Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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The Minister of State might recall a few weeks ago when we debated the cross-party disability motion that I mentioned this issue, but I raise it again today because there is a serious problem with assessments in general in Carlow-Kilkenny. It relates specifically to appointments for speech and language therapy, although there are also issues with occupational therapy.

Speech and language therapy assessments are separated into two categories. Currently, 929 children in Carlow-Kilkenny are awaiting an appointment for speech and language therapy, while there are 137 children on the list who are classified in the disability category. That is more than 1,000 children waiting just for an appointment for speech and language therapy. In the past week, I happened to receive responses to two parliamentary questions I had tabled about two specific cases relating to occupational therapy and speech and language therapy. Both responses predicted that the appointments would be made in October 2021. This is for children who have spent approximately a year on the waiting list, and given that November has just begun, that is almost a full year away. It is heartbreaking to have to go back to parents with that information. There are so many people who cannot afford to access private services and it is just not an option. They are watching their children's condition deteriorate. Particularly in a child's first few years of school, it is crucial as he or she can be set back so many years. The difference that a number of appointments with a speech and language therapist could make is invaluable.

I was surprised that the numbers are as high as they are, even though I knew from people having contacted me that there was an issue. While it is a number of more than 1,000 on a page, that is more than 1,000 children who are suffering as a result. Some have waited 12 months for an assessment and then it turns out to be a wait of two and a half years for therapy. This will have a detrimental effect on them. I urge the Minister of State to examine the circumstances, especially in Carlow-Kilkenny, of the assessment waiting time for speech and language therapy. Something needs to be done. There are six speech and language therapists and five occupational therapists in Kilkenny, and they cover two large counties, with a rural and urban mix. It is not doable and more therapists need to be put in place. While some people will say it is because of Covid-19, this was an issue before that, as the Minister of State will be aware, because she was active on this issue when she was on this side of the House. It is great that she is in that junior Ministry and I hope she will take this on board. I acknowledge she has committed additional moneys, but there is an issue and the only way to resolve it is by recruiting more speech and language therapists and occupational therapists to deal with the assessments and appointments.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for raising this very important issue. It is not the first time that community healthcare organisation, CHO, 5 has been mentioned by her or her colleagues. The HSE and its funded disability partners will continue to provide therapeutic supports in line with the public health guidance and direction while also bearing in mind the availability of staffing resources. Some south-east community healthcare staff members, including speech and language therapists, were redeployed to the swabbing centres in line with the national priority.

The HSE is, however, currently engaged in a recruitment campaign for staff to support community testing facilities for Covid-19. The recruitment of these roles will support the return of staff who have been temporarily seconded to swabbing centres and contact tracing centres to return to their substantive roles. In the south east, the first group of swabbing staff commenced on 15 October and are currently being trained, which will facilitate therapists returning to their substantive roles. In addition, Covid-19 restrictions have impacted on speech and language therapy service provision in recent months. This service is working towards a full service resumption by ensuring that the appropriate measures are in place to guarantee safe service delivery to both clients and staff. Speech and language therapists continue to work with service users and their families remotely and to use technology in effective ways. In resuming services, guidelines on social distancing and infection control must be observed. Routine services have recommenced in recent weeks but at reduced capacity to comply with Covid-19 measures. This, unfortunately, has impacted on waiting times in each service.

South-east community healthcare staff fully understand the frustration of parents and acknowledge the concerns for prompt, continuous assessment of speech and language therapy intervention. They are hopeful, as am I, that services will fully resume at the earliest opportunity. In addition to the issues outlined, it is acknowledged that given increased referral rates and demand for assessment and intervention, there is a requirement for additional resources to meet the current need in each area of speech and language therapy provision. The Deputy mentioned the additional funding. Some €7.8 million has been allocated for assessments of need. While some 643 children in CHO 5 are waiting for an assessment, none of the network disability teams in that CHO is involved in swabbing.

All staff in those teams are in their posts. I spoke with Janette Dwyer of the HSE prior to taking the question this evening. I have asked that the HSE make it a priority in CHO 5 to follow what it has already done in respect to the network disability teams and prioritise the primary care team. Many of the staff referred to by Deputy Funchion working in primary care with those aged between six and 18 years as well as those in the early intervention team are actually out of primary care. That does not fall under my remit. This is not a case of me washing my hands of the matter. I spoke to the Minister for Health, Deputy Donnelly, earlier to get his support for having the primary care team focus on returning our clinicians. This work is now deemed an essential service on the disability side. This is what I have received. Under level 5, my primary care members of staff will return to their posts in early intervention in speech and language.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I welcome that. It is important that essential therapists and clinicians are not used for contract tracing or swabbing. That is not to diminish Covid-19 and the seriousness of it. I understand why there was something of a panic at the start of the pandemic. Now, however, we are well into the pandemic and we can no longer use it as an excuse.

The Minister of State has acknowledged that she wants staff to operate in their correct roles. That is very important. We already had a problem with waiting lists and waiting times for assessments for various therapies. We cannot have that problem compounded by Covid-19 but we cannot use Covid as a scapegoat either. It is very important that the issue is addressed. I understand what the Minister of State is saying but I appeal to her nevertheless. The therapists are doing their absolute best. It is difficult when they see a never-ending waiting list. They know there are large numbers of children waiting and they want to be able to help. They know they have the skills to help but they are hampered because there are not enough therapists. It is important that we have recruitment of speech and language therapists and occupational therapists so that we do not have these waiting lists.

I am dealing with several cases involving children who will wait until October 2021. We simply cannot have that for children. They will fall way behind in school and in their development. Eventually, it will have a major effect on their confidence and mental health, especially around speech and language. It is crucial that school-aged children and those about to start school get these interventions. We always talk about early intervention. We all know how important it is and how much of a difference it makes. It is important that we put this into action and have the required number of therapists. I welcome that the Minister of State will look into this specifically for Carlow and Kilkenny because it is an important issue.

Anne Rabbitte (Galway East, Fianna Fail)
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Deputy Funchion is right about therapists. Budget 2021 included a commitment to recruit an additional 100 therapists. That number will include speech and language therapists, occupational therapists and physiotherapists. I want to have fully staffed children network disability teams, of which there will be 91 throughout the country. However, there is no point in having leads if we do not have the therapists in place to make the interventions.

Another aspect of this relates to the figures. A total of 382 children are waiting for an assessment of needs. I can elaborate on assessments of needs following my conversation earlier with Ms Dwyer in CHO 5. They will be completed by the end of April at the latest. The intervention will follow for those 382 children and the other families who are waiting. The intervention will follow straight away for families who have received letters indicating they will not be seen until August 2021. They will have been on the list for two years. Some 100 therapists were doing contact tracing and swabbing. Some of the 100 therapists to whom we referred never went into their field of being proper clinicians. They are now being returned to the network disability teams. In Carlow-Kilkenny they are all back in their posts. The recruitment of a further 100 therapists will result in a dramatic improvement. That should be of some comfort to the parents as these therapists start to come on-stream. We are seeing the pathways and flows starting. It will take us some time to see the outcome after we have completed the assessments of needs but I am confident from talking to Ms Dwyer that this is a priority for her. I will speak with the CHO, which is fully responsible for this, to ensure this is a priority in CHO 5, not only within the disability area but also in primary care.