As anyone who has a child with special needs will attest, getting the right help is a difficult task. But for parents of children with autism that task is arguably harder, thanks to a rapidly growing demand for limited services and the level of support sometimes required.
Meaningful intervention may require help with behaviour, diet, sleep, language and communication and social skills, and the earlier it occurs the better.
While the Department of Education provides for schooling for autistic children in a variety of preschools or outreach classes, therapeutic services such as psychology, speech and language therapy and occupational therapy are supplied by the HSE.
In counties Dublin, Wicklow and Kildare, these are provided through Beechpark Services which is managed from offices in Tallaght.
Beechpark, set up in 1998, is a HSE-run clinical service for children up to 18 years old who have a diagnosis of ASD (autism spectrum disorder) without a significant developmental delay. It provides services to more than 600 children attending a variety of designated schoolsin the three counties but rising demand and budgetary cuts have put its operations under strain.
By last year, 379 children were on its waiting list, 138 in Dublin north and north city and 241 in areas serviced by teams on the city’s west and south sides. With its budget cut as part of general health cutbacks and a bar on recruitment in place, it was unable to take on new classes of children with autism.
Minister for Health James Reilly is familiar with the service, having worked as a north Dublin GP for 20 years before entering politics. He also has personal experience of the condition: his son Jamie, now 26, spoke this month of his experience with autism; how he didn't speak till he was three and didn't enter mainstream schooling until he was 11.
Dr Reilly met Beechpark representatives in December 2011 and a month later announced that €1 million in additional funding was to be provided annually for three years to address "the needs of children with autism". In April 2012, a HSE report recommended that €300,000 of the extra money be spent in Dublin north and north city in 2012, with the south and west of the city benefiting in
This money was enough to fund five posts each year.
The HSE also proposed dividing the remaining €700,000 each year for early intervention teams equally between its four regions.
"We know that the Minister's focus is on ASD (autism spectrum disorder). However, in line with the national disability strategy and our HSE policies/reports, we are aiming to establish teams that don't differentiate between conditions, therefore I believe that it is reasonable for us to use this portion of the funding to build the resource available to those teams generally," wrote Dr Cate Hartigan, assistant national director for disabilities.
While HSE and department officials discussed how best to proceed, Dr Reilly's advisers and constituency office made repeated inquiries about progress over the months that followed, documents obtained under freedom of information show. Department officials told the HSE they were unable to provide an update on the €1 million allocation as they were still awaiting some "clarification" from Dr Reilly.
At a meeting in June 2012, Dr Reilly expressed his concern at the high level of investment in Beechpark services and said he had asked for an independent objective assessment of autism services to be carried out by an outside expert with an early report to be provided.
Dr Reilly decided to delay making a decision on the spending proposals from the HSE pending the outcome of this assessment.
However, he approved the spending of €300,000 to fill five speech and language, psychology and occupational therapy posts in the Dublin north area.
Dr Hartigan, in a letter to the Department, expressed disappointment at the decision to only fund the Beechpark Dublin northeast element of her proposal.
The HSE’s preferred planfor making best use of the funding was to invest in an integrated care model which allowed children, whatever the nature oftheir disability, to be seen as locally to their home and school as possible.
“This will promote equity and consistency across the country, improving access to required services for all children and will ensure that resources are used to the optimumIt is regrettable that we cannot use the available funding to assist in making this progressive policy a reality,” she said.
While the Minister points to long waiting lists in north Dublin, the lists are not confined to that area. And while there may be merit in the review he has ordered, the delay in its completion has meant that most of the promised extra money has not materialised.
The ultimate effect of his announcement of January 2012 is that only 10 per cent of the promised €3 million has been allocated, all of it in north Dublin.