I propose to take Questions Nos. 176 and 177 together.
The Government recognises that there are unacceptable delays in accessing Assessments of Need. The Department and the HSE are committed to addressing these delays.
Under the Disability Act, an Assessment of Need is an assessment process carried out by the HSE where a person is of the opinion that they may have a disability, for anyone born after 1st June 2002. It first establishes whether the person has a disability (as defined within the Act). It then identifies the health and education needs of the person with a disability and the services required to meet those needs.
It is important to note that children do not require an Assessment of Need to access health services, including HSE Primary Care, Children’s Disability Network Teams or Mental Health Services, or education supports.
There has been intensive work by the Department of Children, Disability and Equality and the HSE to address delays in the provision of Assessments of Need. This is evident in the continued improvement in the number of completed Assessment of Need reports with 5,939 reports completed nationally in 2025. This is a 43% increase compared to the number completed in 2024. The latest HSE data shows that 1,528 Assessment of Need reports were completed nationally in the first 3 months of this year compared to 1,402 in Q1 2025. Improvement can also be seen in the Cork LHOs with 258 AON reports completed in Q1 2026 compared to 198 in the same period last year – an improvement of 30%. This improvement is welcome and must continue.
However, demand for Assessments of Need has increased significantly in recent years, reflecting both the increase in population and the number of families exploring all options to access services for their child. Unfortunately, this demand is outpacing the capacity of the system to respond with the result that there were over 21,700 applications overdue for completion nationwide at the end of March 2026. In the Cork Local Health Office (LHO) area, 1,894 applications were overdue for completion in the same period. These numbers indicate very clearly that more change is needed.
The Department and the HSE have been working intensively to address delays and improve processes so that children and young people can receive the supports and therapies they need as early as possible.
Measures introduced to address these delays include the Assessment of Need Targeted Waitlist Initiative, introduced by Government in May 2024. Under this Initiative, the HSE procures clinical assessments from approved private providers to support the delivery of Assessments of Need to families who have been waiting the longest for an AON. These providers are reimbursed by the HSE for clinical assessments undertaken as part of the Assessment of Need process. By the end of 2025, over 7,700 clinical assessments had been commissioned from private providers since the Initiative started.
Funding of €20 million is being provided this year to continue the Targeted Waitlist Initiative, enabling the delivery of approximately 6,000 clinical assessments with a specific focus on autism assessments. These clinical assessments will inform the Assessment of Need process and support the completion of AON reports.
While it is important to use private capacity to support the completion of Assessments of Need into 2026, we cannot rely on the private sector indefinitely and we must ensure that the public system can meet the clearly growing demand.
This Department continues to work with the HSE to ensure the delivery of actions to support the delivery of Assessments of Need within the public system. This includes improved training for staff involved in the delivery of Assessments of Need, additional administrative supports, and changes to processes where necessary to ensure an efficient and effective system.
As well as these operational measures, officials in the Department are working on legislative changes to Part 2 of the Disability Act, which provides for Assessments of Need. The proposed changes are intended to support more effective delivery of Assessments of Need, and to provide clearer guidance and supports so that the process can be made more efficient, reduce delays and allow therapists to spend more time delivering services. Importantly, these changes will not remove any rights for parents to apply for an Assessment of Need for their child. They also will not 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 along with an FAQ document, providing information on Assessment of Need and the proposed changes for parents, families and any other interested stakeholders. They are available on the Department website under Publications:
www.gov.ie/en/department-of-children-disability-and-equality/publications/from-subject-received-size-categories-aoife-carragher-dcde-fw-dcde-website-aon-1532-1-mb/
The HSE is also implementing actions to address the wider issue of access to services and supports for children with disabilities including:
• Introduction of a Single Point of Access system. This should make it easier for families to be referred to the right service or services, whether that is a Primary Care Service, or a Children’s Disability Network Teams and/or a Mental Health Service. It aims to streamline referrals and reduce duplication, so children do not end up on multiple waiting lists.
• Implementation of the Autism Assessment and Intervention Pathways Protocol, which was launched on 26 May 2026. The Protocol will provide a standardised assessment process across Primary Care Services, Mental Health and Disability Services. It will be the preferred assessment route for autism.
• The creation of eleven new HSE teams, initially, to support assessment processes, including Assessment of Need, providing clinical guidance and administrative supports.
The delivery of an effective, efficient Assessment of Need system continues to be a priority for the Government.
