Pauline Tully (Cavan-Monaghan, Sinn Fein)
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8. To ask the Minister for Children, Equality, Disability, Integration and Youth if he will consider undertaking a stakeholder review of the Progressing Disability Services model; and if he will make a statement on the matter. [43542/24]

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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Will the Minister consider undertaking a stakeholder review of the progressing disability services model in light of the fact that it does not work on many fronts?

Roderic O'Gorman (Dublin West, Green Party)
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The implementation of the progressing disability services programme is agreed Government and HSE policy. This policy supports the reconfiguration of children's disability services to provide equitable child- and family-centred services based on need rather than diagnosis. Crucially, this aligns with the UN Convention on the Rights of Persons with Disabilities. The HSE's roadmap for service improvement 2023-26, disability services for children and young people, was approved by the HSE board and launched last October. It is a targeted service improvement programme to achieve a quality, accessible, equitable and timely service for all children with complex needs as a result of disability and for their families. The delays in accessing children’s therapy interventions are acknowledged and work is ongoing by the HSE to maximise the capacity of children’s disability network teams, CDNTs, through recruitment campaigns and other measures, including sourcing assessments through the private sector.

Regarding a review of the progressing disability services model, I advise the Deputy that this matter is provided for in the HSE’s roadmap for service improvement. I engaged with a number of organisations and stakeholders on the shape of the review, including a stakeholder review. The stakeholders involved currently include the HSE, the NDA and Fórsa as well as the Department. I am informed by the HSE that work is ongoing to finalise the scoping of the relevant elements of the review of the CDNT model of service, with the most recent engagement taking place on Monday, 21 October. Detailed feedback from this meeting between the HSE and Fórsa is awaited from the HSE. We are taking initial steps and reaching out to key stakeholders to get the framework for how this review will be implemented. It will be valuable.

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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The progressing disabilities model is not working on many fronts. There were 91 CDNTs established before the end of 2021. According to the HSE census from a year ago, only one of those teams was fully staffed. A number were close but quite a number had vacancy rates up to 70%. A team cannot function with a vacancy rate of 70% or even 50% or 30%. Many children have no access to their CDNTs. They wait years for any sort of assessment or service. Two parents' representatives on the national steering group for progressing disabilities, Aisling Byrne and Rebecca O'Riordan, resigned during the summer because they felt they were getting nowhere. They did not go in there because they thought it would be easy, they went in to put forward the point of view of parents and representing their children through the CDNTs. It was not vindictive but they felt it was not set up properly, they were not being listened to and things were not being discussed. They felt it was not going anywhere. They also pointed out that there was no stakeholder involvement in the creation of the roadmap, which is serious. If we want these teams to work, which we all do, we need to include everybody who has a stake in those discussions.

Roderic O'Gorman (Dublin West, Green Party)
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I cannot disagree with anything the Deputy said in terms of the challenge the significant level of vacancy poses for the CDNTs all over the country and their ability to deliver crucial interventions for children and the subsequent improvements in quality of life for families. The next Government will look at the progressing disabilities model and have an opportunity to make decisions. We have to be clear that until there are enough therapists, it does not matter if we call it progressing disability services or something else; we need more therapists. That is why the HSE has a workforce planning team in place looking at how to increase the number of health and social care professionals across the HSE and to encourage them into CDNTs. The Minister of State, Deputy Rabbitte, and I have undertaken work with the Department of higher and further education to increase the number of places to train more therapists each year, which will bear fruit. I recognise it is not bearing fruit now but it will in a number of years.

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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We have been hearing about a recruitment campaign for quite some time. The progressing disability model was drawn up in 2013 or 2014, I think. At that time, workforce planning was not done and we now do not have sufficient therapists. I acknowledge it will take time to educate enough therapists but there is no guarantee they will work in disability services. There are many other areas they could work in and many are leaving and going to work in other countries where they can do their jobs.

I feel sorry for therapists and CDNTs who want to do their job but are unable to because of the lack of staff on their team. They end up dealing all the time with understandably irate parents whose children are not being seen or assessed in time or getting therapies. It also annoys parents very much when they are told there have been a certain number of engagements. They are counting phone calls and letters to parents and parents going on courses as engagement with the child. Many decisions are being made about children who have not been seen by the team. That is quite serious.

Roderic O'Gorman (Dublin West, Green Party)
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I take the Deputy's point on getting the therapists who will graduate in years to come where they are most needed. I look at what Tusla did in terms of social workers. Every social worker who graduates from an Irish university gets an offer of employment from Tusla. That is extremely attractive and has been very good in bringing not all social workers, but a significant number to do work and training with Tusla directly. I will continue to engage with Bernard Gloster.

I spoke in response to an earlier question about specific measures to encourage new health and social care graduates into CDNTs and CAMHS. We need to strengthen that. I am sure primary care and older people services are looking for these graduates as well but we have to take a strategic decision that children's disability services and, most people would agree, CAMHS are the least staffed areas across the HSE and are where the HSE should be targeting all new graduates to bring them in and let them do their training. That will reduce pressures on lists and make staying there more attractive.