Seymour Crawford (Cavan-Monaghan, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this important issue and the Minister for replying to it. It is a serious situation in which the HSE has failed to provide a physiotherapist in the Drogheda-Dundalk region, which covers south Monaghan. I have raised this matter because in the last few days I have encountered two serious cases. I have a long letter on one case in which the patient fell ill last May and was transferred from Beaumont Hospital to Dún Laoghaire hospital on 9 June where she received eight weeks of treatment. This shows that she needed that type of support. When her husband took her home she was assured of all sorts of backup.

The HSE talks about home care packages, physiotherapy, and so on. However, this woman has not received anything. After much pressure she received a few sessions of physiotherapy in Drogheda. However, the Drogheda unit, according to the HSE a centre of excellence for the north east, no longer offers physiotherapy services to outpatients. Services at Monaghan General Hospital are being transferred to this centre of excellence. Having spent a period in Dún Laoghaire rehabilitation centre the 39 year old woman returned home but has received no physiotherapy to date. Is that a reasonable or realistic commitment after all the talk about home support and care? She did not receive a home care allowance either. Her husband had to take time off work to look after her. That she has not received physiotherapy is causing her serious problems and affecting her mentally. She was supposed to return to Beaumont Hospital for an appointment on 20 November but this was cancelled and rearranged for next year. Is this the health service to which that family is entitled when we have budgeted €14.5 billion in 2007? I urge the Minister of State to re-examine this situation and what is happening on the ground.

On a walk around Carrickmacross I met a young girl in a wheelchair who had undergone an operation. She cannot receive physiotherapy. Is this the appropriate treatment of a 17 year old who wishes to continue with her life but desperately needs help with cerebral palsy? No home help or physiotherapy is available. This is happening at the centre of excellence to which the colleague of the Minister of State is directing the people of Monaghan and Cavan, assuring them there will be no cutback in the Monaghan and Cavan service until a better service is available. Those in south Monaghan normally attend the hospitals at Drogheda or Louth.

Why are there no physiotherapists? The Minister of State was interviewed on "Today with Pat Kenny" but I listened to a father who complained that his daughter, a fully qualified physiotherapist, cannot find work. None of her classmates, nor those who qualify next year, will find work because of a recruitment embargo. While the embargo does not seem to affect sections of the HSE administration, it affects those in frontline care. I beg the Minister of State, for the sake of the 39 year old woman who is desperate and in serious difficulty, that she be provided with physiotherapy. I will gladly provide the Minister of State with details after the debate. An attempt has been made to facilitate these patients at Mount Hamilton House, Dundalk but neither has received confirmation that physiotherapy is available there. It is not available at Drogheda or Dundalk.

Tim O'Malley (Limerick East, Progressive Democrats)
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I respond to this debate on behalf of my colleague the Minister for Health and Children, Deputy Harney. The HSE has operational and funding responsibility for the provision of health and social care services, including physiotherapy services, in south Monaghan. The HSE has advised me that the primary, community and continuing care physiotherapy service for Louth and south Monaghan has 1.5 whole-time equivalent physiotherapy staff in its core service. Referrals of approximately 150 patients per year are taken and prioritised on the basis of clinical need. Referrals are made mainly by general practitioners, public health nurses and hospitals following an inpatient stay. In addition, physiotherapy is provided in the community by a number of teams working in disability, district rehabilitation in Louth, palliative care, early intervention and children's disability. All these teams cover the south Monaghan area.

The HSE has advised that persons requiring physiotherapy from south Monaghan can be referred to the outpatient unit in Louth County Hospital. The hospital has four physiotherapists attached to its outpatient unit. It takes referrals mainly from GPs and hospital consultants. Hospital and community physiotherapy services are well integrated and the physiotherapy managers jointly manage hospital and community services. Physiotherapists in either the community or in hospital services share the responsibilities when required.

The HSE plans to further enhance the physiotherapy role by filling approved posts within existing teams that are currently vacant, improving the existing community team structure and further developing discharge planning arrangements. Further implementation of the primary care strategy will also impact on the provision of physiotherapy services. The strategy, Primary Care: A New Direction, aims to develop services in the community to give people direct access to integrated multidisciplinary teams of general practitioners, nurses, health care assistants, home helpers, physiotherapists, occupational therapists and others. It has been estimated that up to 95% of people's health and social services needs can be properly met within a primary care setting and the establishment of the new primary care teams can contribute greatly to enhancing community based health services in these areas.

Seymour Crawford (Cavan-Monaghan, Fine Gael)
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The Minister of State is talking bunkum.

Tim O'Malley (Limerick East, Progressive Democrats)
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Physiotherapy services will form part of the services provided by many of the new primary care teams. The HSE received an additional €10 million in 2006 to enable the establishment of up to 100 primary care teams. A further €10 million will be provided in 2007 to meet the full year costs of these developments. The total funding provided by the Government to support the implementation of the strategy will be increased to €38 million. This is in addition to the very substantial resources already in the funding base for a wide range of primary care services.

The HSE is working to establish this complement of primary care teams in 2006 and it expects substantial progress to be achieved by the end of the year. This will ensure integrated, accessible services for the populations served by these teams. The funding is being targeted by the HSE to provide the potential for each local health office, formerly community care areas, to establish up to three primary care teams in accordance with the adopted national policy. It is estimated that approximately 77 of these front line staff posts will be physiotherapy posts.

Seymour Crawford (Cavan-Monaghan, Fine Gael)
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There has been no physiotherapy since September. That is a fact.