“Nobody” in the Health Service Executive has a solution for tackling backlogs facing children seeking to access disability services, Minister of State for Disability Anne Rabbitte has said.
Ms Rabbitte said the health service was unable to simultaneously provide services and tackle the backlog, which she said had now grown to more than 18,000 children awaiting an assessment of need – a crucial first step for children seeking therapies.
While she said that in its new chief executive Bernard Gloster the HSE has a leader who “understands disability”, she said nonetheless “nobody in the HSE has a solution for the assessments of needs”.
“That really concerns me,” she said.
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Ms Rabbitte, in an interview with The Irish Times, was also critical of how the disability budget is treated. The Department of Health used disability services as a “piggy bank” and when money ran out for other areas, she said initially, adding that she believed “they would have gone in there pinching a few pounds”.
The Galway East TD was later forced to clarify that she had intended to state the HSE, rather than the department, had used the disability budget in this manner – but not before the department issued an strong rebuke, saying it “entirely rejects any suggestion that it has ever misused disability funding in the manner suggested”.
The backlog for assessments of need was reduced significantly using a truncated approach limiting preliminary assessments to 90 minutes, but that was struck down by the High Court, which found they did not comply with the law.
Last May, almost 5,500 applications were overdue, with Ms Rabbitte saying the High Court decision meant another 10,000 children were put back on to the list.
She said the HSE was “poor” at conducting both interventions and assessments at the same time. “They’ve clearly demonstrated they can’t do both,” she said, adding she had championed regional assessment hubs: “I am not a clinician ... and I am coming up with perhaps workable solutions, whereas those workable solutions should be coming from within.”
She said Mr Gloster was “listening and responding” but that she was “quite frustrated”. “I have a particular pace I want things to be done at, and it’s not happening.”
Ms Rabbitte said she had rejected HSE plans to bulk-purchase assessments of need from the private sector, which she said was too expensive and didn’t provide the required volume of services. Instead, she promised to reimburse directly by next June parents who are forced to seek private assessments.
Currently, she said, parents are being “led astray” by the idea that there is a system that will work once a diagnosis is in place, whereas the reality is; “no, you go back on another list.”
Disability policy was finally transferred out of the Department of Health and into the Department of Children, Equality, Disability, Integration and Youth earlier this year. However, Ms Rabbitte was critical of her time in her former department.
“I never felt I was welcome from the first day,” she said, adding that disability was “never a priority”, including at budget time, where she had “more rows than hot dinners”. There were strained relations, Ms Rabbitte said, with Robert Watt, the current secretary general of the department, with whom she says she had a “turbulent” relationship.
“As far as he was concerned, I was going out the door. He didn’t need to put time or effort into me, in even having a relationship.”
In the round, disabilities has moved into a far more positive space, she said – but added it would be a lie to say it was perfect.
“Does the system all row together? Disability, education and health, are they on an equal? Absolutely not ... Does the HSE’s own policy on the national access policy [NAP] work? No, it doesn’t. In some areas, it’s very good, but by and large NAP doesn’t work,” she says, with children waiting on varied lists instead of an integrated system.
The HSE did not respond to a request for comment.
Ms Rabbitte said she had confidence in her new department, where she feels she is a priority, has good working relationships and is part of a team effort – which wasn’t the case in health. “And I won’t be behind the door in saying that,” she added.
She rejected the idea that she was blaming the system for failures that were ultimately her responsibility: “My job is to source the money to ensure that they have the funding to do their job. Who’s responsible for the system is Bernard Gloster.”
Asked about recent comments by two Fianna Fáil councillors in Galway following a suspected arson attack on a hotel due to hold asylum seekers, she said she supported Micheál Martin’s rebuke of the two – but would not be drawn on whether she believed it was right to refer them to the party’s internal disciplinary committee.
She said, however, that the two had a mandate from their communities to speak and were not “extremists”.
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