Dáil debates

Thursday, 12 May 2022

Saincheisteanna Tráthúla - Topical Issue Debate

Disability Services

6:15 pm

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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Deputies Ó Murchú and O'Rourke are sharing time. I call Deputy Ó Murchú.

Photo of Ruairi Ó MurchúRuairi Ó Murchú (Louth, Sinn Fein)
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Unfortunately, in the context of all of these issues, there is always an element of Groundhog Day. That is something we need to address. We cannot continue having these same conversations.

I want to start with the response to parliamentary question I received in the past while. It stated that there were no occupational therapists in paediatric services at the HSE primary care centre in Barrack Street, Dundalk, with four vacant posts to be recruited and one maternity leave vacancy. There had been a failure to fill vacant posts via agency recruitment, but there will be a recruitment competition alongside three other CHOs to fill senior vacancies. It will be late autumn before any successful applicants are appointed. What we are talking about is 659 children on the waiting list for primary care, occupational therapy or paediatric assessment. Some 382 of those children have been on the list more than a year. The average waiting time is circa three years.

We can pick multiple issues. I am dealing with a nine-year-old boy with global development delay, which involves mental and physical issues. His father has been told recently that for occupational therapy and speech and language therapy, he could be waiting another eight to 12 months for an appointment. He was initially with the early intervention team in the Boyne Business Park in Drogheda until he was six, and then he was moved to the children's team in Dundalk. He got access to services until October 2019. While I accept that Covid created difficulties, he has not got any face-to-face speech and language therapy in the interim. An occupational therapist has visited since we became involved but, obviously, that is not sufficient to cut the mustard, given the circumstances. We are also dealing with a man with an autistic four-year-old who is not toilet trained and cannot get a place in a school. There are major issues involved here.

Photo of Darren O'RourkeDarren O'Rourke (Meath East, Sinn Fein)
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I thank the Minister of State for taking this matter. The Minister of State, Deputy Rabbitte, will be familiar with the issues in County Meath.

She attended a meeting with parents of children with disabilities on 3 May in Pillo Hotel, so she will have heard the case articulated and spelt out clearly far better than I can do now. Similar to Deputy Ó Murchú, I have replies to parliamentary questions. There are four children's disability network teams in the county and every one of them has vacancies. In some, one in four positions are vacant. There are vacancies at every grade and across every discipline. That has a real impact on the services that are available to people. It has to be addressed, and it does not end there. One can say the same with regard to paediatric psychiatry and say it ten times over with regard to respite care.

6:25 pm

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputies for raising this important matter. On behalf of my colleague, the Minister of State, Deputy Rabbitte, I reaffirm the Government's commitment to children with disabilities and their families.

As Minister of State with responsibility for disabilities, Deputy Rabbitte is fully committed to the development and enhancement of services for children with disabilities. She recognises that the changes brought about through the progressing disability services, PDS, programme have been challenging for many stakeholders, including health professionals and referrers, but most importantly for families. As she has outlined many times when this issue is raised, every Member of the House strives to reduce waiting times for children who require therapy supports. She welcomes the full reconfiguration of children's disability services in the children's disability network teams, CDNTs, with a total of 91 CDNTs across the nine community healthcare organisations.

While this is a positive step, it must be acknowledged that there have been significant difficulties in certain parts of the country in the implementation of the PDS by the HSE. The Minister of State, Deputy Rabbitte, has openly acknowledged this. Unfortunately, these issues have resulted in long delays for families to access much-needed therapies for their children. These delays have caused untold stress and justifiable anger on the part of those families. That anger is understandable and deeply regrettable. Once again, the Minister of State and I wish to put on the record the Government's sincerest apologies to any family experiencing these delays. Such delays are unacceptable and we must work together to find innovative and suitable means to overcome the constraints affecting service delivery.

The Minister of State, Deputy Rabbitte, recently hosted a families' disability services forum in Meath where she listened to a number of concerned families speak about long waiting times for both assessments and therapy supports. She is aware that some families in the area are waiting four years for an assessment of needs. Once again, and in particular for the benefit of families who may not be aware of this, it is not necessary for a child to have an assessment of needs to access therapy supports. The Minister of State is aware that network teams in Kingscourt, Dunshaughlin, Navan and so forth are experiencing challenges, particularly in the area of recruitment, resulting in unacceptably low child-to-therapist staffing ratios which lead to unacceptable delays in accessing supports. This is reflective of the national picture. The HSE recently undertook a national children's disability network teams staff census which highlighted that the CHOs are, on average, operating with a 28% vacancy rate. This is one of a number of issues that require long-term solutions. I assure Members that the Minister of State, Deputy Rabbitte, is currently engaging with HSE officials from the national office on this.

Photo of Ruairi Ó MurchúRuairi Ó Murchú (Louth, Sinn Fein)
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I will quickly revisit the issue of the autistic four-year-old. There was a family intervention meeting and the mother was told that no therapies would be possible for a couple of months. This child is not toilet trained and that is creating specific difficulties. The problem is that the child cannot get a place in a special school or in a regular school until that is resolved. The only thing the mother is being offered is parenting programmes. Obviously, this is not fit-for-purpose.

We must get serious about workforce planning. We know what numbers we have, but we need an assessment of how many people we need and we must find any means possible to ensure we can employ those people. Looking down the line, we must ensure there is a throughput of people being trained. It is also about ensuring we facilitate people with work visas and whatever else is necessary. As we can see, the cost of not doing this is astronomical.

Photo of Darren O'RourkeDarren O'Rourke (Meath East, Sinn Fein)
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In the first instance, I commend Siobhán Campbell and Rachel Martin from Families Unite for Services and Support, FUSS, Ireland, who have been energised, despite everything that is going on in their lives and all their responsibilities, to organise and agitate with parents of children with disabilities in County Meath. It is a huge undertaking. They have clear requests and I will put some of them on the record. In child and adolescent mental health services, CAMHS, in County Meath there is no specific learning disability team. There are such teams in other counties and there must be one in Meath.

On the issue of assessments of needs, the services are not available for children. There is an acute shortage of residential respite care in County Meath that has to be addressed. There is insufficient emergency respite in the county and one must go outside the county to Ardee or Balbriggan. There is a list and I will send it on. The Minister of State is aware of it. We must see progress on these matters.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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Once again, I thank the Deputies for their contributions and for their concerns about this matter in their counties. Deputy Ó Murchú referred to workforce planning. That is quite a reasonable suggestion.

Progressing children's disability services is the policy underpinning children's disability services. The Minister of State, Deputy Rabbitte, believes in the overarching aim of PDS, which is equitable access to a team of multidisciplinary clinicians. However, she acknowledges that the HSE's roll-out of PDS has not been smooth, and the Deputies articulated the challenges that exist. Nonetheless, 91 teams are established and the Minister of State is continuing to engage with the HSE to fill the vacant posts and to bring them towards the levels required.

The Government has provided funding to the HSE for new posts in recent years. Since 2019, almost 500 additional whole-time equivalent posts for children's disability services have been allocated. The Minister of State will continue in her efforts at local and national levels to address the obstacles that exist in recruitment and other important issues. As I outlined, she has begun discussions with the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Harris, about improving the disability workforce supply in the longer term. I restate on behalf of the Minister of State, Deputy Rabbitte, her absolute commitment to strive for the best services possible for children and young people with disabilities and for their families.

Deputy O'Rourke raised a few issues. If he wishes to send the email to the Minister of State, Deputy Rabbitte, I am sure she will deal with it as urgently as possible. I hope there will be some improvement in services in the near future.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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I thank the Members for raising those important matters of topical interest.