Denis Naughten (Roscommon-Galway, Independent)
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Some three-quarters of speech and language therapists in counties Roscommon and Galway are currently involved in contact tracing. Before the lockdown, there was a four-year waiting list to access speech and language therapy in those counties. That means a preschool child referred to speech and language services might not get support before his or her Holy Communion. At present, 1,049 children in the two counties are awaiting access to speech and language therapy but three-quarters of the speech and language therapists are directly involved in contact tracing. This is not a good use of scarce therapy resources. It is not just speech and language therapists. I have received reports that occupational therapists, physiotherapists, audiologists and podiatrists, to name but a few highly trained staff, have been redeployed since the Covid-19 lockdown and remain redeployed in other areas of the health system while the waiting lists for vulnerable children mount and mount. This is not just happening in the west. I have also received reports of it happening in counties Westmeath, Laois, Offaly and Kildare.

How can it be that it has taken months after these staff were redeployed for any attempt to be made to recruit contact tracers? What is even more appalling is the fact that the therapists involved in the Galway-Roscommon autism spectrum disorder, ASD, unit based in Athenry were, prior to Covid-19, involved in a reconfiguration of that service which was to be completed by January of next year. It would not surprise me if Covid-19 is now used as an excuse to drag out that process, rather than the reconfiguration having being done during the lockdown when those therapists were not seeing children. That will add further delays.

What does this mean in reality? Liam, who turned five today, had his first block of speech therapy sanctioned in March but did not have any sessions before he started school this September because his therapist has been redeployed into contact tracing. As Liam was not sanctioned a special needs assistant, SNA, in his school, his older sister must translate for him in the classroom. These issues came about because nobody seems to have been recruited and trained for contact tracing after the first wave of infection months ago. In fact, clerical staff across Government agencies and members of the Defence Forces have been taken off contact tracing and sent back to their previous jobs but that is not the case for front-line therapists who could help Liam and make sure that his older sister, Ava, could be a normal child in first class rather than having to act as an SNA. I want this to stop today. These therapists should be put back to doing the work they ought to be doing today. I do not wish for the Government to wait until next Monday to make this happen. It needs to happen immediately. These staff should never have been redeployed in the first instance. After the first wave of infection, they should have been the first staff to be sent back to their front-line services, rather than sending back the clerical staff and having these staff still tied up in contact tracing.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy for raising this important issue. In preparing for and responding to Covid-19 and to fully align with public health guidance as recommended by NPHET, the HSE and its partner service providers put in place a range of measures.

These included the prioritisation of vital residential and home support services, while curtailing or closing certain services, such as day services as well as certain clinical supports, in order to prioritise essential public health services at community healthcare organisation, CHO, level and ensure continued delivery of the referenced residential and home supports provision.

Effective redeployment of health service employees was a core element of the response by the HSE to Covid-19. Hospital groups and community healthcare organisations, temporarily redeployed staff to support their business continuity plans, to emerging services developing in direct response to Covid-19 and in response to the health and availability of staff in their own organisations.

Having said that, some services continued with therapists, including speech and language therapists, working with service users and their families remotely and using technology in new and effective ways.

The HSE's national HR strategic workforce planning and intelligence unit collects information regarding the redeployment of some staff. Many grades and categories of staff, including speech and language therapists, were redeployed and some continue to be redeployed to other services such as the helplines, contact tracing, testing, public health and service support.

The presence and threat of Covid-19 in Ireland is ongoing and has resulted in significant challenges for service users, their carers and families and for service providers. During these challenging times, disability services and supports, such as residential services, day services, home supports, personal assistant supports, respite services and children's services, were either suspended or delivered in alternative ways in line with public health guidance.

In the absence of regular scheduled day services, respite supports and multidisciplinary supports, CHOs and service providers have tried to maintain services that can be delivered safely, providing outreach and telecare solutions, using technology where possible and using creative and innovative models of care to support service users, both adults and children. The HSE was also mindful of the will and preference of people in terms of receiving services and in certain instances where personal choice was made to put these services on hold.

