Waiting lists for children to have their additional needs assessed are growing substantially due to a doubling of referrals and the HSE’s inability to provide enough services, the Minister for Children has been told.
A Department of Children briefing document published on Monday said the number of assessment referrals rose to 10,000 last year from 4,700 in 2020.
The document suggested the rise in numbers was continuing, with the midlands area Children’s Disability Network Team (CDNT) reporting an 8 per cent year-on-year increase for the past three years.
The document put the HSE’s public health service’s capacity to deliver “assessments of needs” at about 3,600 a year. It said a May 2024 government initiative intended to tackle waiting lists resulted in the procurement of 2,100 private needs assessments over the following six months at a cost of €6.9 million or an average of €3,300 per assessment.
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A further €10 million was allocated for the provision of about 2,850 private assessments this year, but that would still mean an increase to waiting lists of about 3,500 this year based on figures in the document.
“Assessments of needs” are formal procedures set out under the Disability Act 2005 that are intended to identify a child’s health and educational needs. Although a needs assessment is said not to be required to access additional services, it is in practice a key element in getting a child into the system.
Legally, a child is entitled to have their needs assessed within six months of being referred for one.
The growth in demand in part reflects a dramatic recent increase in the number of children and young people being diagnosed with autism.
In early March The Irish Times reported on Department of Education figures that indicated 5 per cent of children were now being diagnosed with autism, a threefold increase in less than a decade.
The growth in numbers was said to be placing a considerable strain on the department’s ability to provide adequate services.
The HSE’s Progressing Disability Services Roadmap for Service Improvement 2023-2026, launched in October 2023, set a target of 19,042 needs assessments to be carried out over the period of the plan.
However, Department of Children officials noted, just 4,569 had been completed by the end of last September, leaving 14,383 outstanding.
The document prepared for Minister for Education Norma Foley said there were 13,505 children awaiting initial contact with a CDNT at the end of last October, while 12,700 assessments were “overdue”, meaning the child concerned had been waiting more than the prescribed six-month maximum period. It cited HSE figures estimating that by the end of 2024 there would be 17,500 assessments due for completion.
The briefing said €10 million was allocated for new staff this year, including 20 senior therapists, but recruitment and retention in the area was a big challenge, with housing one of the wider issues faced.
It said the HSE reported that private-sector capacity was becoming “increasingly limited”.
Reform of the assessment of needs system was required, the document suggested. “There is a critical need to take decisive action to address the rapidly growing [needs assessment] challenge,” it said.
Waiting lists were growing as “demand outstrips capacity”, while significant amount of therapists’ time was devoted to the assessments, it said
Greater co-operation between departments and agencies to simplify procedures was recommended, as was the continued use of private services to help reduce waiting lists.
