James Bannon (Longford-Westmeath, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Minister of State will understand the importance of having a child's development assessed before he or she enters primary school in order for the school to cater properly and professionally for the child's needs. She will also be aware of the procedure of the early intervention team and its vital role in ensuring a child is properly assessed. An early intervention team consists of a public health nurse, an occupational therapist, a speech therapist, a social worker, a dietician and a child psychologist. For a child to be assessed, he or she must meet each of those individuals who will compile their own reports and they will be used as the basis to determine what supports the child may need in primary school. The supports can range from the provision of a special needs assistant, SNA, to helping a child progress with his or her speech development. It usually takes about six months for the report to be progressed through the HSE and the requirements are put in place before the child starts school.

However in Longford, the child psychologist is currently on maternity leave and has not been temporarily replaced. That essentially means the psychological report cannot be produced and therefore the final report to the HSE cannot be completed. As a result, we have a number of children in County Longford whose assessment is essentially at a standstill because the HSE has failed to provide cover while the child psychologist is on leave. That presents a number of serious problems. If parents wish to take the private route, they can pay to have their child privately assessed. However, the HSE will not accept a report from the private sector. There are strict instructions that the report must be compiled by a HSE-employed child psychologist. Therefore, even if a parent is willing to pay €300 to have a private report conducted, it will still not suffice. In that case, all the parents can do is provide the report to the school, which will know exactly what the child requires but it is unable to apply for HSE-assisted funding because the report was not conducted by a HSE psychologist.

Another problem is that when the child psychologist returns from leave, he or she will have a serious backlog of children that must be assessed and that will take a number of months. Many of the children will already have been waiting a substantial period. I wish to stress that this is in no way the fault of the early intervention team. Any one member of the team may have to go on maternity leave, sick leave or compassionate leave. The problem is simply due to a lack of arrangements on the part of the HSE to employ a temporary replacement while the current team member is on leave. Therefore, we have a number of children in Longford who are essentially in limbo.

By the time they enter primary school in September 2016, their needs will not have been catered for properly and I plead with the Minister of State to intervene to cater for them.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context | Oireachtas source

I thank the Deputy for raising this matter. It is widely accepted that the Government has prioritised development of all aspects of mental health policy and services. Despite severe financial pressures overall, it has provided significant additional funding of €125 million since 2012 to enable the Health Service Executive, HSE, to implement the long-overdue modernisation of mental health services in line with the strategy outlined in A Vision for Change. In addition, I recently secured a further €35 million to enhance mental health services in 2016. Key to modernising services, in line with current and future demand and best international practice, is reorientation from a clinical focus to developing enhanced community-based provision. Approximately 1,150 new posts have been approved for mental health services since 2012, of which approximately 280 have been allocated specifically to child and adolescent mental health services, CAMHS, the bulk of which are now in place. However, as in other areas in the health sector, the HSE is experiencing difficulty in recruiting and retaining key staff. Adequate funding for mental health services is not the issue. The HSE mental health division supports timely access to appropriate services to address the mental health needs of all children and adolescents from a preventive care and early intervention perspective. Primary care services are usually the first point of contact for children and adolescents when mental health problems initially present. Primary care refers to health care delivered in local communities by psychologists, general practitioners, GPs, public health nurses, social workers and others in non-specialist settings. Young people's first port of professional support, therefore, will be the primary care system, directly via their GP or other health service professionals.

It is my understanding that there are two whole-time psychologists covering the five County Longford primary care teams and that there are no vacancies on the primary care side in this regard. Community child and adolescent mental health teams are the first line of specialist services for those 17 years or under who are experiencing mental health difficulties. In County Longford there are two psychologists in situ, with no vacancies. However, two additional psychologist posts are being sought by the executive in this area. There are, I understand, two psychologist vacancies in the early intervention and mental health-intellectual disability areas. The former is temporary in nature due to maternity leave, while the latter is a senior clinical psychologist position. The HSE has sought to fill both posts through its national recruitment service, with no success thus far. Some cover is provided in both areas for cases deemed to be urgent. The HSE mental health division is acutely aware of the need to focus on recruitment of front-line staff in the CAMHS and is working closely with the human resources function and the national recruitment service, as well as carrying out international recruitment campaigns to attract candidates to particular specialties or parts of the country. Despite these challenges, the latest figures from the HSE indicate a reduction in the category of those awaiting a CAMHS service for more than 12 months from 479 in March to 214 at the end of September, that is, a decrease of 55%. The number of cases waiting more than three months to be seen has also decreased over the same period. The issue raised by the Deputy will be pursued by the executive in that context. While progress is being made, unfortunately, difficulties are still being experienced, more so in some parts of the country than in others and more so in some specialties than others.

James Bannon (Longford-Westmeath, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for her reply, even though I cannot stress enough the importance of this issue. I have spoken to a number of parents who, essentially, are banging their heads against a brick wall because the assessments of their children have simply been placed on hold for the duration of the period of leave. The Minister of State's reply contains information which is contrary to what I have been given. Once the leave is complete, a child will be placed in a backlog queue and all the while expected to navigate his or her first year or two in primary school without the professional support he or she desperately requires. As the Minister of State is aware, this pertains to children who are just about to start primary school and need a little additional help in certain areas of their development but, essentially, they are being told that while the State is sorry, their assessment is on hold because the HSE is not providing cover. Tht is the case in County Longford. It is not acceptable and this issue should be taken seriously, although I have no doubt that it will by the Minister of State and the Department of Health. These children should not be obliged to wait in limbo for almost 12 months until their assessments are approved officially by the HSE. I plead with the Minister of State to intervene as soon as possible on behalf of the children of County Longford.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context | Oireachtas source

I understand fully the distress this can cause parents, especially when they see their child is making progress and could make even more if he or she had greater support. On the issue of maternity leave, as a woman, I have a particular interest in it, but it is quite difficult to get people to act as a replacement on a short-term basis. People are seeking longer term contracts and unless this is exactly what one does all the time, people really do not wish to act as short-term replacements, which is understandable. In some areas a team of people have been put in place to clear backlogs and if the position becomes acute in County Longford, I will consider this option also.

James Bannon (Longford-Westmeath, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for her positive response.