Pádraig O'Sullivan (Cork North Central, Fianna Fail)
Link to this: Individually | In context

The Minister of State and I are here again. A number of colleagues from Cork North Central and I raised a joint Topical Issue two weeks ago on a very similar issue. I wish to put on record that I appreciate the Minister of State being here again. She has been a great advocate for reintroducing the pilot scheme and trying to get therapists back into schools.

We were here two weeks ago and I do not expect that the answer the Minister of State will give me tonight will be remarkably different from the one she gave me that evening but I draw her attention to three things that have changed from my perspective and that of the parents of St. Killian's Special School in Cork. Six weeks into this pilot programme where four Cork schools were chosen, there has been no intervention in terms of therapies delivered to students in any of the four schools. I texted two of the principals about an hour ago before I came in here to clarify that this is still the case and it is the case. Bar a letter from the head of Cork-Kerry disability teams, one follow-up call and one call from the CDNT manager, no therapies have been delivered in the special schools in Cork.

Does the HSE actually want this to succeed? It is bitterly disappointing that we are here once again and are failing families abysmally in CHO 4. It is either on board with the pilot or it is not and I would like to hear from the Minister of State about how she thinks it is going to progress.

The second point concerns an email that was obtained via FOI and provided to me by one of the parents in a different constituency. That email was dated 8 February 2024 and was issued on behalf of Bernard O'Regan, head of disability services. Bearing in mind that this predates the inception of the pilot, Mr. O'Regan said that he wanted to clarify that if additional therapy capacity was available from other organisations in the area, these could be commissioned to provide supports to children and families under the governance of the CNDT. He said that this could include the provision of therapy supports to children in special schools and that the goal in approving this approach was to improve access to services where this was possible while ensuring that the service continued under the governance of the CDNT until staffing levels improve. We were given the impression here a couple of weeks ago that schools basically had to be in the pilot project to avail of this private therapy access. This clearly is not the case. As I said, Bernard O'Regan outlined on 8 February that there was a possibility that other sources of therapies could be provided. I just read that in the provision. I would like to know why the HSE has not engaged that private route or support. The Minister of State referenced in the past that there are schools around, including one in Wexford we are aware of that, that have availed of private therapy support so could she tell me what is so different about Cork and the inability or lack of willingness to avail of that private therapy route?

Anne Rabbitte (Galway East, Fianna Fail)
Link to this: Individually | In context

I feel that this is a never-ending saga. The Deputy asked me to reference Cork. I think it all focuses on Cork but I will stay on point for a moment on this. The frustrations of families of children with additional needs who attend special schools is acknowledged, as is the urgent need for therapy provision within special schools. The Deputy asked whether the HSE wants this to succeed. The answer is "Yes". I met with Bernard Gloster in the past three to four weeks to discuss this and he told me he has given a clear direction to all the regional executive officers in the country. In particular, he has given very clear direction to the regional executive officers in the areas where the special schools have been selected to co-operate. This is a partnership approach. Sometimes we get given out to in Government for not having a collective piece. This is the collective of the Department, the Department of Education, the HSE and the National Council for Special Education, NCSE, working together to put children at the centre. Bernard Gloster is very clear and has given the direction for that co-operation and leadership for it to succeed.

On 9 August, I welcomed the Government decision to support a special schools pilot that would provide delivery of in-school therapy supports to children in selected special schools. The programme will be provided by the HSE's CDNTs in 16 special schools, four of which are in Cork. The others will be chosen. The Department of Education identified and suggested schools for inclusion in phase one of the pilot based on educational need and detailed engagement undertaken by the Department over recent years.

The Deputy referenced an email from last February. A lot of water has passed under the bridge since then when Bernard O'Regan issued that email. At that point, we did not have a special Cabinet subcommittee headed up by the Taoiseach where all Departments are around the table. I go back to the fact that it was agreed at Cabinet that the pilot programme would be addressed. From February to June 2024, Bernard O'Regan was talking about it. We spoke about the Wexford model about whether private capacity could be capitalised upon. He gave direct instruction to his heads of disability to go and capture capacity if it is there to support families and ensure that children got the services and supports they required. To be fair, in some CHOs, we saw positive interventions while things were not so good in others. One has to ask about what is wrong in Cork and why is it working elsewhere. Maybe it is the fact that the HSE does not have a CDNT on the ground. Maybe it is too far removed from the delivery of services. Maybe it is because it is easier to blame everybody else than to be actively involved in finding a solution. I am frustrated to hear the Deputy say there has been a lack of engagement, uptake and delivery of services to the four schools that have been clearly identified and are queuing up for this. To think that we are not delivering is highly frustrating. I will ensure that this step change is a positive one where the NCSE, the HSE and the two Departments are working collaboratively. Whoever is deciding not to co-operate will be found out.

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
Link to this: Individually | In context

As I said at the outset, I appreciate the Minister of State's genuine interest in this and it is appreciated by us all in CHO 4. One thing I need to reiterate is that six schools were identified, four of which are in Cork, and to my knowledge, and I have spoken with two principals today, not one of them has received a single therapy in the six weeks during which the scheme has been live. I believe the only reason the HSE touched base with those schools at that times was that we highlighted it here and that the HSE had not engaged initially with the schools. Reading the Minister of State's speech again, it is similar to the last answer I got here. Regarding the reference to engagement between the Department, the Department of Education, the HSE and the NCSE, for me, it is a recipe for disaster when there are so many Departments criss-crossing like that.

Ultimately, the Department of Education identifies the suggested schools but then the HSE has to provide the therapists. I am disappointed it has not started. I am very dubious about the success of this pilot scheme at this stage. That is not what the parents at home who are listening in tonight want to hear but I need to say it as it is. I am very dubious about the potential success of this pilot.

Will the Minister of State clarify the dates of the next intake of schools? She has said here previously that at the end of October the next ten schools will be identified and I believe there will be a roll out subsequently. Will she clarify that date?

I have heard there may be issues with the unions relating to CDNT employees and their desire to take part in this pilot. I believe the union in question has recommended that they do not partake in this scheme. Has she heard this or is she aware of it? Will she comment on it?

I said at the start that I know the Minister of State’s heart is in the right place on this. We are all trying to push in the right direction and get therapies delivered to kids but I am very dubious about the success of this project.

Anne Rabbitte (Galway East, Fianna Fail)
Link to this: Individually | In context

The Deputy asked a very clear question as to what is the next phase. October is the next phase for the intake of the additional ten schools to be rolled out in 2024-25.

I might disagree with the Deputy when he says there are too many Departments and agencies involved. It was the lack of Departments and the lack of engagement between various agencies that siloed us and got us to the stage we are in. It is about co-operation among Departments and agencies and putting the child and the family at the centre to ensure that there is that joined-up thinking approach. We must think of a parent who has a child with additional needs in special schools and bringing the therapies into the schools and ensuring that they have that support within the schools so that the parent may want to continue to work or the educators who are supporting the child has first-hand knowledge of how to deliver that support and how they can work to support the family to continue that support at home. That is joined-up thinking and the way it should work in that utopia that others might not see the value of. The Government sees the value of it. That is why in 2021 and 2022 we allocated enough funding to support the recruitment of 221 therapists to do this. We have had success in some of the schools where therapists have gone back in. They might not be in it but allying to it, there is delivery. In the Minister’s constituency, right beside me in Carmona, we have had great success on this. I must query why we feel in Cork that we cannot follow the rules. Why can we not feel like we cannot do what is laid out by the HSE or the NCSE? I will convene a meaningful meeting as soon as possible on the Topical Issue matter. It is not the political system that is lacking will here; it is outside that.