I ask the Minister about the efforts to ensure there is adequate access to residential respite services for young people with complex needs and their family carers in the Cork area.

I thank the Deputy for raising this matter. The Government and the HSE are very much aware of the importance of respite service provision for the families of both children and adults with disabilities and the positive impact it can have on people’s lives. Respite is a key priority area for the HSE for people with disabilities and their families, and there has been significant investment in respite services in recent years. New development funding of €15 million in 2024, specifically for respite, will ensure provision continues to expand significantly across the country. This funding will rise to €25 million in a full year. The HSE’s National Service Plan 2024 commits to increasing occupancy of existing respite capacity, where feasible, and alternative respite provision, including in-home respite support hours and group-based targeted measures such as summer camps and evening provision.

Cork-Kerry community healthcare disability services provides respite services for children and adults residing in Cork and Kerry. To respond specifically to the Deputy's question, the funding has been allocated to CHO 4. That will look after Cork and Kerry. Funding for respite has been specifically allocated for Cork and Kerry. This will ensure that where we have four out of seven nights available, the services will go full tilt to seven out of seven. We are also looking at additional capacity of houses to come on stream, and there are business cases in at the moment awaiting our approval. Some will be as part of shared care, where eight children or young adults could share the same accommodation, increasing that capacity where there is a need. At the same time, we are also looking at bringing other buildings back into operation. I think of Sean Abbott and the Cope Foundation who have buildings available and have business cases on which we await a decision from the HSE to be made.

First, I acknowledge the various services that are being delivered, including at the likes of Enable Ireland, where I understand 48 children are accessing residential respite in the area, and CoAction, which has capacity for two to three per night. I refer also to St. Joseph's Foundation, the Cope Foundation and Brothers of Charity Services Ireland, which are offering real meaningful services to people. However, they do have waiting lists. Enable Ireland, for example, has 16 children on a waiting list. While the organisations have capacity, a number of them are not all available or are being used to full capacity.

Parents want to know that they can get access to those services for their children. The first question relates to ensuring that the capacity that is there is actually being used. Is some effort being made on that?

There is no doubt that we have had challenges with recruiting staff. Funding has been provided. The Deputy has mentioned all the brilliant organisations in his area. When they are working at full tilt in the Cork area, they are providing 10,000 bed nights on an annual basis. That is just Cork alone. He talked about Enable's Lavanagh House. That has not got full capacity yet. It is operating four days out of seven and it is in a position to go to seven out of seven on the provision that it can recruit the staff. To give the parents reassurance we are also looking at adding additional capacity there, not just for children services but also for adult services.

When it comes to respite there is an acute need for higher needs dependencies. With some of the buildings that were procured in the past, when a child accesses the service, it may prevent other children from being in service with them, meaning that a child might only be there on one night. We are looking at doing a two-door model where a child with higher needs will be able to operate in their own apartment, which is part of a house and the other children will be able to operate where there could be three or four in the house.

In some cases when residential respite is not being offered, respite in the home is being offered as a substitute. It can work for some people but for many others it does not really happen. It is not like the family will be going away for a family event without a key member of the family while the respite is ongoing. There might be a call to say they are in trouble and need the support of the parents back in the house. In the event where respite in the home is not suitable or not working out, should those families not be prioritised to access the residential setting? What measures are being taken on that? I recently had the opportunity to discuss with a mother the needs of a child in Baile Bhuirne. It is a very similar situation. It is very important that where the day-centre option does not work out it will be prioritised for the residential facility.

There is no doubt that respite is not one-size-fits-all. Respite needs to be a suite of measures whether it is after-school, Saturday clubs, sibling clubs or holiday camps as well as the in-home support, the residential part of it, the shared care and the home support. It is a suite of measures. Where families are finding that the in-home support is not actually meeting their needs, that is the dialogue required to move to the next level or the next rung of the ladder, as I call it, of what is available in the suite of options, which would in that case be either the home sharing or the shared-care model before we move to that more residential respite. Once they start on that trajectory, they are actually looking at accessing residential respite somewhere down along the line into a full-time capacity. However, keeping that family unit in place for as long as possible with the shared-care or the home-shared model is a better fit for families because it prevents moving to the residential option too early.

Does the Minister of State have any plans for new therapies to be used? The question submitted stated "in the public health sector", but I mean across the board. We have spoken before about getting the best bang for buck. It is two things. We all know we need speech and language therapy, OT and other services. We need to put them where we get the best bang for buck along with any assistive technologies that can also be used.

