Sir, – We are GPs working in disadvantaged areas in Ireland and are increasingly aware of the disproportionate impact of Covid-19 on children living in these areas. While we recognise the challenges for children who already have a diagnosis and are living with disabilities and their families, those awaiting a diagnosis through assessment of need are particularly vulnerable. These services assess children with developmental delay in order to establish an underlying diagnosis and identify an appropriate management plan. This is the pathway through which conditions like autism are identified. Following an initial assessment a diagnosis is made but there are then further waiting lists to access treatment. Without an assessment, no action can follow and children and their parents are left completely unsupported by these statutory services. We have patients who have been told they are on waiting lists stretching out beyond 18 months to three years. Covid-19 has essentially brought a situation that was barely functional to a complete halt, endangering the welfare of the most vulnerable children. While there have been massive delays in accessing assessment of need for years, this has always been worse in areas of deprivation, as services are not distributed based on need, which is much higher in such areas. Parents of children in more affluent areas can afford to get assessments done privately, which also releases the pressure on public services in these areas, further compounding the inequality. This situation is leading to lost opportunities for early intervention, support and special education. There is generally a lack of therapies and interventions once a diagnosis is actually made but the inability to even access an assessment is leading to extreme distress for very vulnerable children and their families. The situation has been greatly exacerbated by Covid.
We are calling for emergency measures to address this crisis in assessment of need, which is undoubtedly leading to life-long problems for these vulnerable children, their siblings and parents and will have knock-on societal and economic effects. While this is a national issue, it particularly affects children in the most disadvantaged communities, where not only are the needs much greater but there is also limited economic capacity to use alternative private services. – Yours, etc,
Prof SUSAN SMITH (GP),
Dublin 8;
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Dr ANNA BEUG,
Dublin 8;
Dr KIERAN HARKIN,
Dublin 8;
Dr EDEL McGINNITY,
Dublin 13;
Dr FIONA MONAGHAN,
Cork City;
Dr ANNA
MARIE NAUGHTON,
Cork City;
Dr NICOLA SWEENEY,
Dublin 2;
Dr DAVID GIBNEY,
Dublin 9;
Dr ANNE O’BRIEN,
Dublin 13;
Dr VIVIENNE WALLACE,
Dublin 5;
Dr NIAMH IRVING,
Dublin 8;
Dr CONOR O’KELLY,
Dublin 8;
Dr EOIN MONAGHAN,
Cork City;
Dr BRID SHANAHAN,
Dublin 1;
Dr PATRICK O’DONNELL,
Limerick City.