HSE ‘hasn't a hope' of complying with the law on assessment of needs, chief executive says

Irish Independent

18-06-2025

Mr Gloster, along with other representatives from the HSE, was before the Disability Committee on Wednesday to discuss disability services.
During the meeting, Mr Gloster told committee members that the law around AONs needed reform.
Specifically he said reform should focus on the purpose of the assessments rather than amending timelines or the AONs themselves.
'My contribution to that conversation has been more about ensuring that the legislation defines the purpose of the assessment and enables access to it, rather than it being a catch-all for everything in the state,' Mr Gloster said.
He added that the way the law is currently means the HSE cannot comply with current legislation and that the health service needed to be honest with families.
'We have to accept and be honest with people,' Mr Gloster told the committee. 'The way the issue has evolved over the years, the way demand has changed, the way other things have happened and other things haven't happened, we haven't a hope of being compliant with the law the way it currently stands.'
The HSE chief said that he believed a third of children referred for an AON should not have been referred and that parents and children were being pushed into these assessments.
'I have no doubt that despite the fact there might be a policy position that people don't need an assessment of need for certain things, they are being told they do, or they are led to believe they'll get it faster if they do,' Mr Gloster said.
'I believe about one-third of referrals to assessment of need are actually quite inappropriate.'
'At the moment, we see about one third of assessments when they're concluded that there's no sign or indication of a disability, and that would suggest people are being pushed into accessing assessment for accessing other things which they shouldn't need an assessment of need for.'
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Long waiting lists for AONs have resulted in scores of families applying to the High Court to try to force the HSE to carry out assessments on their children.
The committee was told that in quarter one of this year, the HSE received 3,131 new referrals for an assessment with 1,412 referrals closed out in the same period.
This, the committee heard, represented an increase in the HSE's overall capacity of 65pc based on quarter one of the year before.
The HSE chief told the committee that the health service would introduce a 'single door' system for applying for assessments and that this would be introduced in October, though he expected pushback.
'I'm around an awful long time to know that it's not going to be easy. I think I'll meet professional objection to it in parts, because people will feel the system isn't ready for it. But if we don't press on with it, we'll be talking about it forever,' Mr Gloster said.
Currently, families attempting to access support are often required to try multiple different services before accessing the correct supports, with parents being told they are trying the 'wrong door' Mr Gloster said.
This new approach would see a triage-like system in place, where a child's application would be assessed and then they would be directed to the correct service.
We're changing it to one front door, and there's no wrong door,' Mr Gloster said.
'Whether it's a GP, a teacher or a family, a child will be referred, and the combined efforts of CAMHS, disability and primary care will decide what's at least the best chance or the quickest pathway for that child to receive an appropriate response, and that will include the autism protocol.'