputy leader Cian O’Callaghan that “fundamentally we need to change the legislation”.

“The High Court decision necessitates, in my view, a change in legislation to ensure that therapists are directed and streamlined to provide services to children more quickly than currently is the case,” the Taoiseach said.

“We have a finite number of therapists currently in the country. The real object has to be to use those therapists optimally in providing services to children. I say that very clear, because I’m looking for solutions here, and I think that is one nettle we have to grasp, and it will be challenging.”

But Ms McDonald said the High Court found the State is breaking the law and wants it to be in compliance with the law. “That’s what the ruling means. It does not mean change the law,” she said.

“Rather than working to be in compliance with the law to ensure that children get the assessment of needs to which they are legally entitled within the statutory framework of six months, your idea is to change the law and to remove that provision,” Ms McDonald said.

Ms Bacik said figures showed that “in first quarter of this year, that legally binding six month deadline was missed in a shocking 93 per cent of cases”.

She said it was an “extraordinarily high rate of failure”, which the Taoiseach “inherited from your own outgoing government”.

Ms Bacik said the Taoiseach said it was not a question of resources but of capacity but she said the Government had done nothing about capacity.

The Taoiseach said special class enrolment had doubled from 9,000 to 19,000 in the past five years and funding had expanded exponentially in the number of additional classes, SNAS, special teachers and other resources.

However, he added that the standing operating procedure model that the HSE adopted was struck down by the by the courts, and the rationale behind it was to prioritise establishing the needs of children, rather than providing the diagnosis immediately.

As the HSE is not in a position to fulfil the law now “we have to respond to enable us to get therapy services to children as effectively [and] optimally as we can, and that is our agenda, to use the resources we have for children who need services”, Mr Martin said.