Both the Government and the HSE acknowledge the ongoing challenges faced with the delivery of therapies for children with autism and their families. Disability services are provided based on the presenting needs of an individual assessment according to the person’s requirements and care needs. The HSE is focused on implementing the actions of the PDS roadmap which will target enhancing capacity in our health service to deliver much needed therapies, including to those with autism.

With specific regard to therapies, the HSE provides information and training to carers and staff in the management of behaviours, such as de-escalation intervention techniques and positive behaviour supports, in addition to clinical therapies including OT, physio and speech and language therapy. Equine therapy, art therapy, pet therapy and music therapy are among the range of offerings now available. I would like to expand the conversation on equine therapy. I know I have two Cork TDs behind me. I first saw equine therapy in Liskennett. It is a phenomenal service involving 600 children each week accessing equine therapy with 20 ponies. That is a regional centre and we are looking at doing one in Stewarts Care in Kilcloon and one in Toghermore in Galway.

Equine therapy, art therapy and music therapy bring in other disciplines. It is a finite resource where we need to look at the training and skill sets. Children's advancement by doing alternative therapy of expression is a game changer and can add huge value to de-escalating young people's agitation. We also have the Cubbie in some libraries here in Dublin. It was designed in Mayo and is in 320 facilities in Ireland and the UK where children are allowed to sit in a little space with the music, colouring and lights to meet their needs.

I will break this into two parts. There is assessment and then ensuring there are therapies. We know a workforce planning piece needs to be done. I do not know how many times I have said that even if we get that piece right, it will take a number of years to have everybody in place, involving CDNTs, primary care and all the rest of it. We need to find the best means to provide the best service to the children and their families. There is that piece and also the assistive technologies particularly when we are talking about non-verbal children and augmentative and alternative communication devices, AAC. Beyond that, I know of people who have tried experimental therapies, if I may use that term. This is occupational therapy and speech and language therapy but further enhanced. Some of this is operated in labs, for want of a better term, abroad. It is just looking into what the best practice is.

When looking at the alternatives, the Deputy is right about the AAC devices. That is why we funded AsIAm this year to purchase more assistive technology devices. The HSE and the Department of Education are purchasing in whole. AsIAm will purchase the guts of 600 devices to be made available to children. Not only will they be made available to children, but they will also be enhanced with speech and language as part and parcel of it.

The Deputy and I are very aware of the trikes. It is important this evening to acknowledge the role of the Minister, Deputy Eamon Ryan. When I could not get funding initially, he co-funded with me to ensure I could have trikes. Trikes provide alternative occupational therapy. I know they are available in Dundalk cycling club. They are phenomenal and allow people to experience greenways and walkways while also getting into the mobility piece.

The last piece is the role of the assistant therapist. We should focus on that in the next part of the Deputy's contribution.

I hope he was not out canvassing on his trike.

I would say he would.

As it has been brought up, I commend the work of the Louth Disability Cycling Club. I should particularly mention Gary Shields, the chair, along with Paul Callan, Paul Newman and the rest of the guys who do great work. It is one of the most impressive things I have seen in a long time. It brings families together and is brilliant. They would always commend the work done by Variety and the Minister of State has her own connection there. That is absolutely brilliant and the more, the merrier. We can never have enough bikes. More children and families come every week to use that service.

I have had families come to me who have kids with autism and Down's syndrome who have used particular technologies abroad that assist speech and language, and occupational therapy in particular. I have spoken at the disability matters committee about how this needs to be teased out. I would like to send some of this information on to the Minister of State. If it works, we should use it.

My own connection with Variety is that I fund them. For clarity, it is the guts of €440,000 annually.

Personally.

It is from the Department, thanks to the Minister, Deputy O'Gorman. We play an important role. It is also important to inform the House that in recent weeks, we signed an agreement with the WHO, which has given us a lever into the next five years of assistive technology and looking at best practices, new models and how we can partner with a larger grouping to see where the best models for intervention are available in assistive technologies. If the Deputy has other suggestions, I would love to sit down and discuss them with him. We could perhaps also organise a meeting the next time members of the WHO are here to continue that dialogue.

I ask the Minister to provide an update on plans to house direct provision, temporary and international protection applicants in State-run reception centres. It is moving away from the issues that exist with the private sector, whether the loss of hotel beds as regards the D Hotel and other hotels throughout County Louth and across the State. There are probably other places that are not that suitable and I understand the issues in the Minister's Department. The sooner we can do this, the better.

