‘The system is broken’
SHOCK More vacancies than staff on Children’s Disability Network
There are, at present, more vacancies than staff available to provide therapeutic resources within the Children’s Disability Network Team (CDNT) operating in Cavan.
The shocking revelation comes as one mother, whose family claims to have spent over €15,000 for private therapy, says the system is "broken" and urgent intervention is required.
Contracted through Enable Ireland, as of October 2023, there were 10.32 people employed in the service locally. This is based on Working Time Equivalent (WTE) basis. It accounts for less than half of the overall allocation for the county, with 14.78 WTE posts currently unfilled.
It means that families like the Whitmarshes from Shercock and others are continuing to have to pay out of their own pocket for their children to access specialist care or as an alternative become “part-time therapists” themselves.
Figures obtained from Enable Ireland (EI) show 3.8 WTE Speech and Language (S&L) therapy positions with just two filled; 2.9 psychologists (1 WTE filled); 3.1 Occupational Therapists (OTs) (4); and 3.5 positions in the area of physiotherapy. There is one WTE physiotherapist in situ, with one more offered a position.
Other vacant roles include 1.04 WTE social worker and 0.44 child and family support worker.
EI claims that a “key barrier” for the organisation in respect of both recruitment and retention is that of “pay inequity” for employees compared to their peers in HSE and Section 38 organisations who are remunerated, on average, 11% more for doing the same job.
As a result, the organisation is in discussion with HSE regarding “a number of initiatives” including use of therapy assistant roles, career progression opportunities through development of clinical specialist roles and international recruitment campaigns.
Linda Whitmarsh is chair of the Cavan Monaghan Parents Committee and mum to three boys, two of whom have additional needs including one with Cystic Fibrosis (CF).
She accepts the position regarding pay disparity but says it is but one of a number of ongoing problems that require “urgent change”.
A qualified nurse, who made the difficult decision to take a career break in order to care for her kids, Linda finds herself increasingly having to balance her time between helping her boys and keeping track of developmental markers and campaigning on their behalf for better services.
“That's not how it should be,” she tells the Celt. “The system is broken. It's very broken.”
Linda's eldest Liam ( now 11) first attended Enable Ireland having experienced a speech delay. He was eventually discharged to community care with “queried dyspraxia” aged six years. He had been waiting close to four years for an assessment.
Finn, meanwhile, was diagnosed as having additional needs at five years, only after the Whitmarsh family had him assessed privately. He has still not received a public assessment and the family say he has been refused early intervention more than half a dozen times.
As per the HSE, the average waiting time for intervention is now two years. This is despite a legal obligation to have children receive an Assessment of Need (AON) under the Disability Act 2005 within a timeframe of six months.
Linda estimates that, to date, her family has spent in the region of €15,000 on assessments and private therapies for their two boys.
She tells the Celt that her son Finn was non verbal until age eight years. He has had three hours of speech therapy and Linda says that's only because she and her family “fought” to make that happen.
In Cavan, looking ahead to next year, there are 30 ASD primary level classes in the county with four of those coming on stream for the 23/24 school year.
There are nine ASD classes at second level with just one new one added, according to the Department of Education, but Linda believes “more is needed”.
“You have a situation across the county where schools are already having to write up waiting lists. The whole system is under pressure and nothing seems to be happening."
Linda says little has changed, and the situation facing many families “has only gotten worse if anything” since she and her husband Ronan appeared before the Joint Committee on Disability Matters to campaign for better supports last year. At the time they pair also called on the government to finally ratify the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), and amend the 2005 Disability Act so that supports for children with disabilities are given a statutory footing.
“I never set out to be a campaigner. All I ever wanted was to be a mum and do right by my boys. But, like a lot of families, I feel like I've been forced into this situation.”
Adult day services
Regarding plans meanwhile to provide suitable new accommodation for day services for adults with disabilities in Cavan Town, the HSE confirmed to the Celt that “further information” has been required in respect of the “premises being sought and this has since been resubmitted to Dublin North East Estates”.
The submission is expected to be discussed at the meeting of the National Capital Estates in early 2024.
“The outcome will be advised to the local service,” said a spokesperson. “The outcome of the meeting will ensure that Cavan Monaghan Disability Services will be better placed to advise on timelines and exact locations.”
It was previously hoped that a new building, constructed on a greenfield site by the Cross Border Community Housing Association Limited, could be leased back to the HSE but an agreement was never reached.
Concerns have also been expressed over Clogher House in relation to capacity, where the number of young adults with severe/profound disabilities is set to increase over the next five years and, with that, a demand for placement and additional supports in the community.
This follows a review carried out in conjunction with the Holy Family School and the Occupational Guidance Officer in 2022, arising from which the HSE began looking for “alternative accommodation” and filed a formal submission for funding in June 2023.