Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank Senator Currie for giving me the opportunity to discuss CHO 9. I will just reverse a little, if the Senator does not mind. When we started the assessments of need in October 2020 one of our largest lists in the entire country was in CHO 9. This meant it was one of the last lists to be completed at that point in time. We were completing the assessment of need process, which was the old assessment of need rather than a preliminary team assessment or anything like that, and we got through it all. The Senator is right that we faltered at the end. We got stuck in approximately 33 cases due to the psychology and complexity involved in them. However, we got all the lists cleared.

While we were doing those assessments of need, the reform of progressing disabilities took place. This was challenging in the Senator's area for the simple reason that we pulled it all apart. The parents are probably telling the Senator that it was all pulled apart. Various teams were put in place. St. Michael's House, the Central Remedial Clinic, CRC, Avista and the HSE were the teams left in charge of the Senator's area.

There is no denying that since then, retention and recruitment in the area of children's disabilities has been incredibly difficult, particularly in Dublin. To that end, I compliment St. Michael's House, Avista and the CRC because they have addressed the issue. They are making their own arrangements for recruitment and have moved ahead of where we were on the PDS roadmap. They could not wait for the central office of the HSE to make a decision. Supported by Olive Hanley, they decided, because they were in a crisis, to start their international recruitment. They set a target to fill 96 posts across all the various levels, specifically speech and language therapy, occupational therapy and psychology. They are being supported by the HSE in that intensive recruitment drive, which has been ongoing since June. I see the fruits of it coming through in the teams.

This is of little comfort for the families who have emailed Senator Currie asking her specific questions. On the question as to whether early intervention is still happening, the answer is "No" because they are now all part of one team. Early intervention teams used to be a separate piece but are now part of the wider CDNT team. However, the skill set is still there and early intervention is still the priority. It was the one piece of the jigsaw that worked very well in the HSE and the various organisations. While people may not have got an assessment, they got the early intervention and were listened to and communicated with.

A lot of work is taking place, as the Senator has said, in providing responses by email or telephone and telling parents when they can expect to get a call back and that they have not been forgotten about. In last year's budget, money was set aside to ensure every single CDNT team had proper administration to answer emails and phone calls. Those administrative positions are being filled or have been filled in the Senator's area to support the teams. We do not want clinicians to be answering phones or writing emails. We want them to be face-to-face with children. To be fair, from what I can see on the ground, this is turning around. CHO 9 has been the most challenging of all the CHOs but they are working together as a collective rather than in isolation. It is not a matter of, for example, Blakestown being in one team and another area having another team. They are sharing resources and skill sets and the recruitment drive in CHO 9. I can see that transitioning down.

To be honest with the Senator, I get uncomfortable when someone is told it will be three years before someone is seen. The teams cannot say it will be three years for the simple reason that we are working with teams that are 74% populated. Some of the teams in the Senator's area had recruitment figures as low as 50%. That is starting to increase slowly but surely. If that figure was to come down to what I could identify as an acceptable level of clinical risk, we would be in a comfortable position. There is a challenge regarding the 96 posts. The target is to fill them within eight months and we are getting through them by working together and knowing what disciplines are needed from one team to the other. The teams have taken ownership of this and I and the HSE are supporting them with whatever they need. Senior managers in Avista, CRC and St. Michael's House have been able to recruit and I can see the difference this has made. This is of little comfort to the parent the Senator quoted but in six months' time, we will have a pathway towards good skill sets. I will discuss this with the Senator shortly.