As the Deputy knows, on 27 March 2024, the Government agreed a new comprehensive accommodation strategy, CAS, for international protection applicants. This has a twofold aim. The immediate aim is to deal with the situation where we are not able to offer accommodation to everybody right now, and a significant number of people were sleeping rough on our streets. The secondary aim, as the Deputy said, was to move away from that massive over-reliance on the commercial sector and have a core of State-owned accommodation. We are looking at a number of strands in terms of how we deliver this. There is the use of State land for prefabricated and modular units, the conversion of commercial buildings, a targeted purchase of medium and larger turnkey properties, design and build of new reception and integration centres and the upgrading of existing IPAS centres.

From 2028 onwards my Department plans to achieve the following composition of accommodation. This includes State-owned reception and integration centres and accommodation centres, at national standards with an overall bed capacity of up to 13,000 beds. We would have a further 1,000 beds in-community accommodation for vulnerable people. We would also have contingency accommodation with bed capacity up to 11,000 and emergency accommodation with a bed capacity of up to 10,000.

As detailed in the updated strategy, accommodation will be delivered through a blended approach looking at a number of strands, whether purchasing turnkey properties or primarily delivery on State-owned sites. My Department launched an expression of interest, EOI, process on 30 April 2024 for the sourcing of suitable properties. The EOI seeks to identify properties for acquisition under the following criteria. The properties would have more than 150 beds. The bedrooms would be in line with national standards. There would be existing properties or buildings in turnkey condition, or existing properties that would require some degree of upgrading or refurbishment. Again, my Department is also working on existing State-owned sites to convert them into reception and integration centres.

Will the Minister provide further information on the timeline? We would all welcome that there needs to be a move away from the private sector. Some of the locations have been utterly unsuitable for all. It is fair to say we have to do whatever we can to look after people who are fleeing dreadful sets of circumstances and the rest of it. However, we need to get a system that works and that is sustainable. That also means improving processing times. The Taoiseach and others have used that term. When that happens it reduces the numbers coming. Everything is exacerbated by the accommodation crisis and the huge number of people seeking temporary protection before we had a spike in international protection. There is a need to get this piece done as quickly as possible.

I agree with much of what the Deputy said. We have to remember we are rebuilding our international protection system in real time. For years we were not getting anywhere close to the European average for international protection applicants. Since 2022 we have been getting the average, but our system was not built for those numbers. We are having to rebuild the processing system. The Minister, Deputy McEntee, has done really important work. In my Department, we are rebuilding the accommodation system. It is important to note that prior to the comprehensive accommodation strategy being published, we had a significant number of male international protection applicants sleeping rough in our streets, from Christmas into March. Since then, more than 1,000 additional male applicants have been offered accommodation. There are still some people sleeping rough. We have not solved this problem yet, but we have been able to bring more than 1,000 people into the system, the vast majority of whom were sleeping rough between December and March. That is a significant achievement.

Has the Minister further information on the timeline and when we will see this move occurring? That is obviously accepting that as things happen there needs to be a huge amount of planning work done. There has to be interaction with those communities where some of these are to be located. Suitability has to be at a premium. Beyond that, will the Minister say where we are as regards improving the efficiency of the system and faster processing of those from safe countries or from where we have a significant number of people coming? There is a wider issue related to work permits that needs to be looked at across Europe. There is also a wider issue of what the western and eastern powers have done to destabilise the Middle East, Africa and other places. That is something that needs to be addressed.

The comprehensive accommodation strategy is to run until 2028. The vision set out in my answer of 13,000 beds and the various elements is something we wish to achieve by 2028. We have already taken significant steps in the use of State land. That has been a huge change. There is the site at Crooksling, County Dublin, and at Trudder, County Wicklow, where we are now accommodating a significant number of applicants. They are initially being accommodated in tents, but we will look to upgrade the accommodation to prefabricated rapid-build units. We are also looking to bring forward significant accommodation on the Thornton Hall site, which is another State-owned accommodation site. We are looking at two other existing sites at Athlone, County Westmeath, and Knockalisheen on the border of counties Limerick and Clare to improve and bring additional capacity and upgrade those to reception and integration centres.

The issue of processing is primarily one for my colleague, the Minister for Justice. She has put in significant investment over the past two budgets and has been able to dramatically shorten processing times. I think she would recognise there is still more work to be done. Part of that is signing up to the EU asylum and migration pact, but very significant progress has been made in that area.

I ask the Minister if he is aware of the critical shortage of personal assistant hours for people with disabilities across the State, and the reason a person whose details have been supplied has been put in a position where they receive no PA support two days a week and only half-day support for two other days. I ask for his views on whether his Department is adequately supporting disabled people who require personal assistants.

