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NOT ONE OF the children’s disability network teams is fully staffed, according to HSE heads in response to questioning at a Joint Oireachtas Committee this week.
Bernard O’Regan, the HSE’s Head of Operations Disability Services, also stated that the HSE has “an average vacancy rate of about 25% across teams”.
In his opening statement, HSE CEO Paul Reid said that “91 children’s disability network teams are now in place across the country”.
This was disputed by Social Democrats TD Holly Cairns who said: “That is untrue – you’ve partial teams across the country.”
“If Ireland started with 10 players last Saturday in rugby, no one would say they had a team. Children with disabilities at least deserve the same standard. You do not have 91 teams.”
Cairns also asked when families could expect fully operational teams to be in place to which O’Regan said:
“In terms of when it happens, I can’t say the point… other than we are working as hard as we can to build up the levels of staff, to make sure we’re using the resources that we currently have available and in terms of our engagement with Government, to further develop those teams in terms of additional funding over the coming years.”
In response to staffing levels, Reid added that none of the HSE’s community teams “are resourced to the extent we define that they need it at this stage”.
He added that this “goes for our enhanced community care teams, our older persons teams, our disability network teams”. He said that the HSE is “in a process” and “got good funding from Government again this year to support that”.
Some of the children’s disability network teams (CDNTs) are “only staffed to around 50%”, according to professor Malcolm MacLachlan, clinical lead for people with disabilities at the HSE. He added:
“There is very significant clinical risk when people are on waiting lists – one for assessment and then two for interventions. People can miss milestones, they can develop secondary disabilities.”
In relation to the potential implementation of more detailed assessments through the assessment of need process, MacLachlan said that in his estimation “the clinical risk will increase because we will have fewer people available to provide the services and supports that are needed to reduce that clinical risk”.
Over 60,000 on community waiting lists
The Joint Committee on Children, Disability, Equality, Integration and Youth was meeting to consider the Ombudsman for Children’s report on this issue as well as waiting lists for children in accessing an assessment of needs.
The ‘Unmet Needs‘ report from October 2020 by Children’s Ombudsman Dr Niall Muldoon highlighted significant and lengthy delays being faced by children and their families in the completion of an assessment of need (AON), despite a legal requirement to begin the AON within three months of receiving an application.
At the Committee, Reid said that there were “about 63,000 community waiting lists for children”. He also said that “waiting lists for children, and specifically the waiting lists for community care for children, are far too excessive and a legacy issue that we are committed to addressing”.
He said that this would be partially done through Government funding that was secured to address waiting lists. Though when pushed on this, he said that he did not have a full breakdown of the amount of this funding which would go to address children with disabilities.
Just over €20m of the €350m 2022 Waiting List Action Plan funding will be directed to community services overall, according to the HSE boss.
Uneven services across country
Cairns also raised surveys by Inclusion Ireland, As I Am and Down Syndrome Ireland which highlighted the waiting time for disability services. Earlier this month, Noteworthy reported over half of the families of children surveyed by Inclusion Ireland were not in receipt of any service.
“The Down Syndrome Ireland survey confirmed the worrying variations in services across Ireland,” according to Cairns. Over 60% of families who took part in this survey from CHO 4 (Cork / Kerry) reported they received no therapy of any kind last year – the highest of all areas. Carins added:
“Progressing Disability Services is currently a failure. It’s failing children and it’s failing their families. It is breaching their rights and it is not providing therapies where they are most needed and most effective.”
“CHO 4 has been our most challenged area” in terms of the number of assessments sought and backlog, according to Anne O’Connor, the HSE’s Chief Operations Officer.
“In terms of the geographical differences, we are very conscious of that,” added O’Regan, the HSE’s Head of Operations Disability Services. “In deploying the additional resources that are allocated to us this year… we have weighted the allocation of posts to those CHOs and network teams that are further behind in terms of the ratios of supports of staff to children.”
In his opening statement, Reid said that “substantial additional resources have been provided to these teams since 2019″ with “more than 475 posts have been allocated to children’s disability services”. This breaks down as 100 in both 2019 and 2020, 85 last year and 190 planned for 2022.
“It is important to highlight that an assessment of need is not required to access these
services. Any parent, health professional or teacher can refer directly to the CDNT.”
He also said that the HSE undertook a census of the staff on these teams which will allow them “to identify gaps and to develop a comprehensive workforce plan for the area” and added:
“It is important to acknowledge that the supply of qualified health and social care professions does not meet the current level of resources available for new posts; and so we are seeking to address this.”
‘You can see the anger’
Poor communication by the CHO teams was raised a number of times by Fianna Fáil TD Jennifer Murnane O’Connor who said that the HSE were not getting in touch with families.
“You can see the anger here today… The problem is there is no delivery and no accountability.”
