Dáil Éireann díospóireacht -
Wednesday, 5 Dec 2001

Vol. 545 No. 5

Other Questions. - Speech Therapy Service.

Jim Higgins

Ceist:

34 Mr. Higgins (Mayo) asked the Minister for Health and Children if his attention has been drawn to the fact that in the Ballina area of County Mayo the waiting list for speech therapy is 49, 36 new referrals are awaiting screening and the waiting list for review is 21; and that from 31 October 2001 an additional 48 clients who receive regular therapy and 44 who are seen on a review basis may no longer receive a service; and his plans to remedy the situation in relation to the recruitment of speech therapists. [26575/01]

Mr. Martin

The provision of health related support services, including speech and language therapy, is a matter for the Eastern Regional Health Authority and the health boards in the first instance. I understand that the Western Health Board is aware of the problem referred to by the Deputy and is pursuing a number of possibilities to alleviate it, including the possibility of using private therapists to provide services on its behalf.

In response to my concern about current labour shortages affecting the therapy professions nation-wide, my Department 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. The report was particularly concerned with speech and language therapists, physiotherapists and occupational therapists. The study, a comprehensive quantitative assessment of workforce requirements for qualified personnel in this area to 2015, was published on 25 July last. The report concludes that a major expansion in the numbers of therapy professionals over the next 15 years is essential, 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; the need for concerted recruitment from overseas; the establishment of the planned system of statutory registration consistent with the requirement for a patient-centred health service; and 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.

I am working closely with my 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 my Department, the Department of Education and Science and the Higher Education Authority. The Higher Education Authority has initiated a formal bidding process between third level educational institutions to respond to the training needs identified in the study.

An Ceann Comhairle

Before I call on Deputy Jim Higgins, I would like to have silence in the House. Those who wish to conduct meetings should leave.

Mr. Higgins

(Mayo): Does the Minister accept that in the Ballina area of County Mayo alone, there are 49 people on the waiting list for speech therapy, 36 on the waiting list for screening, 31 on the waiting list for review and 44 who have been seen for review, but cannot access the service because one of the two speech therapists has left? It is appalling and unacceptable to have 150 people on a waiting list for speech therapy services. These are people with intellect, talent and ability. They are simply locked up because they are orally constrained. When will the recommendations of the Bacon report come into effect? That is the important question as these people cannot wait any longer.

Mr. Martin

I agree with the Deputy that the state of affairs in Ballina is unacceptable. Current waiting lists for speech and language therapists and other therapies are far too long and have been for quite some time. Such circumstances obtain across the country and reflect very poor planning in the past. They also reflect the reality that we have only one school of speech and language therapy in the country producing about 20 to 23 graduates every year. That has been the case for the past 30 years. I decided to com mission Peter Bacon and Associates to conduct a proper manpower study in terms of the needs of that profession and others going forward to 2015 so that, in years to come, people can look back on this era and say the correct planning was done and correct provision made for a sufficiency of graduates and therapists to meet the needs of children and older people into the future.

The report is already in action in the sense that the Higher Education Authority has sought tenders from universities and institutes of technology inviting them to submit proposals to provide for the establishment of new schools of speech and language therapy, physiotherapy and occupational therapy throughout the country. I understand that bidding process will end in a number of weeks and then the HEA, through the specific panel which has been established, will make its decision on the best options and report back to us.

Mr. Higgins

(Mayo): I welcome the fact the Minister has taken the initiative on new schools of speech therapy in the various universities and so on. Is he in a position to give a categorical assurance that these new schools and new places will come on stream next September or October for the beginning of the new university year? What is the anticipated intake for next September or October? The salary structure for speech therapists appears to be a problem. Speech therapy is an area where there appears to be a huge demand while also a huge reluctance on the part of people to enter the profession because of the salary structure. What will the intake be next September and what is the position on restructuring the salary scale to give these people considerably more inducements and to make it more attractive for them to enter the service?

Mr. Martin

It would be my intention if at all possible to do that. I cannot give an absolute guarantee because that is dependent on the tendering process, the type of proposals which will emerge and the logistical issues of getting them up and running over the next number of months to be ready for the academic year of 2002-03. Last year we managed to get some interim additional places, albeit on a small scale. The anticipated intake will be dependent on the type of proposals which emerge, but Peter Bacon has recommended an annual increase of 75 course places for speech and language therapy.

Mr. Higgins

(Mayo): How many would there be then?

Mr. Martin

That would give about 1,000 speech and language therapists in 2015, taking into account a four year degree programme. We achieved this in nursing this year, for example, where a significant allocation was made in this year's Estimates for moving nursing to a degree programme in universities and the third level sector. We would like to achieve a similar historic shift for speech and language therapy and occu pational therapy. It is a key challenge facing the health service and education service and we are determined to achieve it.

The expert group on various health professions was established some time ago. It published a report last year and we have implemented each of its recommendations. The funding was made available to implement every recommendation emanating from that report. Time has moved on and we are continuing to meet the professions on that.

I am also considering the issue of sub-degree programmes in the area of speech and language therapy which can also be useful into the future in providing people who can assist speech and language therapists in their work.

Mr. Higgins

(Mayo): How will they be qualified?

Mr. Martin

This has to be worked out with all the partners and players, but I envisage it would be through the NSAI.

Mr. Naughten

I put it to the Minister that the position in Ballina is one which is mirrored throughout the country. What are the short-term solutions or measures he will put in place to ensure speech therapy is provided to children throughout the country? Does he believe it is acceptable that children with intellectual disabilities have been left for ten months without any speech therapy? Does he believe that to be acceptable or tolerable in current circumstances?

Mr. Martin

Overseas recruitment is probably the most effective interim solution we can put in place. As a result of poor planning in the past and the fact there was only one speech and language therapy school in the country for about 30 years, we have a problem with a chronic shortage of speech and language therapists. I accept the position is not acceptable in terms of the services we need to provide to children with disabilities or speech and language difficulties and to older people with speech and language difficulties. The solution is utilisation of whatever spare private sector capacity exists and overseas recruitment.

On the nursing front, we demonstrated we could achieve a great deal in the interim by an aggressive, proactive overseas recruitment strategy. A similar exercise will have to be undertaken in terms of the therapy grades and especially in terms of speech and language therapy and occupational therapy.

Written Answers follow Financial Resolutions.