Immediately following Leaders' Questions, we will have an opportunity for expressions of sympathy in response to the awful event in Manchester last evening.
Leaders' Questions
I raise again with the Taoiseach the growing crisis in the mental health services. This is occurring for a combination of reasons, including the cutbacks of recent years and a major issue with retention and recruitment of nursing staff, psychologists and psychiatrists. There has clearly been a lack of strategic planning on the human resources side for some time. This is having a significant and damaging impact on people with mental health issues, particularly children. Across the country, it has never been as difficult to access mental health services. One example, which was brought to the Taoiseach's attention by Deputy James Browne, was that of people being treated on chairs in corridors in Waterford. In that case, it involved a young 16 year old in an adult ward.
A case has been brought to my attention by another Deputy concerning the hinterlands of Dublin where a patient presented at an emergency department with a general practitioner's letter saying that he was suicidal. He was simply put on anti-depressants and discharged without admission.
There are bed shortages and staff shortages and the situation is becoming alarming, as illustrated by the news that the Linn Dara child and adolescent mental health service, CAMHS, inpatient unit, a children's mental health facility in Cherry Orchard, is closing 11 of its 22 beds from Friday next for the summer due to staff shortages. We have had correspondence, including emails, from parents of patients at Linn Dara who are under enormous pressure. Children who were admitted two weeks ago at high risk and in need of emergency admission are now being discharged early. Parents have asked us where are they to go next Friday. Why is the HSE saying that the facility will re-open in September? It does not add up that there will be shortages in June but they will be sorted in September.
While there are meant to be 100 child and adolescent beds, there are 63 at present and that will decrease to 52 with what is happening at Cherry Orchard. Deputies across the House are dealing with cases of children, relating in particular to CAMHS, who are on waiting lists for appointments to see psychologists, get access or get assessed. It is time for urgent intervention. That will necessitate using capacity other than public capacity.
Will the Taoiseach intervene to keep the 11 beds in Linn Dara open? I ask him to do so. Will the Government show urgency regarding the retention of staff and the recruitment of additional staff? I do not like saying this but the service is essentially not holding together. It is falling apart at the seams and there are problems.
I thank the Deputy. I do not accept that it is falling apart at the seams. I had a meeting with Deputy Browne and the Minister of State, Deputy McEntee, just last week where we discussed all of this. Funding for mental health, as Deputy Martin knows, has gone up from €826 million last year to €853 million this year, 2017. Over 160 additional posts have been recruited for the HSE mental health area over January to March this year. Recruitment campaigns are carried out to fill further vacancies and they are under way. Sanction has been given and money provided to recruit 114 assistant psychologists to enhance the early intervention primary care counselling services for under 18s in particular and to relieve pressure on the specialist CAMH service. The development of a plan for a 7/7 mental health care improvement nationally has been progressed and is nearing completion. It has prioritised that all areas provide access to a weekend service for current service users and not have situations where nobody has access to a service if he or she needs it. A full mapping exercise is being carried out countrywide. The HSE, at present, is consulting with all of the personnel in the health sector area and assessing the resource implications to develop costed actions. In addition, of course, the construction of the new 120-bed hospital to replace the Central Mental Hospital in Dundrum after over a century, along with a new ten-bed forensic CAMHS unit and a new ten-bed mental health intellectual disability unit, has been advanced. The Minister expects to sign that contract very shortly. Award of the construction contract is due to happen quite quickly. It has been recently agreed that in addition, the contract will also include a new 30-bed intensive care rehabilitation unit.
These are all positive signs of progress in an area that was neglected for so many years and was, over 30 years, the Cinderella of many Health Service Executive Votes and Department of Health Votes. When former Deputy Dan Neville was in opposition on that side of the House, he raised this matter consistently. I am glad that the Minister of State, Deputy McEntee, is making valiant efforts to deal with this.
