Dáil debates

Thursday, 25 February 2021

Topical Issue Debate

Health Services

5:40 pm

Photo of Brian StanleyBrian Stanley (Laois-Offaly, Sinn Fein)
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I welcome the opportunity to address this issue with the Minister of State. It has been the case for many years in Laois-Offaly that there have been long waiting lists for services such as child psychology, speech and language therapy and occupational therapy. However, the situation is now truly awful and this is not all due to the impact of the Covid-19 pandemic. Action is needed now to deal with the backlog of children in these two counties who have been waiting for several years to access these services. It is a scandal that 4,771 children are waiting for services in these three specialties. What is worse is that some of those children, 2,650 of them to be accurate, have been waiting for more than one year to be given an appointment for assessment or appropriate therapy. The damage being done to children who may have autism spectrum disorder, ASD, or some other condition is immeasurable. The Minister of State understands that.

Some 2,014 children are on the waiting list for occupational therapy, with 1,181 of those children waiting for more than 12 months. In the area of child psychology, 1,304 children are on the waiting list, 801 of whom have been waiting for more than a year. There are 1,453 children in the queue for speech and language services, with 568 of those children waiting for longer than 12 months. These are the latest figures I obtained through parliamentary questions and they are shocking. Does the Government understand this situation is storing up massive problems for the future? I say this sincerely to the Minister of State. If appropriate interventions and services are not provided at an early stage in a child's development, more difficulties and more complex issues will arise in adulthood. I am not an expert in these areas, but all those who are experts have told me that over the years.

Aside from the difficulties being caused to children, these waiting lists are also causing great stress and many problems for parents and families. They have been watching their children regressing and have then had to deal with the resultant behavioural issues and cope with all that entails. Teachers are trying to deal and cope with challenges and problems being caused in school classrooms. The community and society in general will also face issues in this regard in future. It is important therefore that we try to rectify this situation. The Covid-19 pandemic does not explain away the existing backlog and the poor state of child services in Laois-Offaly. This area appears to have been a blackspot in this regard for many years. The provision of these services in Laois-Offaly has been poor for as long as I have been around. I was raising this issue some 20 years ago as a county councillor, but these services are in crisis now.

Action is needed. I have raised this situation year after year, and sometimes several times each year. I have raised it with the management of the HSE and with successive Ministers. The real issue here concerns the provision of services where they are needed, which is on the front line. It is crucially important that these services are in place. We should not look at the situation from a financial perspective, but there will be major economic consequences down the line. The human aspect, however, is the most important. I refer to the effects on the children themselves and the problems we are storing up for those children in adulthood, as well as the effects on their families, in classrooms and on the wider community. I ask the Minister of State to address this issue.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for raising this important issue for discussion. I think this is the third time I have come into the House to answer a Topical Issue matter regarding the Laois-Offaly area. I am thankful that Deputies Fleming and Cowen do not seek responses from me as well, or I would be in here every couple of weeks answering these questions.

The Government does understand this situation. I know all too well the difficulties families are facing in securing access to some disability services. That is why in preparation for tonight's answer I have tried to get to the exact root of the issue raised by Deputy Stanley. This has been a priority issue for me since being appointed in July and many parents have contacted my office to voice their concerns, which are particularly acute during the Covid-19 pandemic.

Turning to the situation in Laois-Offaly specifically, this is an area of which I was already aware. I have discussed this matter with the HSE previously, as there appear to be several challenges in the community healthcare organisation, CHO, and these most certainly must be addressed. Deputy Stanley is correct concerning early intervention being key. I have been told by the HSE that the lengthy waiting times for children to access Laois-Offaly disability services are primarily due to two issues which the HSE is struggling with and which we must rectify.

The first of these is the high volume of referrals to the services. I have been told by the HSE that local disability services are constantly striving to maximise resources and ensure that the maximum quantity of services is being provided to children. The HSE's Midlands Louth Meath CHO disability services are also facing and tackling several recruitment issues, which I hope will make a big difference to the waiting times that families are experiencing. The aim is to recruit staff to fill all vacant psychology posts as soon as possible, but the recruitment of staff grade clinical psychologists is dependent on the number of clinical psychologists graduating this year.

