Assessment of need reform 'not code for taking away the right to it', says HSE chief
Waiting lists in Cork and Kerry were also raised and he is concerned about long delays facing children there in particular.
Families nationally should see faster access to services by October with a 'no wrong door' system in place, he also said. This means if the first service a family encounters is not the best place, they can be referred to a more suitable service instead of starting over each time.
Mr Gloster was answering questions on Progressing Disability programmes.
'Assessment of need, I believe, needs reform, that's not code for taking away people's right to it and it's not code for changing the timeline but it has actually become something it was never intended to be,' he said.
'Every single need across public services and across Ireland Inc is now being tagged to assessment of need either because people are led to believe they need it or they form the belief that they'll get something faster.'
That's leading to children who really need it being delayed and children who don't need it being put through it. I have concerns about both.
Labour spokeswoman on disability, Laura Harmon, said in the first three months of this year 'just 7% of assessment of needs were completed within the timeframes of the Disability Act itself".
Mr Gloster said his focus is on 'ensuring that the legislation defines the purpose of the assessment and enables access to it". He is not aware of plans to change the requirement AON should be done within six months of referral.
Ms Harmon said of Cork City waiting lists for primary care assessment for autism 'we're seeing 30 months waiting lists'.
Mr Gloster responded: 'I have a particular concern about Cork', saying he has discussed with the regional team the need for better focus on children's services there.
'No wrong door'
He described meeting GPs during the Irish Medical Organization AGM, saying they talked of how time-consuming it can be to match children to the most appropriate service.
'We're changing it to 'one front door' and there is no wrong door,' he said, saying this will take effect from October.
Teachers, parents, and GPs are among those who can refer to a central system for assessment.
'They will decide what's at least the best chance of the quickest pathway for that child to receive an appropriate response. That will include the Autism protocol,' he said.
Social Democrats TD Liam Quaide raised delays with primary care, saying this is 'deep in crisis' in addition to stresses facing Camhs and children's disability network teams.
For primary care psychology, the waiting list for children is now over 6,500 'and that's for Cork and Kerry alone,' he said.
Children might wait four to five years for help and then only get seven sessions, he added.
Mr Gloster met 600 staff online this week from disability, primary care and mental health services for children to discuss staffing plans.
HSE HR officials set out plans for recruitment to the committee, saying there is a global shortage of therapists and there are plans to increase training places.
Read More
Cara Darmody: The law breakers are at the Cabinet table
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Irish Times
an hour ago
- Irish Times
Husband of woman who killed herself and child calls for changes to support bereaved
Darren Coleman was at work as a primary school teacher one Friday in the winter of 2020 when he received a phone call from an unknown number. On the other line was someone from Crumlin children's hospital (CHI) in Dublin . They said the toxicology screening for his seven-month-old son Henry, who died a number of weeks earlier, had been completed and asked him what he wanted to do with his organs. 'They said I could incinerate them or I could bury Henry with them, which would mean digging his body back up again. And they asked me to let them know early next week. That was it. I went back into the class and went on with work,' he says. 'I rang back next week, because I wasn't going to dig up his body.' READ MORE The phone call came just over a month after Mr Coleman's wife Nicola Keane (34) died by suicide after administering a lethal dose of medication to their son Henry on October 22nd, 2020. She was suffering frompost-natal depression and psychosis. The Health Service Executive (HSE) has since admitted a breach in duty by failing to appreciate Ms Keane suffered from psychotic depression, failing to communicate this to her husband and failing to ensure she received inpatient treatment. [ Man whose late wife administered lethal dose of medication to their baby says mental health system is broken Opens in new window ] 'I feel there was no empathy or care towards me a month or so after burying my family.' Photograph: Dara Mac Dónaill/ The Irish Times Speaking publicly to highlight issues he faced in the aftermath of his family's death, Mr Coleman says when he received the phone call from Crumlin, he was still deep in the throes of grief. He was feeling a range of emotions: anger, sadness, guilt. The call, he says, added to those difficulties. 'Maybe they didn't know I was back at work but these are personal things they're talking about. It should've been a letter asking me to come in to discuss, or they could've called the garda liaison and she could've called over and told me,' he says. 'I feel there was no empathy or care towards me a month or so after burying my family.' A spokeswoman for CHI acknowledged 'unexpected communication was distressing, and we apologise for additional pain caused'. There have since been new guidelines introduced, she said, adding that the experience of Mr Coleman and other families 'helped to inform what we hope are significant improvements in the process'. Ms Keane worked as a paediatric nurse in Crumlin hospital. As a result, Mr Coleman thought he would receive 'too much help' in the weeks after his wife and child died. 