Funding for this area includes youth mental health, improvement of the CAMHS and the adult services, services for older people, out-of-hours services, enhanced service user and carer engagement, perinatal mental health, attention deficit hyperactivity disorder, ADHD, in adults and children, dual diagnosis of those with mental health and substance abuse issues, increased services to meet the needs of those with severe and enduring mental illness with complex presentations and improved specialist clinical responses through clinical programmes.
Deputy Martin raised a specific case in respect of 11 beds. I do not have the details of that here, but I will undertake to follow up on that for him. I know it is an issue of concern locally, and Deputy Browne might have referred to that. Believe me, the Minister of State, Deputy McEntee, is working very hard in this area. The improvements I have outlined are long overdue and it is hoped they will make a significant improvement for the health, in particular the mental health, of children and young adults.
I am surprised the Taoiseach is not aware of the Linn Dara situation because it is all over the media. Linn Dara was opened in 2015 with fanfare. It has 22 beds, 11 of which are to close on Friday, and the children are going to be sent home.
They voted against it. We asked for €37.5 million in funding and they voted against it.
Will the Deputy please keep quiet? Where are those children going to go? That is the question I asked the Taoiseach. No one has an answer. These are children who were admitted in an emergency and they are at high risk. Every Deputy knows this. I have a list of CAMHS cases in my office and I have no doubt other Deputies do also. These are children in severe need of assessment, intervention, treatment and admission but it is simply not happening for them. The anxiety, stress and strain on the parents is unbelievable and unacceptable. It is inhumane.
The time is up.
What I asked the Taoiseach earlier is whether the Government will intervene to prevent the closure of the 11 beds in Linn Dara. It is next Friday we are talking about and nobody has come up with any alternative for the parents concerned other than those parents taking their children back home, which is not a solution.
We proposed 24-7 intervention services and they voted against that too.
Thank you, Deputy.
Sending them to an adult facility is not a solution either. Surely it is within the remit and capacity of the Health Service Executive and the Department of Health to intervene to make sure that service does not close on Friday.
The Deputy is over time.
He is well over time.
I am suspicious as to whether it can magically reopen in September, as per the HSE's comments to the news media this morning. That does not quite add up.
Let me clear up a few things for Deputy Martin. First, intensive efforts are under way to maintain the services at Linn Dara CAMHS unit at Cherry Orchard, Ballyfermot. The Minister of State, Deputy McEntee, is in regular and very close contact with the HSE in regard to the particular difficulties of providing adequate staffing, and meetings are under way this very afternoon. Clearly, however, there are staffing difficulties at this facility. At present, the unit is reliant on providing cover through methods such as staff working additional hours, overtime and agency staff. However, the core issue facing Linn Dara at present relates specifically to staff recruitment difficulties for mental health professionals. I pointed out to the Deputy that 160 have been recruited from January to March this year and an additional 114 assistant psychologists have been approved and are now under recruitment.
Let me clear this up for Deputy Martin. The problem facing Linn Dara does not relate to funding availability or the restructuring of any of the CAMHS services.
Will the Taoiseach support it?
Let me assure people that any discharges from Linn Dara are clinical decisions and are planned discharges. No individual will be discharged to close beds. Let us be clear about that. The HSE is actively engaged in a recruitment process for Linn Dara and is meeting this afternoon. It is exploring every option to ensure this excellent service remains fully operational.
Where are they going to go?
As I said, there has been an increase in moneys and the number of staff this year. Further approval has been given and no child is being sent out of Linn Dara because of either funding difficulties-----
They will be.
They are planned discharges. No individual-----
They are not planned. I can show the Taoiseach the email.
No individual will be discharged to close beds. It is not a question of money-----
Staff shortages.
It is a question of staffing difficulties. Anybody discharged is a planned, clinical discharge.
No, it is not planned.
The imminent closure of 11 child and adolescent mental health service beds at Linn Dara brings acute mental health provision for those under 18 years to 52 beds, which is just over half of what A Vision for Change recommended over ten years ago. Incidentally, Fianna Fáil abstained on a Sinn Féin motion to provide 24-7 mental health services.
