Seán Barrett (Dún Laoghaire, Fine Gael)
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I wish to raise with the Minister of State the wide disparity in average waiting times in the Dublin area for 4,136 children who urgently require speech and language therapy services which vary from as low as three months in Dublin North-Central to 31 months in south Dublin and 32 months in Dublin west.

I have been following up on this matter now for more than 12 months. The situation in the south Dublin area, which includes my constituency, is going from bad to worse. It is extraordinary in that in the Dublin area there are 4,136 children urgently seeking speech and language therapy. The number involved is frightening when one considers the consequences for each child who does not receive early attention.

The Bacon report, published six years ago, recommended that the number of speech and language therapists be increased four-fold to 100 per annum to attain a total of 12,085 therapists by 2015. Those who have qualified are not being employed on the basis that they have no experience. I do not understand how a person can gain experience without being given the opportunity to do so. As a consequence, a number of young children in particular are waiting substantial periods for treatment.

I raised on the Adjournment in January or February this year the situation in respect of a five year old child living in my constituency. I contacted the HSE about this child on 10 November last and was told that having waited 12 months for assessment he had been assessed as an urgent case but that it would be at least a year before he obtained treatment. Children are having to wait one year to be assessed and, having been assessed as in need of urgent treatment, must wait another year for it.

In April, I decided to follow up on the matter to get the latest position in respect of this child. I received a reply which stated that things were worse and that it would be at least another 12 months before got treatment. Despite this child having been assessed as an urgent case, he will have to wait 18 months for treatment.

In Dublin North-Central, there is a three month waiting period for assessment with 207 children on the waiting list. In south Dublin, which includes Dun Laoghaire, there are 598 children on a waiting list and the waiting period is 31 months. These figures were supplied to me by the HSE. I cannot understand this. In Dublin west, for example, the waiting period is 32 months. Surely, something can be done about children five years old and upwards having to wait for up to 31 months at a minimum before they receive treatment. I hope the Minister of State can explain to me this evening on what basis such disparity exists.

Máire Hoctor (Tipperary North, Fianna Fail)
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I take this Adjournment on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

I emphasise the Government's commitment to providing a high quality service to all people with a disability. This commitment is illustrated by the substantial investment in disability services in recent years. The national disability strategy launched in September 2004 reinforces equal participation in society of people with disabilities and provides for a framework of new supports for people with disabilities. This strategy, together with the enhancement of other key support services, are key factors in building the additional capacity required to ensure that services best meet identified needs.

The strategy builds on a strong equality framework, which is reflected in equality legislation. It puts the policy of mainstreaming public services for people with disabilities on a clear legal footing. The main elements of the strategy are the Disability Act 2005, the Education for Persons with Special Educational Needs Act 2004, EPSEN Act, sectoral plans published in 2006 by six Departments, Citizens Information Act 2007 and the multi-annual investment programme 2006-2009 for disability support services.

An integral part of the national disability strategy is the multi-annual investment programme, MAIP, announced in the 2005 budget, which gives a commitment to a cumulative capital and revenue programme of €900 million with the bulk of this funding being spent on health services for people with a disability during the period 2006 to 2009. These commitments include the development of new residential, respite and day places for persons with intellectual disability and autism in each of the years covered by the programme.

As the Deputy is aware, an additional €50 million was allocated by the Government for the provision of disability services in budget 2008 of which €9.8 million was allocated for the provision of 140 additional therapy posts. These 140 posts are being allocated to disability services in 2008 to provide assessment and ongoing intervention services to children with a disability and in particular with reference to the implementation of the Disability Act for children under five years of age, which commenced on 1 June 2007.

By the end of the current multi-annual investment programme in 2009, it is expected that 1,235 new residential places, 398 new respite places and 467 new day care places will have been commissioned for intellectual disability services in addition to 380 new residential places and 1,150,000 extra personal assistant-home support hours for people with physical and sensory disabilities.

With regard to the matter raised by the Deputy on the Adjournment, the HSE has informed the Department of Health and Children that speech and language therapists are concerned with the assessment, diagnosis and management of communication and swallowing disorders. Children referred to speech and language therapy services undergo an initial assessment to identify the existence and severity of the need for ongoing therapy. The priority for ongoing intervention is dependent on the nature and severity of the disorder, following assessment.

The HSE has consistently endeavoured to prioritise the provision of speech and language therapy to children with speech and language delay or disorders. The development of additional primary care services, through the establishment of primary care teams, has led to the creation of several additional speech and language therapy posts. In addition, funding allocated for the development of disability services in line with the multi-annual investment programme and the national disability strategy also allowed an increase in speech and language therapy resources. This prioritisation of speech and language therapy is evidenced by an increase in the number of speech and language therapists employed by the HSE and by agencies funded by the HSE from 498 in December 2004 to 724 in February 2008. However, the HSE states that notwithstanding the 45% increase in speech and language therapy posts, some individual local health office areas have experienced difficulties in replacing staff members who have left the service.

In addition the complexity of service delivery, including the way in which services have been managed by a range of agencies and funded across different care groups, has not resulted in a cohesive approach to service provision. These factors have a bearing on the waiting times for services as raised by the Deputy in this Adjournment debate. As part of its transformation programme, the HSE is developing co-ordinated early intervention services in each local health office. This will ensure that all resources available to each local health office, including those in non-statutory agencies, work as part of a cohesive single service to address the needs of all children.

The HSE states that it is also planning to improve the range and effectiveness of services to children from five to 18 years. These plans are being developed in co-operation with the Office for Disability and Mental Health in the context of preparation for the implementation of the EPSEN Act and the extension of the Disability Act for this age cohort. The Office for Disability and Mental Health was established in January of this year with a remit, inter alia, to facilitate the delivery of integrated health and education support services for children with a disability.