‘An uphill struggle’ for families of children with disabilities

Solicitor Barry Healy is currently working with the families of 80 children in Cavan and the surrounding areas who have not received an assessment of need or have an incorrect service statement.

He held an advice clinic in Cavan’s Digital Hub last week to give parents an opportunity to seek advice on their next step.

“You just have to push and shove. For people with children with disabilities, it’s an uphill struggle.

“There is nothing easy about it,” he told the Celt.

His comments come as figures published earlier this year revealed Cavan and Monaghan as a blackspot for delays in accessing therapies. The HSE figures to the end of 2024 showed thousands of children in this health region on waiting lists for therapies such as Speech and Language and Occupational Therapy.

Hundreds have been waiting more than a year as the Children’s Disability Network Team (CDNT) in Cavan operates at around half its capacity due to job vacancies.

Mr Healy said parents are legally “entitled to have that child assessed to see if they qualify under the Disability Act” for additional supports.

The “big thing” he wishes to raise awareness about is how to correctly get your child logged in the system. He explained that, sometimes, parents think their child is in the system because the HSE has been made “aware of the difficulties” of the child, or because they were assessed by Enable Ireland, however that is not the case.

“They [parents] have to complete an assessment of need application; the State is then obliged within three months to initiate the assessment and, within six months, to complete the assessment.

“Which they almost never do,” he claims.

In cases where assessments have not been completed on time, Mr Healy says they have been writing to the HSE to “warn them”.

“There’s a complaints office, a very good complaints office in fairness to them.

“They immediately conduct an investigation,” he said.

In such cases, he described the investigators will often come back and state “it should have been done” and “usually” give another 30 days to complete the assessment.

“But regularly they will not get it done and we have to go to the circuit court in Dublin and force them to do it,” said Mr Healy.

Any parent who has applied for an assessment of need and has waited six months should go to the complaints office, he advises.

“It doesn’t have to come through a solicitor but I would say it’s probably better because, as soon as the complaints officer comes back, the next course of action is into the circuit court.”

Mr Healy is currently working with the families of 80 children in this position. Sixty-five of these children are from Cavan and Monaghan with others from Donegal, Meath, Leitrim and Louth. Issues he is working on vary from late assessments of need to incorrect service statements.

“The assessment of need points out gold standard - what the child should get. The service statement is a more realistic document saying ‘this is what we can provide’ but it has to set out when, how and where they are going to provide it.”

In his experience, since he began working on such cases some two years ago, the service statements have not achieved that.

“How were they getting it [therapies], when were they getting it, who is going to give it?” - questions Mr Healy said were often left unaddressed in the statement

“It just drifted on for years and years,” he continued.

Mr Healy described working on these cases as “turning an oil tanker in a canal”.

“We say this to the parents all along, it isn’t going to be fixed in 24 hours. You’re in for the long haul here. You’ve got to be persistent over maybe a two-year period.

“It’s wrong but that’s the way,” he said.

“Clearly it’s in breach of the Disability Act, that’s why we get orders because they [the HSE] are in breach of the act.”

He hinted at legislative reform coming down the tracks.

“They’re talking about changing the act now to lessen assistance to people with disability.

“That’s what they’re talking about, I don’t know if it’s going to happen,” claimed the legal practitioner.

See below for the Department's response in that regard.

Mr Healy's advice for parents, meanwhile, is to “make the application for the assessment of need because “they’d be in the system and then they get all the entitlements”.

Then the HSE is obliged to comply with the Disability Act.

“If you are not in the system, none of these rights that I am talking about, they don’t apply.”

He believes Enable Ireland staff and therapists do a “fabulous job” but believes the HSE should be advising parents to “make the application”.

The application can be downloaded on the HSE website.

“A lot of parents make those applications themselves and it takes a good nine months to make the application between the returns and the reversions. We make it, it’s done once and you’re in.”

Legislative reform to improve AON process - Department

The Government is “committed” to putting in place a “sustainable solution” to reduce waiting times for Assessments of Need (AONs), a spokesperson from the Department of Children, Disability and Equality has said.

“The Government is considering options for targeted legislative reform of the Disability Act to improve the efficiency and effectiveness of the Assessment of Need process,” they said, adding that “any changes will not affect the statutory right of any individual to access an Assessment of Need or the statutory timeframes set out in the Act”.

The spokesperson said that the Department has been working with HSE senior management and experienced clinicians to identify those changes, with the intention of bringing forward legislation in the final quarter of this year.

Meanwhile the spokesperson also said that, while children have a right to apply for an AON, they “do not need one in order to access health services”, including those provided by Children’s Disability Network Teams.

“The Department is aware of the growing AON waiting list and has been working with the HSE to identify the delays and blockages within the AON system and put in place a number of solutions to address them, including operational solutions as well as legislative reform,” the spokesperson said.

They further pointed out that, between June 2024 and June 2025, almost 5,000 AONs have been commissioned from private providers under a special initiative.

“As a result of such measures, there has been a noticeable and welcome increase in the number of completed AONs over the past 18 months. This includes a 30% increase in the number of completed assessments in 2024 compared to 2023. The first half of this year saw the delivery of over 2,900 AONs, a 58% increase over the same period last year.”

Waiting times for therapies

The spokesperson said the Government recognises the importance of early intervention for children with disabilities.

They acknowledged the shortcomings. “Minister Foley knows from speaking to parents that the system, as it currently exists, is not working as it should for children, many of whom are on long waiting lists for services.

“Children with complex needs may require supports from their local Children’s Disability Network Team (CDNTs),” they said, of which there are 93 such teams across the country providing services and supports to almost 45,000 children.

“Ensuring that CDNTs are adequately staffed so they can deliver these services when they are needed and where they are needed continues to be a priority for the Government.”

Vacancies

They spokesperson said the CDNT workforce grew by almost 31% between October 2021 and April 2025 and currently stands at 2,009 whole-time equivalent posts. The vacancy rate for CDNTs has decreased from 29% in October 2023 to 18% in April 2025 which is “the lowest vacancy rate since October 2021.”

“The recruitment and retention of staff to support the provision of therapies in CDNTs continues to be a key priority for this Government,” the spokesperson stated.

HSE struggling to meet statutory timeframes

Meanwhile, a HSE spokesperson told the Celt: “Service statements are issued by liaison officers following consultation with the service providers identified and are issued in good faith by the HSE, in line with statutory requirements.

“The Assessment of Need process is set out in the Disability Act, 2005. The aim of an Assessment of Need under the Disability Act is to identify whether a person has a disability, the nature and extent of the disability, any health and education needs arising from that disability, as well as what services are required to meet those needs.

“The Disability Act outlines the statutory timelines under which Assessments of Need under the Act must be completed. In summary, the assessment report must be completed within six months of the date the application was received.

“While the HSE endeavours to meet its legislative obligations under the Act, it has struggled to achieve compliance with these timeframes.”