Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome the witnesses. In her speech the Minister of State said the buck stops with her regarding the failure in the delivery of disability services. The buck also stops with the HSE because it is tasked with the delivery of these services. The Joint Committee on Disability Matters is tasked with overseeing the implementation of the UNCRPD. I state here that the HSE is in violation of the convention. Article 25 states health services needed by persons with disabilities specifically because of their disabilities are to be provided, including early identification and intervention as appropriate along with services to try to minimise and prevent further disabilities. This is not happening. I do not know whether the witnesses realise the stress families and children go through due to the lack of services. Parents have told me the lack of services being provided is the difference between people living independently or in residential care. If we were to look at it in a cold-hearted way, we would ask what will be the cost of this down the line. The cost of not providing early intervention now will come back and cost a lot more later. This is just in money terms and not in human terms.

According to the HSE's census of the children's disability network teams, there 524.5 vacancies. This is an average of 28% across all of the teams but it goes as high as 33% on some teams. I believe there is only one team that is fully staffed. Perhaps there are two teams. A total of 90 people on maternity leave have not been replaced. There are teams without administrative support, family support workers or play therapists. The teams cannot function. They cannot provide the services they are supposed to provide. This has to be down to a lack of workplace planning. In 2014 the national model of care for paediatric healthcare services had a guide to workforce planning that included Progressing Disability Services. Eight years later the teams do not function. There are very big problems. The witnesses have identified them and identified what they will do. Why was this not done before it was rolled out?

Section 39 was mentioned. What has been done to address the pay differential between section 39 organisations and the HSE? Until this is addressed, we will see staff continue to leave section 39 organisations and go to alternatives. Enable Ireland and many organisations will not be able to retain their staff or to deliver their services.

We have huge problems with CORU and the length of time it takes to recognise qualifications, particularly of those who have qualified overseas. I have been contacted by many speech and language therapists who qualified in jurisdictions such as the UK but they are being refused recognition because of one thing not included in their qualification. Could this not be provided to them when they are in the job if needed? This is a sector in crisis and these issues need to be addressed now. I am extremely concerned about the children who need services now. They cannot wait.

The HSE's recruitment process is cumbersome. There is a panel system. Nobody agrees with the panel system. Why can the children's disability network teams not recruit locally? It would make an awful lot more sense. It was mentioned that 35,000 people will be recruited to the HSE. How many of these will be clinical staff or therapists as opposed to administrative staff? Have there been trade fairs overseas to attract recruitment into this area? Has there been enough discussion with the Minister, Deputy Harris, on ensuring enough people are qualified at third level? Have we looked at an allocation allowance similar to that provided to ICU nurses to encourage people to work in disability services? Unfortunately disability services have a bad name and many clinicians do not opt to work in the service. They go to child and adult mental health services, primary care or the private sector. There needs to be encouragement for them to work in this area. Other jurisdictions used qualifications such as therapy assistant. Has this been considered?