The HSE, either directly or indirectly through a range of voluntary and private service providers, provides a range of assisted living services including PA and home support services. Some 80% of specialised disability provision is delivered through non-statutory sector service providers. PA services provide one-to-one support to people with physical disabilities in their homes and communities by trained, professional personal assistants. The PA service facilitates a person’s independence, improves their quality of life, and supports them to participate in their local community. In 2024, 80,000 additional hours have been funded, bringing delivery to approximately 1.77 million PA hours supporting more than 2,600 adults across the country.

Currently, each CHO has a process to manage applications and referrals for PA services. The needs of the individual, compliance with prioritisation criteria and the level of resources available determine allocation. As with every service, there is not a limitless resource available for the provision of home support services, and while the resources available are substantial, they are finite. While many individuals are adequately provided for by their current level of support, many would benefit from more support hours if they were available.

Acknowledging this unmet need, the Action Plan for Disability Services 2024-2026, published by the Department in December, commits to the delivery of 110,000 additional home support hours between 2024 and 2026 to address shortfalls in services and support people with disabilities to live at home, in line with Article 19 of the UNCRPD. The action plan also commits to 800,000 additional personal assistance hours in the same period. A policy review of PA services in light of the UNCRPD, with a working group involving key stakeholders and disabled persons' organisations, to develop formal policy and service description is under way.

I thank the Minister of State.

I asked this question because of a constituent, who was mentioned in the question, and because 40% of those surveyed by the ESRI in 2022 felt their lives had been significantly impacted by insufficient PA hours. The Irish Wheelchair Association estimates that more than 60% of individuals currently receiving personal assistance services or home support require significantly more hours than they are receiving, and that is only an estimate because no comprehensive data on the issue currently exists. The constituent of mine named in my question is wheelchair bound but his independence is curtailed not by his physical ability but, instead, by the fact personal assistants in Clare are so overstretched, and hours so underassigned, that he is reliant on the gaps in his care being provided by his parents, both of whom are in their 70s. This issue is not restricted to my constituent. There is not adequate support for this young man.

With regard to the individual case the Deputy mentioned, officials in the Department have contacted the HSE and a response will issue to her in due course. It is being dealt with, therefore.

There is no doubt we do not have enough PA hours or personal assistants to provide them. Nevertheless, as part of the transfer of function, this was one of the issues on which we were able to shine a spotlight. PA hours had been muddied in with home support and we had to untangle that. PA and home support are two completely different things, but some CHOs were using PA hours as home support. The Minister, Deputy O'Gorman, and I have managed to unravel this in the past 12 months and we are continuing to unravel it, and as we do so, people should feel they are getting more support.

I do appreciate the work the Minister of State has been doing and I have recognised that a light has been shone on this issue, especially in respect of PA hours and in separating, as she pointed out, the issue of home support. In regard to my constituent, the Minister of State has indicated the Department will be in contact, which is positive news to hear, and I really appreciate the work being done in the background to ensure this young man is being supported. It is great because social anxiety is an issue as well for some people and I know that in this case, pointing to the day centre and to maybe taking up additional hours there was not going to work, so I appreciate any support in addition to what he was receiving. I again point to the need to reform PA hours and to enshrine that right for all people with disabilities.

Absolutely. On the reform of PA hours, even though we are spending so much on PAs, at in excess of €60 million on PA support, we do not have it underpinned with a proper framework, so work is ongoing in that regard and we are engaging with stakeholders on the review while, at the same time, ensuring we do not stop the delivery of hours or the roll-out. We are also looking to see what other countries are doing when it comes to PA support, because it can give people back their independence and the life they may have had before they had an accident, or where they were in education or in employment, rebuild their confidence and get them back into the community. It is about working with employers or education and ensuring proper accommodation that meets their needs to integrate them completely.

I thank the Minister of State. The Deputy who submitted Question No. 49 is not present.

How many registered childcare providers are not taking part in the core funding model? Is the trend going up or down? Have any registered childcare providers opted out of the core funding model? In general, how is the model progressing?

I thank the Deputy for raising this matter. Core funding has been in operation since 15 September 2022 and has achieved significant successes in terms of the high level of participation we are seeing. Right now, 4,632 services nationwide are eligible to partake in the core funding scheme. Of those, 4,369 are partner services, meaning 267 services have not signed up to core funding. We allocated €259 million to core funding in the first year, in which there was a 95% uptake. We grew core funding in year 2 to €287 million, which is what we have for core funding this year, and there was a 94.5% uptake, reflecting a decrease of 0.5% in the uptake between year 1 and year 2. In real terms, there was an increase in the number of services, given the overall number of services grew. These figures reflect greater engagement with the scheme in year 2 and, as I said, the numbers continue to grow.

