Dáil debates
Thursday, 8 December 2022
Saincheisteanna Tráthúla - Topical Issue Debate
Disability Services
3:25 pm
Chris Andrews (Dublin Bay South, Sinn Fein)
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I apologise for being late; I was at a Zoom meeting. I thank the Minister of State for his patience. Life is hard enough for children with disabilities. Families with children who have disabilities are already creaking under the pressure. As the Minister of State will know, waiting lists for children are growing at an unprecedented rate. More than 18,000 children are now on the waiting list for initial contact with the children's disability network team, CDNT. According to the latest data available up to the end of September, 18,473 children are on these waiting lists, an increase of more than 1,000 from the end of May. That is a shocking increase of 6% in only four months. If this trend continues, waiting this could rise by more than 15% in a year which is an enormous toll to put on any children with a disability and their families. These waiting lists are longest in Dublin in community healthcare organisation, CHO, 9 and CHO 7. In CHO 9, I understand 2,295 children have been waiting for more than a year for initial contact with the disability network team. In CHO 7, 1,323 children have been waiting more than 12 months for their initial contact. In total, 2,991 children are on this waiting list in CHO 9 which covers north Dublin and a devastating 77% of those children have been waiting more than a year for contact with their team. That is simply not acceptable and I know the Minister of State will not try to defend it. He knows as well as I do that that is unacceptable and must change. There must be an invention. By comparison in CHO 7, 2,456 children are waiting for contact, meaning that 54% of children have been waiting for more than a year in CHO 7. That sounds good in comparison to CHO 9, but it is not.
It is devastating for the children and their families that they are waiting for so long. The CDNTs are supposed to help families and children navigate their way through the health system but it does not seem to be working in many cases I know of a young lad Seán who has autism. He is from Ringsend and was going to school outside the area in Blackrock. He ended up having to go to a primary healthcare clinic for dental work.
The confusion and lack of services for him was just ridiculous. It should not matter where a child goes to school. He is only going to school in Blackrock because there is not a school locally for him and for children with his disability. There are very long waiting times and there is a very significant problem in community healthcare organisation, CHO, 4 and CHO 8, which cover the midlands, Cork and Kerry. Half or more of the children on the lists in these counties are waiting more than a year. Will the Minister of State give these families and these children any hope or light at the end of the tunnel?
3:35 pm
Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Deputy Andrews for raising this important issue.
The Government is fully committed to the development and enhancement of children's disability services through the implementation of the Progressing Disability Services for Children and Young People or PDS programme. I fully acknowledge this change programme has been challenging for many stakeholders, in particular, for children and young people using the service as well as for their families. These challenges have resulted in unacceptably long delays for families to access much-needed therapies for their children. The Minister of State with responsibility for disabilities would like me to take this opportunity to reiterate on her behalf her sincerest apologies to any family experiencing such delays.
Prior to the introduction of the PDS programme, children in different parts of the country with the same needs got varying levels of service based on geography rather than need. This was clearly unfair and needed to change. The core principle of PDS is to achieve fairer and more equitable access to services for all children with disabilities based on their needs and not where they happen to live.
As the Minister of State with responsibility for disabilities has said in this House, the reconfiguration of children's disability network teams, CDNTs, by the HSE has faced challenges, particularly relating to the recruitment and retention of staff. There is currently an average vacancy rate of 28% across the 91 CDNTs, which equates to approximately 524 vacancies out of a total allocation of 1,892 whole time equivalent staff. Notwithstanding these challenges, it is important to acknowledge the significant work involved in establishing the CDNTs and the services that are being delivered. Approximately 35,000 children are currently receiving services and supports provided by these teams.
Having said that, we must acknowledge there are waiting lists and there is much more work to do. In this regard, funding has been provided to the HSE for additional posts in recent years to strengthen the capacity of children's disability network teams to ensure services can be provided. This funding provides for in excess of 600 additional whole time equivalent posts for children's teams. It is evident the vacancies in the teams are not due to a lack of resources but due to the scarcities that exist in the health and social care sector for specialist therapy professionals.
I assure the House that the HSE continues to pursue a range of options to enhance the recruitment and retention of essential staff across all aspects of the health services, such as targeted national and international recruitment for CDNTs, the inclusion of an agreed relocation allowance where appropriate, the provision of both apprentice and sponsorship programmes for therapy grades, the employment of graduates as therapy assistants as they await CORU registration, and the expansion of therapy assistants in the system with the HSE supporting individuals to return to education to qualify as therapists.
I trust this clarifies the issue raised by the Deputy about Seán in Ringsend who suffers from autism, and I will bring the Deputy's views back to the Minister of State as soon as possible.
Chris Andrews (Dublin Bay South, Sinn Fein)
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I acknowledge the commitment of the Minister of State, Deputy Rabbitte, to children with disabilities. There is no questioning that because she put in a great amount of work. She is very committed and is trying and working very hard to unpick or disentangle the mess that applies to her brief. This is not about lack of will from the Minister of State.
The Government very much needs to step up to the plate and to invest in resources. The measures mentioned by the Minister of State, Deputy Feighan, need to be fast-tracked to ensure the vacancies are filled. Some 20% of all posts are vacant. That equates to 450,000 lost therapy hours a year. That is massive for families who are struggling to manage, support and care for their children.
The figures and data I outlined earlier relate to waiting lists for initial contact. We do not have data for those waiting for other appointments because of ICT deficits. That is something we must strongly challenge. As the Minister of State knows himself, families are struggling and life for children with autism and various disabilities is very difficult. When they go to particular schools, often they are bussed out to their school because there is not a local school for children with autism. This is something in which we, as a society, have failed. We have failed children with autism and we must stand up for children with disabilities and with autism.
Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy again for his contribution and concern in this very important matter. I assure the House that the Minister of State, Deputy Rabbitte, will continue to engage with the HSE to fill the vacant posts and to drive them towards the levels required. Most of the disciplines working in the CDNTs are similar to those working in other areas of the health and social care sector, both public and private.
In this context, the HSE disability services continue to experience ongoing challenges in recruiting and retaining staff across all the disciplines and grades on their children's network teams. A comprehensive PDS national team development programme has been provided for network managers and has been circulated to all team members. This programme, which was designed to support the establishment of the new CDNTs and to support implementation of the new model of service, will also support staff retention.
Both the HSE and the Department acknowledge that while many children with disabilities and their families are accessing services, too many families are reporting an unsatisfactory experience. Some families are experiencing long waiting lists and others report varying degrees of consistency in the services they are receiving. We understand and recognise the distress this causes and I can assure the House that the Minister of State, Deputy Rabbitte, will continue to work tirelessly with the HSE to find long-term solutions to the staffing issues which, when improved, will ensure children and young people with complex needs will be able to access the services that are vital for their development.
The Deputy has mentioned fast-tracking the services and I restate I will bring his views back to the Minister of State. I thank Deputy Andrews again, however, for raising this very important matter. I also agree with him that the Minister of State, Deputy Rabbitte, is doing everything she can to address this very difficult situation.