Marc MacSharry (Sligo-Leitrim, Fianna Fail)
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I welcome the Minister of State, Deputy Doyle, to the House. It is not his fault. This is a matter specifically to do with health. It is good to have the Minister of State at the Department of Agriculture, Food and the Marine with responsibility for food, forestry and horticulture here to give the response but it does not inspire confidence in the level of prioritisation we are giving to key matters when he should be engaged in important work in his own brief and he is being sent in here to give a pre-written response by some official in the Department.

I wrote, on 3 May, to the Minister in relation to a patient who has given her express permission to mention her name and wishes it to be mentioned. Ms Haughney lives in Sligo. She has cerebral palsy, asthma, arthritis and a shoulder complaint. The seriousness of the condition is such that she is in a wheelchair.

Under the Government's report, Time to Move on from Congregated Settings – A strategy for Community Inclusion, in 2011, Louise moved from residential care to independent living with a range of supports including physiotherapy, access to an occupational therapist on demand, home help hours or personal assistance hours. Obviously, she was given access to a wheelchair. She had a social worker, a case co-ordinator and a GP.

What has happened since is Louise has effectively been abandoned by the system. Through no fault of her own, she has not been provided with essential physiotherapy since 2015. She has had no access to occupational therapists since April 2017, despite requesting and urgently needing one since July 2017 given her condition, and an urgent requirement for a new mould for her wheelchair. She has no back-up wheelchair. She has had no social worker since August-September 2017 and she has no case co-ordinator since a year ago.

In a letter, Ms Haughney's GP states that in the past he sat around the table at primary care meetings, which are obviously time consuming, with all these individuals and it appears now that he is the only individual left on her primary care team. He writes that she has been abandoned by the system, stating that this is an absolute joke. The occupational therapist, who is the acting primary care occupational therapist, wrote back stating that she has seen some service users in Sligo town but just does not have the capacity to see Louise.

I put it to the Minister of State that if this was the subject of an "RTÉ Investigates" programme, which may not be far away, or an afternoon hearing on the Joe Duffy show, this Chamber would be alive with calls of condemnation for the fact that this vulnerable person has been abandoned by the system. Ms Haughney loves living independently and loves her home. She was thriving with the supports that were put in place that the Government and those it manages have stripped out.

Since this letter went to the Minister for Health, Deputy Harris, on 3 May, I received the standard acknowledgement from the Department. I also sent a message to the director general of the HSE, now out of post, whose replacement referred it to the parliamentary affairs division.

In the meantime, nothing has happened to this lady. On the back of a referral from this doctor months ago, she was contacted by the community physiotherapist who, with an over-the-phone consultation, decided she needed to see an occupational therapist first before she saw the physiotherapist. We are going around in circles. I am beginning to know where all the managers are in our health service. They are all talking to each other, writing to each other and referring to one another and the people who need care are being abandoned.

I appreciate it is not the Minister of State's brief and it is not his fault he was sent here today but it is an indication of the level of autopilot and hands-off approach we are taking when it comes to individuals' care. She wanted her name mentioned; it is Louise Haughney of McNeill Drive, Sligo. I want to know by the end of the day that people have contacted her about occupational therapy, about moulding a new seat for her wheelchair, about providing the additional hours she needs and about providing the physiotherapy, occupational therapy and all other services she needs because it is unacceptable. If I do not hear from her today, I will telephone the people from RTÉ "Prime Time Investigates" and bring them to visit her at her home.

Andrew Doyle (Wicklow, Fine Gael)
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I thank Deputy MacSharry for raising the matter and for articulating the issue in the context of a real life that has been affected. I am here on behalf of the Minister of State, Deputy Finian McGrath.

The Government is committed to providing services and supports for people with disabilities that will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. Significant resources have been invested by the health sector in disability services over the past number of years. As the Deputy will be aware, the overall health budget is in the order of €15.3 billion. Of this, the Health Service Executive has allocated funding of €1.772 billion to its disability service programme.

