Special Educational Needs.

Thursday, 5 June 2008

Questions (6, 7)

Martin Ferris

Question:

6 Deputy Martin Ferris asked the Minister for Health and Children if she will establish a national working group comprising children with specific speech and language impairments and their parents and key agencies involved in service provision including her Department, the Department of Education and Science and the Health Service Executive, with a view to reviewing and establishing agreed terminology and diagnostic criteria for specific speech and language impairments and addressing policy and service development. [22274/08]

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Ruairí Quinn

Question:

66 Deputy Ruairí Quinn asked the Minister for Health and Children if she will meet the Irish Association of Speech and Language Therapists to establish a national working group to address issues regarding speech and language impairment; the co-operation and interaction between her Department and the Department of Education and Science; and if she will make a statement on the matter. [19707/08]

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Oral answers (22 contributions)

Deputy John Moloney

I propose to take Questions Nos. 6 and 66 together.

Recognising the cross-cutting nature of the national disability strategy, the Government established the Office for Disability and Mental Health in January 2008. This office helps me in exercising my functions as Minister of State with responsibility for disability and mental health across the Departments of Health and Children, Education and Science, Enterprise, Trade and Employment and Justice, Equality and Law Reform. The office brings together responsibility for a range of different policy areas and State services which directly impact on the lives of people with disabilities and mental health issues. The office will aim to bring about improvements in the manner by which services respond to the needs of people with disabilities and mental health issues by working to develop person centred services, focusing on the holistic needs of clients and service users and actively involving them in their own care.

A key priority for the office is to support the implementation of the health sectoral plan under the Disability Act 2005 and the planned implementation of the Education for Persons with Special Educational Needs Act 2004. The office will focus in particular on facilitating the delivery of integrated health and education support services for children with special needs by further developing existing mechanisms for co-operation and co-ordination between the health and education sectors at national and local levels.

A cross-sectoral team consisting of senior officials from the Office for Disability and Mental Health, the Departments of Health and Children and Education and Science, the Health Service Executive and the National Council for Special Education meets on a regular basis to address issues arising in respect of the implementation of both Acts, as well as issues of cross-sectoral responsibility. The focus of the team is on the interaction required between the education and health sectors in order to advance and enhance services to people with disabilities. The matter raised by the Deputy regarding the provision of appropriate services to children with specific speech and language impairment must be considered within the overall context of preparations within the health and education sectors for the implementation of the Education for Persons with Special Educational Needs Act. I have asked the cross-sectoral team to consider the matter in this context and to report back to me in due course.

Deputy Caoimhghín Ó Caoláin

I tabled this question last week for a written response and I received almost exactly the same reply. I do not wish to begin on a feisty note but nowhere in the reply is reference made to speech and language therapy, even though this is the critical focus of my question. I ask the Minister of State to pass that on to those who assist in the preparation of these responses.

The Minister of State might take this opportunity to correct the remarks made by the Taoiseach on 14 May. He caused concern within the sector by suggesting that the shortage of speech and language therapists was caused by the requirement on new graduate therapists to undergo a one year period of supervised clinical practice. Does the Minister of State agree with the statement of the Irish Association of Speech and Language Therapists that the Taoiseach's comment was ill informed and does he accept that one year of supervised clinical practice is an internationally recognised best practice approach for all health professionals? Does he agree that the problem is not caused by the requirement on new graduates but by inadequate resourcing, insufficient posts to meet the demand for speech and language therapy and poor management by the HSE?

Does he acknowledge that the services are not properly co-ordinated? Implementation is required of the recommendation by the Irish Association of Speech and Language Therapists on a national working party. The Minister of State referred to the cross-sectoral team but the critical difference between that and the proposed working party is that the latter would directly involve service users, including children and their parents, and the Department of Education and Science and the HSE. That is clearly absent from the formula used in the replies given to the questions tabled today and last week.

I acknowledge and welcome the 300% increase that has been made to the number of training places for speech and language therapists. However, that will not work on its own if it is not matched by the development of critical posts. With the recent HSE cuts, we face the prospect of increasing numbers of trained therapists leaving the country while children are deprived of the therapy they desperately need. I ask the Minister of State and his departmental colleagues to ensure that the increased numbers of trained therapists are retained within the system and that posts are opened up. They are clearly required given that children need intervention as early in their lives as possible.

Deputy Jan O’Sullivan

I congratulate the Minister of State on his new position.

