Ms Vickie Kirkpatrick:

I will address the matter of numbers and models and Ms Kenny might speak to recruitment. With respect to best practice models, from the numbers given to us by the disability operations office in June that were shared with the committee, it is not hard science. Those with the lower numbers are in places that have reconfigured. One of the barriers for clinicians on the front line, or even most important for families, is the one point of access. We echo Dr. Morgan's point that it is not only about human resources for those posts; it is also about restructuring and models of best practice. We had that model with its publication in 2005 through to 2009. The greatest challenge is that a change of that magnitude requires front-end investment and project management, as well as lead-out. It cannot be done in a vacuum. It is a big restructuring process. My suspicion is the places where there has been change are smaller and it has not been as cumbersome to restructure them. This is all the more reason for proper project management and investment to manage the change required.

We heard figures in the previous session about investing now because of what the cost would be later. It is again about ensuring that a workforce is in place. The workforce in health and social care has increased exponentially over the past 15 years with Irish clinicians training at top universities. The programmes are recognised. The IASLT enjoys mutual recognition with the United States, Canada, United Kingdom, New Zealand and Australia. Our graduates are recognised and, therefore, we have the power to produce highly qualified professionals. It is about the structures in place and not necessarily about a targeted number of posts. It is important that there be a structure to facilitate one point of access for families. The tiered model moves into a social model of care rather than an impairment model. The other struggle is even in terms of legislation. The Disability Act 2005 was a great advance for people with disability in Ireland but as legislation it needs to continue to grow and modernise. It is an impairment-based model in terms of what people can and cannot do, which is difficult when a person is three years old.