'Hard to defend the indefensible' on assessment-of-need backlog

All AON applications were on behalf of children aged five or under. File picture

HSE efforts to cut the backlog in processing assessment-of-need applications appear to be falling short, with new figures showing some parts of the country have seen zero applications moved onto the second stage of the process within the legal timeframe.

Disability Minister Anne Rabbitte said of the situation: "It is sometimes hard to defend the indefensible."

Parts of the country where no new applications were progressed within the statutory three months after they were lodged include Cork North, Cork North Lee, and Dublin South West.

The assessment-of-need management report for the third quarter of 2021 shows 1,270 completed applications were lodged in the period, from three in Cork West to 172 in North Dublin. All applications were on behalf of children aged five or under.

While 69% of those applications were acknowledged within a fortnight and every application proceeded to stage two within three months of the completed application being lodged in Galway, Mayo, and Roscommon, just 10% did in Community Healthcare Organisation 7 (CHO7), the area which includes Dublin West, Dublin South West, and Dublin South City, as well as Kildare/West Wicklow.

Dublin South-West was one of four parts of the country within various CHOs that saw 0% of new applications progressed within the statutory timeframe. Others included Tipperary SR (none out of 17 applications), Cork North (none of three applications), and Cork North Lee (none of four applications).

Overall, just 35% of applications entered stage two within three months in CHO5 (Waterford, Wexford, Carlow-Kilkenny, and part of Tipperary), 42% in CHO9 (north and west Dublin), and 44% in CHO4 (counties Cork and Kerry).

In North-West Dublin, just four (2%) of the 166 completed applications proceeded to stage two within the specified timeframe.

Nationally, 58% of applications were progressed within the legal timeframe.

When it came to completed assessment reports, the national average duration of the process was more than 17 months. None of the assessment reports was completed on time in two CHO areas taking in Dublin and parts of Wicklow and Kildare, with 2% completed on time in CHO9, 3% in CHO5, and 10% in CHO4.

When it came to the service requirements of those identified in completed reports, more than half needed psychotherapy, occupational therapy, and speech and language therapy, while almost a quarter needed an ASD service.

The most recent data shows that of the 2,907 applications overdue, 68% are overdue by more than six months.

Situation 'not acceptable'

Fianna Fáil senator Catherine Ardagh said the situation was "not acceptable".

Separately, figures provided to Fianna Fáil TD Michael Moynihan, chair of the Oireachtas disability matters committee, shows almost 55,000 people were waiting for assessment for physiotherapy at the end of August.

Almost 16,400 people were waiting an initial assessment for speech and language therapy and almost 56,000 people were awaiting a first assessment for occupational therapy.

In the Seanad this week, Ms Rabbitte said: "It is sometimes hard to defend the indefensible. Unfortunately, the challenges faced in some parts of the country have resulted in delays for families in accessing much-needed therapies for their children."

She said the total number of children awaiting an assessment of needs, including those who make up the backlog, amounts to just under 4,000 and that resourcing has been an issue.

"Since 2019, 285 therapists have been added to the teams," Ms Rabbitte said. 

"At the same time, however, we are still short approximately 400 staff. The staff in this labour market are predominantly women, and at all times our staff level seems to be down by 40%, for various reasons."