Brendan Smith (Cavan-Monaghan, Fianna Fail)

I thank Deputy Wall for raising this issue and for giving me the opportunity to outline the current situation with regard to occupational therapy in the Kildare and west Wicklow area. There are close to 130,000 people employed in the delivery of our public health and personal social services, the vast majority of whom provide direct service to patients and clients. Staff costs make up 70% of the HSE's overall budget and must be carefully managed if the HSE is to live within its budget.

As the Deputy will be aware, a temporary recruitment pause has been put in place as part of the HSE's financial break-even plan for 2007. In any instance where a critical or essential vacancy arises it may be filled through redeployment of existing staff by the relevant line manager or reassignment of responsibilities based on assessment of priority need. Notwithstanding this, it has been recognised that during the period of this temporary recruitment pause, there are some circumstances where appointment of staff may be necessary in frontline services. Accordingly, the HSE has put a process in place to evaluate, monitor and approve requests for derogation from the general recruitment pause. A small group has been established which meets regularly to consider such applications. Of the applications received to date, derogations to the value of 520.8 whole-time equivalents have been approved throughout the entire HSE where posts have been identified as critical to service delivery.

Demand for occupational therapy in the health services has been significant, hence the substantial investment which has been provided over the last number of years. The number of occupational therapists, OTs, employed in the public health service has grown from 287 whole-time equivalents in 1997 to 1,102 in September of this year. This is an increase of 725 whole-time equivalents, which represents growth of almost 253%. The Government has also committed to further investment in disability services via the multi-annual investment plan, and in primary care services, and this will result in a further increase in the resources available for occupational therapy.

A particular priority for the Department of Health and Children and the Department of Education and Science in recent years has been to increase the supply of therapy graduates, including OTs. New courses in occupational therapy were established in three universities, UCC, NUIG and UL, with an initial intake of 25 places on each of the three courses. The UL course is at Master's level and the first cohort graduated in 2005. The first cohorts from the bachelor's degree programmes in UCC and NUIG are graduating this year. The number of training places for OTs has increased by 86, from 29 in 1997 to 115 in 2007. This represents an increase of almost 297% over the past ten years.

The House will agree that these changes clearly demonstrate the commitment of my colleague, Deputy Mary Harney, the Minister for Health and Children, the Government and the HSE to ensuring focus on patient care and the recruitment of frontline personnel.

On the matter raised by Deputy Wall concerning the provision of occupational therapy in the Kildare-west Wicklow area, the HSE has advised that the current complement for OTs in the area is 21.5 whole-time equivalents. Thirteen of these posts are currently filled and 8.5 posts are vacant. The Department has been advised by the HSE that of the vacant posts, two posts in primary care were advertised in June of this year and 2.5 posts in the area of older persons — one in the community, one in Baltinglass Hospital, and 0.5 posts as hospital liaison — were advertised in August 2007 locally and through the international recruitment programme. One OT is due to commence work in the near future, so 1.5 posts remain vacant. Two OTs are on maternity leave and the HSE is attempting to fill these vacancies on a temporary basis. One post in palliative care has yet to be advertised. A job description is being discussed and prepared in consultation with the recently appointed palliative care consultant and palliative care team. One post in the area of disability has yet to be advertised.

Working within the parameters of the current recruitment pause, the HSE has advised that it is committed to filling these posts as soon as possible. I will convey to the HSE the concerns outlined by Deputy Wall this evening.

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