Dáil Éireann Debate, Thursday - 19 February 2026
111. Deputy Paula Butterly asked the Minister for Children, Disability and Equality if she will consider establishing a cross-Border assessment-of-needs scheme, similar to the existing cross-Border dental and surgical treatment schemes, to allow patients particularly children to access timely assessments outside the State; and if she will make a statement on the matter. [3419/26]
Amharc ar fhreagraThe delays faced by families in accessing Assessments of Need are unacceptable. Intensive work is underway by the Department and the HSE to address these and improve the system.
I must emphasise 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.
The Assessment of Need process is set out in the Disability Act 2005 and the HSE is the body responsible for the administration of the process. HSE Assessment Officers are responsible for the production of assessment of need reports. As part of the process, they 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 AON 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.
Whilst recognising the challenges, I have requested that officials engage with the HSE to identify whether further opportunities exist to leverage cross border supports.
It is important to recognise that progress is being made over 5,900 completed AON reports in 2025, 43% more than 2024.
This improvement has been achieved by several measures, including the AON Targeted Waitlist Initiative, which resulted in over 7,700 clinical assessments sourced from approved private providers since June 2024.
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 AON process intended to improve access to both assessments and therapies for children who need them. These include targeted amendments to Part 2 of the Disability Act 2005, which provides for Assessments of Need.
I want to reassure families that the proposed legislative 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. An FAQ document has also been published, providing information on Assessment of Need and the proposed changes for parents and any other interested stakeholders.