Murnane O’Connor said that the HSE teams did not have “proper communication” with parents who needed to know what was happening with services. “The HSE is a disaster for that. I find when you are trying to get things done, it is just a nightmare.”
“There is no excuse for our services not responding to families in terms of their needs, other than them being understaffed,” said MacLachlan, clinical lead for people with disabilities HSE. He added that they needed to address responsiveness to families when they have queries.
Children’s Ombudsman Dr Niall Muldoon renewed his call for the recommended actions set out in their ‘Unmet Needs’ report to be advanced.
He also said that it was “something to our shame as a Government” that it has not ratified the optional protocol of the UN Convention on the Rights of Persons with Disabilities (UNCRPD). This would enable disabled people to make individual complaints to the United Nations.
“It just feels like the goal posts keep moving” in relation to this, added Ciara McKenna-Keane from the Office for Ombudsman for Children who said it was part of the Programme for Government to ratify it. She said that “the point here” is that all rights “should be actionable”.
DELAYED DELIVERY Investigation
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Reid really is stealing a living at this stage.
In his opening statement, HSE CEO Paul Reid said that “91 children’s disability network teams are now in place across the country”.
This was disputed by Social Democrats TD Holly Cairns who said: “That is untrue – you’ve partial teams across the country.”
When the CEO is spouting fibs and tall tales, then you can be certain there is no accountability in any of the departments under him.
North county Dublin CDNT was to be operational August 2021 (after ‘covid’ delay) then October 2021 (nothing) then March 2022 not sure what the craic is but had contacted them for the 5th or 6th time in January 2022 to discover that they’d “misplaced” the electronic copies, registered post copies and hand delivered copies of my child’s referral and had nothing from him. By chance I discovered 3 days later several other parents had been told the same re loss of files… whole system is a shambles!
The Journal, can you do a piece about the Assessment of Needs fiasco please? I’m almost 2 years waiting for the report on my son, these are suppossed to be fully completed within 6 months.
@Tina Kelly: and in regards to the community teams, in these 2 years my son had 1 zoom appointment with the OT last summer before she went on maternity leave – no replacement since. Luckily we met the S&L Ther.apist for 3 appointments before she was promoted to manager of the community team after a retirement. So my son has a community team manager but ZERO ther.apists!!!
Which surprises precisely no one who’s tried to engage with them.
Can we not put the Reid lad on a performance based salary?
We could cut his wages by about 90% based on the current shambles he is presiding over!!!
The system was working so well for some and not at all for others. They came along and blew the whole thing up. Working parts and all and now it’s working for no one. I don’t understand how pds has gone so badly wrong but it needs fixing much with more urgency than has been applied to date.
My daughter will be 16 in July. In all those years she has received at best a handful of therapies. She, like thousands of other children, has been failed by the state and nothing will ever change that. Shame on those responsible.
Glad to see the current AON system being brought up for discussion again on The Journal because it is not fit for purpose and absolutely criminal.
Fantastic to see that in his valiant quest for more funding in these trying times Mr Reid’s salary hasn’t suffered. The HSE are an absolute shambles, worse than a joke. 3 years waiting for my son to be assessed, one year completely wasted because somebody had lost his file and didn’t bother following up on it. If it wasn’t for my wife badgering them he would just have been forgotten about. I wonder how many families have actually just been forgotten about due to lost files etc?
@Football in the Groin: is no joke , its below the 3rd worlds country , because even in the likes of romania – the health system is actually working.
The disability sector is in crisis in this country. I work in adult services and I have never seen the staffing shortages we have in over 20 years in the sector. We pay inflated pay rates to private agencies to get staff who earn substantially better pay with a for profit agency than being employed by a HSE funded organisation. When I say substantially better I mean above minimum wage. Those who remain are being worked to exhaustion and are leaving the sector. The HSE and government do not value those with disabilities and reaching and sustaining appropriate and professional standards of care and support is no longer realistic.
@Anne Mc Namara: totally agree. Childrens services the same. Also the Private companies being paid an absolute fortune for high support residential services when families hit crisis point instead of long term planning and quality respite and home support.
We received the report within 8 months, but the waiting time for the next stage is 36 months. 8 years old child, Swords area
Hasn’t been a child psychiatrist in Meath in FOURTEEN years. No access to private services even if you could afford it. Camhs won’t see children with an ID. It’s a total shambles when it comes to children’s mental heath. And that’s aside from the long waiting lists and vacant posts in other disciplines.
This does not surprise me one bit, with this government only self interest matters to them
You’ll never get proper funding until you organize. I can’t understand how you allow yourselves to be walked on and ignored.
If it was one of my children I’d stop at nothing to get justice. As a parent you have a responsibility to your children .
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