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.

In the Dáil, 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,” the Taoiseach said. “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.

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.

Ms Foley said the “critical issue of information and communication” is an area “ripe for immediate improvement” to better explain to parents what is available and who to turn to for advice.

She added that assessment of children with autism rose from 18 per cent to 36 per cent of all completed reports in 2023. “The HSE has been developing an autism assessment and intervention protocol” and once in place “will help to alleviate the confusion and stress experienced by a lot of children and their parents”.

Sinn Féin spokesperson on children Clare Kerrane highlighted how waiting lists are sometimes “just seen as numbers and are almost normalised. Nobody is surprised any more as they continue to go up and up”.

“We have to remember all the time that these are children. They are children who require additional supports to meet their potential.”

She stressed that “we also need to see the workforce plan to provide the number of therapists needed. The top and bottom of this issue is that we do not have the people to do the job they need to do”.