Pat Deering (Carlow-Kilkenny, Fine Gael)
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I thank the office of the Ceann Comhairle for allowing me to raise this important issue for my constituents in Carlow and everybody else. I thank the Minister of State, Deputy Alex White, for attending.

In recent years there has been a very efficient and comprehensive radiography service based at the old mental hospital, St. Dympna’s, in Carlow. The service was reduced some years ago to three days each week to facilitate the acute hospital in Kilkenny with a promise that it would be restored to a five day service in due course. The main advantage of the service was that people could walk in from the street, having been referred by their doctor, to have an X-ray without having to go to an accident and emergency department, thereby clogging up the system in Kilkenny. This is important. The service was important to older and younger people, as they did not have to be transported to the busier hospital in Kilkenny.

Unfortunately, the radiographer has now retired and there is no service at present. I have been assured by the HSE that the position will be advertised and that a process is being put in place to try to fill the role. Unfortunately, in the meantime there is nobody covering the important service, thereby putting more pressure on the service in Kilkenny. We do not want to clog up that service and need to have more people looked after at local level. Will the Minister of State fast-track the recruitment process? The position is not new; the original position still remains and I ask the Minister of State to fill it in the near future.

There is a lack of early intervention services for children with disabilities in the Carlow area. Currently, there is no physiotherapist or paediatric physiotherapist in the area. This is very disappointing for those with disabilities. The number of occupational and speech therapists being provided for the Holy Angels Daycare Centre for children with disabilities is less than adequate. Children are being seen once every two years for a formal occupational therapy review and every 18 months for a speech and language therapy review. All children have assessment of needs statements clearly stipulating the services they require. However, where early intervention is concerned, this is totally inadequate and leaves children at a severe disadvantage. I have been contacted by a vast number of doctors in the area and parents of children who are very concerned that children are not getting the services they require. Will the Minister of State assure me that the positions of paediatric physiotherapist and occupational therapist will be filled in the area in order that the children suffering from disadvantage and with disabilities will have the same opportunity as others?

Alex White (Dublin South, Labour)
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I thank the Deputy for raising the issue of health services in the Carlow area. The HSE provides a wide range of primary, community and continuing care services in Carlow. They include long-term residential and rehabilitation services for older people, a step-down transitional care unit providing palliative and respite care, mental health services and primary care services, including an out-of-hours general practitioner service. Sacred Heart Hospital in Carlow provides long-term continuing care and residential and rehabilitation services for older people, while Carlow District Hospital provides a range of services, including step-down transitional care. Mental health services are provided, including acute day services and community mental health services, at St. Dympna’s. St. Luke's General Hospital, Kilkenny, is the acute general hospital for the Carlow area. It is a 270-bed hospital that provides a range of inpatient day-care and outpatient medical and surgical services for the population. Consultant geriatricians from the hospital provide day hospital outreach clinic services and rehabilitation support in Sacred Heart Hospital.

With regard to radiography, an issue the Deputy raised specifically, the GP radiography referral process for Carlow and Kilkenny is centralised in the X-ray department at St. Luke's General Hospital. As part of service reorganisation and in order to facilitate safer services for patients, all urgent X-ray referrals are undertaken in St. Luke's General Hospital. Non-urgent elective GP referrals are undertaken St. Dympna's in Carlow. This facilitates improved access to diagnostic services for the Carlow population. All X-rays undertaken at St. Dympna’s are transmitted electronically through the nationally integrated medical imaging system to St. Luke's General Hospital where they are reported on by the consultant radiologist. In 2013, 2,971 patients attended the X-ray service at St. Dympna’s. Following the recent retirement of the permanent radiographer at St. Dympna's, X-rays are provided through the radiotherapy service at St. Luke's General Hospital. A recruitment process is under way to fill the post.

The Deputy raised the issue of paediatric physiotherapy services. The HSE provides services for children up to the age of 18 years who present with complex needs. I can confirm that a paediatric physiotherapist works as a core member of the early intervention team for the area. This is a multidisciplinary team that includes other professionals such as a speech and language therapist, an occupational therapist, a psychologist and a paediatrician. The team works together with children aged up to six years who have a physical or an intellectual disability. The team also works with the families of these children.

The HSE has indicated that there has been a temporary deficit in staff numbers in the paediatric physiotherapy service overall in Carlow since November last year. This was due to a combination of factors. Approval has been given to fill one vacant post and the recruitment process is under way.

Pat Deering (Carlow-Kilkenny, Fine Gael)
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I thank the Minister of State for his comprehensive reply. I do not want to be negative because I am well aware of the excellent facilities that we have in Carlow. Even though we do not have a major hospital in Carlow, we do have great facilities which myself and my late father have used in recent times. The district hospital is a great step-down facility which takes a lot of pressure off the hospital in Kilkenny and the same is true of the Sacred Heart Hospital.

The Minister of State pointed out that 2,000 X-rays were provided in Carlow last year, which is a very large number. If those 2,000 X-rays had to be carried out in Kilkenny, that would put an awful lot of pressure on the facilities there and would clog up the system, which we do not want to see. I am glad the Minister of State has given a commitment that the filling of the post will be fast tracked and that a radiographer will be in position in the very near future to handle potentially another 2,000 cases this year. Otherwise, we will see a situation where queues will develop in Kilkenny, putting extra pressure on those facilities.

Occupational therapy and paediatric physiotherapy are very important for children with disabilities, as I said earlier. It is essential that such children can access these services when they require them so that they will not be at a disadvantage for the future. I have personal experience in this regard and know that if children do not have these services early in their lives, they will find it very difficult to catch up later on. Again, I ask the Minister of State to ensure that these positions are put in place in the very near future to ensure these children will have the same opportunities as everybody else.

Alex White (Dublin South, Labour)
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I fully acknowledge that there are deficits within the paediatric physiotherapy service which have arisen as a consequence of sick leave, maternity leave and a number of vacant posts. I have addressed the issue of one vacant post already but I take what the Deputy has said about the importance of early intervention very seriously. I understand the Deputy's point in that regard and acknowledge what he has said. Everything that can be done, within our power, to expedite the provision of these services and the filling of posts, within the constraints that exist, will be done by the HSE and I can give the Deputy an assurance in that regard.

In respect of the provision of a radiography service, the Deputy is correct in what he has said about the excellence of the services that are provided. The particular post referred to by the Deputy has been identified locally as a critical post for filling. The process to progress the backfilling of that post is underway and is a priority.