HSE chief admits waiting lists for assessments for children with disabilities will get worse

David Raleigh

The head of the Health Service Executive (HSE) said on Tuesday that he was “hugely” concerned at growing waiting lists for disabled children seeking vital health assessments and admitted the crisis will get worse.

Bernard Gloster acknowledged a “significant challenge” in tackling the crisis, with more than 15,000 children with serious disabilities waiting to access their legal right to assessments.

When asked if the crisis was ‘going to get worse before it got better’, Mr Gloster replied: “Yes”.

The HSE chief said: “Until we get extra capacity and until we reform the legislation, we are going to be challenged.”

“It would be very wrong of me to say anything different to people across the country, it would be untruthful to do that,” he told reporters in Limerick.

The HSE predicts that the children’s assessment waiting lists will increase to beyond 25,000 by the end of this year.

After meeting Cara Daramody, a 14 year old campaigner for the rights of children with disabilities, Mr Gloster pledged that the HSE will advertise tenders for assessments to the private clinicians, to try and tackle the problem.

Prior to the meeting, Ms Darmody, accompanied by her father Mark Darmody, called out the government via the HSE for breaching current legislation requiring it to provide health and education needs assessments for children with disabilities.

Ms Darmody said children had been left to “rot” on the waiting lists and urged Mr Gloster to act fast to rescue the waiting list backlog for the vital assessments.

Ms Darmody, who led a 50-hour protest outside the Dáil last month highlighting the crisis, said she gave Mr Gloster “crucial information that totally contradicts the myth that capacity has been reached in the system in relation to the number of psychologists available to assess autistic children”.

Ms Darmody said she also informed Mr Gloster that she is aware of “private” clinicians who have sought to help reduce assessment waiting lists but who have been delayed in doing so by bureaucracy.

Ms Darmody claimed she knows of at least one private clinician who could have “eradicated” the AON waiting list in her home county of Tipperary over the last 12 months, by performing an additional 220 AONs, had they been given the opportunity.

Ms Darmody said the clinician had applied for a HSE Assessment Tender last October, “but only got confirmation a month ago” that they had been accepted.

Ms Darmody questioned “why in the middle of a national crisis did it take eight months”, and she accused the government of not acting fast enough on the waiting lists.

Mr Gloster said this evening he was “taken aback” at the details presented to him by Cara Darmody and Mark Darmody.

Commenting on the alleged eight-month wait for the provision of the assessment tender, Mr Gloster said: “I have to say, it can happen, we are a very big organisation and we have to have rules and systems, and they, by their nature, can become bureaucratic.”

“I’m the first to put my hands up and say, that’s for us to do better.”

“I don’t think that my own people are doing anything bad or wrong, but it is for us to better, we are paid public servants and Cara and her Dad are not.”

Mr Gloster said, going forward, he would try to “tighten the timeline” on assessment tenders applications by the private sector.

He acknowledged that “in the short-term” the HSE required “help” from the private system to help reduce the assessment waiting lists.

“In the next few weeks, we are going to redesign the specification of private sector provision to help us provide assessment of need,” Mr Gloster said.

“We are going to widely advertise and promote it, so that if there are suitably qualified clinicians who can conduct an assessment of need, and who are qualified and registered to do so, and are safe to do so, then there will be no issue with us using that additional capacity,” he said.

“Even if it possibly reduced the timeline for a couple of hundred (children), then it would be a really productive thing.”

Mr Gloster said: “If you apply for an assessment of need, you are entitled to it in law; you should be able to get it.”

The Limerick health service boss said other “challenges” existed beyond the assessments, including timelines over children’s access to “therapeutic support and intervention”.

“The amount of therapists we have in Ireland that are available to us is limited, but the government are making some really good interventions to increase the supply,” he said.

Mr Gloster said that Cara and Mark Darmody’s “anecdotal evidence” of a possible reduction in the waiting lists may exist in the private system; their arguments to investigate it further were “legitimate and appropriate”.

Mr Gloster acknowledged that it had been “a while” since the HSE had “updated” its “framework” of assessment providers, “so, therefore, there is nothing to lose and everything to gain” by investigating potential capacity in the private system.

“If (it is) proven that there is capacity out there that isn't being used, we’ll be delighted that more that can be done, because it means that we can immediately enter into arrangements with professionals to buy additional services to support our own (services),” Mr Gloster said.

Ms Darmody described their meeting as “extremely successful”.

“I got what I wanted from the meeting, which was for Mr Gloster to look into the issue and to start looking for solutions nationally, and in my own county, Tipperary, and possibly internationally,” Ms Darmody said.