Ms Linda Whitmarsh:

I thank the Deputy for his questions. I feel the services are worsening. There is no communication at all with the team. You have to ring constantly to ask where your child is on the waiting list. For three or four years, the answer is that your child is a priority. My child was a P1, or priority No. 1. He was a P1 because he had been on the waiting list for more than a year and because we had seven consultant letters sent to the CDNT on our behalf. If one consultant letter is sent, your child should be P1. My child was a P1 six or seven times because all his cystic fibrosis consultants and consultants in paediatrics, autism and intellectual disability referred him for interventions. I do not know how it can be said a child is a P1 seven times if he or she still has to wait three to four years. It is absolutely ridiculous. The system is completely failing the children of this State.

With regard to recruitment and therapists, there is no international recruitment. We have been asking about this and it has been brought up in the Seanad. The WHO’s Global Code of Practice on the International Recruitment of Health Personnel keeps getting mentioned but that is non-binding. Trade missions have been carried out before. LinkedIn seems to be relied on heavily when recruiting staff, whereas going to another country to recruit should be considered. In the past, we brought in a large number of nurses from the Philippines and India. Trade missions work but they are just not happening.

When the Government was asked about this, one of its answers was that the Magee campus of Ulster University produces speech and language therapists. However, they cannot come from the North to the South because they have not done a dysphasia course. Furthermore, the Government’s answer is not an answer because only 23 speech and language therapists come from Magee campus per year. There are 580-plus vacancies in the 91 CDNT teams. Twenty-three speech and language staff will just not be sufficient.

The pay gap between section 38 workers and section 39 workers is also a huge issue. There was pay restoration in 2019 and 2020, with €7.7 million spent in 2019. If speech and language therapists are given a choice to work with children in whom an immediate improvement will not be seen and are to be paid €4,000 to €5,000 less than others, will they opt for that job? I refer to the main reason for the inability to retain section 39 staff. In Cavan, it is a big issue because we have only 10.5 of those workers. There has been no drive for an allowance for complex needs workers. The budgets are in place. There are budgets for staff but staff are not being got. Why, therefore, do we not keep the staff we have and introduce an allowance for complex cases and give job guarantees? Newly qualified staff cannot work for CDNTs if they have not got paediatric training. Why do we not have a bit of foresight and provide this in college? Students could do some of their thousand placement hours in paediatrics so they could work for CDNTs when they graduate.

There are many other issues I could get into but I will let everybody else give their answers now.