Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank the Senator for raising this very important issue. I am very interested in some of the points she has raised in this regard, particularly the last point because, in theory, we have a strong emphasis on services being provided within primary care settings. The Programme for a Partnership Government commits to a decisive shift within the health service towards primary care in order to deliver better care close to home in communities right across the country. That is the first thing. The aim of primary care policy is to provide services in local communities so that people can be maintained in their own homes and communities for as long as possible. Effective delivery of primary care services will enable people to have direct access to integrated, multi-disciplinary teams of GPs, nurses, physiotherapists, occupational therapists and others. It has been estimated that up to 95% of people's health and social service needs can be met within a primary care setting and primary care teams contribute greatly to enhancing community-based services in these areas. In regard to the issues raised by Senator Conway-Walsh, physiotherapy services form part of the services provided by many primary care teams. In particular, physiotherapists play a key role in chronic disease management, especially in instructing and guiding patients through safe and appropriate exercise regimes. Physiotherapy services for adults and children are also delivered through specialist disability providers or early intervention and children's teams from birth to 18 years of age.

In regard to the specific issue raised by the Senator, I am advised by the HSE that physiotherapists in County Mayo have in the region of 37,000 face-to-face contacts in a year, which is a significant figure. The HSE has informed me that there are staffing related matters affecting the delivery of physiotherapy services in County Mayo. These staff issues relate to a number of factors in paediatric services across the county, including maternity leave, sick leave and a recent resignation, as mentioned by Senator Conway-Walsh. I am further advised that, in regard to adult services, a physiotherapy post in the Erris primary care area is now vacant as a result of maternity leave. The HSE is exploring the use of agencies to deal with priority one trauma clients in the area. These are the most urgent cases and require physiotherapy services after orthopaedic surgery and hospital discharge.

Delays in access to physiotherapy services can be very difficult for those affected. The need for additional therapy posts is highlighted in A Programme for a Partnership Government. At the end of February 2017, there were 529.38 whole-time equivalent physiotherapists employed by the HSE in primary care, of which 59.48 whole-time equivalents were employed in the community health organisation area two, which includes County Mayo.

To follow up the concerns of Senator Conway-Walsh, the HSE has established a service improvement group to develop a new model to improve waiting times for physiotherapy services. The terms of reference of the group include devising and implementing short-term measures to address current waiting lists and agreeing a revised national model of physiotherapy provision that will be standardised across all community health organisations. This group will examine standardisation of recruitment, which is very important, to include an agreed process and approach to vacancy management. That issue must be addressed. The work of the group is ongoing and a report on the issue is expected later in the year.