Assessment of need backlog for children 'a national scandal'

Gareth Noble, left, seen here in a file photo from 2019, told the committee that '91% of children do not receive their assessments within the timeframe prescribed and mandated by law'. Picture: Sam Boal/RollingNews.ie

A lawyer who has represented families trying to secure services for their children amid chronic HSE backlogs has told an Oireachtas committee that delays in assessment of need (AON) is a "national scandal".

Gareth Noble of KOD Lyons was speaking before the Joint Oireachtas Committee on Children, Disability, Equality and Integration, and said efforts by the HSE to change the current AON system threatened to make a bad situation worse.

The AON system has been beset by problems in recent years and the most recent figures showed more than 6,000 overdue applications at the end of September. Additional funding has been secured to try and assist each health area to tackle the growing backlog.

AON is meant to provide a gateway to services to meet the needs of a child and is to be delivered within a limited, statutory timeframe.

"It is a national scandal that 91% of children do not receive their assessments within the timeframe prescribed and mandated by law," said Mr Noble. "It has led to untold and ongoing damage, stress, and real prejudice to children. 

It cannot be dressed up as being anything other than a breach of their rights. 

"It is also hugely significant to note that the Oireachtas made it clear under the [Disability] Act that an assessment should be carried out without regard to costs or capacity to provide the assessment.

"The dilemma faced by many parents when their children are not meeting their developmental milestones, are presenting with challenges, are being left behind by their peers, where they may be non-verbal, unable to perform basic tasks independently, totally reliant on their caregivers is to how best to proceed to meet the needs of their children in a timely manner. 

"The Disability Act provides them with a mechanism to achieve a pathway to progress. Sadly, however, it is not just the letter but the spirit of this legislation that has been, and continues to be, bypassed, circumnavigated, and routinely ignored. 

"The overall health budget for 2020 as set out in the approved service plan was some €17bn and yet the priority provided to children in assessing and meeting their needs remains woefully inadequate."

Referring to the HSE's implementation last January of a new model of how children are to be assessed, Mr Noble said: "They did so without any adequate concern for the needs of the children in question and their families.

"They have, in effect, sought to kick the can down the road in the proper assessment of children and they have sought to do so in a blatant and cynical way. 

"Under the new model, children will no longer be assessed as they have heretofore under the act. There will be no multidisciplinary assessments which seek to determine what the act requires, i.e. to determine whether or not a child has a disability and the extent of those needs. 

"Instead, we have a triage system where an initial assessment will be conducted to ascertain whether further assessments are required. The child in need of the ASD assessment will not have that assessment commenced or completed within the six-month time limit prescribed by law or at all. Instead, the HSE have sought to include such assessments in service statements which they will then claim are subject to resources."

Mr Noble urged continued Oireachtas scrutiny on the issue.

"I fear very much that a substantial further number of children face the real risk of being lost and their childhoods diminished as a result of the new model and that service delivery will, therefore, be even more out of reach than previously."

The same committee also heard from Psychological Society of Ireland president Mark Smyth and others.