'All the people who were around Crumlin [hospital] - I was in and out visiting Henry's body - and there were so many people coming up to me saying they will get help for me. And I was like: ''Yeah, send help', but it never came,' he says. He organised counselling through FirstLight, a charity that provides free support to parents who have experienced the sudden loss of a child. He also returned to work eight days after the funeral in a bid to resume a sense of normality. But while he was trying to navigate these feelings, he was also worrying about the house, changing the bills into his name, and other life administrative tasks. For the first year, he says, he blamed himself for their deaths. 'I kept thinking I had missed something.' After obtaining one report into his wife's care, he realised he needed to do further research. He spent the next three or four years reading reports, going over what happened again and again. 'She told them how sick she was. She was crying out for help. But she wasn't getting the help she needed,' he says. [ Demand for HSE's free 'talk therapy' reaches 1,000 a month Opens in new window ] The inquests were another difficult moment during his grieving process. On two occasions, he said they were cancelled with two weeks' notice because depositions weren't handed over on time. It took a toll on him, he says, as in the lead up to the inquests he was preparing to 'go back through every fact of the day'. He sued Children's Health Ireland (CHI) and the HSE over the circumstances leading to his family's deaths. The mediation process was long and difficult, he says, once again hindering his ability to grieve properly. In May 2024, the legal action was settled through mediation. Though the HSE admitted a breach in care, CHI denied all claims. Mr Coleman is still frustrated he never received an apology from CHI. Less than a month before their deaths, Ms Keane attended a play therapy session with Henry at CHI Crumlin. Following this session, a child psychiatrist from the hospital informed Ms Keane's adult psychiatrist they believed she was psychotic. However, Mr Coleman says he was never informed of this and they allowed his son to go home with her when they believed she was experiencing psychosis. 'It's just about changing things so that other people who need help can get it. The help I wasn't given.' Photograph: Collins Courts 'I think they still have to be found accountable. Just an apology. That's all. I should've got an apology,' he adds. A spokeswoman for CHI said it cannot comment on individual cases, but extended its 'deepest condolences to the family'. In the aftermath of the settlement, it was announced the HSE would conduct a review into the care received by Ms Keane and her son Henry. Mr Coleman said he didn't want or ask for one, as he didn't think it would bring him any more closure. By that stage, it was almost four years since they died; he wanted to move on. Draft terms of reference for the review were sent to Mr Coleman on July 2nd last year. In it, they described Henry as being four months old instead of seven, and said the date of deaths was October 22nd, 2023, when in fact it was three years earlier in 2020, email correspondence shows. 'It was a lack of consideration towards me again. That really hurt me, it just brought back the negligence. It was only a two page document and they had two glaring mistakes,' he says. [ Better mental health support needed for women after giving birth says midwifery professor Opens in new window ] The terms of reference said the review would be completed within 125 days. Last October, Mr Coleman contacted Kevin Brady, the head of mental health at the Dublin South, Kildare and West Wicklow HSE health area, as that deadline was approaching, requesting an update. Mr Brady responded to Mr Coleman via text stating that 'regrettably there has been a delay in getting commenced' adding that the 'restructuring within the HSE' delayed the review process. Mr Coleman said this news sent him 'right back at rock bottom again', adding that he wants to move on but has 'no trust or confidence in this review being done correctly'. He is not engaging with the review process. Responding to a series of questions from The Irish Times, a spokeswoman for the HSE acknowledged 'the profound and devastating impact that the deaths of Nicola and Henry have had on Mr Coleman and we would like to reiterate our deepest regret and sincere sympathies to him, and to their extended families'. The review into their care is 'well advanced', the spokeswoman said, and the review team 'are in the process of drafting a report'. 'The HSE continue to remain available to engage with Mr Coleman and make what supports he needs available,' she added. Now, Mr Coleman is letting the anger he had go. Instead, he is looking 'positively to the future'. He runs marathons, has started travelling more, and climbed Machu Picchu in Peru. He returned to college to do a postgraduate degree and sought career advancement in work. What he would love to see in the future is an improvement in supports for the people who are left behind, picking up the pieces, when tragedy occurs. He wants to see the immediate establishment of mother and baby units, which provide inpatient care to mothers with serious mental health conditions. He also believes there should be family liaison officers or link workers in hospitals, to help people in the immediate aftermath of such incidents so they can understand what happens next. 'I'm not even a file number. Henry and Nicola are file numbers, but I'm not even considered in anyway. I'm just invisible. I often think it's because I'm a man that no-one was knocking on my door,' he says. 'Now, it's just about changing things so that other people who need help can get it. The help I wasn't given.'
