Health Service Executive CEO Paul Reid has told an Oireachtas hearing that there have been "huge failings" regarding the provision of disability services for children.
Mr Reid was appearing before a joint hearing of the Committee on Disability Matters and the Committee on Children, Equality, Disability, Integration and Youth.
"I want to acknowledge we have had huge failings in terms of communications, inconsistency of communications, engagement, levels of empathy and the inconsistencies across different CHOs [Community Health Organisations] and community areas", he told politicians.
Mr Reid said that many HSE staff were working "night and day" and "care hugely" about delivering for children with additional needs.
The HSE and the Department of Health are currently working to develop an "overarching roadmap" to improve the provision of services for children, he told the committee.
Politicians heard that this is due to be completed in the coming weeks.
However, during a tense exchange, Independent Senator Tom Clonan accused the HSE of "completely failing" to provide adequate services to children with additional needs.
Senator Clonan called on both the HSE and the Department of Health to issue statements to that effect, making it clear that "you have failed".
Sharing the experience of his son, Eoghan, Senator Clonan told witnesses that "he has not received any meaningful physiotherapy, speech therapy [or] occupational therapy since 2011", adding "that's when [the problem] started, with the crash".
Mr Clonan said that the obstacles placed in front of the "tens of thousands" of families like his were inflicting harm on children.
Minister of State for Disability Anne Rabbitte said that as somebody from "within the Department of Health" she would like to "apologise to you, your son and to other families as well for that lived experience that you have articulated".
She said that she cannot apologise enough for the lack of services that Eoghan has endured, "it is not right".
Malcolm MacLachlan, HSE Clinical Lead for National Clinical Programme for People with Disability, also said that in the case of Eoghan Clonan and others like him, the HSE had failed.
However, Mr MacLachlan added that there are children benefiting from HSE services but that anyone on a waiting list is "almost by definition being failed".
Mr MacLachlan acknowledged that austerity cuts during the recession were still having an impact.
Addressing the issue of staffing levels, Mr MacLachlan said that pay was not the main issue, as Senator Clonan had claimed.
Mr MacLachlan said that he didn't believe paying clinicians more was the solution to "stop failing people", but rather the answer was to employ more clinicians. He said that clinicians and consultants were well paid by international standards.
Senator Clonan accused Mr MacLachlan of giving a "patronising, condescending" response.
Mr MacLachlan reiterated his belief that conditions were problem, as opposed to pay. He accepted that there were not enough staff "on the ground".
