The Crisis of Assessments: Parents Must Now Lead the Reform
Our Children need therapy not bureaucracy.Ireland is facing a shameful reality: over 15,000 children are now trapped on the Assessment of Need (AON) waiting list, their rights and futures hanging in the balance.
This is no natural accident. It is the direct result of deliberate actions by the HSE — notably the 2020 alteration of AON procedures, found unlawful by the High Court in 2022 — and years of systemic neglect. The outcome has been devastating. Rather than receiving vital therapies, children are stuck in an endless cycle of assessment, while actual service provision collapses. Therapists are diverted from delivering treatments to conducting assessments that ultimately offer no benefit if they are not followed by intervention.
The real scandal is not just the length of the list. It is that Ireland is using scarce professional resources to diagnose problems we already know exist, while doing nothing to address them. Every month spent “assessing” without treating sees children’s conditions worsen, robbing them of potential and opportunity.
Despite this catastrophic failure, it is astonishing that the HSE — the architect of the problem — appears positioned to lead discussions about reforming the AON system. This is fundamentally unacceptable. Those who oversaw the breakdown of child disability services cannot be trusted to repair them. Reform must be parent-led, driven by the lived experience of families who know exactly where the system is failing.
Parents must be at the table not as token stakeholders but as decision-makers. They understand that what children need is timely therapy, not endless paperwork, not “pathways” or “process reviews” that lead nowhere. The crisis will only be solved when policy shifts from bureaucratic compliance to practical action: recruiting more therapists, reallocating resources to direct intervention, and ensuring that assessment leads immediately to service delivery.
Politicians must stop hiding behind management layers and confront the brutal truth: unless urgent action is taken, thousands more children will be condemned to lives limited not by their disabilities, but by the failures of the very system meant to support them.
The HSE had its chance. Now, real leadership must come from those who have the most at stake — the parents. The future of our children demands nothing less.