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Dáil Éireann debate -
Wednesday, 8 Nov 2000

Vol. 525 No. 3

Adjournment Debate. - Occupational Therapy Assessments.

My concerns relate mainly to senior citizens served by the Old County Road Eastern Regional Health Authority clinic which serves a large area covering parts of Dublin 12 and 6. Delays refer to stair rails, showers, shower fittings, house extensions and wheelchairs for the disabled, elderly and frail people who cannot even get an assessment.

I was told recently that there is a priority one list in Old County Road which deals with people as soon as possible, whatever that is, a priority two list which says they will be dealt with within a year – some priority – and a third priority list of people who will be assessed within two years. I know of cases of people who are confined to their homes, unable to use the stairs or bath, unable to move around or unable to get to the shops because they have not been assessed for a wheelchair or a fitting or some other basic item which would allow them use their homes. At the last count, there were 1,400 such people in the Eastern Regional Health Authority area alone.

I wrote to the health board on 9 March 2000 to make representations on behalf of a named person in Kimmage, who was seeking a visit from the occupational therapy unit to assess her application for an invalid bathroom, which had already been approved by Dublin Corporation in December 1998. She rang Old County Road clinic, to be told she would have to wait another year or two before they could come to assess her. My office rang in March to be told she was not even on the list.

A large number of constituents have told me about delays in receiving visits from the occupational therapy unit in Old County Road in recent years. I have not received similar complaints about other areas in the city. There is a specific and real need in this area, which is by no means the most affluent in the country. I urge the Minister to take steps to deal with this.

I pursued the case of a man from Drimnagh who cannot have an assessment carried out. I received a letter from the health board about this man on 8 February 2000 which stated the occupational therapy department had confirmed the man named was on a priority three waiting list and that the current waiting period was two years. The letter went on to say that if the situation deteriorated he could telephone the occupational therapy department any Tuesday to discuss his case with a therapist.

We have a very serious problem in relation to secondary care. We have a waiting list of 31,000, if we are to accept the Minister's figures, which I think are very optimistic and do not take account of the fact there is a waiting list to get on the waiting list. These people are struggling not to have to go into institutional care or hospital. However, they are being left for long periods awaiting assessment and are becoming prisoners in their own homes for the sake of a stair rail, a shower fitting, a wheelchair or a minor extension. Those people should be able to freely enjoy their homes.

If any Member of this House or any member of our families were asked to wait two years for an assessment we would go through the roof. However, this is the routine treatment of frail and old people in the Dublin 12 area, particularly in the Old County Road clinic. I ask the Minister of State, Deputy Moffatt, if he is not in a position to respond tonight on the specific issue of the Old County Road clinic, to communicate with me in writing, telling me the specific problem there. This cannot be allowed to continue.

I thank Deputy Gay Mitchell for raising this issue. As the Deputy is aware the provision of occupational therapy services to eligible persons is the statutory responsibility of the relevant health board and, in this case, the Eastern Regional Health Authority.

I have been advised by the regional chief executive of the authority that two issues which affect provision of occupational therapy services are increasing demand, coupled with recruitment difficulties. In relation to the former, I am advised that the decision by people to remain in their own homes and avail of occupational therapy, together with the complexity of cases and problems arising out of requests to receive treatment at home, has placed increased demands on the service.

Furthermore, the regional chief executive has informed me that the difficulty in recruiting occupational therapists has also contributed to delays. The authority states that the three area health boards are making every effort to address this problem through active recruitment campaigns.

On 30 August 2000 my Department commissioned a workforce planning survey to report on the prospective supply and demand for occupational therapists, physiotherapists and speech and language therapists between now and 2015. This report, which will be prepared by Dr. Peter Bacon and Associates, will be presented by end of 2000 and will address the number of additional training places required for these professions. Through the Higher Education Authority, the possibility of increasing the number of training colleges, as well as training places, will be addressed as a result of the findings of this survey. In the meantime, following contacts between the Minister for Health and Children and the Minister for Education and Science, the number of occupational therapist training places has been increased by five places this year and a further additional five places per annum will be provided over the next three years.

The expert group report on health professionals recommended that talks commence between employers and staff in relation to the creation of a clinical specialist post for the therapy grades, including occupational therapy. The creation of this post would allow for a new grade of clinical specialist and allow for career progression for those who do not wish to move into management. It would also ensure that clinical expertise is not lost to the professions. Good progress has been made to date in talks with the trade union IMPACT in relation to the detail of these posts, that is, qualification for the post, job description etc.

The expert group also recommended that grading structures be examined and has put forward new criteria for the upgrading of occupational therapy posts from basic grade to senior. A survey of all employers has been undertaken with a view to identifying these posts and my aim is to put this new structure in place as quickly as possible.

I would like to take this opportunity to point out that additional revenue funding provided to services for older people has been increased significantly in recent years. In 1998 the additional amount provided by the Government was £7 million. In 1999 the amount of additional funding was £16 million and in 2000 the figure has risen to £23.6 million. When nursing home subventions are included, this investment will total nearly £30 million. A proportion of the development funding available this year has been targeted at the provision of additional community supports, that is, nursing and paramedical posts. It is intended to improve these community supports in the coming years, leading to an enhancement of service provision.

This Government has also increased significantly the funding for physical and sensory disability services and, since coming into office, has provided additional funding of just over £72 million for services to people with physical and sensory disabilities. This additional funding includes a total of approximately £32 million additional ongoing revenue, £5 million provided in 1998, £9 million in 1999 and approximately £18 million this year, for the maintenance and development of services, including paramedical services, for people with physical and sensory disabilities. Priorities for the allocation of funding available for the development of services in the sector are decided by the health boards, in consultation with their regional co-ordinating committees for physical and sensory disability services.

I will try to return to the Deputy on the particular issue he raised with me.

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