Irish Times
an hour ago
- Irish Times
HSE to gather more detailed abortion data from Irish hospitals
The age, number of previous pregnancies, form of contraception and gestation of women who access abortion services in Irish hospitals is to be collected by the Health Service Executive for the first time. The National Women and Infants Health Programme (NWIHP) is running a pilot system designed to collect more information about termination-of-pregnancy health services in Irish maternity hospitals. Though the data system is only running in a number of maternity units, there are plans within the HSE to make it national. While it will mainly collect information about abortions carried out in hospital settings rather than from pills provided by a GP, the HSE will also start collecting details of women who present to hospital after taking abortion pills at home or accessing a termination abroad. READ MORE Until now, the only national data collected about abortion each year was the total number of terminations carried out under each section of the law, the month that it was carried out and the county or country of residence of the woman accessing the health service. This data was required to be reported to the Minister for Health under legislation introduced in 2018, following the repeal of the Eighth Amendment. The HSE said that 'until recently, there was no formal or systematic national mechanism for monitoring and evaluating [termination of pregnancy] services'. It said the NWIHP has developed 'a national electronic data collection system'. The system is focusing on collecting data from hospital-based abortion services, which make up a minority of terminations carried out in Ireland every year. The most recent data available from the Department of Health said that the number of women who had abortions in Ireland rose to 10,852 last year. The overwhelming majority, 10,711, were early pregnancy terminations, where a woman takes two types of medicines prescribed by a GP up to 12 weeks of pregnancy. The HSE said that its new data system will collect more detail about abortions provided in hospital settings. It will include the number of abortions carried out in hospitals and the section of the law under which each abortion was carried out. This will include early pregnancy abortion, a termination in a case where there is a risk to a woman's life or health, a termination carried out in instances where there is a risk to the woman's life or health in an emergency, or following the diagnosis of a condition likely to lead to death of a foetus. The HSE will collect data on whether a hospital-based abortion was medical, surgical or surgical under general anaesthetic, as well as how far along in the pregnancy the woman was at the time of the abortion. Post-abortion complications and the care provided to women in those instances will also be collected for the first time, as will any presentations to hospital of women following an early medical abortion pill or a termination carried out abroad. The HSE said that 'some maternal characteristics' will also be included in data collected, including 'age, previous pregnancies and contraception use'. The HSE said it was 'important to note that the system does not collect any patient-identifiable information and does not capture the personal reasons or circumstances behind an individual's decision to end a pregnancy.' Under Irish law, there is no requirement for a woman to disclose her reason for choosing an abortion up to 12 weeks - the gestational limit under which the vast majority of abortions happen in Ireland.
