Erin McGreehan (Fianna Fail)
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I thank the Minister of State for being here today and I acknowledge the apology of the Minister of State, Deputy Rabbitte, for her absence due to an unavoidable issue elsewhere.

I ask for an update on the children's therapy and assessment waiting lists and staff vacancies in County Louth children's disability network teams, CDNTs. As a public representative, the Minister of State knows this is one of the most heartbreaking issues we come across, that there are gorgeous, amazing little children who are not getting access to therapies, assessments and supports. It is so important to advocate for these children and their families. They should have equitable access to therapies for their children. Every child has a right to be healthy, and access to therapies plays a pivotal role in ensuring children with disabilities can lead a quality and fulfilling life and reach their potential. As a parent, all you want for your child is that they reach their potential and that they are happy. That is the goal. Due to a chaotic and fragmented system, we know children with additional needs are facing huge barriers and difficulties. They deserve timely and specialised attention and tailored therapies to overcome the challenges. Figures show that at the end of last year, 104 children under five years of age were waiting for more than a year for their first assessment for occupational therapy, and an unbelievable 564 children over five years old were waiting more than 12 months for their first assessment. Throughout the country we see the issue with staffing. I hope the Minister of State can give me an update on the staffing levels and vacancies in Louth. Previous reports suggest there is only half an occupational therapist when there should be six.

I want to give hope to parents and prove to them this State believes in all the children of the country. On 2 June 2022, we were informed by the Minister at the Joint Committee on Disability Matters that the HSE was developing a roadmap to bolster the progressing disability services, PDS, programme. Is there an update on that PDS roadmap and on how it will support families? At that meeting, various things were suggested by the Department, such as, for example, that there would be a pilot using groups such as the local Down's syndrome organisation to ease pressure on CDNTs, even if only for a defined period. Another suggestion was the temporary use of private providers where CDNTs were particularly restrained. This was also highlighted recently and supported by the Minister during a Dáil debate. There were suggestions of a temporary pausing of the individual family support plans until the CDNTs are more resourced, an expansion of the critical skills occupation list to include clinicians who will be recruited internationally, and scoping out what we can do to entice undergraduates to commit to working in the CDNTs after their graduation. The Department also said we could conduct some form of audit on how the PDS is being implemented throughout the country and have better communications with parents.

There seems to be an awful lot of energy put into reviews, scopes, and temporary this and that. However, the children and the families do not seem to be gaining the benefits of the increased funding, the emphasis and the urgency this Government, especially the Minister of State, Deputy Rabbitte, is putting into this very important issue. I hope the Minister of State can update the House on some of those matters.

Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank Senator McGreehan for raising the issue of the waiting lists for therapists and assessments for children and staff vacancies in both north and south Louth as part of the children's disability network team. As the Senator is aware, I am taking this matter on behalf of my colleague, the Minister of State, Deputy Rabbitte, and I am grateful to the Senator for raising it.

First, the Minister of State wishes to be completely clear that the development of any child with a disability to reach his or her full potential is of the utmost importance, and recognises that it is essential to ensure a timely and effective process that works for children, young people and families. The principle and importance of early intervention is recognised by both the Minister of State, Deputy Rabbitte and the HSE.Additionally, the key focus of the HSE has been to develop a strategy for services that is above all child and family-centred and reflective of the best national and international practice.

The progressing disability services programme has been challenging for many stakeholders, most importantly for children and young people using the service and their families. The Minister of State, Deputy Rabbitte, is aware the challenges faced have resulted in unacceptable delays for families seeking to assess essential therapies for their children. She is clear and unequivocal she finds it unacceptable and that is why she has dedicated her time and energy to dealing with the issue. The Minister of State reiterates her unhappiness at the situation as well as her commitment to addressing it. I compliment her for her determined focus to deal with this issue.

On the children's disability services in Louth, I can inform the Seanad there are 29.8 whole-time equivalent posts allocated for the North Louth Children's Disability Network Team, of which 8.5 whole-time equivalent posts are vacant. That is a significant percentage. It is at least 30% vacancies in the area. These vacancies mean families are experiencing waiting times of between six and 18 months, depending on the discipline and ongoing demand. There are 31 whole-time equivalent posts allocated to the South Louth Children’s Disability Network Team, of which 15 whole-time equivalent posts are vacant. That is a 50% rate of vacancy. This translates into waiting lists of up to 18 months for services, with additional disciplines also affected. The HSE recognises the recruitment challenge and is taking measures nationally to encourage recruitment and retention of staff in the CDNTs, including targeted national and international recruitment to include an agreed relocation allowance where appropriate, both apprentice and sponsorship programmes for therapy grades and employment of graduates as therapy assistants as they await their CORU registration.

I am conscious recruitment will be beneficial only if current staff are retained. Initiatives to support staff retention, such as training and development programmes, are also being implemented by the HSE. The HSE has provided funding for 600 additional posts in recent years to strengthen the capacity of these local teams to ensure services are provided. Vacancies are arising not because of a lack of funding but because of supply issues in the health and social care sectors for specialist therapy professionals. While recruitment and retention efforts proceed, 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 assessment and interventions externally via private service providers. I think we have seen an increase in that in many areas recently. The Minister of State, Deputy Rabbitte, is fully committed to pursuing every avenue in order to improve access and reduce waiting times for children seeking access to disability services in County Louth and across the country. The single biggest issue is recruitment and retention, which she is committed to working on, though there are time delays in that.

Erin McGreehan (Fianna Fail)
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The Minister of State outlined a fairly depressing picture of staff vacancies in County Louth. I am aware the Minister of State, Deputy Rabbitte, is absolutely relentless and that it is also up to us to be relentless in this cause and in pushing the HSE to implement the recommendations of all these reviews and scoping exercises. We must work. The HSE has a responsibiltiy to pull out all the stops to hire staff. It has a responsibiltiy to ensure those waiting lists are covered. If it is the case we go to private operators then so be it. We must do it. Children deserve the best and that is what we ask for as parents from the State. The present Minister of State sees this quite often in his constituency as well and he is a great advocate and supporter of the Minister of State, Deputy Rabbitte, who has provided the HSE with the funding for these improvements. The HSE is now under the Department of Children, Equality, Disability, Integration and Youth. It is about time the HSE looked at how it is not in line with the Department it is under to not provide these services to children and not provide the proper staffing levels.I thank Senator McGreehan for continuing to raise this issue. I have heard her speak about it several times and not just here in the Seanad today. Ensuring vulnerable children receive assessments and therapy services is of urgent importance. As I mentioned, the issue relates directly to vacancies across the network. The issue is being actively progressed by the HSE to maximise funding allocated by the Government in recent years for over 600 additional posts nationwide.

Improvements to waiting lists are dependent on suitable staffing levels. A range of measures designed to encourage staff recruitment and retention are being employed by the HSE to improve capacity. In addition, measures such as the development of new clinical guidance to replace preliminary team assessment and dedicated assessment teams are expected to provide enhanced capacity within the system ensuring access for families is improved. The measures being developed at national level and at local level in north and south Louth are expected to benefit families in the delivery of assessment of needs and therapeutic intervention. I agree with and reiterate the use of the private sector in the meantime until we get internal recruitment up to the level required. That should be prioritised immediately.

Martin Conway (Fine Gael)
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I know the Minister of State is leaving us now. I thank him for his time in the Seanad this afternoon.