Roderic O'Gorman (Dublin West, Green Party) | Oireachtas source

I thank Deputy Duncan Smith and his colleagues in the Labour Party for tabling the motion. I welcome the opportunity to restate the Government's commitment to children with disabilities and their families. We must face important and very real challenges if disability services are to meet the hopes, expectations and needs of those at their heart and enable them to optimise their potential in life.

It is absolutely accepted on this side of the House that the pace of improving disability services for children to ensure equal opportunities for all has been too slow. I hope the Minister of State, Deputy Rabbitte, and I can outline this morning the progress that has been made and also the important steps we are continuing to make.

The motion covers a number of cross-cutting areas and highlights the interrelated and cross-governmental nature of providing support to people with disabilities. In March of this year, the transfer of specialist disability functions from the Department of Health to my Department was completed. This transfer will provide new opportunities to continue work on improved cross-Government policy development, service provision and, in particular, the implementation of the UN Convention on the Rights of Persons with Disabilities, UNCRPD. The transfer signals the Government's commitment to and recognition of the scale of the task of creating better integration and more opportunity for our citizens with a disability. This is aligned with a whole-of-government approach that sees a range of initiatives and efforts across Departments to advance services and supports for people with disabilities, their families and their carers and progress the cause of Ireland achieving better alignment with the principles set out in the UNCRPD.

It is worth noting that this commitment has been backed up by significant funding in recent budgets. This year's budget sees a record annual amount of €2.63 billion for community-based disability services to reinforce and support the sector and provide for new services and improved services. Despite these commitments, it is absolutely acknowledged that many challenges still pertain and that it is of the utmost importance that we fully apply ourselves to finding solutions. For this reason, the Government will not be opposing the motion. Across the House, our aims and objectives are very much aligned on these important issues.

The motion rightly notes the difficulty experienced by families in accessing the vital therapies and supports they need to help support their children. It would be disingenuous to ignore the fact that there have been genuine difficulties in parts of the country with the implementation by the HSE of the programme Progressing Disability Services for Children and Young People, PDS. This has resulted in delays, often extremely significant, for families in accessing much-needed services for their children. That position is not acceptable.

Every single Deputy in this House has been contacted by a family at some point in the recent past regarding delays in getting an assessment of need or access to therapy, be it speech and language therapy or occupational therapy, or other supports to help their child. The frustration and anger that come across in the letters, emails and phone calls to our offices are heart-breaking but also entirely understandable.

The motion rightly points out the capacity issues affecting access to vital therapy supports through CDNTs, with many families experiencing waiting times that are far too long. Funding has been provided in recent years for additional posts to enhance the capacity of CDNTs and shorten waiting times. One hundred and ninety posts were allocated to children's disability services in budget 2022. Budget 2023 provided for an additional 136 posts specifically to provide services in 104 special schools for children with complex needs. The overall funding in recent years provides for over 600 whole-time equivalent posts. However, the reality is that there are genuine recruitment challenges in the disability area. This is due to several factors, including workforce availability and the significant number of employment opportunities across the wider health sector. These opportunities provide personnel with options regarding the areas where they wish to work. Working with children with complex needs is very rewarding but also very demanding, and the recruitment and retention of staff are presenting very real challenges to the HSE. These challenges affect the capacity of the services provided. It is obvious that demand for therapeutic supports is outstripping supply and that more therapists are required to meet the demand. It is a recruitment issue as distinct from a funding issue.

To address the recruitment issue specifically, the HSE is progressing several initiatives to improve the supply of potential therapists to the disability services area. My colleague, the Minister of State, Deputy Rabbitte, has been deeply engaged in this work. The initiatives include: confined competitions to fill all vacant senior posts across all disciplines on CDNTs; targeted national recruitment for CDNTs; targeted international recruitment for CDNTs, including relocation allowances; and sponsorship programmes for therapy grades. In addition, the Department and HSE are exploring the following additional options: an apprentice programme for therapy grades; the employment of graduates as graduate therapists as they await CORU registration; the expansion of therapy assistants in the system, with the HSE supporting individuals to return to education to qualify as therapists; and an increase in the number of clinical placements on CDNTs.

Despite recruitment remaining a challenge, the HSE and my Department remain committed to progressing efforts to increase the workforce and deliver better services to children. I realise that listing a range of recruitment initiatives can seem somewhat removed from the very real pressures that parents and children are facing, but I cannot overstate the extent to which the challenges in our CDNTs are primarily driven by the shortage of staff. That is why recruitment and retention have been my core focus and that of the Minister of State, Deputy Rabbitte, since the transfer of functions. Indeed, it was also her focus while she was operating within the Department of Health.

We look forward to the HSE rapidly publishing its PDS roadmap, in which it will set out in detail the range of recruitment and retention measures as well as wider measures to improve engagement and communication with parents. Deputies have spoken about the anger and frustration of parents over the lack or poor quality of communication by the HSE. Even when bad news has to be delivered, it is better to deliver it up front rather than shroud it in jargon. This is something the Minister of State, Deputy Rabbitte, and I have highlighted.

The motion points out that the recent staff census of CDNTs highlighted an overall vacancy rate of 34% across the teams. That is too high. We will be working in conjunction with the HSE to reduce it. It is worth noting that there was an increase of 11% in approved posts between 2021 and 2022, as well as an increase of 2% in actual staffing levels. This was achieved in the context of an average turnover rate of 9.6% in health and social care professionals each year.

The issues affecting the assessment of need process have been very much the same, with demand significantly outstripping the capacity to deliver. To drive down waiting times for assessments of need, the HSE has been allocated funding in budget 2023 to facilitate additional assessments through a suite of measures. These include the establishment of dedicated assessment of need teams, private procurement and overtime initiatives for existing staff, and the recruitment of administrative resources to free up therapists so they can assist with the assessments. The implementation of these additional initiatives on the assessment of need side will be set out in the forthcoming PDS roadmap.

I hope I have been able to demonstrate that the Government very much understands the scale of the challenge in this area and that, working with the HSE, it is making concrete efforts to alleviate the problems and improve services and supports for children with disabilities and their families.

We are acutely aware of the impact of these delays on children and their parents and guardians. Within our Department, we have identified improving children’s disability services as our absolute priority. My colleague the Minister of State, Deputy Rabbitte, has been consistently proactive in her engagement throughout the country in respect of individual issues when they arise and of the wider reforms needed to improve services. No one, irrespective of their allegiance in this House, wants to see a child having to wait one day more than is necessary to receive therapy supports. I assure all Deputies that the Government and our Department will remain focused on providing the best possible services for children and adults with disabilities.

See this speech in context