There are two vacant occupational therapy posts in Laois-Offaly children's disability services and every effort is being made by the local HSE to fill these posts as quickly as possible. Two speech and language therapy posts are vacant in Laois as a consequence of maternity leave, with one person due to return this month. In addition, there is one permanent vacancy and this post is due to be filled next month. In more positive news, the Deputy will be glad to hear that three posts which had been vacant were filled within the past month. As the Deputy may be aware, I secured funding for an additional 100 new therapy posts in the recent budget and I hope to see some of these posts allocated to the Laois-Offaly area in due course.

It is also important to inform Deputy Stanley that I met with CORU last week, which is the organisation responsible for recognising and validating the qualifications of those people who may have returned from overseas and granting them a place on the professional registers. I am working with CORU to ensure that task is undertaken speedily and I have been told that the turnaround time for physiotherapists is now down to 69 days. I am also pleased to note the Trojan work ongoing across all CHOs to clear the assessment of need backlog.

I meet all disability managers every month to monitor the progress being made on clearing the backlog. I am happy to report that in CHO 8, specifically in Laois-Offaly, the backlog fell from 410 in September 2020 to 100 at the end of January 2021, a 75% drop in five months, which the Deputy must agree is phenomenal progress. The important offshoot of this progress is that it will ensure that as the backlog becomes less of an issue, therapists should be better able to focus on the delivery of interventions, which is what children need most.

5:50 pm

Photo of Brian StanleyBrian Stanley (Laois-Offaly, Sinn Fein)
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In the ten years I have been raising this issue, this is the first time that I have had some hope. It seems that, as the Minister of State outlined, the Department has intervened and that she has taken it up with the HSE. Sometimes we raise such issues in the House and express our concern and so on, but we do not get firm answers. The Minister of State, however, has outlined some reasons for hope in respect of recruitment to the disability services. She referred to the recruitment of clinical psychologists and stated that every effort is being made to fill the vacant occupational therapist posts, something I will come back to in a moment. She went on to state that speech and language posts that are vacant as a consequence of maternity leave are being addressed, and that is positive. There is some hope to be found in the announcement of 100 additional therapist posts in the recent budget, as well as in the effort to recruit practitioners who are returning from overseas. That is excellent.

There is a difficulty with recruitment that I wish to raise, although I do not know the exact ins and outs of it. I have been told there is a problem with people applying for these positions because sometimes they are offered only six-month or 12-month contracts and people do not find them attractive enough to apply for. We need to offer people full-time positions whereby those who get through a 12-month probationary period will be over the line and will have a permanent job.

I always get the impression that the HSE is very top-heavy. The Minister of State outlined some progress on trying to fill the gaps on the front line, which is really important. I encourage her to accelerate that and to examine the terms of the contracts being offered. Is the length of such contracts an issue and if so, can the Minister of State have that addressed in an effort to drive it on? It is a severe disappointment to me. It is one of the issues that I prioritised when I was first elected to the House ten years ago. I came to this debate with a heavy heart. I thought I was in here again raising this issue and would probably go home with no progress. The Minister of State has outlined some progress that has been made and I hope that is the case. She should keep her foot on the pedal and drive it on. She has our full support in that regard. She might comment on the issue of contracts and how they might be made more attractive.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I agree with Deputy Stanley in respect of contracts. It is often a fear that short-term contracts are intended only to bridge the gap for six or 12 months. The HSE will this year recruit approximately 16,000 people throughout the sector, including 100 therapist posts coming to my Department. They are all full-time, permanent positions that will be spread across all nine CHOs. There also will be recruitment to primary care, which also provides occupational and speech and language therapists. Furthermore, in the school inclusions model, there is a pilot for two CHOs that is yet to be announced, where there will be a further 100 therapist posts to focus specifically on the likes of speech and language therapy. There will, therefore, be a real bolstering of supports. All the positions to which I refer are full-time, permanent positions.

As the Deputy is aware, when the HSE is involved it is a long and drawn-out process but I hope matters can be expedited. Many people have returned home and have expressed an interest to CORU. I would like CORU to turn around their applications swiftly in respect of the vacancies that exist in order that we can capture the talent that has returned and ensure that those people will work at home and locally, and that the investment that was put in by their families through the years will be rewarded by having them working for us, because we have the best of talent. In fairness to the CHO that has provided assessments of needs in the Deputy's area for four months, it has worked tirelessly. Based on the figures I outlined earlier, it must be complimented. When the backlog is cleared, more therapists will be available and that will be complemented by recruitment. As a result, I hope I will not have to appear before the House on the matter for a few months to come.

The Dáil adjourned at at 6.16 p.m. until 10 a.m. on Wednesday, 3 March 2021.