Peter Power (Limerick East, Fianna Fail)
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In January 2004, a state-of-the-art six-unit residential complex, custom-built to cater for young Limerick people with moderate to severe mental handicaps, was completed at St. Vincent's, Lisnagry, County Limerick, at a cost of €4.25 million. It remains closed one and a half years later. Tonight, the Department of Health and Children stands indicted for failing to provide the staff to properly operate this vital facility for young Limerick people.

I raise this matter to discover why this situation was allowed to develop and continue to the present. The children who should have been accommodated in this modern facility are tonight languishing in sub-standard facilities, cared for by dedicated Daughters of Charity staff, who look out the window with envy and disbelief at a modern facility which was custom-built to their needs and ask how this situation arose at a time of unprecedented resources.

The boys with challenging needs are currently accommodated in this facility in large groups, which is contrary to best international practice. Bowls, sink units and hand basins have been dismantled by some of these patients. The new unit was designed to accommodate fewer numbers in each group and the materials used in its construction stand up to any attempt to dismantle the unit. This flagship project backed by the best available expertise is, regrettably, deteriorating before our eyes for want of a commitment from the Department to employ staff to run it.

Mental hospitals have been closed because the system of care was repressive. Locked wards have no place in the treatment of persons with learning disabilities. The Daughters of Charity have developed an effective holistic treatment for their patients. Nurses there are professionally trained to administer this therapy. Patients require nursing care rather than care workers. I am looking for answers and a commitment from the Department that it will ensure this important facility in Limerick is opened as soon as possible.

Ivor Callely (Dublin North Central, Fianna Fail)
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I am pleased, on behalf of my colleague, the Minister of State at the Department of Health and Children with responsibility for services for people with disabilities, Deputy Tim O'Malley, to have this opportunity to clarify the current position in the provision of funding to staff a new six-unit residential complex at St. Vincent's, Lisnagry, County Limerick. I thank my good friend and colleague, Deputy Peter Power, who expressed to me his deep frustration and anxiety about this unit.

The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act the executive has the responsibility to manage and deliver or arrange to be delivered on its behalf health and personal social services. This includes responsibility for funding new or enhanced levels of health and personal social services. I understand from the Department of Health and Children that the Health Service Executive is examining the proposals it received from the various areas, including the mid-western area, on new and enhanced service provisions that have been agreed within those areas.

The Minister of State, Deputy Tim O'Malley, has asked the executive to provide him with details of the services which will be put in place nationally with the additional funding available for 2005 as soon as decisions regarding these matters have been finalised. The Minister of State has also asked the executive to inform Deputy Peter Power of the outcome of the particular matter he raised. I assure the Deputy that, as a result of the forthright representations he has brought to my attention regarding his concerns about the residential complex at St. Vincent's, I will also be happy to pursue this matter with my ministerial colleague with a view to a successful conclusion and the opening of the unit as soon as possible. I will keep Deputy Power informed of developments.

Denis Naughten (Longford-Roscommon, Fine Gael)
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I am grateful for the opportunity to raise the issue of the lack of an audiology service in the west, particularly in the west. At present, approximately 750 adults and 210 children in the west await the services of an audiologist. This figure includes new referrals and recalls. The average waiting time for child audiology services in County Roscommon is four years. A child who, due to hearing difficulties, requires speech and language therapy cannot progress until a hearing aid is provided. This is disgraceful and it should not be tolerated. I ask the Minister of State to take up this issue to ensure that this pathetic situation is addressed immediately.

People cannot take up employment because of the liability associated with their limited hearing, and they cannot get an appointment for a hearing aid. It takes some time from ordering to delivery of the hearing aids and when people eventually get them they may not fit.

In 2003, I raised this issue with the relevant health board. After transferral of the service to the community services in County Roscommon, I was told that arrangements were being put in place to restore the service as quickly as possible — the people of County Roscommon never had an adequate service — but to date, no action has been taken. In August 2004, I was told that the service would resume in mid-September. In January 2005, I was told that an audiologist was not available but that efforts were being made to appoint one to provide a service. Last month, I was told that, following interviews, a shortlist had been compiled for an audiologist for adult services and that it was hoped the service would be operational soon.

