Eoin Ó Broin (Dublin Mid West, Sinn Fein)
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I hope the Minister of State pleases me as much as she did her party colleague.

Catherine Byrne (Dublin South Central, Fine Gael)
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I do not know about pleasing.

Eoin Ó Broin (Dublin Mid West, Sinn Fein)
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There are 130 families in my constituency in the South Dublin County Council area who urgently need adaptations to their local authority properties. These are tenants who, either because of physical disabilities or because of accident and injury, desperately need stair lifts, walk-in showers or home extensions. They need these through the local authority disability and mobility adaptations grant scheme. The problem is their grants cannot be processed because the HSE, in the relevant community care area, does not have the necessary occupational therapy staff to provide the reports.

What is particularly galling for those in my constituency in Clondalkin and Lucan is that across the Naas Road in the neighbouring HSE community care area, which is also in the same local authority, the HSE has the staff to progress the adaptations. A resident of Clondalkin today cannot have his or her application progressed whereas a resident in Tallaght can have his or hers progressed. That is causing a particular problem.

This is not a new issue. This difficulty has been ongoing since 2015. I was on South Dublin County Council at the time and we raised it with the HSE locally. We raised it with the local authority management. There had been ongoing negotiations between the HSE and the heads of service in South Dublin County Council to try and get this issue resolved.

In some cases, we are talking about families who have not been able to have their application progressed for as many as 24 months. One woman, for example, has a stair lift that is no longer functioning and is in urgent need of that repair, and she has not been able to progress that application for almost two years.

Another family have had shower works completed upstairs but urgently need a stair lift to allow the family member access those adaptations. However, they cannot have that progressed. Not only had I raised the issue when I was on the council but I had asked my party colleague, Deputy Mary Lou McDonald, to raise it with the Minister in the previous Government as far back as 2015.

More recently, South Dublin County Council, to try to progress the matter, offered to pay half the cost of these occupational therapy, OT, reports on an interim basis until such time as the Health Service Executive, HSE, was able to recruit staff. While the HSE has given some indication that it might be willing to deal with that, the reality is that the 130 families who desperately need these adaptations still have not got their cases progressed.

Does the Minister believe it is acceptable that, depending on where they live, a family can have an urgent adaptation grant progressed, that is, somebody in Tallaght, while somebody literally across the road in Clondalkin cannot? Does she not accept that, effectively, this is a geographical discrimination that does not just affect constituents in Dublin Mid-West but in other HSE service areas?

The most important question is what the Minister and the Department intend to do. How will they ensure that the relevant HSE community care organisation, area 7, has the staff it needs to progress these cases as a matter of urgency? What assurances can the Minister of State give to the families, some of whom will be watching these proceedings this evening, that she is doing everything in her power to ensure they will not have to wait any longer before the OT reports are available and their applications can be progressed?

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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We hope the Minister has some good news.

Catherine Byrne (Dublin South Central, Fine Gael)
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I will try my best. I am taking this Topical Issue on behalf of the Minister of State, Deputy Finian McGrath, who unfortunately cannot be here this evening.

A Programme for a Partnership Government commits to a decisive shift within the health service towards primary care in order to deliver better care close to home in communities across the country. Community occupational therapy is a key component of a multidisciplinary primary care service and can play a significant part in supporting people to remain living in their own homes and communities.

Occupational therapy has, as one of its core values, the principle of enabling people to remain in their own homes and communities. For this reason, services are often provided in the client’s own home and advice and assistance is given in regard to minor house adaptations to allow the client greater independence and support in their own homes.

With regard to the particular issue raised by the Deputy, the Minister of State, Deputy Finian McGrath, has been advised by the HSE that the provision of occupational therapy housing adaptation reports to councils in community healthcare organisation, CHO, area 7 is not standard. Currently, reports are provided in Dublin south west and Dublin south city but not in Dublin west or in Kildare-west Wicklow.

To review the effectiveness of the service provided, I understand a review over a six-month period was undertaken by the HSE in Dublin south west. The results showed that only 44.4% of reports written by occupational therapists were submitted by clients to their local council and only seven, or 4.5%, of the 154 clients reviewed had work completed. Another finding was that where works were completed, they were not uniformly following the specifications of the reports. The HSE believed that this level of activity proved unsustainable, given the poor outcomes for clients.

