Ms ?ine Lawlor:

As Dr. Higgins said, on recruitment there are issues with the panel, which have been flagged for many years. There are also issues with the length of time it is taking to recruit and get staff physically into posts. The process of actually getting staff is a major issue particularly when so many posts are available. We are competing with other sectors which can recruit people much quicker and we are losing people in the time that it takes to get him through some of the HSE recruitment processes.

There are also issues with pay and conditions for some staff, particularly those in section 39 organisations who are different from their HSE colleagues. This also impacts on recruitment. As Dr. Higgins said, there is a career pathway piece for clinicians. When we want to keep clinicians in services where they have built expertise, we lose them. Staff need development opportunities such as becoming seniors within services or building specialism in clinical specialist posts or advanced practice posts. It is really important that we can show what health and social care professionals can do.

The Deputy asked if the HSE is aware of it. The recruitment piece is probably recognised to an extent but the issue is with the retention of staff. The recognition of the culture for staff working in disability services is very challenging. Undoubtedly there is an impact for families and children too but if we want to keep staff, we need to recognise that culture. We need to look at why staff are leaving and how we can keep staff. Other reports have recommended exit interviews and looking at things like that. As a professional body we have spoken to our speech and language therapists about that. They have said that the structures in place in those disability services are impacting on them staying in those posts.

The Deputy asked what specialist pathways have not yet been published or implemented. The priority ones for speech and language therapy relate to augmentative and alternative communication, and also for feeding, eating, drinking and swallowing difficulties. For disability services and for PDS it has been happening for many years. Policy documents are meant to be coming and staff on the ground are hearing that they are coming. We need agreed action and completion on strategies and policies. They do not just need to be published, but we need a plan to support the implementation of them nationally so that services are equitable and streamlined and the same processes are happening throughout. There needs to be a more strategic oversight on those.