The Journal
3 hours ago
- The Journal
Only 100 free-of-charge car parking spaces at new children's hospital not enough, say critics
OF THE 1,000 car parking spaces that will be available at the new National Children's Hospital, just 100 of them will be free-of-charge for families in need. It was revealed two years ago that car parking charges at the children's hospital will be capped at a maximum of €10 per day, something which sparked controversy at the time. In answering a parliamentary question, Health Minister Jennifer Carroll MacNeill said the car park will be split across two floors of the new hospital with a total of 994 car park spaces. There are 319 spaces dedicated to staff and 675 for patients and families, of which 100 spaces are for those who will not be required to pay for parking, she confirmed. The new National Children's Hospital Ireland is located in the heart of south central Dublin city on the grounds of the wider St James' Hospital campus. Patients attending the hospital are encouraged to use public transport 'where possible' with just a limited of number of onsite parking with direct access to the main entrance. Access to the National Children's Hospital Ireland on the St. James' Campus is well served by public transport, said the health minister, though she acknowledged there is a need for families to access the hospital by car. However, Sinn Féin's David Cullinane has hit out at the government for giving over such a small number of free car parking spaces to families. Advertisement Government watering down promises Speaking to The Journal , he accused the government of watering down its previous promises around capping car parking charges in hospitals. 'My view is that car parking charges should be phased out in hospitals, but particularly when you're talking about children. There is a cost of a child being sick. Parents have to take time off work. Parents can be up and down the hospital a lot. 'Obviously, with a sick child, parents need to be there more often. So for all of those reasons, I've contended that all of the spaces should be free [at the new hospital],' he said. 'For only 100 of them to be free, it doesn't seem fair and doesn't seem right. As we transition to the new site, hopefully sometime next year, I would hope that the right decision will be made to ensure that car parking spaces are free,' said the Waterford TD. Promise to cap charge Hospital car park charges have been a contentious issue for a number of years. In 2018, the HSE undertook a national review of car parking charges at the request of the then-health minister Simon Harris. It recommended that hospitals should cap the maximum daily rate for parking at €10 and introduce concessions for regular patients and found that 'funding of approximately €4.75m would be required to offset the reduction in income as a result of these changes'. Reducing hospital parking costs became a key promise in the 2020 Programme for Government but there was little progress on the issue over the last five years. There are huge regional disparities in parking costs. According to the Irish Cancer Society, cancer patients in Dublin can pay up to five times more than those in rural areas. However, despite this being a key talking point for the last number of years, in particular as the 2026 opening date for the new children's hospital gets closer, the new Programme for Government has done away with a commitment to cap parking fees and now merely promises to 'explore further ways to reduce hospital car parking charges'. Related Reads Minister says wing of new children's hospital might be named after medic Kathleen Lynn The country's new children's hospital will be called (drumroll) – the National Children's Hospital Ireland Children's hospital may not open until 2026 due to 'risks' of moving sick children during winter The government's commitment on parking charges has been 'watered down' in the new Programme for Government, Cullinane said. Under Sinn Féin's policy, hospital charges would be phased out over a period of time, he said, stating that obviously, like any measure, it costs a lot of money and might be difficult to do in one go. 'But I don't have confidence that the government is going to do any more than what they have done,' he said, adding that the previous health minister Stephen Donnelly had expressed an opinion that car parking charges should be free. 'What we're seeing now in the new Programme for Government, in my view, is a rolling back of that, a watering down of it, with no detail as to what is actually meant in the programme for government. 'Now we have a situation where the new Children's Hospital potentially could have the vast majority of spaces at a cost and I think that's unacceptable, given that we're talking about sick children and parents visiting sick children. So the government needs to do the right thing and ensure that they're free from day one,' added Cullinane. Outsourcing hospital car parks Labour's health spokesperson Marie Sherlock agreed, expressing concern over the outsourcing of car parks to profit-maximising companies. She suggested that the new hospital should directly manage parking and therefore could increase free or low-cost spaces. 'The whole point of constructing these hospitals is that people are coming from right across the country and they will have to drive. They will not be there for short periods, they'll be there for long periods of time, either as an inpatient or outpatient. So the reality is that we have to have an accommodating situation with regards to car parking in the new National Children's Hospital,' said Sherlock. She said people are angry and upset over the high cost of parking charges at hospitals stating that there's a real responsibility with this new public building that patients and their families would be accommodated to much greater degree. Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
