HIRING STAFF INTO children’s disability network teams is Minister Roderic O’Gorman’s number one priority, he has said.
A children’s disability network team (CDNT) provides specialised support and services for children who have a disability and complex health needs associated with their disability.
The CDNT supports a child’s development, wellbeing and participation in family and community life.
Last year, Noteworthy reported that not one of the country’s CDNTs are fully staffed.
Bernard O’Regan, the HSE’s Head of Operations Disability Services, told an Oireachtas committee last year that the HSE has “an average vacancy rate of about 25% across teams”.
Speaking to The Journal in a wide-ranging interview, the Minister for Children, Equality, Disability, Integration and Youth said it is a “huge concern” to him that thousands of children are not getting the level of service they need right now.
O’Gorman has had the word “disability” in his job title since June 2020 but powers in the area were only transferred to him from the Department of Health last March.
Minister of State Anne Rabbitte also has responsibility in this area, but has spoken openly about coming up against roadblocks trying to organise meetings with HSE senior managers to discuss their staffing shortages, something Health Minister Stephen Donnelly had to intervene in.
“The transfer of functions kicked in from March of this year. Both myself and Minister Rabbitte were frustrated it didn’t happen earlier, because for me, I would have been able to kind of sink my teeth into the issue far earlier.
“But it has transferred and we’ve been very clear, our number one priority is staffing on the CDNTs and we were able to get additional financing in the budget this year towards that,” O’Gorman said.
The minister said there is a new roadmap that deals directly with recruitment and retention issues, adding that work is underway to open up more college places on courses to boost numbers.
“But obviously, it’s going to take a couple of years for that to deliver. We’re looking at Master’s programmes for people who maybe did a life science degree and can convert to being an occupational therapist or a physiotherapist in two years rather than four years and funding some of those.
“As a consequence, people would commit to working in the teams. We are also looking at assistant therapy grades. So these would be FETAC level four, five or six qualifications where people could, under the guidance of an occupational therapist, provide some intervention to children,” he said.
“So it’s all about your staffing of these teams, because our vacancy rates are too high and until we get people into those teams, we’re not going to be able to either do the assessments of needs or deliver the therapies that flow from an assessment,” O’Gorman added.
His comments come as Health Minister Stephen Donnelly tells this news website that one of his regrets was not amending legislation relating to disability services immediately after an instrumental court case ruled on the standards of assessments that must be carried out.
In 2022, the High Court ruled that a preliminary process used by the HSE to assess the needs of children with suspected educational and health problems did not comply with the disability laws.
The High Court determined that a full and comprehensive assessment of a child’s needs and services was necessary and this could only be done with a proper diagnosis of a child’s condition.
The HSE accepted the judgment and did not appeal it.
However, the HSE boss at the time, Paul Reid said that under the model of care that was deemed not to comply, waiting times for assessments was falling. Last year, he told an Oireachtas Committee that the number of overdue assessments of need had fallen from 6,558 in June 2020 to 2,395 at the end of 2021. In early 2022, prior to the court ruling, the waiting list had fallen to 1,800 and was continuing to fall.
When asked about the same issue of families having to wait for months for proper services, Donnelly said “one of my regrets was not amending the legislation immediately” to continue with the model of care that was in place.
The health minister said the model of care in the past “was working”, in his view, stating that “tens of thousands of children in Ireland today are not getting the care they need because of that court case. This was getting resolved”.
“Part of the solution is amending the legislation. And it is one of my regrets that I didn’t immediately bring that in,” he said.
Donnelly said the court ruled that children needed assessments that would take over 30 hours, which had knock on impacts on resources.
“I’m not criticising the courts, the courts are only interpreting the law. The implication of that was that we had to stop treating children and spend a huge amount of very precious resources giving children assessments that they never needed. And it completely reversed really important progress that we were making,” he said.
Donnelly said when he came to office there were 70,000 children waiting for treatment.
Funding was allocated to Rabbitte “to use whatever capacity she could find – public, private, insourcing, outsourcing. Anne drove around this country having pretty tough conversations with HSE”.
“And the lists fell… So this was getting resolved and that court case, not only stopped all of that progress, it reversed all of that progress,” he added.
Due to the lack of staffing in the CDNTs, the health minister said that children are now being removed from the teams and are getting treatment in primary care, in some cases.
“It may not be the exact same level of specialty in terms of disability services, but they’re all highly trained clinicians. So Roderic [O'Gorman] and Anne [Rabbitte] are on this, additional funding has gone in. The HSE has really struggled to hire into those CDNTs,” said Donnelly.
“My view, and this is a call for Roderic and Anne to make now, it’s not in my portfolio anymore, but my view is we should amend that legislation to provide the model of care that was being provided and was working.
“I know some people would disagree, but how anyone could stand over saying we have a child who, with a one hour or two hour assessment, we know this child needs a speech and language therapist or a physio or an occupational therapist or a combination.
“We know that, but we’re going to do another 36 hours of assessment. That’s 36 hours this child and other children aren’t getting. So that’s my view,” said the health minister.
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