‘The system is getting worse’
Only eight out of 80 Assessment of Need reports in the Cavan-Monaghan region were completed within the statutory timeframe over a two-year period (2024-2025), according to new Health Service Executive figures.
The data shows sustained delays, with 66 assessments completed in 2024, and just seven delivered on time.
In 2025, 21 assessments were completed, and none within the statutory timeframe; while in the first quarter of 2026, only one of 12 was delivered within the required period.
An Assessment of Need (AON) identifies a person’s - usually a child’s - health and educational needs and the specific services required to meet those needs. In Ireland, this process is governed by the Disability Act 2005 and is managed by the Health Service Executive (HSE).
Despite a national rise in demand and output - with over 5,900 AON reports completed nationally in 2025 alone - the Cavan-Monaghan region remains among the poorest performing nationally.
For disability rights advocate Serena Dawson, the figures confirm what families have been experiencing for years and come as “no surprise”.
“Things are getting worse. I don’t understand how there’s still no meaningful action at this point.
“It feels like nobody is surprised any more. It just keeps getting worse and worse.”
Serena, a mum of three from Belturbet, has been to the fore in terms of organising weekly peaceful protests calling for urgent reform of children’s disability services and early intervention therapies. Her focus has been on long waiting lists for occupational therapy, speech and language therapy, psychological supports, and assessment pathways for children with additional needs.
Serena believes the official figures don’t fully reflect the reality faced by families. A HSE disability forum meeting scheduled for earlier this year was cancelled, and the next is pencilled in for a date in September. Serena fully expects the atmosphere to be tense.
“There’s a real issue with how data is being represented,” she says of the push to have children assigned Individualised Family Support Plans (IFSPs), whether or not they have access to the required supports outlined.
“Children are being taken off waiting lists and placed on ‘open caseloads’, even though they’re still receiving no actual intervention,” Serena explains. “That doesn’t reflect reality. I know from experience - my child is technically ‘in the service’, but not receiving any supports.”
In that regard she accuses the HSE of a simply “moving numbers around”.
“They’ll say, ‘We’ve taken X number of children off the waiting list,’ but in reality, it falls back on parents who are still doing everything themselves.”
Serena’s son Nathan (8), was diagnosed as autistic at the age of two years and also has a mild intellectual disability. Her younger son Dara (4), has complex additional needs. She says delays in assessment and intervention have a direct impact on development during critical early years.
“We were able to access private assessments, but that’s only because we could afford it,” she said. “Many families simply can’t, and they are left waiting without support.”
Beyond childhood services, Serena warns that families are also facing uncertainty about long-term adult provision.
“What happens when my son turns 18 - in less than 10 years?” she asked. “There are no adequate adult services either. How can the most vulnerable people in society be left like this?”
Weekly protests in Cavan Town have drawn participants across generations, including older residents who say the current problems are the same as they experienced decades ago.
“People in their 60s, 70s, and 80s are coming out and saying they were dealing with the same issues when their own children were young,” says Serena. “How are we still in this situation - and arguably in an even worse one?”
She adds however that the issue isn’t with frontline staff. “It’s the decisions being made at a higher level that need to change. The system is getting worse, not better.”
The HSE has been asked for comment.