Ms Linda Kelly:

On what it takes to solve the problem, one of the things that has been most concerning for us in recent months has been the HSE saying it has set aside its own workforce plan for children’s disability network teams. There is a document from 2015 that is referenced in the appendix that looks at safe staffing numbers. The HSE has told us it has set that aside. It has not provided any sort of alternative to that or given any indication it is going to look to establish an alternative to that. Looking at things in terms of a systemic failure and sustaining this into the future, how is that to be done if there is no plan for how many staff are needed? It is one of the basic cornerstones that we need within the health service. A recommendation from this committee that there be clear workforce planning guides would be powerful.

That is, for us, tied into the lack of a chief health and social care professional, HSCP, within the Department of Health, even though there have been political commitments left, right and centre. Our friend, Robert Watt, was at the health committee last week saying it was going to be implemented. I will believe it when I see it and it is actually in place. That is a key strategic piece. If we do not want to be here in five or six years’ time again, we need to have those pieces squared away.

On more immediate solutions that can be found, what we have at the moment within the HSE is an industrial relations process around a career pathway review for health and social care professionals that is 20 years overdue. The HSE is implementing it in one section, in primary care, but not implementing it in others. What we have then, in effect, is different streams of the HSE competing against each other for health and social care professional staff, because people are leaving disability services to go to primary care where they have more options for promotion and progression within their chosen profession. That can be easily remedied. We know the details of that process and it can be implemented in disability services. It would demonstrate symbolically to staff that they are valued and are wanted to be retained.

One of the concerning pieces is that, anecdotally, what we are hearing from people on the ground is that they are actually leaving without another job to go to because they are so unhappy with what is happening. Imagine that. We have a scenario where health and social care professionals are leaving disability networks and are not going into any other employment because they have been so damaged by what is happening there. We need a person who is responsible for this change management process, who has a budget to implement it and who can address things like the lack of offices, lack of assessment and funding for people around continuing professional development, CPD. In the main, most of the people working in this, even though they are not deemed a clinical specialist, are in reality operating at that level. We need to reflect that in what we provide for them. Most of the detail of that is outlined in the submission, but I am happy to write in and provide further detail on that if required.