Barnardo’s urges immediate action to tackle child waiting lists

Children's support agency Barnardo's is calling on the Government to use the National Treatment Purchase Fund to tackle child waiting lists for speech and language therapy.

The call comes as figures obtained by Barnardo’s through parliamentary questions show tens of thousands of children waiting for treatment in areas of mental health, disability, speech and language.

The figures highlight Ireland’s two-tier health system, said Barnardo’s head of advocacy June Tinsley.

"The figures clearly demonstrate that Ireland has a two tier health system because frequently parents, if they can afford it, end up having to pay for private sessions for speech and language . . . Low income families don't have that luxury and as a result their children are left slipping behind. It affects so many aspects of their family life and their ability to thrive," she told RTÉ's Morning Ireland.

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The data shows that more than 30,000 are awaiting speech and language assessments or therapies, in excess of 2,500 are on Child and Adolescent Mental Health Service waiting lists and above 4,000 are waiting to undergo a disability assessment.

"Over 10,000 children waiting for an initial assessment, of those over 470 are waiting longer than a year, that's up over 50 per cent on March 2018, likewise over 12,000 waiting for further therapy, 1,000 still waiting longer than a year," said Ms Tinsley.

A parent, teacher, GP might have identified that a child was not beginning to communicate, interact with peers. And this raised a flag. They then underwent the next step which was a referral. More than 10,900 children are waiting for that initial assessment to determine how much intervention a child needs.

“In the area of speech and language therapy assessment should happen early on and while Barnardo’s can’t diagnose conditions, we certainly help parents through our early years service. We work directly with parents to try to encourage them to communicate as much as possible with their children.

“The window of opportunity for children is so short in the area of speech and language . . . in a child’s life the difference between a child age two and a child six, is so significant it certainly affects their entire development.”

Ms Tinsley noted that the National Treatment Purchase Fund covers hospital waiting lists. “We’re just trying to think creatively how else we can try to tap into ensuring that children are getting the assessments they need.”

Key findings in Barnardo’s analysis:

• Mental health services: CHO4 area (Cork and Kerry) remain the worst with 29 per cent of children in those areas waiting more than a year for a Child and Adolescent Mental Health Service service.
• Speech and Language services: 50 per cent increase between March and August 2018 in the number of children waiting more than a year for either an initial assessment or therapy appointment for speech and language.
• Disability: 78 per cent of children (3,153) have been waiting longer than the three month statutory time limit to undergo an Assessment of Need with CHO4 area faring the worst.

Barnardo’s has developed a plan which, if implemented, would alleviate the crisis affecting children’s healthcare, said Ms Tinsley.

It includes:

• Tackling regional disparities by expanding the remit of the National Treatment Purchase Fund to include reducing waiting lists for children's mental health, speech and language and disability assessment and treatment services by providing access to local, private assessment or treatment for those children waiting longest.
• Matching resources to the reality that prevalence of conditions such as speech and language difficulties, dyslexia and communication or co-ordination disorders is much higher among poorer people. This approach along with age profiling of the population areas would ensure services are distributed more appropriately and patients treated based on need and not their ability to pay.
• Increase investment in and availability of clinical and non-clinical solutions in the community. Develop clear pathways from primary care where children on waiting lists can be referred to and access these community based services.
• Guarantee one primary care team with a full complement of multidisciplinary professionals for every 1,500 children. These teams must comprise of GPs, nurses, home helps, physiotherapists, speech and language, psychologists and occupational therapists, and act as a one-stop shop for community care needs.
• Develop 24/7 crisis intervention mental health services across the country. Young people have described accessing supports through hospital A&E departments as distressing.
• Ensure ways of referring people are clearly defined for GPs and other health and social-care personnel. Create a resource for parents that outlines what services are available and how to access them.