Brendan Smith warns of crisis in Cavan Monaghan children's services

Thank you Alaskan Cora. There is a very urgent need to recruit healthcare professionals such as speech and language therapists, occupational therapists, physiotherapists, psychologists and social workers across Cavan Monaghan. At present we have totally unacceptable delays in children with special needs and children with a disability having assessments and follow-up treatment and support. Progress in recruitment of such healthcare professionals is absolutely essential and must be progressed without further delay. Thank you Alaskan Cora. Thank you very much Deputy and I am taking this on behalf of Minister Anne Rabbitt and she sends her apologies to the Deputy. The HSE acknowledged that Cavan and Monaghan's children disability network teams are currently operating their services with reduced staff numbers due to recruitment issues being experienced both locally and nationally. The HSE advised that it is currently in the process of recruiting for vacant posts in the areas of speech and language therapy, occupational therapy, physiotherapy, psychology and social work, psychology and social work. However, it is acknowledged that there are significant challenges in the recruitment of staff due to the availability of options for candidates across the health and social care sector. Senior management in CH01 are currently examining a range of options to attract staff. At present there are a number of initiatives currently supporting efforts to provide timed therapeutic interventions in the area. The Joint Committee's disabilities and primary care autism spectrum disorder diagnostic waitlist initiative. This joint initiative has been allocated funding to complete 130 private provided ASD assessments for those waiting longest in Cavan and Monaghan. If I could just say to you Deputy, as you know the Cavan Children's Disability Network Team is based in Hillside, Ratcorrick in Cavan and the lead agency for the team is Enable Ireland. The team has a whole time equivalent staffing allocation of 24.2 posts. However, at this time there are only 15.3 posts in place with 8.9 posts of vacancies, so you could say 9 vacancies. I was looking at the figures there and I have noticed that there were actually five resignations and there are actually two on maternity leave at the moment which is having a huge impact on these services. The service is currently in the process of recruiting to the vacant positions but it is proving difficult to backfill these positions with minimal interest, if any, in any of the positions advertised. Thank you Minister and I appreciate Minister Rabbit's particular interest in this area. Along with Aroftis colleagues we met Minister Rabbit on Tuesday last, along with parents from Cavan Monaghan. And the stories that the parents told to the Minister that day were really heartbreaking. I had met the parents previously myself and have been seeking better services for their children. Could I say Minister, it is most disappointing that there are a total of 18.4 whole time equivalent vacant healthcare professional therapy and social work posts vacant in the two children's disability network. That is in Cavan and Monaghan. And as you said yourself it has been proven difficult to recruit. Could I just say that there has been a deterioration in services particularly in the past five to six years. We have far too many children who have not had assessments, far too many children unfortunately who did not get early intervention when they needed it. We have parents who are paying for private assessments, really stretching themselves financially to try to get private assessments to ensure that their children can get access to special teaching units and to ASD units. It is just not acceptable what is happening at present. Minister Rabbit has been engaged in various areas all over the country and as you know she has also taken to the road. She is holding public meetings in various different CHO areas to try and see what actions can be taken. As you recognise, it is not from her want of trying. The Occupational Therapy Physiotherapy Waitlist Initiative. This initiative is managed by Primary Care Services in Cavan and Monaghan, offering assessment and brief intervention to children who are waiting for occupational therapy physiotherapy. The initiative has commenced in 2022 with the HSE aiming to reduce the number of children on the waiting list over a 12-month period. So that is two different initiatives that are underway. The Primary Care Autism Spectrum Disorder Waitlist Initiative that is targeting 130 children and this particular one. But as you know Deputy it cannot come soon enough for the parents. Thank you Minister. Just one area that the parents have highlighted to me in meetings and in correspondence, Minister Donnelly would take an interest in this as well. There has been no international recruitment for such healthcare professionals. We know that there was success in recruiting nurses back over the years from the Philippines and elsewhere. But some of the parents put forward the suggestion in regard to international recruitment. And you know is there an issue with permits for people with relevant qualifications? And also I do not think the National Treatment Purchase Fund is being used. I think there is a question mark in regard to the recognition or the status of reports from private practitioners. This area needs to be addressed. And if there is capacity within the private sector to buy in that necessary work and that necessary expertise, then we need to address it very urgently. And Minister, are there proposals to increase the number of places in our colleges to train such therapists? And one other area that has not been considered, to my knowledge, is maybe involving final year students in doing some practical work as well while they complete their studies. Deputy, you raised some really, really good points there. And there is no doubt I will say it to Minister Rabbit in relation to, you know, encouraging people from outside the EU to come in and to work in these particular areas. We are actually looking at it in relation to home care at the moment as well. Because, as everybody knows, there is a shortage within the workforce. I know Minister Rabbit had been speaking to Minister Donnelly in relation to funding to buy private capacity. That capacity was actually bought in for the assessments of need 12 months ago. And it did reduce that waiting list significantly. But I suppose what happened was a lot of the children then were put on to further waiting lists as a result. But that assessment of need was done. And in relation to the NTPF, primary legislation would be required in order to access the NTPF in relation to psychiatry, psychology. I actually had a meeting about this yesterday. And it is actually quite complicated. You know, if you refer somebody for a cataract or a hip, it is a one-off procedure, the money is paid. But in relation to multiple sessions for children, for psychology, psychiatry needs, therapies, it is a lot more complicated. But we are looking at it. Moving on to the next question. Thank you, Ms. Thank you.