Complaint

This complaint was brought to the Office by the parents of a four year old girl with significant motor problems resulting in a diagnosis consistent with Cerebral Palsy. An application for a powered wheelchair was made to the HSE but was refused. The Local Health Office of the HSE informed the parents of their policy of not providing powered wheelchairs to children under the age of seven.

Examination

Over the course of the investigation, the Ombudsman for Children’s Office found that there are no national policies or guidelines for the provision of occupational therapy equipment including the provision of powered wheelchairs for children. Each Local Health Office develops its own procedures or guidelines, has its own budget and assesses applications according to the needs of the area or its own priorities. However, in correspondence with OCO, the HSE indicated that the Irish Posture and Mobility Network – a group of professionals working in the area – formed a subgroup in February 2010 to develop best practice guidelines on powered mobility.

Following the initial decision to refuse the child a powered wheelchair, reviews of this subsequently took place. However this was poorly documented. Advice was sought from three professionals two of whom did not have sight of the specifics of the case.

Further to its investigation the Office recommended that the HSE carry out an early and entirely fresh review of the case based on complete information including the research evidence in the area and an assessment of the child’s ability including the identification of steps that can be taken to strengthen her competencies. The Office also recommended that:

• HSE policies and decisions should accord due recognition to waiting periods that may arise in the actual provision or supports depending on the level of priority in any particular case;

• The HSE expedite the work initiated in consultation with the Irish Posture and Mobility Network, to develop national guidelines for the provision of powered wheelchairs for children;

• The HSE take all necessary steps to establish clear criteria and guidance in order to achieve consistency on the part of Local Health Offices in relation to the processing of applications, and appeals in cases relating to the availability of powered wheelchairs for children.

Outcome

Following consideration of the OCO’s findings and recommendations including communicating directly with the child involved, the HSE undertook a review of this child’s individual circumstances, met with the child and the family and, subsequently, a powered wheelchair was provided. In addition the HSE advised that a National Committee had been established with the aim of agreeing national policies for powered wheelchair use which would ensure equity between all service users. The National Committee hoped to issue a report on this matter by spring 2012 and the OCO remains in correspondence with the HSE in this regard.

Posted in: Investigations Health