Tom Clonan (Independent) | Oireachtas source

While listening to proceedings, I have been struck by how people have been very frank in their exchanges. I really appreciate that. Last year, the committee got a very frank admission from the then CEO of the HSE, Mr. Paul Reid, that progressing disabilities had failed and that the CDNTs were not functioning as they ought to. The Minister of State, Deputy Rabbitte, and Minister, Deputy O'Gorman, are making efforts to try to deliver a pathway out of that failure.

My first question is general in nature and is for all the witnesses, given the stark findings and narratives around Nowhere to Turn and reports like that. With regard to children with disabilities, mental health and the support we need from CAMHS teams, are we failing children, young people and adolescents at the moment? It is not to assign blame but not unlike the financial crash, it is so that we begin from a position of intellectual honesty. That is the first question. Are we in failure?

I heard a couple of contributors say that there are CDNTs that function really well and are examples of best practice, and that work very well with their counterparts in CAMHS teams. Of the nine CHOs, could Mr. Leonard say how many have functioning CAMHS teams and CDNTs? Sometimes, the HSE will give an example and point to or highlight the hospital in Waterford and say it is an example of how a hospital has innovated and dealt with the crisis in the emergency department and trolleys. It cites it as an example of best practice. Are there CHOs in which the services work for children with disabilities?

Before I ask my final two questions, I have had some time to reflect on rights-based care for children with disabilities. To my mind and as a parent of and carer for a child - now an adult - with disabilities, there seem to be three principles obstacles to that, the first of which is resources. The second is a lack of a statutory basis for proper provision for services whether they be for intellectual disability, physical disability or child and adult mental health care. However, the most powerful one in my experience is culture. We have a very particular lens in Ireland through which we view disability and disabled citizens - disabled children and adults. They are not perceived as having the same rights or human potential as other citizens. I imagine we will have to work very hard to change that narrative.

The Government has a very expensive campaign at the moment in saying that human rights are disability rights. I believe they will only become human rights if we legislate for it and if we fully ratify, for example, the UNCRPD and progress legislation, such as the type of legislation I introduced in the Seanad on disability rights.

My final two questions are specifically for the Mental Health Commission. Dr. Hillery might forgive me if this is repetition; I may have asked him this previously. Does the Mental Health Commission have a view on doctors with no higher specialist training being appointed to consultant posts in CAMHS teams? That is extraordinary. If I was sitting on the tarmac on an Aer Lingus flight to Heathrow Airport and the pilot came over the PA and said, "Welcome to flight EI162. I have flown a couple of flights in a Cessna; I think I can fly this thing", everybody would get off the aeroplane. With regard to Dr. Hillery's view on the appointment of people to consultant post with no higher specialist training, is that something that happens in other disciplines? Does that happen in oncology? Does it happen in orthopaedics? I do not know. Is it peculiar to psychiatry? The reason I ask that question is because as a layperson, my understanding is that part of the problem that was identified in the County Kerry CAMHS situation was that there was inappropriate prescribing, and one of the reasons may have been that the person doing the prescribing did not have higher specialist training.

I receive a huge amount of correspondence. I was elected by Trinity College Dublin graduates, but, unfortunately, Trinity graduates do not write to me. They do not correspond with me. However, I do get a large amount of correspondence from the community of carers and parents and families of people with disabilities. A pattern is beginning to emerge. They are all in crisis, I am sorry to say. Every day, I get dozens of contacts from people all over the country who are in crisis. One of the things that is beginning to emerge is a pattern around Covid-19 whereby people with disabilities, disabled citizens, were perhaps disproportionately impacted by the confinement of Covid and lack of services. In many cases, services were withdrawn or curtailed and this is beginning to manifest itself. From Dr. Hillery's perspective, is that something he has observed or is there any evidence to support that? If so, is there a plan to deal with that? Are we expecting a demographic cohort to come through who may present with more complex problems? I do not know the answer to that.