Seanad debates
Wednesday, 11 October 2023
Nithe i dtosach suíonna - Commencement Matters
Health Services Staff
10:30 am
Tim Lombard (Fine Gael)
Link to this: Individually | In context | Oireachtas source
The Minister of State is welcome. I raise the issue of podiatry care. It is a significant issue nationally and is a major issue in my part of the world down in west Cork. The level of podiatry care that is being provided by the HSE at the moment is very limited. We have had patients come to my office in the past number of years who have been waiting 18 or 19 months for appointments. We have a huge issue as to how to make sure that the cohort who need podiatry care have the opportunity to get it. We had the same Commencement matter debate in October 2022 and we asked for an update on the recruitment campaign that was happening. At the time, we were told that in my area, which is the CH04, 15 of the 25 posts were vacant. This is really significant when you take into consideration what we are talking about here. When 15 of the 25 posts were vacant in March 2022, we realise why we have a huge issue. I know the Minister of State has a unique understanding of the geography of west Cork. We had patients being moved from Bandon to Bantry, from Bantry to Skibbereen, from Clonakilty to Skibbereen. It was hectic and was all over the place. The geographical distance that patients had to travel, sometimes in areas without major public transportation routes, was absolutely huge and it made no logical sense. This really affected a cohort who needed help.
The obvious knock-on implication is that the private podiatry services are overloaded beyond all belief at the moment. A person would be waiting three to four months for a private appointment in west Cork today. The entire system is crumbling at the moment. Finding an avenue or a pathway to make sure we can get appropriate podiatry care into places like Bantry, Skibbereen, Clonakilty, and Bandon, is really important. I realise that there is a third level podiatry course in the University of Galway. There is a really significant issue about trying to make sure we get new recruits into the system itself. It is an avenue we need to start talking about to make sure we have more recruits coming through that podiatry course and maybe a second course somewhere in Ireland. In the long term we have an issue going forward for the whole country; in the short term, west Cork in particular is really badly affected. Will the Minister of State provide an update as to where we are with the recruitment process? How are we regarding the huge gap in the service itself? Last March, we had something like 15 of 25 posts vacant. Do we have movement on that? What can I tell my constituents regarding this really important issue?
Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
Go raibh maith agat Senator Lombard for raising this really important issue. I will answer on behalf of the Minister for Health, Deputy Donnelly, today. I am aware that the recruitment and retention of staff across community healthcare organisation, CH04, has been very challenging recently as considerable organisational and operational changes have been implemented. As the Senator knows, this is not only in podiatry. Indeed, as part of the enhanced community care programme there are several vacancies across Cork and Kerry, including in west Cork. Cork Kerry Community Healthcare teams continue to run recruitment campaigns at a local, national and international level to fill these vacancies. The teams assure me that a robust communication campaign is being utilised to attract eligible candidates. Cork Kerry Community Healthcare has identified a number of factors which contribute to the difficulty of staffing these roles. There is a high demand for these healthcare professionals, which is outpacing the supply of trained podiatrists. The current workforce in some areas is ageing. As these staff members retire, new graduates are needed to fill their positions.
Training to become a podiatrist is an expensive and lengthy process, with only one course available at the University of Galway. The Senator has made a really valid point. I spoke earlier to Senator Clonan regarding Trinity College Dublin and pointed out that the Minister, Deputy Harris, had put in place 15 new medical positions this year through universities and colleges. Progress has been made. The Senator made the point about there being only one college in Galway where students can go. We saw recently that a course on home economics that was only available in Sligo previously is now available in Mary Immaculate College, St Patrick’s Campus, Thurles. That is extremely important because before this, everyone had to go to Sligo if they wanted to do that course. The Senator has made a very valid point about the podiatry course only being available in Galway. Students choosing a course may be unaware that podiatry is an option for study diverted by other healthcare fields such as orthopaedics and nursing.Once they enter the workforce, podiatrists may prefer to work in urban areas. This can lead to recruitment difficulties in rural areas, which is identified as a problem in several geographical areas of Cork and Kerry. Addressing these factors requires a multifaceted approach, including expanding educational programmes, just like I spoke on, providing financial incentives to encourage individuals to enter the field, and implementing policies to ensure equitable distribution of podiatry services across regions. All efforts are being undertaken within the parameters of the HSE to address the deficits, including international promotion and recruitment campaigns, increased training places, and formal engagement with academic partners. The recruitment for staff grade posts is being communicated to graduates through the national recruitment service. A bespoke campaign has been developed to recruit senior grade posts which will launch imminently.
Eligible patients continue to be seen and are being provided with ongoing care. Those who are most urgent on the waiting list are being seen first. The HSE advises that when all the active, in remission and high-risk patients are seen, and when space in the schedule becomes available, moderate risk patients will be offered scheduled appointments. There are currently 1,138 people on the podiatry waiting list in Cork, in CHO 4. The HSE reports that there are three children, aged up to 17, on the waiting list. Some 359 adults have been on the waiting list for less than 12 weeks. However, 329 adults have been waiting for more than a year. The number of patients seen within 52 weeks has improved slightly at 71% compared with the same time last year when it was just under 70%. The Minister, Deputy Donnelly, and the Department have been assured that priority is being given to those patients most at risk and that most of those waiting are in the lower risk categories. However, the Department has asked the HSE to accelerate the process by which those waiting over one year can be seen.
Tim Lombard (Fine Gael)
Link to this: Individually | In context | Oireachtas source
I thank the Minister of State for the update. I think we are probably where we were last year. There is no major change. More than 1,100 people are on a waiting list. Unfortunately, 329 adults have been waiting for more than 12 months. It is probably that cohort who have been talking to me. That is a really significant figure.
Something needs to be done about the CHO 4 area regarding where it is going with this and other issues. How will we make sure that staffing levels in this area are appropriate compared with other areas? There needs to be a national approach. If we were to look for the figures across the entire country and compare this with other places, I am nearly assured this is the highest in the country. There needs to be a combined approach and even the potential of moving staff from other parts of Ireland to this location to make sure that the Cork-Kerry region can actually work on what we are dealing with. It is a huge waiting list. There has been no significant move in the past 12 months. I suggest that the national approach, which obviously involves recruitment, should also have the relocation of staff as key. A programme needs to be put in place to move staff to this location, otherwise I will be back here next October with the same Commencement debate, the same figures, and the same people calling me in the office asking what in the name of God is happening.
Mary Butler (Waterford, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
I thank the Senator. The problem is that the demand for podiatry healthcare professionals is growing everywhere. It is not only in CHO 4. This is in part due to an ageing population, with people living longer, and the increased prevalence of chronic conditions like diabetes. Obviously, as Minister of State with responsibility for mental health and older people, I am proud of the fact that we have the highest life expectancy in the EU, as deemed by the World Health Organization, and support older people to age in place. Podiatry services are necessary to ensure that people have access to the right care, in the right place, at the right time, which we are aiming for under Sláintecare. The HSE advises that every effort is being made to fill the current podiatry vacancies in CHO 4. The Minister, Deputy Donnelly, agrees that there needs to be a robust campaign to ensure the recruitment of suitable staff to these important vacant posts. At times, when I hear people saying it is very hard to recruit, I wonder because we are recruiting into some of the most scenic areas in the whole country. We often see challenges with filling posts in child and adolescent mental health services in Donegal, Kerry and many different counties. I find that hard to believe because we are recruiting into beautiful areas.