Dáil Éireann Debate, Tuesday - 29 April 2025
95. Deputy Peadar Tóibín asked the Minister for Children, Equality, Disability, Integration and Youth the number of community disability network teams across the country which are fully staffed and the number which are not. [20957/25]
View answerIn recent days I have received significant information that there is an independent review of the children's disability network team service model. It has been obvious to most people that this system is completely broken around the country. Will the Minister today confirm to the Dáil that the entire CDNT service model is being independently reviewed?
As I stated to Deputy Ó Murchú, the CDNTs workforce survey was conducted last October. That captured staffing levels across various disciplines and grades, providing a snapshot of the current workforce across the 93 teams. The 2024 CDNT workforce report is based on the outputs of the survey.
The published report shows that all six regional health areas were carrying vacancies at mid-October. There is a wide disparity in vacancy levels across the country, with the highest levels in Dublin and the south-east region and the lowest levels in the mid-west region. Separately, the HSE has advised me that the majority of CDNTs are currently carrying vacancies, with four teams having no vacancies at present.
The HSE is using the data from that report to support focused recruitment and retention initiatives in the areas with the highest vacancy rates, taking learning and related actions from areas with lower levels of vacancies.
While the vacancy rate remains high, the CDNT workforce increased by 17% in 2024 when compared with 2023 and the CDNT vacancy rate reduced from 29% to 22%.
As the Deputy knows, in budget 2025, my Department secured €2.84 million in new development measure funding to provide an additional 40 health and social care professionals, comprising 20 senior and 20 staff grade therapists, 20 therapy assistants and 15 clinical psychology trainee placements.
A dedicated disability workforce strategy will be developed this year to meet growing service demands and address recruitment and retention challenges. Also, under the disability action plan, we have the progressing disability services roadmap, and that sets out measures designed to attract and retain staff in CDNTs. I can outline those later.
My information indicates that the independent review has been commenced by the National Disability Authority. The Minister of State might confirm in her answer if that is the case. The figures I have seen as to what is happening in the CDNTs are absolutely shocking. They are unbelievable. In 2023 there were 817 vacancies in CDNTs across the country. In CHO 1 there has been a drop-off of 22% in therapy hours in the space of a year. Some 44% of CDNT posts in the HSE are vacant at the moment. Some 43% of psychologist posts are vacant at the moment, 62% in CHO 1 and 59% in CHO 5. That is a failure on a monumental scale when we see that the majority of those posts are empty. In my constituency I have seen children waiting for 14 months to get onto CDNTs and some cases where children are being bounced between CAMHS, CDNTs and therapy services without ever ending up on a waiting list at all. The Minister of State has to agree that this is outrageous.
I agree that far more needs to be done as regards retention and recruitment within the CDNTs. That is an absolute priority for my Department. We have under the disability action plan and the progressing disability services roadmap set out measures. I will outline a few briefly. We are supporting practice education in CDNTs. We are supporting student sponsorship programmes. There is an initiative whereby four years' salary is now paid to new graduates over five years to support them in taking a gap year in year 5. We are also developing apprenticeship programmes.
The HSE is driving a number of initiatives to address the CDNT vacancy rate. That includes intensive recruitment efforts across the HSE and section 38 and section 39 organisations. Also, we are engaging with secondary schools and higher education institutions to expose more students to the rewarding and impactful work within CDNTs and within the disability sector overall.
Seven of the disciplines required for working within the CDNTs are included on the critical skills occupations list in the Department of Enterprise, Trade and Employment as well.
I indicated the massive figures of absences and vacancies in the sector but I want to drill down to what this means for an individual child. I have been contacted by a constituent who is a foster mother of a child. She has worked tirelessly to help her young boy. The boy presents with significant complex behavioural problems and has been expelled from two preschools and four times already from primary schools. He is currently on reduced school hours because of the situation and he is falling back in his education massively. Despite urgent GP referrals to CAMHS, he is facing a 14- to 18-month wait for an initial assessment. In the meantime, his condition is deteriorating and his education is severely disrupted. Referrals to speech and language therapy and other services have yielded nothing but long waiting times, and his GP believes he needs immediate interventionist care. The foster mother, who is doing her utmost for this child, has contacted Tusla, CAMHS, disability services, social workers, private psychologists - everywhere she turns she meets delays. That is what those absences, those massive levels of vacancies, mean to an individual child.
We will go to Deputy Ó Murchú for a supplementary question.
I will restate the question I asked earlier. We all know there is a huge amount of vacancy. Even if there have been improvements, when this workforce report was carried out there were, I think, 529.72 whole-time equivalent positions. We need to really ensure that is dealt with. Even if we fill those positions, though, does that mean we have a CDNT system that is actually able to deliver for those who require the assessments and then the therapies? The therapies are meant to follow but we know they do not at the moment.
There are also a huge number of schools saying they do not know where to put kids until they get an assessment. This is a huge issue across the board and unfortunately I feel like a broken record in here constantly repeating the same questions, but we need to get to a better place.
I take both Deputies' points on board and it is an absolute priority. I came from having responsibility for special education and the Minister, Deputy Foley, was Minister for Education. We are now in the Department with responsibility for disability. We have a very clear picture of the need for more therapies, access to therapies and access to assessments. That is at the forefront of the work we are doing. We have a Cabinet committee on disability. Therapy in schools was mentioned. We are going to roll out that pilot to all special schools and eventually into all special classes in mainstream schools as well. That will help with children getting access to those therapies. In the communities with the CDNTs we want that multidisciplinary approach whereby children, if they need to get access to a dietician, physio or whatever, will have access to those therapies. My door is open if there are suggestions about recruitment. We are looking at therapy assistants-----
It is pay, terms and conditions.
We are looking at pay and terms and conditions. That is under way as well, as the Deputy knows. We are looking at absolutely everything. There is our national disability strategy. That will not be just the Department with responsibility for disability but every single Government Department having disability in their brief. I will be publishing that strategy before the summer recess and that is going to feed into this as well. I absolutely agree with what the Deputies have said. It is an absolute priority of mine as the Minister of State with responsibility for disability sitting at the Cabinet table. My door is open for suggestions as well, if the Deputies have any.
