Brendan Smith (Cavan-Monaghan, Fianna Fail)
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86. To ask the Minister for Health the progress to date in recruiting therapists for primary care in counties Cavan and Monaghan, taking into account the urgent need to reduce waiting times for children with additional needs seeking to access essential supports; and if she will make a statement on the matter. [52459/25]

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I have previously had the opportunity to mention to the Minister my serious concern about the ongoing delays for children with additional needs accessing therapies in Cavan and Monaghan. The delays that are occurring are absolutely unacceptable. Some children are assessed and do not get follow-up therapies and there are even delays in getting assessed. We need more clinicians in the Cavan and Monaghan area. I sincerely hope that additional efforts will be made to recruit more clinicians across particular therapy areas for those two counties.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I agree with the Deputy. While in 2024, nearly 1.4 million people accessed therapy services across disciplines including physiotherapy, speech and language therapy, occupational therapy, dietetics, psychology, podiatry and all of that, in many cases waiting times are wholly unacceptable. To tackle this, the Department of Health is working closely with the HSE on a targeted, programmatic approach to managing therapy waiting lists in primary care, in particular. As well as looking at the longer term changes that are needed, we are trying to do what is possible right now. I have asked the HSE CEO to now put in place measures to address physiotherapy, occupational therapy and speech and language therapy waiting lists to reduce the waiting times for these three therapies to less than 10 months, which I hope will be achieved. That would be a massive improvement on where we are now. It would remove 60,000 people from the waiting lists across these three therapies and get them therapeutic services. That is a challenge but unless we set a direction and a target, which I have very clearly given to the HSE CEO, I am concerned nothing will change without some direction and the resources and support to do that.

I do acknowledge that we have global workforce challenges, the same as everybody else in healthcare. We are trying to advance initiatives to retain and recruit the skilled professionals we need. Recruitment efforts include offering permanent roles to all Irish HSCP graduates, streamlined registration with CORU, which has improved enormously over the last number of months, and the introduction of 320 new training places via the CAO. The Deputy will be aware that since January 2020, 5,019 additional therapists have joined the HSE, a 30% increase. In that time, 40 additional therapists have been recruited in the Cavan and Monaghan area, bringing the total to 177. The Deputy will be aware that includes 12 new occupational therapists, 14 physiotherapists, 7 dietitians and 3 speech and language therapists, demonstrating our commitment to strengthening front-line capacity. I still acknowledge the concerns the Deputy raised and remain committed to targeted reform in the way I have given direction to the HSE CEO.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I very much appreciate the Minister's determination to deal with this issue once and for all. At my clinics last Friday night and Saturday, there were a number of young parents with children who have not got assessments or therapies. One parent spoke to me about her son who got a speech and language therapy appointment in June 2021 and has not got one since. That child got an occupational therapy appointment in 2022 and 2025. Another of that young mother's children was assessed and diagnosed 18 months ago and there still have not been any follow-up therapies. There is an opportunity in the Cavan area, in particular, to outsource more therapies. Assessments are being outsourced, although I know that is not the answer to all our concerns.

A few years ago, we discussed with the Minister's predecessor, Stephen Donnelly, in this House one night during Question Time the introduction of development therapy assistance. Speaking to clinicians, I believe that can help speed up the number of people delivering therapies and delivering services. I know some of the colleges of further education offer an initial course that enables students to go on to a university or institute of technology to pursue courses across different disciplines, including occupational therapy and others. That may not be included in the Minister's brief but the area of therapy assistance is an area we should pursue and make more progress in.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. He might allow me to reflect on that and discuss it with my officials further.

What we are trying to do to build capacity in primary care therapy services is this three-part national programme, which I will lay out for the Deputy. Workstream 1 is an analysis of regional productivity to optimise current therapy care to maximise capacity within existing resources. Frankly, there is variation between regions and we need to understand specifically what that variation is and have a national response that prioritises patients who have been waiting over one year for therapy access. We are developing a primary care therapy waiting list management protocol, the purpose of which is to ensure consistency and transparency during referral, waiting list management and discharge across all primary care in the different regions to improve overall patient experience. We have seen this used in other areas to good effect and it is now time this be properly used for primary care therapies.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I thank the Minister. Another difficulty is that the CDNT in County Cavan is led by Enable Ireland. We know it has difficulties with recruiting and retaining staff because of the issue around section 38 and section 39 workers. I know that is a broader Government issue but it needs to be addressed.

Have the universities and colleges made enough places available to ensure we have the professionals to deliver healthcare and meet the ongoing and increasing demand for different healthcare services across our country? I understand there is still a shortfall in the numbers graduating compared with those who are retiring. We must also consider the increased demand.

An issue was brought to my attention at the weekend. It may not be absolutely accurate. Apparently, study in speech and language therapy, occupational therapy and other therapies takes the form of an apprenticeship in Britain rather than the traditional university or college route that we take. There may be a financial incentive for some students from our State to go to those colleges in Britain. It is an area that the Minister, the Department, the HSE and our colleges need to keep a close eye on. We do not want students being drawn from our State because of a monetary attraction to pursue a specific course at a British college.

Thomas Gould (Cork North-Central, Sinn Fein)
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I will follow up on a point made by the Deputy. I have spoken to the representatives of some colleges and they have told me that they have the capacity to deliver more therapists and all the professionals we need. They are saying that if they get the funding and resources, they can meet the challenges. I know UCC is rolling out additional courses. There should be more courses to allow universities to deliver more therapists. Parents tell me they cannot get therapists for their children. They feel their children are regressing. There is nothing more heartbreaking for parents than to see their children not living up to their potential because they are being failed by the State and are not getting the support and therapies they need. Parents are heartbroken because they are looking at their children and know that if they do not get support now, it will have a negative effect for the rest of their lives. That cannot be fair.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank both Deputies. There are an additional 320 new training places via the CAO in the different colleges. That is a significant expansion. I will speak to my good colleague the Minister for further and higher education, Deputy Lawless. My responsibility is, of course, in respect of the clinical training places that must go alongside the academic piece. We moved from a sort of apprenticeship model of nursing to an academic degree model to try to lift standards and expertise as far as possible, and enable the sort of advanced practice we want across the specialisms. We are now trying to do that with health and social care professionals too.

I have met representatives of CORU about its registration processes, which, frankly, were too slow. There has been an enormous improvement to those processes. I have also met the different professions to signal clearly that we will be aligning ourselves with the European standards to enable even greater numbers of people to come from different parts of Europe to work in Ireland. That has not happened in the past at the rate we should have seen. CORU is working hard with the professions to ensure that clinical training places are available not just in acute hospitals but in primary care and other areas as well.