During the May 26th sitting of Dáil Éireann, Deputy Richard Boyd Barrett asked the Minister for Health about the Government's plans, if any, to address the delays in assessments of need and the subsequent roll-out of services to children with developmental delays and if he will make a statement in relation to the matter.
Deputy Boyd Barrett recounted the story of two year old Frankie:
"His parents, very worried, came into my office this week because a paediatrician and their own observation established that Frankie has very serious developmental delays, is non-verbal and is showing all the signs of severe autism. They got a letter stating he would be assessed within the legally required time, and then they got a phone call shortly afterwards from the disability network team stating it would be two years before Frankie would be assessed. That is a disgrace." he said.
Responding on behalf of the Minister, Deputy Mary Butler commented that they hear stories such as Frankie's all the time and that the Minister is well aware of the situation. She went on to state that:
"the new standard operating procedure for assessments of need was implemented for all new applications for assessments of need from 15 January 2020. Since then, approximately 10,000 preliminary team assessments have been completed. In quarter 1 of this year, the data indicate there were 1,719 assessment of need reports completed."
The recent judgment of Mr. Justice Phelan in the High Court directed that the preliminary team assessment approach does not fulfil the requirements of the Disability Act. The judgment states a diagnosis must determine the nature and extent of a person's disability.
Deputy Butler went on to state:
"the HSE will now implement a process for a revised approach to assessments of need. In developing this, the HSE has engaged with a wide range of stakeholders, including families, providers, staff and representative bodies, in an intensive consultation to develop a pathway for assessment of need that seeks to comply with the requirements of the Act but also protects the commitment to the provision of intervention and principles as set out above. ... what is different now that was not there before is that children do not require an assessment of need and may be referred directly to their local children's disability network team."
Deputy Boyd Barrett responded stating;
"I have also been talking to one of the barristers who is taking many of these cases and the situation is very bad. This story suggests the establishment of the disability network teams is not making any difference; it is just another layer. We have assessments of need, disability network teams, CAMHS and NEPS. It is all fragmented. In reality, while they might tick certain boxes, they are not actually doing the assessments or getting the services. The point is Frankie's future and the future of many thousands of other kids are at stake. If Frankie gets the early intervention and the supports now, he will be fine. Despite developmental delays and so on, he can flourish. If he does not get that, his future will be seriously jeopardised, as will the future of many other children. There are new layers of bureaucracy. Disability network teams, by the way, are 28% understaffed. That is the problem. ... We need the law to be upheld and the rights of Frankie and other children to be upheld."
The issue being rightly raised by Deputy Boyd Barrett here is that preliminary assessments are not assessments of need. This is also what Judge Phelan was getting at in the High Court. Inserting this layer of preliminary assessments is a way of appearing to tick the legally required box of assessment without actually providing the necessary assessment or the diagnosis. In essence, the Executive have referred the applicant to the people who provide the assessments and so they can dust off their hands and move on to the next one. In Frankie's case, the parents received a letter stating that they will receive the assessment by May and then, after the referral was made, they received a call from a person within the disability network team stating that they are swamped and it will be at least two years before he is seen. In the Government's eyes, they've done their bit and the fault lies elsewhere.
Deputy Butler concluded in tentative agreement with Deputy Boyd Barrett stating "the Deputy is completely right that early intervention is key. Two years is not an acceptable wait time for any child or his or her family."
Whether this will evolve into any temporal action on the part of the Government remains to be seen.