The HSE funds a range of community services and supports to enable each individual with a disability to achieve his or her full potential and to maximise independence. Services are provided in a variety of community and residential settings in partnership with service users, their families and carers and a range of statutory, non-statutory, voluntary and community groups. Voluntary agencies provide the majority of services in partnership with, and on behalf of, the Health Service Executive. The Minister of State, Deputy McGrath, has been advised by the HSE that a number of therapy positions in its Sligo-Leitrim physical and sensory disability services and its Sligo-Leitrim primary care services are unfilled at present. These posts include a neurological case co-ordinator key-worker position as well as vacancies in social work and occupational therapy. The Minister of State fully appreciates the pressures that these vacancies are placing on service delivery. However, he has been assured by the HSE that a process is under way to address these staffing deficits. It is being progressed by the HSE through both its national recruitment service and its human resources department.

In terms of specific services, this Government has committed to increasing the number of occupational therapists in primary care. Funding of over €1 million was allocated in the budget to provide for 40 additional occupational therapy posts to address waiting lists and improve access to services. These posts are due to be recruited from quarter three. Occupational therapists play an important role in primary care teams and work to meet the health needs of individuals, families and the community. Their role is to provide individual intervention, assessment, advice, therapy or retraining for patients in the appropriate setting such as their institution, home, work, school or other centres. The HSE has also established a service improvement group to develop a new model of provision for occupational therapy to ensure resources are effectively managed and service are maximised. The work of this group is nearly completed.

Marc MacSharry (Sligo-Leitrim, Fianna Fail)
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I know it is not the Minister of State's brief which is why I would love to be getting stuck in to the Minister of State who is responsible. These pre-prepared responses from the Department are always a celebration of all that is great and all the money that is being spent. I can tell the Minister of State one thing for certain. The money being spent is not being spent on the care of Louise Haughney, 10 McNeill Drive, Sligo town and that is a problem. Is it being spent on extra managers? We hired three new managers a week in 2017. There has been an 11% increase in senior managers since 2011 and a 50% increase in middle managers since 2013. We are over-complicating something that is very simple. Louise Haughney needs 45 hours per week personal assistance, physiotherapy as is required for her condition, occupational therapy, a social worker, a case co-ordinator, a back-up wheelchair and a mould for the seat of the wheelchair she is currently in. During Storm Ophelia, because somebody did not call to her house, she was confined to her bed for 19 hours, unable to avail of toilet facilities. We cannot stand over this. There is no announcement of resources, models or processes. Let us simplify what is simple. It is about having front-line staff in place and having them provide the care.

I will not walk out of here thinking it is dealt with. I expect the Minister of State to lift the phone to the Department and tell it to get someone on the case today. Louise Haughney needs progress. She has been abandoned by the system. The GP, in his own words, is now the only person left on her primary care team. He described it as a joke. The occupational therapy manager down there has been an acting primary care occupational therapy manager, through no fault of her own, for over a year because we are not filling these positions. Why are we not filling these positions? If we cannot find people, why are we not using the National Treatment Purchase Fund to procure people from the private sector to look after critically urgent cases such as this one?

Andrew Doyle (Wicklow, Fine Gael)
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On the Deputy's last point, I am not sure if the National Treatment Purchase Fund can recruit people for primary continuing care.

Marc MacSharry (Sligo-Leitrim, Fianna Fail)
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The Minister said he was considering it some months back so I hope it can be done.

Andrew Doyle (Wicklow, Fine Gael)
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That is fair enough. I was not sure about it. Anything the Deputy has said is on the record. I will ensure his concerns are communicated straight away to the Department.

Marc MacSharry (Sligo-Leitrim, Fianna Fail)
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I thank the Minister of State.

Andrew Doyle (Wicklow, Fine Gael)
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It is unacceptable that anybody will spend that length of time without any support especially during an incident when they probably feel very isolated. The primary care delivery model, which centres around social work, primary care, occupational therapy and physiotherapy, along with an individual's general practitioner is something that needs to be strengthened but the real problem here is recruitment. The money has been allocated for 40 additional posts in occupational therapy. It is very important we ensure these positions are filled as quickly as possible and that the people are assigned to the relevant areas. As I said in my opening remarks, the Sligo-Leitrim area has a significant deficit in resources in terms of the skillsets needed for the delivery of a full independent living support package for individuals with significant challenges. The Deputy can take it from me that as far as I am concerned, it is something not just in Sligo and not just for the lady he mentioned, it is a priority and should be rolled out around the country.