Dail Éireann · 2026-02-19
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My question is in respect of the unacceptable number of children who are currently waiting for an assessment of need in counties Monaghan and Cavan in my constituency. Some 550 children have been waiting over six months for an assessment of need in the two small counties, population-wise, of Cavan and Monaghan. How many children last year in counties Cavan and Monaghan actually received their assessment of need within six months, the legal time limit?
Will the Minister of State consider establishing a cross-Border assessment of need scheme, modelled on existing cross-Border dental and surgical treatment pathways, to ensure that children can access timely assessments outside the State when domestic waiting lists are excessive? How many children last year actually received an assessment of need within the legal time limit of six months?
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My question is in respect of the unacceptable number of children who are currently waiting for an assessment of need in counties Monaghan and Cavan in my constituency. I ask the Minister for an update on the number of children who have been waiting more than three, six and 12 months.
The delivery of an effective, efficient assessment of need system is a priority for the Government, which is why we are bringing in reforms in this area. There has been intensive work by the Department and the HSE to address delays in the provision of assessments of need to children and their families. Children do not require an assessment of need to access health services, including primary care, children’s disability network teams or mental health services. It is important that people are aware of this. However, demand for assessments of need has increased significantly in recent years, reflecting both the increase in population and families exploring all options to access services for their child.
The number of applications for assessments of need increased from 4,700 in 2020 to over 13,000 in 2025. Unfortunately, this demand is outpacing the capacity of the system to respond. As a result, HSE data shows that the number of applications over the completion date rose to over 20,200 nationally by the end of the year. This is unacceptable, which we acknowledge, and we will address it.
For Cavan-Monaghan LHO, in the Deputy’s constituency, the numbers he requested are as follows: 520 applications in total were not completed within the statutory timeframe of six months, 31 of which were overdue for less than one month, and 36 of which were overdue for between one and three months. The remainder, 453, were overdue for three months or more.
These numbers are stark. Every one of them represents a child or young person. I want to see this situation change so that families do not have to wait so long for their assessment of need applications to be processed. That change is happening. We have seen a notable increase in the number of completed AONs nationally over the past two years, but there is a lot more work to be done. That is why, in December 2025, the Government announced a series of improvements to the assessment of need process, including new legislation, which will be coming through pre-legislative scrutiny at the Joint Committee on Disability Matters.
The Minister of State started her response by saying this is a priority for the Government. I would hate to see it if it were not a priority for the Government. Some 550 children have been waiting over six months for an assessment of need in the two small counties, population-wise, of Cavan and Monaghan. That is 550 times that the members of Government have broken the law. They are obliged under the Disability Act 2005 to ensure that children receive an assessment of need within six months. Imagine that. We have a Minister of State saying they have broken the law 550 times in just one constituency, but they are going to do something about it at some point in the future, including changing the law so they cover themselves and so they are not actually in breach of the law. How many children last year in counties Cavan and Monaghan actually received their assessment of need within six months, the legal time limit?
Will the Minister of State consider establishing a cross-Border assessment of need scheme, modelled on existing cross-Border dental and surgical treatment pathways, to ensure that children can access timely assessments outside the State when domestic waiting lists are excessive?
I want to be absolutely clear, and to reassure parents in particular, that proposed legislative changes will not in any way remove any right for parents to apply for an assessment of need for their child, and will not alter the six-month timeline in the Act. That is important to say, and I do not want parents to be misled on that.
The changes include changes to Part 2 of the Disability Act, which provides for assessments of need. These legislative changes include ensuring the assessment process focuses on a child’s needs, so that more intensive clinical assessments are only used where required. They will also ensure the development of statutory guidelines to better support HSE assessment officers to do standard assessments in a standardised way, so that no matter where people are in the country, they get the same clinical approach.
With regard to the cross-Border scheme, that is definitely worth exploring. At the moment, we want to make sure that we are delivering more assessments of need. To that end, we have prioritised a waitlist initiative. We have set aside €20 million to provide for 6,000 assessments of need to be completed by private providers.
Regardless of what the Minister of State says changes to legislation will do, it will be of no comfort whatsoever to those people who are watching the Government break the law as it currently is. I asked her a specific question in respect of Cavan and Monaghan. How many children last year actually received an assessment of need within the legal time limit of six months? I will ask that question again.
We know that at the heart of this are children - children with disabilities who need access to therapies. Right now, they are waiting too long for access to therapies and too long for assessments of need. That is wrong. That is why, just in December, we outlined reforms. Those reforms include statutory guidelines, which will streamline and standardise the process. That will include decisions being communicated to parents.
How many last year?
There will be a new pathways option for children who are potentially autistic. They will be set up by in-reach teams, 11 of which will be created across the country.
I thank the Minister for State for that. How many children last year in Cavan and Monaghan actually got their assessment of need within six months?
Order, please.
I will revert to the Deputy with that exact number. I have the exact number that he requested in his question, which I read out, but I will get the number for last year too and give it to the Deputy. That is no problem.
We are also hiring more people for the CDNT teams. We have a new single point of access that ensures no child is on the wrong waiting list, and there is no such thing as a wrong door from a HSE perspective. In addition, we are supplementing our workforce by outsourcing a number of AONs as well.