I have been told that the recruitment of an audiologist for children is being actively pursued. Due to the scarcity of this grade of workers, a number of past attempts to recruit to this position were unsuccessful. The reality is that the health service has let these children and adults down. They are being ignored simply because they reside in the midlands and County Roscommon. The health service is washing its hands of this matter by claiming that it cannot recruit for the position. If a recruitment cannot be made on the salary offered by the health service, an enhanced salary should be paid or other incentives put in place to ensure that the post is filled.

A person's physical location should not be a cause for discrimination. Nobody should have to tolerate the situation where he or she must wait four years for an appointment with an audiologist. The Minister of State should ensure that this issue is addressed and that we are no longer fobbed off on this issue. These circumstances have obtained for the past two and a half years, but nothing has happened. No one has been recruited and the backlog has not been addressed. The lack of hearing aids means people cannot find jobs and children cannot access proper speech and language therapy. The Government must do something immediately.

Ivor Callely (Dublin North Central, Fianna Fail)
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I am happy to have the opportunity to address on behalf of the Tánaiste and Minister for Health and Children, Deputy Harney, the issue raised by Deputy Naughten. As the House will be aware, the Health Act 2004 provided for the establishment of the Health Service Executive on 1 January 2005. Under the Act, it is the responsibility of the executive to manage and deliver, or arrange to be delivered on its behalf, health and personal social services, including audiology services. I am happy to set out the development of policy in this area and to convey the information provided by the chief officer of the executive's western area on the specific question raised by the Deputy Naughten.

The chief officer of the western region of the HSE has informed the Department of Health and Children that there are approximately 750 adults awaiting appointments as new referrals and recalls in the western region. The number of children waiting for appointments is 210. I concur with Deputy Naughten's view that 950 is an unacceptable number of people to be waiting. While waiting times for tests in Mayo are relatively short at up to four months, there are difficulties in Roscommon and Galway. Excessive waiting times of up to four years obtain in the two counties due to difficulties in recruiting the necessary specialist staff. Deputy Naughten will support my view that early intervention is the best policy by far, especially in relation to children. If one does not intervene early, one finds one has to provide other support services at a later stage. I would like to see the earliest possible intervention and appropriate services being made available as quickly as possible.

The chief officer has advised the Department that the main difficulty giving rise to delays relates to the recruitment of audiological scientists. While audiological scientist and senior audiologist posts have been advertised on three separate occasions, the HSE has been unsuccessful in recruiting the required specialists due to their scarcity in the workforce. The posts are being re-advertised in Ireland and an advertising campaign is also being carried out in the UK. The HSE's western area has informed the Department that in some areas it has engaged a part-time audiological scientist to deal with the most urgent cases. In other areas, the HSE has received support from the audiology department of University College Hospital Galway. In addition, the services of an audiologist from the royal group of hospitals and dental hospitals in Belfast have been employed. He is contracted to provide services to Mayo as he can only undertake services in one county. This accounts for the improved position of Mayo compared to the other two counties.

Since 1 January 2005, 35 adult clinics have been held in the audiology department of Galway community services. A total of 714 clients have been called for hearing assessment and the fitting of hearing aids during these clinics. In addition, 18 children's clinics have been held, during which 207 children, including those aged from four years down, have been called and assessed. In Mayo, approximately 100 adults and 30 children are seen and assessed each month. The average waiting time in Mayo for audiological treatment is from six to eight weeks for children and from two and four months for adults.

In January 2004, following an evaluation of the posts of scientist and senior scientist on foot of the Labour Court recommendation, the posts of audiology and senior audiology scientist were upgraded. The upgrade linked the posts to those of physicist and senior physicist and provided for significant increases in salaries. In addition, the appointment of a chief audiologist was sanctioned for a number of HSE areas. The regrading of posts is expected to enhance their attractiveness to future recruits.

The Department of Health and Children is committed to the development of community audiology services, for the development of which it has provided since 2000 additional ongoing funding in excess of €2.6 million. The funding has been allocated to provide for the development of services and capital funding for the improvement of facilities in Health Service Executive areas. In addition, the Department provided once-off funding of €407,000 in 2004 and €329,000 in 2003 for the purchase of hearing aids.

I assure Deputy Naughten that the Department of Health and Children has taken steps to provide an attractive grade structure for audiologists and funding for improved community services. Unfortunately, recruitment of audiological scientists to work in the western area of the HSE has proven difficult. The Department will continue to impress on the HSE the need to address this matter as a priority in service delivery and is optimistic that an improvement in services will be witnessed.