HSE needs 400 more therapists to reduce child assessment waiting lists

The HSE has said its proposed changes to how children are assessed regarding a possible disability is not aimed at “dumbing down” the work of clinicians — and also admitted that 400 more therapists are needed in the coming years.

The HSE also said the chronic waiting lists in Cork for overdue assessments of need is a “priority”, with additional therapists needed but also a restructuring within the area to facilitate their work.

The joint Oireachtas committee on health had earlier heard from organisations representing parents, occupational therapists and psychologists who have all voiced serious concerns over the proposed standard operating procedure (SOP) for assessment of need. 

The proposed changes are also the subject of ongoing negotiations between the executive and trade union Fórsa.

As well as a lack of consultation, those groups also told the committee they were concerned that a proposed 90-minute screening of children would come to replace aspects of the current assessment process which in some cases can add up to more than 40 hours in the case of a diagnosis of autism spectrum disorder (ASD).

Assessment of need is meant to be completed within six months, with another month to file reports, but there are serious backlogs in some areas, led by CHO4 of Cork/Kerry with 1,718 overdue assessments.

Dr Morgan said: “The SOP will not resolve these problems — that is absolutely the case.”

“We are not trying to dumb down or limit clinicians in how they are working, but we are trying to put a framework in place.”


He said it was often the case that therapists in some areas ended up working “in silos” through no fault of their own and that there was a lack of coordination between services that exacerbated the delays, with one response the rolling out of disability network teams.

As for the talks with Fórsa, he said it was a “line-by-line review” and that the 90-minute screening element was “open for discussion”.

Angela O’Neill, national disability specialist, community operations, said she believed the outcome of those discussions would be “a much wider range around the timeframe”.

Dr Morgan also said the system is going to need around 400 additional therapists over the coming years, adding: “There is no doubt but investment is absolutely required.”

Ms O’Neill said the aim of the SOP was to ensure that children ended up on the right waiting list and for shorter periods of time, claiming that in some cases children awaiting a completed AON can go without other services or supports they could be availing of in the meantime. 

She said she believed the new SOP could meet the HSE’s obligations under the Disability Act.

Dr Morgan said he would write to all CHOs to ensure the new SOP was not implemented until the discussions with Fórsa were successfully concluded, that he would meet again with the professional representative bodies and with the health and social work regulator CORU to ensure the SOP was in line with its code of practice.

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