To address the large increase in demand for the occupational therapy input and taking account of therapist resources, a recent meeting between personnel from primary care in CHO area 7 and the housing, social and community development units of South Dublin County Council had a successful outcome. Agreement was reached that the HSE will provide the staff resources to address the outstanding 126 reports with funded support from South Dublin County Council. Furthermore, the HSE and South Dublin County Council are in discussions to agree a more streamlined process in the future to ensure assessments are completed in respect of applicants who are most likely to proceed with the works.

The Deputy may be interested to know that an occupational therapy service improvement group has been established by the HSE. This joint primary care and social care project will include a detailed analysis of waiting times and resource deployment across the country. The group’s objective is to complete its work by March 2017. It will seek to make the services more responsive to people’s needs and also to put in place a standardised approach to the delivery of occupational therapy services across the country.

The group will agree revised models for primary care occupational therapy services to include development and agreement of care pathways, workforce planning and an implementation plan. These are priority actions in the HSE primary care operational plan for 2017. I will address some of the other issues the Deputy raised when I respond again.

Eoin Ó Broin (Dublin Mid West, Sinn Fein)
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I thank the Minister of State for the response. I have had all of that information for over a month, both in replies to parliamentary questions and from the HSE locally, so there is nothing new in what she said to me here today. It is very disappointing that the HSE has asked the Minister of State to present the results of the survey in the way in which it did. Not all surveys will be submitted to the local authority because the occupational therapist report is to determine whether somebody has an adaptation grant need. In some cases the occupational therapist's report will say they do not, therefore, a report will not be submitted where it is not supporting the requirement.

The other point I would make, and the Minister will know this well from her own local authority area, is that the waiting time once someone gets on the list for the adaptation grant can be two years. That is not the direct responsibility of the Minister of State, Deputy Byrne, in her current role but the reason is because the local authority adaptation grants have been slashed in the past six years, something which the Minister of State would have supported in her support for Fine Gael's budgets over that period. There will be a small take-up within six months of receiving the OT's report but the idea that those two statistics suggest that this is not an appropriate use of HSE staff time is appalling when we consider the level of disability and limited mobility these people have in their own homes.

I presume the Minister of State will not be able to reply to my last question other than repeating what she has said but she said that resources will be provided. When will they be provided? When will the 130 families who urgently need occupational therapy reports have the occupational therapist in their house assessing the level of need? When will they have the reports that can be submitted to the council? Every month in which there is a delay in that resource being provided means a further delay before they start to join the queue of the local authority for the funding to provide the grant. Telling me something that I, and these families, knew months ago is of no use to me. I would like to know when the resources will be provided, when these families will get the reports and when will they finally get the adaptations they so urgently need.

Catherine Byrne (Dublin South Central, Fine Gael)
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I cannot remember the question the Deputy asked at the start but my answer would be "No". He spoke about the difference between people living in Tallaght and Clondalkin in terms of the length of time it takes for them to be assessed by occupational therapists. I will not disagree with the Deputy because I am dealing with that problem in my own constituency where people have to wait a long time. As the Deputy said, that is because there are not enough staff members to quickly process the applications.

I do not have an answer to the question as to when the 130 reports from the occupational therapists will be seen to but the Deputy should have no doubt that I will come back to him on that because I also want to know the answer. The reply from the Minister of State, who unfortunately could not be present, indicates clearly that the occupational therapy service improvement group has been established by the HSE. It is all very well establishing a group and to have a paper on that but the people the Deputy, me and every Deputy in this House look after want to be assured that if somebody is in need of a chair lift, an adaptation to their bathroom or anything else that it will be done in a speedy manner.

The Deputy is right to a certain extent but he is not always right. A good deal of money has been put into providing adaptations to people's bathrooms but the difficulty is that when people submit the applications sometimes they have not completed the forms properly. I know from talking to people in South Dublin County Council and Dublin City Council that there is a need for people to include all the information sought to make sure they can be dealt with.

I will give the Deputy a typical example. Two weeks ago, a lady from Inchicore, where I live, came to see me. She applied for a grant for her bathroom to be adapted. She is an old age pensioner who lives on her own. By last Monday she had confirmation from Dublin City Council that her application was approved and that the work would go ahead. I am not saying that is happening everywhere and I would not disagree with what the Deputy said but I will make sure that the Minister of State or I will come back to the Deputy with the specific answer to the question he asked.