Therapist shortfall causing "unacceptable" delays for children needing care

Fifteen out of 24 available therapist posts for the Cavan children’s disability network team are currently vacant, resulting in "unacceptable" delays in providing urgent assessments, support and treatment.

Speech and language therapists, occupational therapists, physiotherapists, psychologists and social workers are among the many areas in which County Cavan is enduring shortfalls. However, it has emerged the HSE is receiving "minimal interest, if any" in the advertised positions.

Across Cavan and Monaghan there are 18.4 full-time equivalent healthcare professional therapy and social work posts vacant in the two children's disability networks.

The ongoing problem in recruiting therapists for Cavan and Monaghan was raised in the Dáil last week by Deputy Brendan Smith (FF).

In a bid to address the recruitment crisis the local TD suggested that the minister look to recruit healthcare professionals internationally and to make use of of the National Treatment Purchase Fund.

"There was success in recruiting nurses over the years from the Philippines and elsewhere. Some parents put forward a suggestion regarding international recruitment. Is there an issue with permits for people with the relevant qualifications? I do not think the National Treatment Purchase Fund, NTPF, is being used in this area either. There is a question mark over the recognition or status of reports from private practitioners. This area needs to be addressed.

"If there is capacity within the private sector to buy in that necessary work and expertise, we need to do so urgently. Are there proposals to increase the number of places in our colleges to train such therapists? One other possibility that has not been considered, to my knowledge, is final-year students doing some practical work while they complete their studies."

Delays

The Fianna Fáil TD had sought from Minister of State Anne Rabbitte a timeframe for the recruitment of when additional healthcare professionals "in view of long delays for children receiving appropriate therapeutic interventions and supports".

"At present, we have totally unacceptable delays in children with special needs and children with a disability receiving assessments and follow-up treatment and support," said Deputy Smith.

Junior Minister Mary Butler fielded the question on behalf of her colleague, Minister Rabbitte.

She said the HSE acknowledged that Cavan and Monaghan children’s disability network teams are currently operating their services with reduced staff numbers "due to recruitment issues".

"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 CHO 1 are currently examining a range of options to attract staff."

In the interim the Minister Butler outlined how the joint children’s disabilities and primary care autism spectrum disorder, ASD, diagnostic wait list initiative has been allocated funding to complete 130 private provider assessments "for those waiting longest" in Cavan and Monaghan. She also said that the occupational therapy and physiotherapy wait list initiative has commenced this year, with the HSE aiming to reduce the number of children on the waiting list over a 12-month period.

Hillside

"The Deputy will be aware that the Cavan children’s disability network team is based in the Hillside facility at Rathcorrick, County Cavan. The lead agency for the team is Enable Ireland," said Minister Butler.

"The team has a whole-time equivalent staffing allocation of 24.2 posts, but at this time there are only 15.3 posts in place, with 8.9 vacancies - one can say there are nine vacancies. Having looked at the figures, I note that there were five resignations and there are two people on maternity leave at the moment. This 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."

The exchange in the Dáil followed the appearance of Cavan mother Linda Whitmarsh at a Joint Oireachtas hearing on "progressing disability services" on May 21. She was representing the campaign group 'Cavan Monaghan Parents Committee'.

Deputy Brendan Smith and his party Deputy Niamh Smyth also joined the campaigning families in their meeting with Minister of State, Deputy Rabbitte.

"The stories those parents told to the Minister of State that day were really heartbreaking. I had met the parents previously as they have been seeking better services for their children."

Deputy Smith noted the recruitment issues and said: "There has been a deterioration in services, and particularly in the past five to six years. Far too many children have not yet had assessments. Far too many children, unfortunately, did not get early intervention when they needed it. Parents are paying for private assessments. They are really stretching themselves financially to try to get private assessments to ensure their children can get access to special teaching units and ASD units. What is happening is just not acceptable."

Responding to Deputy Smith's recruitment suggestions, Minister Butler seemed positive about encouraging people from outside the EU to come and work in these areas, and also funding to buy private capacity.

However she noted primary legislation would be required in order to access the NTPF for psychiatry and psychology services.

"I had a meeting about this yesterday. It is quite complicated. If someone is referred for a cataract or hip operation, it is a once-off procedure but for children with psychology, psychiatry or therapy needs who require multiple sessions, it is a lot more complicated. We are looking at it," she concluded.

Constant battle

Fellow Fianna Fáil TD Niamh Smyth spoke after attending the Leinster House meeting between the Cavan Monaghan Parents Committee with Minister for Disabilities Anne Rabbitte.

Deputy Smyth described it as a "constant battle" for parents to access therapies and assessments in the disability services sector for their children.

"This is simply not acceptable. Parents are struggling and battling for every single thing. It’s exhausting for them and today the Minister listened to what is working and more importantly, what is not working within the system.

"Our meeting was a productive 90 minutes with the Minister where these parents got to speak openly about their daily battles and share their story and of those that they represent," Deputy Smyth said.

"Minister Rabbitte vowed to pursue these issues, a number of which she is already working towards, on behalf of these parents who need the supports and critically the children who need the therapies.

“Parents are genuinely worried that their children’s outcomes are being compromised. The current delays due to staffing gaps cannot be allowed to continue. Staffing levels must be increased to cope with the current demand with no child left waiting. This must be made a priority."