Over 10,000 children with disability left waiting more than a year to see specialist

More than 10,000 children with disabilities have been waiting over 12 months for initial contact with a specialist team, as the service struggles with massive staff shortages and rising demand.

Thousands more children are waiting to be assessed for disability, with a record 5,484 overdue applications for the assessment of need process in the first quarter of this year.

This is more than three times higher than the figure recorded in the same period in 2022.

[ ‘Gaping holes’ in child disability services leaving vulnerable children at risk, committee hears ]

[ In 2022 over 700 vacancies across country’s 91 Children’s Disability Network Teams ]

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Assessment of need, which is used to identify whether a person has a disability and what their needs are, is an essential first step for a child needing help. Yet 4,206 of the overdue applications have been pending for more than three months, according to figures supplied by the Health Service Executive to Sinn Féin health spokesman David Cullinane.

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A total of 7,144 applications for assessment of need were received in the year up to last March, the highest figure since the system was set up in 2007. The longest waiting lists are in Dublin, Kildare and west Wicklow.

The HSE is unable to say how long the average wait is, but the proportion of applications from over-fives has doubled over the past decade, reaching 55 per cent last year. This appears to indicate children are having to wait for an assessment for ever longer periods.

The number of children waiting to access a children’s disability network team (CDNT) stands at 17,157, including 10,696 who have been waiting for more than 12 months. The teams include specialists in nursing, occupational therapy, psychology, physiotherapy, speech and language therapy and social work.

Mr Cullinane described the delays as unacceptable. He said that many children faced consecutive waits, first for an assessment of need, then for initial contact with a CDNT and then for specific therapy.

“One waiting list after another” is how one mother described to The Irish Times her experience of trying to get her children assessed and then treated.

“The Minister needs to take a serious look at this. No child should have to wait for access to essential therapy but to have to wait more than 12 months for just an initial consultation is completely unacceptable,” said Mr Cullinane.

“We need proper workforce planning that targets the areas finding it difficult to recruit staff. Unless you deal with the retention issue you won’t be able to recruit sufficient staff.”

Court case

Up to 2021, the HSE succeeded in reducing the assessment of need backlog by limiting preliminary assessment to 90 minutes. However, delays have soared again after this truncated approach was struck down by the High Court.

The HSE says the court ruling has had a “significant impact” on operations and has resulted in longer waiting lists. “The requirement for services to prioritise the statutory assessment of need process will also impact significantly on their capacity to provide necessary intervention/treatment for children with disabilities,” it also acknowledges.

More than 610 CDNT posts have been provided since 2019, but many teams are running under complement due to difficulties recruiting staff. While the HSE has outsourced work to the private sector, this has had the effect of making the public posts relatively less attractive and thereby even harder to fill.