Joan Collins (Dublin South Central, Independents 4 Change)
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A constituent contacted me recently regarding local parents whose babies and children are registered with the Old County Road primary care clinic. The clinic is no longer doing baby and child developmental checks. Several local mothers have reported being told by the clinic that these checks cannot be carried out on their babies or small children due to staff shortages. They are being sent postal questionnaires in the place of physical checks, including, in some cases, the crucial three-month and ten-month checks. These parents are very concerned that issues unknown to them may go undetected in their children, with potentially serious consequences. These developmental checks are essential. The HSE states on its website:

Make sure you bring your child to their developmental checks. It can help identify any health or developmental problems. Early diagnosis and treatment can help to improve issues your child may have.

I tabled a parliamentary question to the Minister for the attention of the HSE. It confirmed that this is the case. It confirmed that it will try to have the children on the waiting list seen in 2023. It stated that every effort is being made to recruit new public health nurses and a recruitment campaign will get underway in January 2023. There is a bit of a contradiction there. I do not know how it is going to catch up on the backlog when it does not even have the public health nurses required.

This is a basic healthcare provision that is required for newborn babies and children. Parents have been let down. Does the Minister of State, Deputy Butler, agree that this situation is intolerable? The Old County Road clinic is is another area of the health service that is in crisis, just like home care packages, the trolley crisis, consultants, mental health, access to dental services and services for disabled children and adults. Other areas, such as the Armagh Road clinic, have not been affected in this way.

I am raising this issue because it is very concerning and I want to find out exactly what the HSE is doing to resolve it. Maybe the Minister of State will provide the number of children on the waiting lists in this regard. I have not yet been given that information.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this matter and for the opportunity to update the Dáil on it.

Public health nurses play an extremely valuable role within the community healthcare system and provide an extensive range of services, including the provision of child health screening and supports for parents. It is vital that the local community in Crumlin, and all communities across the country, have access to public health nurses when they need them.

Their valuable role was highlighted when public health nurses, along with other front-line staff, were redeployed to assist and lead the Covid-19 response. This redeployment, in turn, had an impact on the capacity of the public health nurse service to deliver day-to-day services, including child development checks. During this period of redeployment, a prioritisation framework for child development checks was put in place by the HSE to enable public health nursing staff to identify and support those at greatest need in the community. Public health nursing staff have since returned to core duties. However, in some local health areas, the public health nursing service continues to be challenged by staff shortages, mainly due to reductions in the availability of staff due to retirement, internal movement, leave and challenges in replacing staff. Where these shortfalls are occurring, the prioritisation framework continues to be utilised to ensure those with the greatest need in the community continue to be prioritised and supported. It is important to note that this framework also ensures the safe delivery of services.

Data to August 2022, the latest published data, shows that, nationally, 83.8% of children reaching 12 months within the reporting period had their child health development assessment on time or before reaching 12 months. This represents a significant improvement from the 59.8% of 12-month checks that had taken place on time at year-end 2021, when many staff were redeployed to assist in the response to Covid-19. We sometimes forget that at this time 12 months ago, we were in the throes of the Covid pandemic. Thankfully, that is no longer the case.

Specifically with regard to child development checks at Old County Road primary care centre, the HSE has advised there has been a delay in completing checks due to staffing shortages. However, it has advised that a plan has now been put in place by the services in Crumlin to address the backlog. This plan commenced last week and children have been invited to attend developmental appointments. I know the Deputy will welcome that. The HSE has advised that it is exploring every avenue to fill outstanding staff vacancies and recruitment is ongoing.

Of course, the Department recognises the stress and frustration caused by the delay in the delivery of development checks. The Department and HSE would encourage any parents with a concern about their child's development to contact their GP or local public health nursing service directly. Any of us who had the support of a public health nurse when we had a very young baby recognise the importance of ensuring parents, especially first-time mothers, can get those supports.

In addition, in response to the broader challenges of recruitment and retention of public health nurses, the HSE recently established a community nursing national oversight group. The group is tasked with developing proposals and recommendations that will aim to address issues in the recruitment and retention of public health nurses and community registered general nurses. The Department of Health recognises the need to improve access to the wide range of services provided by public health nurses and it will continue to engage with and support the HSE to address these existing challenges.

Joan Collins (Dublin South Central, Independents 4 Change)
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I thank the Minister of State for her reply. What is happening in the area in question? I understand there was a lot of restructuring and that public health nurses were redeployed to deal with the Covid crisis but this issue relating to developmental checks has been going on for a year. The Covid crisis lifted in April last year and one would have expected that staff would have moved back into their roles at that stage. The Minister of State pointed to retirement and so on and stated that parents who are concerned about their child's development should contact their GP - GPs are also under severe pressure at the moment - or the local public health nursing service directly.

I am not satisfied with the response of the Minister of State. She stated that 83.8% of children reaching 12 months within the reporting period had their child health development assessment on time or before reaching 12 months, which is better than the 59% that pertained previously, but this is a crucial area of health for children and babies. They need these checks, which are very important for their long-term future. In the first 12 months, there is vitamin D, tests for babies, the BCG vaccine, pneumococcal conjugate vaccination, meningitis C vaccination, hearing tests and heel prick tests. There are so many tests done in that period to assess the future development of the child.

There are certain areas into which the HSE should be putting its staff and resources. This is one of the main such areas. It should have contacted and put in place either a GP visit or another measure to respond to the situation.

I would like more feedback on that because I am still concerned about the situation at Old County Road. We do not know what is happening in many other clinics.

Mary Butler (Waterford, Fianna Fail)
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To reiterate, I am pleased to confirm that the return of public health nurses to their core duties has now enabled the resumption of child development checks across the country. Last year, for example, 84% of children had the check before they reached 12 months, whereas in the previous year, in the height of Covid, the rate was sitting at 59.8%. There has been a huge increase but we want to get it to 100%. We want to make sure every child receives these vital checks, as the Deputy suggested. The role of the public health nurse cannot be underestimated, whether it pertains to very young babies and children or older individuals.

Specifically on the child development projects at Old County Road primary care centre, which I know the Deputy addressed in her question, the HSE has advised that there has been a delay in completing checks due to staffing shortages. However, it has also advised that a plan has now been put in place by the service in Crumlin to address the backlog. This plan commenced last week and children have already been invited to attend developmental appointments. The HSE has advised that it is exploring every avenue to fill outstanding staff vacancies, and recruitment is ongoing. I hope all those invited will take up positions and that the backlog can be addressed as soon as possible.