Untold Damage as Children Spend Years Waiting for Essential Health Services

Barnardos is calling on the Government to urgently address the lengthy wait for some key essential health services experienced by thousands of children across the country. Reviewing the last seven months of waiting list data, Barnardos is highlighting the continuation of delays in Child and Adolescent Mental Health services and Speech and Language services, as well as widespread regional inconsistencies in the time children are left to wait for assessment and / or treatment.

June Tinsley, Head of Advocacy, Barnardos said: "Childhood is a time of rapid development - untreated speech and language challenges or mental health difficulties can severely impact a child's ability to communicate, to learn, to develop relationships and to function in the world. The damage caused by lengthy delays in accessing services cannot be understated. Tragically, the longer a child waits for an intervention the less likely it is that treatment will be effective.

"Barnardos welcomes a sizable decrease (35.2% between February and September 2017) in the number of children waiting longer than a year for speech and language assessment, however this development is somewhat diminished by the fact that there has been an 11% increase nationally in the number of children waiting more than two years. There is wide regional variance and wait times are actually increasing in some areas. Combining assessment wait times with treatment wait times means that some children particularly those in Dublin South West, Kildare and West Wicklow (CHO7) could be waiting more than four years for treatment. It is clear that the volume of public speech and language services currently provided does not meet supply. The number of speech and language therapists in Ireland would have to double to meet the recommended levels of 35-60 cases per therapist."

For a three year old who only has a few words, waiting a year for speech and language treatment is like waiting a lifetime.

Barnardos' Project Worker

Ms. Tinsley continued: "In September 2017 there were 2,333 children waiting for mental health services, this is a decrease of 9% since February. This decrease is welcome, but worryingly there has been a 20% increase in the number of children waiting longer than one year for their first visit. Again, there are widespread regional variations and shockingly, in the Kerry / Cork area, the number of children waiting for mental health services doubled during the seven month period.

"In an effort to combat these long waits and to save their children from unnecessary harm, those who can afford it, end up having to pay for private consultation. We know from our research that children from low income families are far less likely to be in good health than their wealthier peers. A two-tier health system where parent's ability to pay determines their child's access to treatment deepens this divide and perpetuates disadvantage and inequality."

We have put ourselves under unbearable pressure to pay for a private speech and language assessment for my 4 year old son because of the length of the waiting list for assessment. We are not able to pay gas and electricity bills because we feel our only option is to continue paying €60 per half hour for private treatment.

Parent, Dublin

Ms Tinsley added: "Access to health services should be based on need and timely interventions are crucial to a child's development, Barnardos recommends the full implementation of the Slaintecare proposal to stop treating private patients in public hospitals thereby ensuring public patients can access health services in a timely manner. Additionally, regional disparities could and should be tackled by taking a more practical approach to resource allocation - taking into account an area's age profile and level of deprivation. The health, wellbeing and development of too many children is being compromised because of inefficiencies and resource gaps in our public health system. Barnardos will continue to monitor waiting list data and the impact of lengthy waits on children and families.

Read Barnardos Waiting List Report, December 2017

Barnardos believes tackling waiting lists can be achieved by:

• Fully implementing the proposal of the Oireachtas Committee on the Future of Healthcare Slaintecare (2017) to stop treating private patients in public hospitals, except in cases where specialist treatment is needed. This would drastically reduce the numbers of patients on waiting lists, and would ensure more public patients can access public health services in a timely manner.
• Guaranteeing one Primary Care Team with a full complement of multidisciplinary professionals for every 1,500 children. These teams must comprise GPs, nurses, home helps, physiotherapists, speech and language, psychologists and occupational therapists, and act as a one stop shop for community care needs.
• Tackling regional disparities by modifying the resource allocation model taking into account an area's age profile and level of deprivation. This would ensure services are distributed more appropriately and patients treated based on need and not their ability to pay.
• Developing 24/7 crisis intervention mental health services across the country. Young people have described accessing supports through hospital A&E departments as inappropriate and distressing to an individual experiencing a mental health crisis.
• Ensuring CAMHs has its full staffing levels as originally envisaged in Vision for Change.