Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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90. To ask the Minister for Health his plans to ensure that all positions within the children's disability network teams, CDNTS, are filled and that there are no staffing gaps. [37487/22]

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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On Question No. 90, I call Deputy Cullinane on behalf of Deputy Ó Laoghaire.

David Cullinane (Waterford, Sinn Fein)
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I am taking this question on behalf of an Teachta Ó Laoghaire. It relates to the resourcing of the CDNTs but, more specifically, the staff positions and the high numbers of vacant positions, and seeking an update on plans that have been or will be put in place to try and fill all of those vacant posts.

Anne Rabbitte (Galway East, Fianna Fail)
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It is important to clarify the position on the reply to a parliamentary question that Deputy Ó Laoghaire received a number of weeks ago, which attracted many headlines. At the time, the Deputy referred to 714 vacant posts. Let us be clear that 555 of the posts in question are vacant. Some of that figure relates to people who are on maternity leave, a total of 120. The Deputy would have got the breakdown, but it is important to lay out the position.

On recruitment and the filling of those posts, in the context of workforce planning, we in the Department of Health are, in conjunction with the Minister and the HSE, putting a number of measures in place. First and foremost, we want to bolster the teams. How we plan on doing that is by looking at targeting international recruitment. This involves: national and international recruitment to the CDNTs being targeted; an apprenticeship programme for therapy grades; employment of graduates to therapy assistants as they await their CORU registration; and an expansion of the therapy assistant systems within the HSE. My colleague, Deputy Brendan Smith, explored the position regarding the latter earlier on.

We are also looking at the recruitment of behavioural therapists. Behavioural therapist is not currently a grade within the HSE. The executive is working through the plan of giving it a particular pay grade. We are training these therapists but we are not recruiting them. When one is looking at the spectrum within disability teams, it is important to have everything from occupational therapists to the physiotherapists. We also need to have behavioural therapists on those teams. We are looking at that model.

In the context of social care workers, we are looking at link workers as well. We are expanding the range of what should be within the team also to recruit into it. We are not only looking at a medical model; we are looking at a social model and a more holistic approach. Disability teams no longer need to look only at the medical aspect. We need to meet all the needs of all the children.

David Cullinane (Waterford, Sinn Fein)
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I accept that the number of vacant posts changes and fluctuates because people who are on maternity leave come back and because the HSE is constantly recruiting. However, I would be interested to hear what the accurate figure is. At a recent meeting of the Joint Committee on Children, Equality, Disability, Integration and Youth, we had a good discussion on all of these issues. We talked about the CDNT census, which identified 542.5 whole-time equivalent posts as being vacant at that point. In budget 2022, an additional 190 posts were funded. How many of the 542.5 posts that were identified in the census are still vacant and how many of the 190 additional posts are vacant? Maybe that figure can be given. What we really need to know is how we will fill those posts and what additional measures can be taken, in terms of international recruitment, domestic recruitment and other ways, to fill them.

Anne Rabbitte (Galway East, Fianna Fail)
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If I was to talk specifically about what is happening around the CDNTs in the various CHOs, I would say that CHO 4 - if Deputy Ó Laoghaire was here I would have explained - is piloting recruitment within Ireland to the colleges. As they are exiting, they give them the opportunity and show them the attraction of work. One of our biggest challenges is the fact that in our CDNTs the population of clinicians is so low and we do not have a critical mass of clinicians. We are failing to grasp the opportunity to give that training on the ground. Perhaps next year, one of my plans is to work with the Department of Education on special education where the summer programme will give the opportunities for trainee therapists to have practical engagement so that they can build towards their CORU hours. That is a practical way we are looking to build on.

David Cullinane (Waterford, Sinn Fein)
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I thank the Minister of State. I would say to the Minister for Health as well that we need to increase training places in this area. Obviously, we need more of a pipeline of staff coming through.

I welcome that this is an area that was added to the critical skills lists as well in recent times, which means that international recruitment is now an option. The reply I received recently to a parliamentary question referred to a relocation payment that could be provided as well to entice some people to come here from abroad. That should not be a substitute for dealing with the many reasons why we have disparities in some of the teams because there are 16, 17 or 18 different providers of services. The HSE is the biggest provider for these teams but there are many section 38 and 39 organisations. There are pay parity issues at play which need to be resolved as well.

The HSE says it is looking at a sponsorship programme, an apprentice programme and other measures. All of those are needed. Everything that can be done should be done to fill those vacant posts because there are far too many hours which are not being delivered to the children.