My Department is very happy with the high level of engagement. Obviously, we cannot force services into the scheme, but every mechanism is being used to make the scheme attractive and encourage more providers to enter it. We have again grown the overall budget for year 3, with a very significant 15% increase. There will be €331 million in year 3, starting in September of this year, which is an increase far beyond the existing rates of inflation, recognising the pressures services face and the fact the number of services participating is growing, which is helping us to deal with that capacity issue the Deputy and I have spoken about previously. The additional money in year 3 will allow us to make certain enhancements to the scheme, and I am especially interested in what we can do to support the smallest services.

I thank the Minister for his response and congratulate him on the work he and his Department are doing on this important area. Has he or his Department carried out any audit of areas in the country to identify black spots where it is very hard for people to find childcare, crèches and so on, and if so, is that information available? One thing I came across when I was canvassing recently was the number of parents who are under an awful lot of pressure trying to find facilities, services and registered childcare providers, and it was put to me that some registered childcare providers were opting out of the core funding. Will the Minister confirm whether that is the case, and if so, does he have numbers on it?

There were a couple of questions there. We have some information about black spots, mainly through the city and county childcare committees. We have just set up a new unit in our Department, a bit like the forward planning unit in the Department of Education, very much designed around a better understanding of where pressure spots are, and we are feeding that information into local authorities for their development plans in order that they might be able to designate more areas as potentially available for childcare. We are just starting that process but it is a recognition we need to do more. We do not have the same levers as those we have with schools, but we nevertheless need to have that level of data.

Every year, some services will probably leave core funding. One of the reasons we have put in that very significant 15% growth in the overall budget relates to the fact we have more money to support services.

We are asking for a fee freeze so we are looking to provide more money through core funding to make up for what services might previously have gotten through raising fees.

I have two brief follow-up questions. Is it the case and can the Minister confirm that services which are not involved in the core funding model can charge what they like and that the Minister has no control over what they can charge?

Has the Minister or his Department entered into any discussions with the Department of Education - the Minister of State, Deputy Rabbitte might be interested in this as well - with respect to the possibility of registered childcare providers getting involved in the July provision model? They have the expertise, premises and staff who are quite often highly trained. Will the Minister initiate that particular debate and discussion with his colleague in the Department of Education? I am aware of places around the country where parents cannot get July provision yet there are very professional, registered childcare providers in place who can provide that service. I suggest the Minister investigates that. It might help a lot of families who are under pressure at this time.

Right now, where a service is not involved in the core funding model my Department does not have a mechanism to influence how much it charges. If the service is in the NCS the Department provides a significant subsidy to parents, which is growing this year - very significantly in September - and which will lessen the costs. However, right now the Department does not have a mechanism if services are not within the core funding model. That is why it is so important that 94.5% of services are in the core funding model.

In terms of schools, the Department of Education published a new document this week on the use of school buildings. I am not sure if the Deputy has seen it yet so it is worth a look. The Department inputted to that. It is certainly far more positive in terms of the use of school buildings for childcare but particularly for after-school. Sometimes new schools give an extra class TCC and need it later on and it becomes a conflict but for after-school the whole school building is free and it has been confirmed that the income that goes to a school from after-school will not be deducted by the Department of Education. That is a really positive step.

My question is to ask the Minister for Children, Equality, Disability, Integration and Youth further to a parliamentary question response to Deputy Emer Higgins in January of this year to liaise with the Minister, Deputy Humphreys, on the disgraceful fact that foster carers do not receive pension support even if their child has additional needs and Tusla has advised the foster carer to be in the home to support him or her.

Foster care is the preferred method of care for children in care who cannot live with their families of origin. As we know, foster care provides a safe, secure and stable home environment for some of our most vulnerable children. Tusla's assessment of any foster carer must consider the foster carer's expected availability to meet and support the needs of the child who has come into his or her care. The assessment and approval process explores what type of care the prospective foster carer can best offer to a child depending on factors such as accommodation, the age of the child in their home and the carer's availability and experience. Tusla does consider working foster carers but the main consideration will be their availability to meet the child's needs and for some children it may be necessary for one carer to be at home full time.

Foster carers are not employees of Tusla and the foster care allowance is payable to foster carers on behalf of and to offset the expenses that exist that are related to the child in foster care. The allowance is not considered as a means for social welfare purposes. It is not subject to tax. The allowance is in recognition of the vital and valued role foster carers play in the care of the most vulnerable children in our society. The allowance is one element of the supports given to foster carers but it is important to note we were able to significantly increase that allowance in January and will do so again in November of this year.

