I thank the Ceann Comhairle for the opportunity to raise this important matter on the Adjournment. I wish to bring to the Minister's attention the serious problem of long waiting lists for occupational therapy services via health board health centres. I understand that this is a problem across the country, but I deal with it on a daily basis in the South Western Area Health Board area, especially Ballyfermot, Crumlin and the south inner city. It is older people who have lost out most. They have been told that they must wait three or more years for assessment and a further period before the work is carried out. The health board's clients are looking for household adaptations to their bathrooms, bedrooms or entrances to their home to facilitate their mobility. The elderly people in question are still active and wish to remain in the community. They need a little assistance to allow them remain at home.
The people in question are on pensions and work on tight budgets. They have little discretion to obtain the services of private occupational therapists and to get the work done privately. They often live in the large housing schemes built by Dublin City Council and constructed with no regard for the fact that the residents will grow old. It seems the health boards have allowed their public occupational therapy services to run down. It also seems as though the professionals have not moved to rectify this situation.
The problems with the public occupational therapy service is a reflection on the corrosive effect of our public-private health service. Why have the public waiting lists been allowed to grow so long? A professional occupational therapist employed by the health board may be available for private work. At the same time the public waiting lists grow ever longer.
I would like to bring to the attention of the Dáil the case of an elderly lady living in the Islandbridge area of Dublin 8. This lady urgently needed an initial occupational therapy assessment but was told that it would be three years before she was seen by an occupational therapist. She is a member of a family of limited means. The lady and her husband are pensioners, while their only son is in receipt of disability benefit. As I know this family well, I offered to pay for a private occupational therapy assessment and to submit this report to the health centre in Cherry Orchard for it to provide the necessary chair and other devices. However, the health board refused to entertain this proposal and the private occupational therapist I contacted refused to do the initial assessment.
As a Labour Deputy, I would prefer a properly functioning public health service that puts the interests of the patient and client first. We are a great distance from this standard of care. We have a hybrid public-private system within which vulnerable people lose out.
I propose that the Minister for Health and Children put the power into the hands of the patient. In this case, I propose that the clients on the health board waiting lists be given vouchers to allow them obtain occupational therapy services from qualified occupational therapists. There is a similar system for chiropody services, which operates satisfactorily.
Nothing has been done to provide a more efficient public occupational therapy service. There is little or no use of occupational therapy assistants or walk-in centres. Advantage has been taken of a delay in providing occupational therapists.
It is disappointing that the health board structure, including the Dublin area health boards, continues to put such a stranglehold on the delivery of health services. The boards have considerable budgets and huge power but no accountability. It is impossible to track down responsibility for any given service. The mantra is that it is always somebody else's responsibility.
The South Western Area Health Board which covers my Dublin South-Central constituency has its headquarters in Naas, County Kildare. Responsibility for the services is dispersed geographically through the area health board and different boundaries operate, depending on the service. From a geographical point of view it is a mess. Could the health board services not be divided according to Dáil constituency boundaries, as is the case with the delivery of Dublin City Council services?