The HSE acknowledges that during the current Covid-19 pandemic situation, it has not been possible to maintain full services. It has, therefore, been difficult to complete clinical assessments or provide interventions while maintaining social distancing and meeting health and safety requirements.

The HSE is aware of the numbers of children and adults waiting for therapy services, as the Deputy outlined, including speech and language therapy, and is fully cognisant of the stress this can cause to families. One of the key priorities for the HSE is to improve waiting times for therapy services.

In respect of the provision of disability services and in the context of the Government's Resilience and Recovery 2020-2021 framework, the HSE regards the provision of disability services as essential to maintaining a response to people with a disability. This means that therapies including speech and language therapy, while being delivered in new ways, will gradually be re-introduced to children with disabilities. It is a priority for the HSE to release redeployed staff back to their substantive grade and a national recruitment campaign is under way to retain testing and tracing resources in order to deliver this priority. As the Deputy rightly stated, 50% of the staff redeployed at the beginning of the pandemic have already returned to their substantive grade.

Denis Naughten (Roscommon-Galway, Independent)
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In response to the Minister of State and with all due respect, as this reply was presented to him by the HSE, that is farmyard manure because it does not address any of the issues that I have raised with the Minister of State here. I have given a week's notice on this specific issue.

In relation to all of these therapies, all the private providers have been back delivering these exact same services, and charging for them, for months at this stage, but not the HSE staff.

With all due respect, 50% of the staff have not returned to the front-line services that they were providing prior to this time. As I have already put on the public record here, three-quarters of the speech and language therapists, physiotherapists and occupational therapist are still involved in contact tracing instead of the job that they should be doing.

I had the opportunity here in the House on Thursday last to bring this up with the former Tánaiste, and current Minister for Defence, Deputy Coveney. The Minister told the Dáil that Defence Forces staff would be made available to provide contact tracing if the HSE asked for them. He also told the House that only 24 of the 647 applications received from former Defence Forces personnel to re-enlist to help out during the pandemic had been approved due to eligibility criteria, such as age. Surely some of those 623 applicants and, I am sure, many more staff who have answered Ireland's call, and staff who have already left the HSE, would be willing to come back to help out in order that children could learn to talk or to walk and that children could have ordinary everyday lives, just like their brothers and sisters and friends and neighbours. Surely it is not too much to ask that these valuable therapists would be sent back to the job that they should be doing at the front line, treating children on a day-to-day basis, instead of picking up the phone.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy for raising this issue.

The Minister acknowledges the significant contribution of health and social care professionals to the Covid response, in particular, the urgent requirement for testing in the community services. I am aware that in the Department of Health, many of the various teams are still working on Covid.

The HSE has put a plan in place to stabilise the testing workforce to release staff back to their substantive roles. However, with the rising number of cases and the requirement for the HSE community services to respond to meet the evolving priorities, there is a fine balance to be struck between the competing priorities of responding to Covid and the restarting of services temporarily paused on the onset of Covid. I will bring the Deputy's forthright and helpful advice to the Minister when I meet him tomorrow.

Denis Naughten (Roscommon-Galway, Independent)
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The Army stands available to do this. Its personnel are the ones who should be used.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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There are, however, a significant number of measures being put in place to manage such competing priorities, for example, a national requirement campaign for dedicated testing and tracing resources. We expect that such measures coming in place will assist in our ability to meet both Covid and non-Covid service demands.

HR in community operations has been in dialogue with trade union partners regarding the matter and has agreed to progress a roadmap for the return of all staff to their substantive roles as the new staff come on stream in a co-ordinated way.

I appreciate Deputy Naughten's advice and I will bring it to the Minister. However, sometimes there are many other issues. When I got involved in politics first, I was told the fight is never what the fight is about. Sometimes there are other issues, of which perhaps we are not cognisant. We are in the middle of a dangerous Covid pandemic. The situation is evolving and what pertained last week may not pertain this week. We see in our own areas the rise of Covid-19. I certainly congratulate all the front-line staff of the HSE for all the work they have done so far.