Dáil Éireann Debate, Thursday - 19 February 2026
157. Deputy Paula Butterly asked the Minister for Children, Disability and Equality if she will examine the feasibility of establishing a cross-border pathway for timely assessments for children with disabilities, in light of ongoing delays in the assessment-of-needs process; if her Department would engage with the Department of Health and the HSE on this issue; and if she will make a statement on the matter. [12386/26]
View answerThe Government recognises that there are unacceptable delays in accessing Assessments of Need. The Department and the HSE are committed to addressing these delays.
It is important to note that children do not require an Assessment of Need to access health services, including Primary Care, Children’s Disability Network Teams or Mental Health Services.
However, demand for Assessments of Need has increased significantly in recent years. This reflects both the increase in population and families exploring all options to access services for their child. This has led to a growing backlog of applications and long waits for children and their families.
An Assessment of Need is a specific, formal process to determine if a child has a disability as defined under the Disability Act 2005. If it is determined that the child has a disability as defined under the Act, the Assessment of Need process should identify any health and/or education needs, as well as the health services required to meet these needs.
The HSE is the body responsible for the administration of the Assessment of Need process, with HSE Assessment Officers responsible for the production of Assessment of Need reports. As part of the process, Assessment Officers may request a clinical assessment to inform their report.
These clinical assessments can be requested from HSE services such as Primary Care or Children’s Disability Network Teams or can be sourced from private providers. The HSE must ensure that any such providers are appropriately qualified, registered with professional bodies, where appropriate, and garda vetted.
The HSE has advised that it sought legal advice on the applicability of the Cross Border Directive Scheme and the Northern Ireland Planned Healthcare Scheme for clinical assessments under Assessment of Need.
The legal advice received by the HSE is that clinical assessment for an Assessment of Need under Section 8(2) of the Disability Act must be arranged by the HSE Assessment Officer. As such, the HSE Cross Border Directive scheme and the Northern Ireland Planned Healthcare Scheme are not appropriate for commissioning Assessments of Need.
I appreciate the frustration of parents and families seeking to access timely assessments for their children. Applications for Assessment of Need have risen from 4,700 in 2020 to over 13,000 in 2025. Unfortunately, this demand is outpacing the capacity of the system to respond. More positively, there has been continued improvement in the number of completed AON reports with over 5,900 completed in 2025, 43% more than 2024.
This improvement has been achieved by several measures, including the Assessment of Need Targeted Waitlist Initiative, which resulted in over 7,700 clinical assessments sourced from approved private providers since June 2024. These clinical assessments are used by HSE Assessment Officers to inform the production of an assessment of need report.
The initiative will continue this year with €20 million provided for the delivery of some 6,000 clinical assessments, with a specific focus on autism assessments.
In December 2025, Government announced a series of changes to the Assessment of Need process intended to improve access to both assessments and therapies for children who need them.
These changes include targeted amendments to Part 2 of the Disability Act 2005, which provides for Assessments of Need.
It should be noted that the proposed legislative changes will not remove any rights for parents to apply for an Assessment of Need for their child nor will they alter the statutory six-month timeline set out in the Disability Act.
The General Scheme of the Disability (Amendment) Bill has been published on the Department’s website. An FAQ document has also been published, providing information on Assessment of Need and the proposed changes for parents and any other interested stakeholders.
It is important that we recognise that legislation is only a part of the response. The HSE continues to work on a number of significant non-legislative actions to address the wider issue of access to services and supports for children with disabilities including:
• The creation of eleven new HSE teams, initially, to support assessment processes, including Assessment of Need, providing clinical guidance and administrative supports.
• Implementation of the Autism Assessment and Intervention Pathways Protocol by the HSE in early 2026. The Protocol will provide a standardised assessment process across primary care, mental health and disability services. It will be the preferred assessment route for autism.
• Introduction of a Single Point of Access system by the HSE in 2026. This should make it easier for families to be referred to the right service, whether that is primary care, CDNT or mental health services. It aims to streamline referrals and reduce duplication, so children do not end up on multiple waiting lists.
The provision of an effective and efficient Assessment of Need system continues to be an absolute priority for the Government.
