Dáil Éireann debate -
Thursday, 11 Oct 2001

Vol. 542 No. 1

Adjournment Debate. - Speech Therapy Service.

Mr. J. Bruton

I am disappointed at the Minister of State's response to Deputy Perry's case for St. Edward's national school in Sligo, which I had the pleasure of visiting on one occasion.

I raise this problem because it concerns the case of a young boy aged three years who has been on the waiting list for speech therapy assessment since June 2000, that is, 15 months ago. He is unable to talk, deeply frustrated and, arising from this, has all sorts of problems. When his parents came to me they had been told that they had no chance of having their child assessed by a health board speech therapist before January next year, three months from now, or a year and a half after their child was originally put on the waiting list.

His parents told me that they had been advised that County Meath has the worst and longest waiting list for speech therapy assessment in all of Ireland. They had looked at the possibility of having their child assessed by a private speech therapist, but were told that this would be very difficult, almost as difficult as staying on the waiting list for the public service because therapists in the private sector tend, for financial reasons, to concentrate their work on insured adults such as stroke victims for whom there is insurance recoupment by the likes of the VHI. Private sector speech therapists are not, therefore, available for or generally specialised in the assessment of children who for the most part are, therefore, forced to rely on the public service.

I propose that this matter be dealt with in three ways. First, more training places for speech therapists should be provided. Second, a sufficient number of speech therapists dedicatedly available to deal with the problems of children should be ensured. Third, all waiting lists for speech therapy should be consolidated.

The waiting time for children for speech therapy in County Meath is about a year and a half, as I have illustrated, whereas in Dublin it is only six months. That is wrong. The child about whom I am concerned lives only three miles from the Dublin border, but because of those three miles was asked to wait a year longer for assessment by a speech therapist than he would have had if he lived three miles further in the direction of Dublin.

The story to which I am referring has had a sequel. After I had tabled this matter I was informed by the parents that they had eventually succeeded in having their child privately assessed by a speech therapist as a result of their own totally unaided efforts. They were told at this second assessment that while the child does have a cleft palate, he has a range of other problems unrelated to any speech or hearing problem. If they had not been able to find this out themselves, their child would have had to wait until next Jan uary or February to have the extra care needed provided for him.

This case illustrates the deep-seated problems that exist as far as children with special needs are concerned, and I hope my raising of this matter today will lead to action by the Minister.

Ms Hanafin

I am glad to take this opportunity, on behalf of my colleague, the Minister for Health and Children, Deputy Martin, to clarify the situation in relation to the provision of speech therapists in the North-Eastern Health Board area as raised by the Deputy. He will be aware that the provision of speech therapists in the area is the statutory responsibility of the North-Eastern Health Board, but I would first like to reply to his point regarding the non-consolidation of waiting lists for speech and language therapy.

I advise the Deputy that the Minister is aware that health boards and non-statutory organisations are experiencing difficulties in both recruiting and retaining the allied health professionals required to deliver these services. This is despite the fact that there has been a significant level of investment in health related support services for people with an intellectual disability, autism and physical and sensory disabilities in recent years. In acknowledgement of these difficulties, the Department of Health and Children has asked the Eastern Regional Health Authority and the health boards to take a flexible approach in using the resources allocated to the services, including the possibility of the purchase of additional sessions with a view to facilitating as many children as possible to access the necessary support services.

In response to the Deputy's concern regarding the lack of training places affecting the therapy professions nationwide, the Department of

Health and Children commissioned a report from Dr. Peter Bacon and Associates on current and future supply and demand conditions in the labour market for certain professional therapists, including speech and language therapists. The study, a comprehensive, quantitative assessment of workforce requirement for qualified personnel in these areas to the year 2015, was published on 25 July last. The report concludes that a major expansion is essential in the numbers of therapy professionals over the next 15 years, including a fourfold increase in speech and language therapists. This will require a significant increase in training places with a recommended annual increase of 75 course places for speech and language therapy.

Other key recommendations of the report include the provision of sufficient clinical placements within the health service through the establishment of a national network of clinical placement co-ordinators; the need for fast-track qualification and review of the existing training system; concerted recruitment from overseas; the establishment of the planned system of statutory registration consistent with the requirement for a patient-centred health service; and a career structure, workload, working practices and skills-mix issues encompassed in the context of the report of the expert group on various health professions published in April 2000.

The Minister is working closely with our colleague, the Minister for Education and Science, Deputy Woods, to ensure the rapid provision of the additional places as an urgent priority. To this end, an inter-agency working group has been established comprising representatives of the Department of Health and Children, the Department of Education and Science and the Higher Education Authority. The Higher Education Authority has initiated a formal bidding process among third level educational institutions to respond to the training needs identified in the study.

With regard to the Deputy's statement concerning the fact that speech and language therapists are being artificially diverted into work covered by health insurance rather than assessment of children, which is not covered, the Minister understands from the North-Eastern Health Board that there is no evidence that this is the case for speech and language therapists employed in the area.

Since coming to office, additional funding of £320 million has been allocated for the maintenance and development of health related services in the disability sector. This level of funding emphasises the Government's commitment to its policy of providing the necessary services and supports, including speech and language therapy services, to enable people with disabilities to maximise their potential and live as independently as possible. This will remain one of the Government's main priorities.