I support Deputy Ó Caoláin's comments regarding the need to establish this group. I am also concerned about the Taoiseach's claim that one year of supervision was somehow holding up the provision of services to people who need speech and language therapy when that is in fact the international norm for ensuring new therapists are clinically safe. The record needs to be corrected by somebody in Government.

Does the Minister of State consider it acceptable that children have to wait up to two years to receive the speech and language therapy they need at a crucial stage in their lives? What will be done about that situation? Due to embargoes and posts going unfilled despite the availability of trained graduates, that is the reality on the ground.

I understand that disability services in certain parts of the country have not yet been given their budgets for 2008. Can the Minister of State clarify that?

Deputy James Reilly

I concur with the previous two speakers. There are precedents for clinical supervision. A newly qualified doctor has to serve an intern year under full supervision before being considered a fully fledged professional or continuing on to post-graduate training. The Taoiseach was unwise to use that example.

As I noted earlier, 4,136 Dublin children are waiting an average of 18 months for speech and language services. If a child with autism does not receive an intervention between the ages of three and six, the window of opportunity is closed. Half of that period could be spent in waiting. It is an unacceptable situation and the Minister of State will have to address it in a more forceful manner than has formerly been the case.

An entire class of physiotherapists have been trained at great expense and are badly needed for community and primary care, yet they are leaving the country because they cannot find employment.

Deputy John Moloney

I am not in the business of correcting the Taoiseach because he is usually right. I will not speak on his behalf until I consult him directly.

Deputy James Reilly

He is achieving a status similar to that of papal infallibility.

Deputy John Moloney

He is close enough to doing so. I do not want to make little of the response. However, I want to be as direct as possible. I made the point that those involved with education for persons with special needs and the cross-sectoral team will meet shortly.

The former Taoiseach, Deputy Bertie Ahern, established the new office with responsibility for disabilities and mental health, which has only been up and running since January last. Prior to that issues had always arisen in respect of the HSE and the Departments of Health and Children and Education and Science. The establishment of the new office represents an attempt to deal with these issues in one place. All of the issues to which the Deputy refers come within the remit of the office. As reports are received in the coming months, it will be our responsibility to decide how to proceed, particularly in the context of learning and special educational needs.

From the figures, one might obtain the impression that we are downgrading services. I do not wish to use the time available to rattle off details of what has been achieved. However, it is worth placing on record the fact that the number of physiotherapists has risen by 230, or 20%, that the number of occupational therapists has risen by 320, or 45%, and that the number of speech and language therapists has risen by 140, or 28%.

Deputy James Reilly

From impossibly low bases.

Deputy John Moloney

I accept that we are coming from a low base. However, I ask the Deputy to bear in mind that the office was only recently established. The Government recognises the importance of the work of the office. It also accepts that we need to catch up quickly and that is what we are doing.

The first priority on the agenda of the cross-sectoral teams is how the issues should be resolved and how the required professional staff should be put in place. I ask the Deputy to give the office a 12-month settling down period. When we return with a proposal in September or October, we will clearly show how we intend to deal with the matter of recruitment. It must be remembered that there are industrial relations issues with which we must deal.

Deputy James Reilly

Will the Minister of State offer those physiotherapists who achieved of the order of 580 points to gain entry to courses and who are now fully trained an opportunity to earn decent incomes?

Deputy John Moloney

The awful reality is that when the jobs in question were advertised three to four years ago, we could not get people to even apply for them.

Deputy Jan O’Sullivan

Now the Government is going to export them.

Deputy James Reilly

Are we going to live in the present or is the Minister of State determined to remain in the past?

Deputy John Moloney

The establishment of the office underlines the commitment on the part of the Government to ensure that the issues raised by the three Deputies will be dealt with. We will communicate further with them in October or November when the process has been properly evaluated and when the position regarding need and demand has been established.

Deputy James Reilly

What will be the position as regards the class of 2008?

Acting Chairman

I must allow Deputy Ó Caoláin to put his supplementary before the Minister of State answers that question.

Deputy Caoimhghín Ó Caoláin

In a previous reply, the Minister for Health and Children, Deputy Harney, referred to the National Treatment Purchase Fund. Will the Minister of State, in the context of question I posed, indicate where stands the commitment in the programme for Government to ensure that any child under five waiting more than three months — not the two years to which Deputy Jan O'Sullivan refers — for occupational or speech and language therapy will be allowed to access these services automatically through the National Treatment Purchase Fund? How many children have been given such access?