Elaine Loughlin: What chance have parents when disabilities minister can’t meet staff?
Since entering office, Disabilities Minister Anne Rabbitte has quickly learned how acutely frustrating it is to have to deal with the HSE.
Documents published by the this week show the level of effort senior officials have gone to in continuously blocking Ms Rabbitte from getting “on the ground” updates from staff amid serious concerns about services for children with disabilities.
The “skip-level” meetings sought by Ms Rabbitte are often seen as extremely effective in obtaining unfiltered and honest information about what may be really happening in an organisation.
These interactions provide employees the opportunity to speak freely about the company with their CEOs, directors or — in this case — their minister, without their own manager in attendance.
But the top brass in the HSE, it appears, is very much against the idea of a minister coming down from her ivory tower in Miesian Plaza to speak with staff who might have an idea of what’s going on.
What exactly do they think she might hear?
The health system is in chaos. Just ask the parents of any child with a disability who has been waiting months and in some cases years to get an initial assessment before being shunted on to several other lengthy list for therapies, treatments, and supports.
Parents are also being ordered to attend training courses so they can carry out therapies on their own children. Parents say they have been told that if they do not avail of these courses, their children will be taken off HSE lists for therapies such as speech and language and physiotherapy.
Added to this is a transfer to the new Progressing Disability Services for Children and Young People (PDS) programme, which has been billed as a massive departure in how services are provided, but which has been a bumpy transition to put it mildly.
But the level of chaos, it appears, is being exacerbated by top-level officials in the HSE who seem intent on engaging in power struggles and petty squabbles over who wields authority instead of engaging constructively with a minister to ensure services for some of our most vulnerable children are improved.
Ms Rabbitte, who is known for straight talking and a no-nonsense approach, wanted to get to the bottom of things and sought one-on-one meetings with each of the teams in the nine community healthcare organisation (CHO) areas across the country late last year. In what initially appeared like a straightforward ask, Ms Rabbitte’s adviser explained: “The minister wants to change from having monthly meetings with all CHO Disability Managers present together to meeting the CHO managers one at a time.”
There would be “no extra burden” on the schedule of managers as they already attend a combined monthly meeting, only on the minister and her officials.
“To ensure delivery, the minister wants to hear first-hand from the disability managers and their teams about how things are going on the ground,” her adviser wrote in one email to the HSE’s national director of community operations Yvonne O’Neill.
But the HSE swiftly told the minister that the proposed individual meetings were “not operationally feasible”.
Ms O’Neill also contacted each of the nine mangers asking them to respond to the minister by stating that “these requests for routine/regular meeting be made directly to the National Director Community Operations please”.
In a follow-up email, the minister’s adviser asked: “Are you saying that the disability managers in each CHO and some of their team cannot free up 45 mins every month to meet the minister to discuss what has been described by the HSE itself as one of the most fundamental changes across the health service in how we deliver care to children in Ireland?”
At the same time as she was seeking these meetings, Ms Rabbitte was quietly meeting parents, including one gathering held in Galway on November 11, 2021.
At the meeting, it became clear that children were effectively being left in limbo as their files had not been transferred over to newly-configured assessment groups, established to overhaul and speed up the assessment of children.
As part of the reorganisation of how services are delivered, 91 children’s disability network teams (CDNTs) have been established to provide supports for all children with complex needs within defined geographic areas. But some of these new teams had been left without access to children’s files for more than two months.
In a strongly-worded email, Ms Rabbitte accused the HSE of “not giving a full and true reflection of what is actually happening on the ground” and said “if the HSE is trying to deplete the minister’s confidence in their ability to deliver on their commitments they are doing a very good job”.
The letter, sent to officials in the Department of Health by Ms Rabbitte’s officials, and released via freedom of information stated that she had been left “quite shocked” by the delays in transferring files.
In her tenure as minister of state for disabilities, Ms Rabbitte has not been shy in her criticism of the HSE and has publicly hit out at delays in assessment of needs for children with disabilities who have been waiting an average of 17 months. Ms Rabbitte told the in November:
“I am not a spokesperson for the HSE, I will not be an apologist for the HSE, and sometimes when things are wrong you can’t defend the indefensible.”
This type of comment does nothing to improve already tense relationships. But FOI documents show a side of the HSE that is actively working against her.
How can we ever expect our health service to work in a way that serves patients when the HSE is preoccupied with blocking ministerial requests and shutting down opportunities that might lead to change?
Above all, what hope do already overstretched parents have when the minister responsible for disability services can’t even get in the room?
April 30: The Adoption Bill, which established An Bord Uchtála, was published. In a sign of the times, The Cork Examiner reported that “an adoption order shall not be made unless a number of conditions in regard to religion are fulfilled”.
In 2015, a bust of Václav Havel, former president of post-communist Czechoslovakia and the Czech Republic, was unveiled in the LH2000 wing of Leinster House.
Bill Shipsey commissioned the work, which was funded by the Czech community living in Ireland, friends and supporters of Havel, and Amnesty International. It was the first time a bust of a foreign head of state was accepted by the Oireachtas.
Havel was a writer, playwright, and political dissident. His party played a key role in the Velvet Revolution, which ousted the communist regime in Czechoslovakia in 1989.
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