Assessment of need reform 'not code for taking away the right to it', says HSE chief

Bernard Gloster arriving at Leinster House to answer questions from deputies on Wednesday. He told the Oireachtas Disability Committee: 'Assessment of need, I believe, needs reform.'   Photo: Sam Boal/Collins Photos

HSE chief executive Bernard Gloster pledged reform of the assessment of need (AON) system is not code for removing children’s right to this at the Oireachtas Disability Committee on Wednesday.

Waiting lists in Cork and Kerry were also raised and he is concerned about long delays facing children there in particular.

Families nationally should see faster access to services by October with a ‘no wrong door’ system in place, he also said. This means if the first service a family encounters is not the best place, they can be referred to a more suitable service instead of starting over each time.

Mr Gloster was answering questions on Progressing Disability programmes.

“Assessment of need, I believe, needs reform, that’s not code for taking away people’s right to it and it’s not code for changing the timeline but it has actually become something it was never intended to be,” he said.

“Every single need across public services and across Ireland Inc is now being tagged to assessment of need either because people are led to believe they need it or they form the belief that they’ll get something faster.” 

That’s leading to children who really need it being delayed and children who don’t need it being put through it. I have concerns about both. 

Labour spokeswoman on disability, Laura Harmon, said in the first three months of this year “just 7% of assessment of needs were completed within the timeframes of the Disability Act itself".

Mr Gloster said his focus is on “ensuring that the legislation defines the purpose of the assessment and enables access to it". He is not aware of plans to change the requirement AON should be done within six months of referral.

Ms Harmon said of Cork City waiting lists for primary care assessment for autism “we’re seeing 30 months waiting lists”.

Mr Gloster responded: “I have a particular concern about Cork”, saying he has discussed with the regional team the need for better focus on children’s services there.

'No wrong door'

He described meeting GPs during the Irish Medical Organization AGM, saying they talked of how time-consuming it can be to match children to the most appropriate service.

“We’re changing it to ‘one front door’ and there is no wrong door,” he said, saying this will take effect from October.

Teachers, parents, and GPs are among those who can refer to a central system for assessment.

“They will decide what’s at least the best chance of the quickest pathway for that child to receive an appropriate response. That will include the Autism protocol,” he said.

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Social Democrats TD Liam Quaide raised delays with primary care, saying this is “deep in crisis” in addition to stresses facing Camhs and children’s disability network teams.

For primary care psychology, the waiting list for children is now over 6,500 “and that’s for Cork and Kerry alone,” he said.

Children might wait four to five years for help and then only get seven sessions, he added.

Mr Gloster met 600 staff online this week from disability, primary care and mental health services for children to discuss staffing plans.

HSE HR officials set out plans for recruitment to the committee, saying there is a global shortage of therapists and there are plans to increase training places.