Colm Burke (Fine Gael) | Oireachtas source

I thank the witnesses for their presentation. I apologise for not being here for all of it. Unfortunately, I had to be in the Seanad for an item.

I want to revisit the staffing issue. This is a challenge across the board in the health service, in areas such as maternity, orthopaedics, etc. We face a challenge in recruitment. At present, 40% of medical practitioners who register with the Medical Council in Ireland are from overseas. If we decided to recruit new occupational therapists and staff who operate in the area of psychology, would they be available? That is my first question. Second, if we were to increase the level of services and earlier assessment, is there a plan outlining the other supports that would be needed in order to provide fast and efficient services? I am wondering if anyone has actually looked at that. I know it is the responsibility of the HSE because it is the main body involved. Has that been done?

The other issue that has arisen regarding autism and disabilities generally is that we have had a huge reliance on agencies outside of the HSE over the past 50 years. Approximately €3.5 billion is paid to more than 2,500 different organisations via the HSE's annual budget. Is there insufficient co-ordination between the bodies that are helping in this area and the HSE? Is there a buck-passing exercise going on as well where parents are concerned? Do organisations say that a certain problem is really not their responsibility and claim that parents should be dealing with someone else? I have come across families to whom this has happened, namely, families who are going from one organisation to another. It is a hugely frustrating system.

I also wish to consider the area of education. We have been lucky enough where the education system is concerned that we have employed a huge number of special needs assistants, SNAs. I think we now have the highest number ever, with about 15,000 SNAs in our school system. I am not saying that it is ideal or that everything is perfect but it is a huge improvement on the situation 15 years ago. Why have we not been able to do the same thing at the very initial stages? I was dealing with a family at the weekend in respect of a mental health issue. I was so frustrated - and I am still frustrated - by the challenge of trying to get access to mental health services for a young person. The initial stages are the most important and I just do not understand why we do not seem to be able to get them right. If someone gets into the system they are fine. The initial stages seem to be the problem. Has anyone ever sat down and evaluated what we need to do, how we can prioritise and how we can fast-track this process?