Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

Some of the 743 posts will include special schools posts, which were halted last year. There were 85 therapists posts, but some of them have been recruited into. It does not include all special schools. They are a make-up of the posts I recruited for in 2021 and to date in 2022, and the additional 85 special schools posts last year. People have also failed to identify that we have lost staff from our CDNT teams. We have lost staff to primary and acute care. That is why the number is so high.

In the current budgetary cycle, I plan to seek additional funding to ensure that therapists are added to CDNT teams to cover special schools and new schools, which is not included. The 85 therapists posts are included, but I know from Deputy O'Sullivan's side, that I need to add another 30 therapists which are needed for Cork schools. That is part and parcel of it. Additional funding is required for additional therapists posts for the special schools.

Deputy Collins wishes to tease out the idea of outsourcing. Outsourcing is about using the private sector to assist us with some of the assessment of needs. I am not saying the private sector will assist us with all of it by any manner or means. Four of our nine community healthcare organisation, CHOs, are currently using various operators to assist them in the delivery of assessment of needs. They can only do it to a level of €25,000 because of procurement procedures. They use that bulk of money to do it and it works successfully. I have seen it working very successfully in CHO 2. It works. Outsourcing will complement our assessments of needs until such a time that we are in a space where interventions are happening and it is not all about assessments. We need the therapists on our teams to also deliver interventions.

The system is overwhelmed at present. It seems to be focused on assessments and not enough on interventions. We need to create a balance. However we create the balance, I do not want people getting private therapies and finding it difficult to them come into access services, because they have left the system. I would prefer to keep everybody in the system, if I could, and bring everybody along the journey as quickly as possible. That means I have to work with outsourcing in conjunction with the proper clinical oversight from within the teams structure. It is not as though the outsourcing is put out there and there is no connectivity back to the teams.

It would be outsourced but there would be an acknowledgement and notification of who the child is, how they have come back in to the teams and how their delivery of care would continue. It is no different from how we did it with the assessment of needs two years ago when we cleared 6,500, which was fantastic. That was with the old assessment of needs model. That was not a preliminary team assessment, PTA. I know it can be done in a timely fashion but we need to run both parallel with each other. There is no point doing an assessment if there is no intervention because that just frustrates parents. Parents need both.