The Department of Health has expressed concern that it may be vulnerable to widespread litigation as a result of delays in treating patients across a range of services. Carl O'Brienand Martin Wallreport.
Internal documents seen by The Irish Timesshow that officials are worried that a recent High Court decision, in which a family received damages for delays in accessing therapy for their autistic child, may have wide-ranging implications for other patients on waiting lists.
Shortages of staff and resources across a range of areas mean that young people are waiting months or even years for services such as psychiatric assessments, orthodontic care, speech and language therapy and disability services.
The High Court case involved a seven-year-old autistic boy, Seán Ó Cuanacháin, whose parents argued that he was entitled to a specialised form of one-to-one education known as Applied Behaviour Analysis.
While his parents lost the central plank of their case the court awarded the boy damages because of the "unreasonable" delay in diagnosing his condition and in providing appropriate therapies.
An internal department document says that the case raises "important questions about what constitutes an unacceptable delay in the provision of services".
It adds: "The plaintiff's claims against the minister were dismissed on May 16th, 2007, but the judge found that delays in provision of services by the Health Service Executive constituted a breach of duty of care and awarded damages. The judgment has potentially significant implications for all services involving a waiting list."
It says that the matter is being pursued with other government departments and with the Attorney General.
Long waiting lists are common across a number of areas. In mental health, for example, more than 3,000 children have to wait for psychiatric assessments for up to two or three years despite evidence that delays leave young people at risk of becoming chronically unwell.
In the area of orthodontic treatment, a total of 16,000 children and adolescents are waiting for treatment or assessment in the public sector. Some children have been waiting for up to four years.
Internal documents show that senior officials acknowledge that there is a serious shortage of child and adolescent in-patient beds. The documents say that waiting times vary for treatment or assessment across the State, although "urgent cases are seen immediately".
In the Ó Cuanacháin case, the High Court judge, Mr Justice Michael Peart, said that if Seán Ó Cuanacháin's autism had been diagnosed earlier, and a package of measures to which he was entitled had been put in place sooner, his challenging behaviour might never have reached the level it had.
He said that Seán would probably, for example, have been more advanced in the area of communication than he was when he began pre-school in February 2004.
In his decision on damages the judge found that there was a culpable and unreasonable seven-month delay by the HSE before diagnosing Seán's autism in November 2002 and a further delay in his being provided with appropriate services.