As my colleague, the Minister of State, Deputy Joe O'Brien, has outlined previously the Department of Social Protection has a number of schemes in place that may be of benefit to foster carers. Foster carers are entitled to the benefits of PRSI credits, home making disregards and home caring periods when they meet the criteria in the same way as any parent. I have been advised that under these schemes if a foster carer is a recipient of child benefit or the caring periods are confirmed by Tusla he or she can register for caring periods for each child under the age of 12. In the case of a child who is over 12 years of age caring periods can be registered where the child requires continuous supervision and regular assistance throughout the day with the activities of daily living. The maximum caring period available is 20 years and I encourage foster carers who believe they may be entitled to the benefits provided under these schemes to so apply.

I raised this issue with the Minister of State, Deputy Joe O'Brien, during the 11 June session but he pointed to the Minister as being the best person to revert to on this issue. It seems to be a complex pension issue. I point to the fact that the IFCA found that 50% of the carers surveyed said they are experiencing financial difficulties due to their commitment to caring and have considered giving up fostering as they are worried about being able to provide an adequate level of care. Tusla is actively recruiting for foster carers in my constituency of Clare but is struggling to recruit. When consulted in January the Minister stated that foster carers are not employees and, accordingly, Tusla does not make pension contributions on their behalf. Is that an accurate summation of the Government's position, that it is aware of the issue but that carers are now employees? Home caring period schemes can help carers to qualify but as the Minister stated it only applies to children under the age of 12 or disabled children over the age of 12.

I thank the Deputy for keeping the spotlight on this issue because it is so important that we support foster carers. I have met IFCA and Movement for Change in Foster Care and other organisations representing foster carers regularly. In particular, I met them after, not the 2024 budget but the 2023 budget, and I said I would work with them to deal with the allowance which was a key issue for them. The allowance has been raised by €25 from 1 January and will increase by another €50 from 1 November this year. This means foster carers this year will receive an additional €1,700 but in the full year of these increases they will receive an additional €3,900. The Deputy is right that some foster carers struggle with the costs but that is a significant additional support my Department is making available to them. It is absolutely deserved and it is some of the best investment my Department can make both in terms of the quality of outcomes for children but also looking at the bottom line in terms of costings and savings for the State foster care is the better way to proceed on both of those bases.

The increases in the allowances are welcome and Movement for Change in Foster Care and IFCA have pointed to that as well. The fact most foster carers are women and they are inhibited on this pension issue in particular is an area that needs further progress to be made. The organisations have done a lot on this themselves over the last number of years and have met with various Departments including that of the Minister but that kind of engagement needs to continue, maybe spearheaded by the Minister. It needs to move beyond the State. It is clear that all of the agencies, Tusla, the Minister's own Department and the Department of Social Protection need to apply themselves to find some workable mechanism to ensure no foster carer is experiencing that kind of financial hardship.

When I met IFCA and Movement for Change in Foster Care, we spoke about five broad areas where they felt the State needed to be doing more. These were allowances - which the Deputy has discussed already; travel expenses - which I am working on with Tusla; and additional concrete supports particularly in terms of therapies and we now have therapist groups available to foster carers from which they can draw because often children in care have a range of significant additional needs. We have also put a much greater focus on foster caring within Tusla so now, for the first time, there is a national lead on fostering in Tusla. I was always shocked we did not have that position before but we have it now. I do not know if the Deputy attended Bloom this year but Tusla had an amazing garden highlighting the work foster carers do so we are seeing a real focus across there. Pensions is the other issue. I have engaged with the Minister, Deputy Humphreys and have met her twice on this issue. We will continue to engage to see what can be done within the existing framework to provide some additional supports there.

I ask the Minister about the engagement he has had with the HSE regarding the need to source private contractors following the recent announcement the Government will finance an assessment of needs initiative. How soon does he expect the impact will be made on the waiting list and is he confident progress can be made to clear the backlog?

I thank the Deputy for raising this question. It is a little bit like Cinderella at this hour, 12 midnight, and Deputy O'Sullivan appears. To be honest, we normally never get to deal with this number of questions. It is the first time we have done it, so I am answering this one totally unscripted. Luckily, I was at the committee today and I do remember what was said to his question.

Thanks to the Taoiseach and the Minister, Deputy O'Gorman, who is here beside me, the Cabinet approved and ring-fenced €6.8 million, which is to look after 2,500 of our longest waiters. From talking to Bernard O'Regan earlier today, clear direction will be given from the HSE's national office of disability that the assessment officers will determine who are the longest waiters because they are the people in the nine CHOs who will have access to that information.

