Michael Cahill (Kerry, Fianna Fail)
Link to this: Individually | In context

The waiting list for children needing psychological treatment in County Kerry, and in the Cork-Kerry region, as recently outlined by the HSE for the period 2022 to 2025, shows a growth pattern that only be described as highly horrendous. The list grew by 470%. These figures appear to have spiralled out of control during that timeframe. There is widespread fear and frustration in the families of those affected.

It is of the utmost importance that the Minister of State outlines to us the valid reasons why we find our healthcare community in this horrendous position and for the emergency solutions that are being implemented, along with timeframes for drastic improvements. Do the Minister of State and the Minister have concrete plans for the employment of sufficient additional professionals suitable for the roles that are lacking in Cork and Kerry? Will provision be made in the upcoming budget for the very significant increase in funding for this obviously under-resourced health service in Kerry and Cork? Is the Minister of State satisfied that the steps being taken will show big improvements very quickly? How quickly? Is he satisfied that the steps being taken will show major improvements in this area?

The shocking figures for Kerry show that at year end 2020, the number of children in Kerry registered as waiting was 217. The figure for 2025 is 1,022. Yes, 1,022, which is an astronomical rise of 470%. Does the Minister of State agree that it is indefensible that the HSE allowed this trend to continue unchecked for over four and a half years? Is this down to bad management on the part of the HSE? Is the option of replacing the management team responsible being considered? We have already witnessed the CAMHS fiasco in both south and north Kerry and in other parts of the country. Our vulnerable children who are suffering from psychological issues need to be seen, diagnosed and treated with speed, professionalism and efficiency. This does not appear to have been the case over this five-year span.

I trust that as the Minister of State is taking on tonight's session, he will make his views strongly known to Cabinet in the budget formation talks as the voice of these children, who are the responsibility of all of us. I trust that his colleagues in Cabinet will see, understand and heed the most dangerous position these children have been allowed to fall into through no fault of their own. This situation has the potential to damage an awful lot of these children, who await somebody to simply see what is wrong and what has to be done to make it right. Patients and their families will endure an extreme amount to see their loved ones getting better, but waiting lists should be avoidable.

Kieran O'Donnell (Limerick City, Fine Gael)
Link to this: Individually | In context

I thank the Deputy for raising this important issue. I am taking this Topical Issue on behalf of my colleague the Minister for Health, Deputy Jennifer Carroll MacNeill.

Primary care psychology plays a central role in providing care and treatment to both children and adults in the community and, particularly, in offering the opportunity for early intervention for children and young people. The increased pressure and demand on primary care services, and on primary care psychology for children and young people in particular, are related to the increase in referrals and the increasing complexity of presentations requiring longer intervention times, as well as staff shortages and ongoing recruitment challenges in the community. These factors all contribute to an increase in waiting lists for primary care services, including primary care psychology services across the country, including in Cork and Kerry.

To address long waiting times at a national level, the Department of Health is working with the HSE on a focused programmatic approach to primary care waiting list management to put in place considerable standardised infrastructure to support systematic responses to primary care waiting lists.

This will facilitate a greater understanding of the scale and drivers of demand; allow for improved planning, interventions and investment considerations; and support the most efficient use of capacity. As well as looking at the long-term changes that are needed, the programme of work will also examine what can be done to address those waiting over a year on access to primary care therapies. This approach involves three main workstreams that aim to improve access to primary care therapy services by analysing activity and maximising capacity, developing national measures to reduce long wait times and creating a consistent management protocol for referrals and waiting lists to these services.

At a regional level, HSE South West has highlighted significant work that is currently under way to enhance access to primary care psychology in Kerry. In June 2025, the regional executive officer appointed a regional director of psychology with a specific focus on reviewing psychological services, including workforce planning, reviewing the service provision model and considering other psychological support services that can meet the needs of the population.

Progress has also been made in relation to advancing recruitment to fill allocated vacancies in the Kerry primary care psychology service. National primary care funding was allocated to HSE South West mid-2025 to initiate waiting list initiatives to increase access to psychological intervention for children and young people on existing primary care waiting lists.

In terms of increasing capacity, there has also been a significant increase in 2025 for doctoral training places for psychology - clinical and educational programmes - in the region, with a total of 18 trainees funded by HSE South West who commenced in September 2025. This is part of a sustained trainee programme that now has 45 trainees in the system over a three-year cycle. All graduates will be offered a permanent post in the region on completion of training, capitalising on the investment and thereby improving staff to population ratios and reducing waiting lists. HSE South West has also highlighted several key initiatives currently in process and aimed at improving access to services.

The establishment of the new single point of access working group is supporting a more efficient triage of children to ensure that they access the most suitable service in a timely manner and is reducing waiting list duplication across primary care psychology, CAMHS and CDNTs. The HSE South West child psychology service waiting list improvement initiative working group has also just been established under the regional director of psychology. Its three main priorities regarding aiming to improve access to psychological services for children in the region are workforce planning and development, waiting list and capacity solutions, referral pathways and demand management and clinical service model innovation. I will bring the points raised by the Deputy to the attention of the Minister and the Department.

Michael Cahill (Kerry, Fianna Fail)
Link to this: Individually | In context

As I outlined earlier, the figure for 2025 is 1,022. The list grew by a massive 470% from 2022 to 2025. These figures appear to have spiralled completely out of control during that period and there is widespread fear and frustration within the families of those affected. This cannot be allowed to continue. As I stated earlier with regard to CAMHS, we have already witnessed the fiasco in north and south Kerry. We cannot allow a repeat of this disaster. I believe the Minister of State will make every effort to ensure that these issues will be addressed in the upcoming budget, with proper staffing levels and adequate resourcing. I plead on behalf of the children of County Kerry, their parents and the children of Cork and the rest of Ireland that everything possible be done to address this very serious matter. I believe it is in the interests of all of us here in this Parliament to address this most serious issue.

Kieran O'Donnell (Limerick City, Fine Gael)
Link to this: Individually | In context

The Minister recognises fully the frustration of people in the local area with long waiting times for certain services and realises that much more needs to be done to fill local vacancies, address waiting lists and ensure consistent, equitable and timely access to primary care services. Since 2021, the primary care psychology waiting list initiative, which targets removals from the waiting list of those under the age of 18 waiting longer than 52 weeks to access services, has been operational. To date, the initiative has successfully removed 12,000 clients from primary care psychology waiting lists nationally. Funding for the continuation of this initiative will be allocated as part of the Estimates 2026 process. Outside this, a joint Department-HSE programmatic approach to primary care waiting lists is also under way to develop short-term and long-term solutions to long waiting lists for primary care services. The Minister wishes to again assure the Deputy that this Government remains committed to the further development of primary care and community healthcare services as part of the programme for Government. HSE South West is also working to reducing the waiting lists for primary care psychology as evidenced by the initiatives to which I previously referred, including advanced recruitment efforts, building capacity for the future and the introduction of bespoke waiting list initiatives targeted at children and young people who need to avail of this very important service. I will bring the matter raised by the Deputy in terms of the upcoming budget to the attention of the Minister and the Department.