Boy with ‘profound’ autism waiting two years for reassessment despite recommendation to three HSE managers

Taoiseach says he is ‘not happy’ with services provided by HSE for children with special needs

Taoiseach Micheál Martin has said he is “not happy with the services provided through the HSE” for children with autism.

The problem is at a scale it should never have reached “and it’s not a funding issue”, he said of the delays in the assessment of more than 2,500 children with special needs.

The resources have been allocated but the health service says it is a recruitment issue, the Taoiseach said, stressing that salaries and conditions are not problems because recruitment and retention of therapists in other areas of the health service is not an issue.

He was speaking after Sinn Féin leader Mary Lou McDonald accused the HSE of “stonewalling” and ignoring the family of a 10-year-old boy who has yet to be reassessed for autism services despite his condition being described two years ago as profound and severe.


Ms McDonald raised the case of Neil Dermody from Tipperary who was diagnosed in 2016 as having a mild to moderate autism spectrum disorder.

Four years later a HSE child psychiatrist said his disability was severe and he should be reassessed but this had never been “actioned” despite the recommendation being sent to three separate HSE managers.

She said Neil’s brother John also has autism but has progressed because of privately paid intervention.

Neil “bites himself all day. The household is chaotic. The child needs constant care and is not getting the services he needs but hasn’t even been reassessed.” She said that his parents had lost employment because of the need for constant care.

During Leaders’ Questions Ms McDonald mentioned the campaign by Neil and John’s 12-year-old sister Cara who had appeared before an Oireachtas committee and also met Taoiseach Micheál Martin in July.

“Cara spoke to the Oireachtas committee two weeks ago and told members her brothers had been treated “disgracefully” as had “almost 18,000 children who have been left to rot on waiting lists”.

The Sinn Féin leader said the assessments of 2,500 children are overdue and more than a quarter of HSE positions for children’s disability services are vacant.

Mr Martin said they would make representations and “talk to the agency in respect of the case” but he stressed that there are other children who require access to services and a recent legal case had impacted the “model of service” that was in place.

He said he had convened two meetings with all the Ministers responsible for special needs to deal with this issue. “We have to develop more accelerated means to assess needs but the key issue is recruitment of a sufficient number of therapists to provide not just assessment, but interventions for children who require them.”

The Taoiseach said therapists were taken out of special schools to have a general pool available but this diluted the service.

“We made it very clear that we wanted the therapists back into special schools as a first step. That has been agreed although we’re following through on the implementation of that with the HSE because there has been resistance.”

He said there are different perspectives but “I made it very clear that in special schools, the multidisciplinary approach is best and I want the therapists in the special schools”.

Mr Martin said rapid progress had been made in the last two years in education with additional special schools, additional special classes and additional resources, but there was more to do.

But the availability of therapies was “not satisfactory” in some areas where there was a larger catchment of children with special needs. The key issue was the HSE’s capacity to recruit staff but “that’s of no consolation to children and families trying to access services”.

The HSE had “far greater success in recruiting therapists for a whole range of other services” but “there seems to be a particular difficulty in recruiting and indeed in retaining therapists across the board and that is a key issue”.

Marie O'Halloran

Marie O'Halloran

Marie O'Halloran is Parliamentary Correspondent of The Irish Times