Paul McAuliffe (Dublin North West, Fianna Fail)
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11. To ask the Minister for Children, Equality, Disability, Integration and Youth the current vacancies within the children's disability network teams in CHO9, Dublin; the number of posts assigned to this team; the current status of the vacant posts; and if he will make a statement on the matter. [15745/23]

Paul McAuliffe (Dublin North West, Fianna Fail)
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The children's disability network teams, CDNT, have been a controversial reorganisation of services for parents of children with disabilities. Unfortunately we have a significant level of vacancy and this is having a service impact for these children. Will the Minister outline to the House the steps we are taking to try to improve this service provision and tackle the vacancy rates?

Roderic O'Gorman (Dublin West, Green Party)
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As Deputy McAuliffe knows, CHO9 also covers my area. The children's disability network teams in CHO9 were fully established in late September 2021, with 12 CDNTs in place across the CHO. There are currently 283 posts assigned across the CDNTs in CHO9. This is the whole-time equivalent allocation for the area. Figures up to last month indicate approximately 194 posts were filled across the CDNTs. While funding has been allocated to fill vacancies, the vacancy rate throughout the CHO is 33%.

At present, there are significant challenges, which we discussed earlier, in recruiting and retaining staff in the healthcare sector, particularly with regard to the therapy professionals required in children’s disability services. This is leading to vacant posts in CDNTs throughout the country. Despite this, the CDNTs in CHO9 have increased their caseload by 654 children since reconfiguration in late 2021.

The HSE disability services, along with the lead agencies, in CHO9 are running a targeted international recruitment campaign for therapists and interviews are ongoing. Concurrently, the CHO has undertaken to increase administrative support to all the CDNTs, to enable existing clinical staff to devote more of their time directly to children and families.

The HSE is also taking measures nationally to encourage recruitment and retention of staff in CDNTs. These measures include targeted national and international recruitment to include an agreed relocation allowance where appropriate, apprentice and sponsorship programmes for therapy grades, employment of graduates as therapy assistants as they await CORU registration, and expansion of therapy assistants in the system with the HSE supporting individuals to return to education to qualify as therapists.

The HSE is also driving a number of initiatives to reduce waiting times for children and families and providing the support they so urgently need, such as sourcing therapy assessments and interventions externally via private service providers.

Paul McAuliffe (Dublin North West, Fianna Fail)
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I thank the Minister. Much of the information he has given me he has also provided in reply to other parliamentary questions and I thank him for it. I do not think there is anybody in the House who believes that the current level of service provision is acceptable. We have a fantastic group of parents in Ballymun and Finglas who have established a peer support group. People often come to my constituency office with a diagnosis for the first time and their experience of the assessment process, the diagnosis and the plan for treatment and therapies is sparse to say the least. People are told that their allocation of hours for treatment and therapies has been used up by the assessment process in that year and they must wait until the following year. Often they are handed very medical and technical diagnoses. People are never sat down for an explanation of what autism might be and what their condition might be. The anxiety is significant. We need to put these posts in place because these children desperately need a better service.

Roderic O'Gorman (Dublin West, Green Party)
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I thank Deputy McAuliffe. He is absolutely right that it is deeply concerning. It is deeply concerning for me as a constituency Deputy to know these figures. On Monday we had a good discussion at the Cabinet committee on health about the issue and longer-term solutions for greater recruitment of staff, particularly opening up more places in third level institutions on courses to do with occupational therapy, speech and language therapy, physiotherapy and psychology.

As Deputy McAuliffe knows, my colleague the Minister of State, Deputy Rabbitte, and I have been working with the HSE on the delivery of the Progressing Disability Services roadmap. This is an indication of how we can bring improvements in the short to medium term throughout the system to issues of retention and recruitment, which are very important. What is also important is recognition that in many places at present the relationship between parents and the HSE or relevant service provider has broken down badly. This needs to be addressed. This is not just about getting people into places. There is a wider trust issue that has built up. We will work very closely with Bernard Gloster, the new chief executive of the HSE, in order to see what we can do to start to rebuild it. These basic concerns of parents are also extremely important.

Paul McAuliffe (Dublin North West, Fianna Fail)
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I thank the Minister. In the Minister of State, Deputy Rabbitte, and the Minister we have two people who fully understand the problem and who want to make a change. Recruitment is a challenge throughout this and other sectors. We see advertisements on the sides of buses looking for bus drivers. I was at a community employment recruitment fair yesterday. We know that recruitment is an issue. I welcome the steps taken to go abroad. There does seem to be some capacity in the private sector. I am loath to lean on the private sector when we should be building capacity in the public sector but we have to find solutions for these children as 30% is a significant number. I understand that in Finglas the vacancy rate is 50%. It has to be addressed and we should try where we can to seek capacity to address it. It is not a long-term solution, which is to build up the service. The group in Ballymun and Finglas and I would very much appreciate anything the Minister can do.

Marc Ó Cathasaigh (Waterford, Green Party)
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I thank the Leas-Cheann Comhairle for this opportunity. This is an issue that has been consistently raised at the committees on education and autism. The staffing issues are a big problem. Does the Minister have the pertinent statistics for CHO5 where I am? As Deputy McAuliffe said, it is not just per CHO. There are individual areas within each CHO, such as west Waterford, where it has been extremely difficult to recruit and retain people to the CDNTs. They are of pivotal importance. This is a huge stumbling block for parents. They get past the initial assessment of needs and think they will access the services their child requires but then find the CDNTs are not adequately staffed and the services are not being provided.

Seán Sherlock (Cork East, Labour)
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We spoke about CDNTs earlier in a question I raised. To give the Minister a further prospective on CHO4, which is my area, it has a caseload of 555 children and the number of staff available is 13.5%. There is a vacancy rate of 38%. The number of therapeutic hours available according to a report issued recently stands at 5,815 per annum. The end result is that there is a mere 10.4 hours are available per child per year. This is completely and utterly unsustainable no matter what way we look at it. We are trying to be of assistance to the Minister in trying to tackle this issue. Ultimately it is about children and young adults. Until such time as the issues of recruitment, retention and the restoration of parity of esteem and pay parity between section 39 organisations and the HSE are dealt with we will continue to have these challenges.

Roderic O'Gorman (Dublin West, Green Party)
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I thank the Deputies. I understand the very real focus this issue has for so many Deputies. The numbers that Deputy Ó Cathasaigh requested for his CHO are deeply concerning. Of 192 positions that are provided 111 are filled at present with 81 unfilled. This is a 42% vacancy rate. It is even higher than what we discussed earlier and it is deeply disturbing. It is having a very real impact on children and on their parents and their level of worry.

I agree with Deputy McAuliffe in that I do not like relying on the private sector. It should be a question of building up State capacity. At the same time, however, when issues are in as much a crisis as we have now, we must look at all elements, especially in terms of the provision of assessments to get that element done. We are going to have to talk about that element of assessment. As we know, the court case last year had a very significant impact. A new standard operating procedure is being brought forward at the moment. I hope that can bridge some of that gap, but the issue of ensuring the availability of assessment does not impact on the delivery of therapies is something with which we will have to grapple.

Catherine Connolly (Galway West, Independent)
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Speaking of young students, I welcome all the young students in the Gallery. Fáilte roimh anseo.