HSE to revise children’s disability needs assessment after court ruling, Reid says

Health service will not appeal High Court decision to strike down current process

The Health Service Executive says it will not appeal a court decision striking down the process it uses to assess the needs of children with disabilities.

Earlier this month, the High Court judge ruled that a preliminary process used by the HSE to assess the needs of children with suspected educational and health problems does not comply with the disability laws.

Ms Justice Siobhán Phelan held that the “standard operating procedure” (SOP) which the HSE has applied when assessing the needs of children with disabilities does not comply with the requirements set out in the 2005 Disability Act.

HSE chief executive Paul Reid said the judgment required the organisation to revise its approach. The HSE accepted the judgment and would not be appealing it, he told an Oireachtas committee on Tuesday.

Substantial work has been done to address waiting times for assessments, using funding from Sláintecare, he told the Children, Equality, Disability, Integration and Youth Committee. The number of overdue assessments of need has fallen from 6,558 in June 2020 to 2,395 at the end of 2021, and indicative figures for February point to a further reduction to about 1,800.

Mr Reid said the SOP was implemented to ensure children received timely assessment under the 2005 Disability Act.

On the basis of assessments carried out last year, 86 per cent of children were put on an intervention pathway and 54 per cent were identified as requiring further assessment “but this did not delay their access to health services”.

Ombudsman for Children Niall Muldoon said that in light of the High Court judgment, a promised independent review of the SOP was now redundant and continued implementation of the SOP was “untenable”.

Dr Muldoon pointed out that the SOP replaced the former assessment process under part 2 of the 2005 Act, which had resulted in less than 10 per cent of assessments being carried out within the statutory timeframe. Under the new SOP, uniform screening assessments had to be completed within 90 minutes, regardless of a child’s needs.

Concerns

The ombudsman’s office had previously raised concerns the new assessment would “push back” children’s diagnostic assessments and be less thorough, given the time restriction involved. “These concerns were not unfounded,” he observed.

Committee members were highly critical of the standard of HSE services for the disabled. Labour TD Ivana Bacik described the disability service as a failure. "It's failing children and it's failing their families. It's breaching their rights and it is not providing therapies where they are most needed and most effective."

Sinn Féin's David Cullinane said parents were infuriated and frustrated at the services the HSE was providing for children with a disability. He accused the HSE of cutting corners with the SOP and said parents would not tolerate any dilution of the law.

Dr Muldoon called on the HSE to outline clearly what it required from Government to meet its obligations under part 2 of the 2005 Act and to ensure that children receive the services they need in a timely manner.

Bernard O’Regan, head of disability services, said the HSE was considering the judgment and was also awaiting the imminent judgement in a related court case. It would then convene with stakeholders before deciding on a new mechanism for assessing children. In the meantime, parents could elect to avail of the preliminary, non-statutory assessment system.