Ms Deirdre Kenny:

It was a good question about recruitment and retention. The last time there was workforce planning, it followed the Bacon report of 2001. There have been recommendations from the HSCP to look at workforce planning nationally.

We are working on old information.

The reason clinicians generally leave is because they might be looking for promotional opportunities or they want to move around the country. Their initial placement might be somewhere they do not ultimately want to live. There is anecdotal evidence that the urban centres might be suffering because it is so difficult for people to afford live in Dublin.

The second half is around replacing those who leave posts. There might be a post that becomes available and there is interest in that post, but the length of time recruitment is taking is an issue. There is a national recruitment service, the Health Business Services, HBS. There are panels in place and when one person walks out the door, one must submit the paperwork locally. It has to go through local pay bill. That can take however long, depending on where budgets are at the local area, before it ever goes to national recruitment. When a person walks out the door, one has a whole-time equivalent post but it may take six to eight months for somebody else to arrive in to that post. Not only is nobody being seen in that length of time in that particular setting but when the new person comes in, he or she needs to be inducted. It might take longer to upskill. I refer to all that extra time on top of the length of time the post has been vacant.

The speech and language therapy is in primary care and social care. Where a child at 12 months is not talking, the public health nurse may say that he or she will refer the child to a speech and language therapist in primary care. When the child comes to that speech and language therapist, she may recognise that it is a much more complex disorder - potentially autism spectrum disorder - and then look to refer on to a disability team. Depending on waiting lists, the child may have waited 12 months to see an SLT in primary care and then have to wait another 12 months or longer after he or she is assessed.

In terms of the work practice, as speech and language therapy, nationally, in primary care, we have looked at a review of how we can deliver services better. There is a report sitting in the HSE that has yet to be published which looks at how we can improve the way we work in primary care.