The HSE also has €5 million to carry out other assessments of need. That is going to ensure 1,850 children will have an assessment of need. At the same time, there is capacity of approximately 3,200 within our 91 teams across all of our services, which would mean that because of the additional funding, the overall assessments of need we should get through this year will be 7,650. That still does not address the fact we have 9,900 people who are overdue an assessment of need from a statutory viewpoint, and we are only in the month of June at this time. I have no doubt the figure will grow. Given that, we sought the funding in advance. Do I think they will get to it? Absolutely. Do I see it all done? I will ensure that when I meet with my disability managers, I know exactly what percentage they are doing each month.

I welcome the initiative. It is just like in 2022 when the last attempt was made to clear the backlog, especially in my CHO in Cork, CHO 4. I have considerable concerns that we are here again, two years on, with another waiting list. Will the Minister of State elaborate on the reasons for that given, as I said, we thought we had cleared the waiting list two years ago and now we find ourselves back in this position again with another waiting list? As many TDs in the House recognise, one of the most significant issues in weekly constituency clinics is people struggling to access therapies, assessments of needs and so on. Will the Minister of State please clarify the position? I welcome the fact she has sourced the funding. To be fair, the vast majority of people and the stakeholders involved recognise her good work on this, but will she clarify the reason we are here again two years on?

Deputy O'Sullivan is right. We managed to clear the backlog with the funding that was sourced in 2020 when we had 6,500 children waiting for an assessment of need. It took us approximately 14 months to clear the entire backlog. Why have we found ourselves here again? We have found ourselves here again because of the soft model, which is the standard operational procedure, SOP, which meant that 10,000 children were deemed to have a right to access an assessment of need in its entirety. The assessment of need does not take one or two hours. It is actually the guts of approximately 30 hours of full assessment. Let us also be clear: when we cleared the backlog in 2020, it was also the full 30 hours' assessment.

The other piece we will have to look at is the flexibility of doing the interventions. The no-show rate is only 10%, so to be very fair to parents, they are very committed once they get a time to attend. Our no-show rates are very light in this regard. I have no doubt any parent who gets it will attend the assessment process.

Despite the difficulties we have experienced, I cannot reiterate enough that I commend the Minister of State on the work she has done. I know we have talked privately and we have met with stakeholders. We have talked about the benefits of AIM classes in particular and access to language classes, especially for students who do not require an assessment of need to be undertaken. In the remaining time, will the Minister of State speak to the importance of AIM classes and language classes for kids who have a requirement for intervention and how we can best utilise that model and possibly expand those classes in future? What conversations has she had with the Minister for Education in that regard?

This is a new concept I was not completely aware of, namely, that we have 63 specific speech and language disorder, SSLD, classes in the country, which are speech and language classes for children with very set criteria who have verbal dyspraxia. There are seven in a class with the lead teacher and a speech and language therapist. They know that with regular daily intervention over a two-year programme, the child's speech can come on. There is no doubt that is the case. The clinical outcomes of the classes are incredibly successful. In fact, the therapists in those schools come under the remit of primary care and the Minister for Health, Deputy Donnelly. I will be appealing to him and to the Minister for Education, Deputy Foley, to step up these classes because they are critical from a primary intervention point of view, as opposed to specialist disabilities.

We must also seek to widen the use of the 2007 circular. That circular omits the fact that children with Down's syndrome can participate in these classes. It does not include them or see them as being part of mainstream education. That is also the case with children with physical disabilities. When we talk about the UNCRPD and mainstreaming, the SSLD classes should be expanded to more than 63 schools but they also should be expanded to include children with Down's syndrome and physical disabilities. That is my appeal to the two Ministers for budget 2025.

This might be the last question for tonight. I now get why people were smirking and laughing when I came in. Will the Minister of State give an update on the timeline for the reintroduction of therapists to special schools and make a statement on the matter?

I thank Deputy O'Sullivan very much. I have no doubt, given he is a Cork TD, that the introduction of therapists to special schools is primarily focused on Cork schools. To be honest with him, a comprehensive submission has been made in recent days by David Walsh and Bernard O'Regan. Officials in the Department have been meeting with the CEO of the HSE to address the introduction of the pilot scheme that would be required for the 14 special schools in the Cork area. One of the concerns was where the governance for the reinstatement would lie. All the therapists who will be returned to special schools in the Cork area will be part of the local CDNTs. First and foremost, parents will have the choice, which is very important, where they access CDNT services. Most children attending a special school are encouraged to choose the CDNT closest to the school so that the CDNT can provide the support, whether it be OT, physio, speech and language or psychology, but also at the same time the CDNT can provide the clinical governance piece and support the teaching staff and the parents. That is a piece parents in the Cork area had not been provided with. They did not have the option of choosing a service close to home or close to a school. That is part of the PDS framework document from its inception in 2009.

