Brian Stanley (Laois, Sinn Fein)
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I wish to raise a very important issue with the Minister of State, which is the absence of any audiology service in the midlands. In Laois-Offaly alone,1,383 people are waiting for hearing tests and treatment, of whom 315 have been waiting for more than a year. More concerning is the fact that 255 people have been waiting for more than two years, of whom 185 are children. Some children have been waiting for up to 156 weeks, three years, for an appointment. There has been no paediatric audiologist in Laois-Offaly since March 2019. Two posts are vacant. The only service is provided by an occasional visiting audiologist from the Dublin region, which itself is under pressure. The situation in Longford-Westmeath is not much better, as 273 people have been waiting for more than a year to be seen, of whom 132 have been waiting for more than two years. The service simply is not there. It is chronically under-resourced and is in crisis. It gives me no pleasure to stand up here and say this, which is why I looked for this special debate.

Everyone knows the importance of timely examination and appropriate interventions, such as hearing aids. It is important for everybody for quality for life but it is very important for children. Their education and development can be affected by not being able to follow what is happening at school, at home, in the playground or in the street around them. There are children in Laois-Offaly who have been waiting for up to three years for appointments while some children in Longford-Westmeath have been waiting for up to two years and six months. It is totally unacceptable that anyone must wait that length of time for an appointment. We need to realise that a quality of life issue arises in this regard and that there are issues in respect of child development and people's ability to function.

The Minister of State mentioned earlier that there is no embargo. There is a freeze on recruitment, so let us call it a freeze. We will not argue over words. If the Minister of State does not want to call it an embargo, we will call it a freeze. There is a freeze on recruitment imposed by the Government that is preventing HSE management from filling these posts, which have already been granted. I am asking the Government to lift the freeze on recruitment to allow audiology services in Laois-Offaly and the midlands to function. We must make an effort to get this service back on track. There are significant waiting lists there. I have raised this issue with the Minister.

Families in my constituency are coming to me because they cannot get audiology services. In addition, however, dental services for children do not exist in my constituency. My grandchild will be 14 in a few months' time. She has not yet been seen by a school dentist. There is no service in Laois-Offaly. If she lived over the border in County Carlow, she would have been seen four or five years ago. I was seen by a school dentist many moons ago in second or third class, along with the other children in the school at the time. Child psychology services are difficult to access, as are speech and language therapists. I could go on. We are putting loads of money into it and, yes, Sinn Féin argues for that. I know the Minister of State backs that and the taxpayer is willing to do that but the services are not there on the ground. I meet HSE management and it tells me about what it is doing internally and who is talking to who but no effort is being made to build services at the front line. That is the problem.

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for the opportunity to address the issue of the difficulties and delays being experienced with audiology services in Laois and Offaly. Under section 67 of the Health Act 1970, the HSE is required to provide free audiology treatment and appliances to preschool children and children of primary school age, including those taught at home, who are referred from child and school health examinations, as well as to adult medical card holders and their dependants.

Services for adult medical card holders include hearing assessments; hearing aid prescription provision; hearing aid management and rehabilitation; advice on assistive devices; and onward referral as required, for example, for medical intervention, assistive devices, communication supports and additional support.

Services for children include screening, assessment, investigations, treatment, habilitation and devices. This includes screening of babies shortly after birth, under the newborn hearing screening programme, to identify risk of hearing defects and speech and language therapy and referral of children with a hearing loss to the visiting teacher of the deaf services provided by the Department of Education and Skills.

The community audiology service for CHO 8, which includes Laois and Offaly, has experienced severe difficulty recruiting and retaining audiologists in the midlands. There is currently an allocated workforce of 6.6 whole-time equivalents allocated for the CHO, with 2.5 whole-time equivalent vacancies. Difficulties in recruitment and retention of staff have had a detrimental impact on waiting lists. There are currently 729 children aged up to 18 years and 654 adults on the audiology waiting list in Laois and Offaly. The longest waiting times for children aged zero to four is 156 weeks. The longest waiting times for children aged five to 17 is 140 weeks.

In March this year, the paediatric audiologist working in the midlands resigned and has not yet been replaced. In the interim, a 0.6 whole-time equivalent locum has recently been approved by HSE and is now in post.

In addition, both the national clinical lead in audiology and assistant national clinical lead for audiology are providing clinical support to the service. The service continues to look at options of increasing capacity on a temporary basis through waiting list initiatives. This is something we are taking very seriously.

Brian Stanley (Laois, Sinn Fein)
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The Minister of State mentioned that the Government is looking to increase capacity in the short term. That is fair enough to clear a waiting list but there is a problem here. The Minister of State mentioned that there are 2.5 whole-time equivalent vacancies in CHO 8, and the great number of counties included in that catchment area, but there are two audiology positions missing in Laois. There is one visiting audiologist who comes from another area. That is what is happening.

The Minister of State has confirmed the figures that I got in reply to a parliamentary question to the effect that children aged zero to four are waiting up to 156 weeks for a hearing test. One can see the damage that is being done if a child aged between zero and four years of age is waiting 156 weeks for a hearing test and the delays that would be experienced if there is a problem with a child's hearing. Children between five and 17 years of age can be waiting for up to 140 weeks, which is almost three years. That is an absolute scandal.

I take on board the point the Minister of State made about the difficulty with recruitment of audiologists but the HSE needs to be focused on recruiting these people. How many are in training? Are we encouraging people to go into training to become audiologists? If there is a shortage, what are we doing about it? I highlighted this matter in the Dáil over the past eight years. It takes roughly three to four years to train somebody in college. Have we been encouraging people to choose this as a career path? What are we doing to try to make it a career option for people so they will stay in these posts? This is a significant challenge.

We are putting more money into the HSE and the health service, there is no argument there, but we are not seeing the benefits at the other end. There are 10,000 more staff in the HSE than there were three years ago, and that is good, but where are they? What are they doing? The Minister of State said there are 800 new nurses and they will be useful but I suspect there is much existing dead wood in the system. There are roughly 110,000 people working in the HSE and yet we do not have a full-time audiologist in Laois-Offaly, among other gaps in service.

I want the Minister of State to take up the urgency of this matter with the senior officials in the Department and the HSE. Children cannot be left waiting three years for hearing tests.

Pat Gallagher (Donegal, Fianna Fail)
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The Minister of State to give his response.

Brian Stanley (Laois, Sinn Fein)
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The development, future and education of those children are at stake here and it is important that the children in Laois-Offaly have the benefit of that.

Finian McGrath (Dublin Bay North, Independent)
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I will, of course, take back the urgency of the issue to the Department and I have a particular interest in this area as Minister of State with responsibility for disabilities. I absolutely understand the urgency and importance of the issue and I will bring the Deputy's concerns to the Minister and the HSE.

There is an issue with recruitment and retention right across therapies. I have encountered a similar problem in speech and language therapy. We had a budget of €100 million. We have allocated €63 million of that and we are trying to slide in the next €37 million between now and Christmas. It has been difficult. There has also been one resignation in the Laois-Offaly area.

I take the Deputy's point that we need to focus on this issue and take on board the urgency of it and increase capacity. The Minister for Health, Deputy Harris, accepts that the situation in Laois-Offaly is far from satisfactory. Officials from the Department will continue to work with our counterparts in the HSE, exploring all opportunities to address the level of services in the Laois-Offaly area.