Sir, – As consultant paediatricians working in neurodisability in Children’s Health Ireland, we welcome the advocacy of our GP colleagues in Deep End Ireland on behalf of children (News, July 24th). We have advocated for improvements to this system for many years through engagement with the HSE and its social care division, and have done so on the assumption that all stakeholders are primarily focused on the welfare of children.
The assessment of need system does not meet the needs of children and families. In its current form it appears to be motivated primarily by a desire to meet statutory obligations rather than to improve the lives of children. Our concern in this regard is shared by professional bodies representing psychologists, occupational therapists and speech and language therapists.
The disability legislation (Disability Act 2005) provides a means for a person to have their needs independently assessed within a specified time frame. This should never have been interpreted as having any role in the provision of early intervention for children. The assessment of need process was never configured to reach a meaningful diagnosis or assess a child’s pattern of strengths and difficulties. It was intended to determine whether a child had a disability. While legislation provides a statutory framework for providing assessment, it does not include a right to timely intervention, and thus intervention has been deprioritised.
Supporting children with developmental delay and disability is not primarily about assessment, but about intervention. Early intervention is effective in improving the lives of children, provided it is actually early. There is little or no early intervention at present, with waiting times routinely exceeding a year, often two years, and up to six years for intervention at school age in some areas of Dublin.
This current system is clearly failing children, and we need only look to our colleagues in Northern Ireland for examples of meaningful intervention. In the Derry area, children identified as having developmental needs are seen by their local intervention team, which includes healthcare and therapy staff, within eight to 10 weeks of referral. If they are deemed to require a particular assessment, for example, for autism, this assessment is available within another eight to 12 weeks, but crucially the child is provided with intervention in the interim.
The correct response to this crisis in providing timely intervention to children is to adequately resource a system which has been chronically neglected, and to employ expert staff in sufficient numbers to meet the needs of the population. Families and professionals have repeatedly highlighted the grave inadequacies of the current system which must now be urgently addressed. – Yours, etc,
Dr DENISE McDONALD,
Dr IRWIN GILL,
Dr JOANNE BALFE,
Dr EMMA CURTIS,
Dr JANE LEONARD,
Dr LOUISE BAKER,
Dr SUSAN FINN,
Dr SINEAD HARTY,
Dr NIAMH LAGAN,
Dr JACQUELINE
McBRIEN,
Dr BARRY SCANLAN,
Dr SHASHI VAISH,
Children’s Health Ireland,
Dublin 8.