There is also a role for the assistant therapist post, which sometimes gets overlooked. When a clinician can write up the programme of works, the roll-out of the programme can also be done by the assistant therapist in the area of OT, physio and speech and language. To be very fair to us in our Department, along with the Department of Further and Higher Education, Research, Innovation and Science, we are working very hard. We have secured the funding for 125 therapists. The programme of works ensures they get the training they require and a placement within the CDNTs.

I again thank the Minister of State. I do not doubt her bona fides in this regard. I know she has been trying her best to resolve this issue in recent years.

Approximately two and a half years ago in Limerick, we met all the principals of Cork special schools. I note that the Minister of State has been working away in the background trying to resolve this issue, but she is obviously acutely aware of the problem. I have no doubt that hiring therapists and people with specialties has been difficult right across the HSE and not just for special schools. Yet, we are being faced with the prospect of having one in three - even one in two in some cases - posts not being filled. Nobody here is going to call for the privatisation of any of these therapies but, unfortunately, the reality of the situation is that the HSE is finding it very difficult to appoint these people to posts and hence the call for these to be outsourced, for want of a better word, to private providers in the interim. I stress that this would not be my preferred route, but it is being considered as an interim measure.

The Minister of State mentioned 14 schools. In particular, St. Killian's Special School in Mayfield is ready to go and desperately wants a green light to ensure that the children concerned can get the services that are required.

In relation to special schools, this has now been going on for in excess of two years. It was in May 2021 that we placed a pause on the removal of therapists from special schools. We then sourced our secure funding for 86 therapists to be replaced into schools. Overall, we secured funding for 221 therapists, and only 126 have been returned. When I say “returned”, I mean that they were returned to special schools and that they are part and parcel of their local CDNT team. We have had some good success on this. Yet, in other areas, we are very challenged and unfortunately, we are quite challenged in the Cork area.

There is a complete willingness within the HSE to find a solution to work with ETBs. I must acknowledge the patience of the parents in this regard. I have no doubt that we will find a Wexford model that can be applied to a Cork solution.

The Minister of State referenced how the Wexford model has worked. That is what I am hearing anyway, and I have discussed this with colleagues. Could the Minister of State again elaborate on this? She mentioned that 220-odd posts were required and that 126 of them have actually been appointed at this stage. There is therefore a shortfall of approximately 100 appointees that are yet to take up a post. Can the Minister of State clarify where things are? How many of those posts are outstanding in terms of advertising, whatever the case may be? I would appreciate any updates in relation to that.

Second, the Minister of State and I both know that other stakeholders in Cork have stepped up to the plate while people have been going without. I am not trying to come in here again and speak negatively about the provision of service that people get in these special schools. Yet, for the largest part, many children are going without basic intervention and certain groups, such as Rainbow Club Cork, have stepped in. Can the Minister of State elaborate on the role of Rainbow Club Cork to bridge that gap in the short term?

As I said to the Deputy, of the 221 whole-time equivalent posts, 126 have been filled. Wherever they are in the country, at this stage there is a shortfall of more than 700 whole-time equivalent staff on our CDNT teams, which have a role in supporting our special schools. The Wexford model has been phenomenal in the sense that there has been real collaboration there. I have no doubt the same collaboration is in Cork as well between our teaching body and local CDNT teams, where there is a knowledge of where the capacity was within the private sector to support this. There was no breach of data under data protection rules. They were able to support the local CDNT team in updating the children's records and passing on that information. That can still be done and the CDNT held the risk for all of the clinical governance on it.

I will finish on this point. As the Deputy quite rightly said, the role of Rainbow Club Cork is important. I have visited it twice and the Minister, Deputy O’Gorman, has been to Rainbow Club Cork. To be quite honest, without Rainbow Club Cork, which provides an additional 500 therapy interventions on a weekly basis, we would be having a far different conversation about the crisis in Cork. Rainbow Club Cork, under Karen and Jon O'Mahony, has played a phenomenal role. I was delighted last week to hear that the National Ambulance Service base has moved off-site and the key has gone to Cork City Hall. I hope the expression of interest will move along at pace so we have the opportunity to develop a centre of excellence in a lovely area where children do not have to keep putting away their goods on a daily basis. It is the intention of both myself and the Minister, Deputy O’Gorman, to support the Rainbow Club, as we do for any of these groups that provide valuable interventions when we do not have the capacity in our CDNT teams.