On Friday, along with my colleague, an Teachta Munster, I visited the department of psychiatry acute inpatient unit in Drogheda. This is a world-class, state-of-the-art facility. I commend everyone, including the Minister of State, Deputy McEntee, on bringing it to fruition. The purpose of this unit is to assist citizens from counties Louth and Meath who present with acute mental health problems. They receive treatment and therapy for a short time - usually about two weeks. They are then discharged to the community mental health staff for follow-up care. In Drogheda, the Singleton House facility provides individual patient treatment but there is no day hospital for ongoing treatment and recovery.
A Vision for Change places a strong emphasis on community-based psychiatric services but in north Louth, these are practically non-existent. In Dundalk, the picture is particularly grim. In north Louth, all HSE mental health provision is delivered from a 60-year old building at the Ladywell centre in Louth County Hospital, Dundalk, which the Taoiseach should visit. Against all the odds the mental health providers do great work, but because of issues of damp and lack of suitable space, much of the Ladywell centre is unsuitable. That means there is no child and adolescent mental health provision and no psychiatry of old age in north Louth. After considerable lobbying, additional staff members were allocated to the area, which I welcome, but there is no accommodation for them in Dundalk. Therefore they cannot even be in the place that needs them. Instead patients travel to Ardee or Drogheda, which is totally unacceptable.
There is a long-standing promise of a primary care centre with a facility for community mental health for Dundalk. However, that promise is worthless. There is no start date, no definition and no real commitment. Sometimes this promise is used as an excuse to refuse to upgrade the Ladywell centre. They are stuck in this decrepit building that is not fit for purpose. They are told it cannot be upgraded because a primary care centre is due. There is no definition of when that might be. The choice is quite simple. The Government should deliver the primary care centre for Dundalk as soon as possible or it must upgrade the building at the Ladywell centre.
Louth and Meath have the lowest per capita mental health spend in the State.
I thank the Deputy.
Tá mé críochnaithe anois. As I am sure the Taoiseach knows, there are areas in Dundalk that are highly deprived. I ask the Taoiseach to intervene on two counts. Will he intervene to ensure that citizens in north Louth get the facilities they deserve? Will he intervene to prevent the closure of the 11 child and adolescent mental health beds at the Linn Dara facility?
I have already referred to the Linn Dara situation where a meeting is taking place this afternoon. Sanction has been given for the recruitment of personnel already from January to March this year, including a further 114 assistant clinical psychologists. The difficulty with the Linn Dara facility is not funding but is a question of staffing difficulties. Serious efforts are being made today on a continuing basis to deal with that matter. I hope it can be dealt with conclusively and positively. It is not a case of the usual claim of a shortage of money. Some 1,100 new posts have been provided for mental health and sanctioned and filled between 2012 and 2016. There was additional substantial funding of more than €115 million. Budget 2017 provided further additional funding for mental health, which means that the HSE funding for this key care programme will increase from €826 million in 2016 to more than €850 million this year.
In budget 2017, an additional €35 million was allocated for services to be initiated in 2017. The Deputy is talking about north Louth, which, no more than any other part of the country, still has inadequate services. The range of what I have outlined, which is of particular to the Minister of State, Deputy McEntee, is evidence of the Government's continuing commitment to dealing with this.
The Deputy mentioned A Vision for Change. A review of the 2001 Act is under way.
As I mentioned to the Deputy last week, some points made by Deputy Browne are being taken into account. In line with A Programme for a Partnership Government, the Department recently commenced a policy review of A Vision for Change. This began with the evidence-based expert review of international best practice and existing service development. The latter was completed in February of this year and it will inform the next stage of a policy review process and that will take into account the review of the Mental Health Act.
The Minister of State, Deputy McEntee, chairs a task force that comprises a diverse group of 18 people from a number of different mental health sectors - public, private, community and voluntary. The task force has a balance of age, gender and diversity and is an action-focused group which has been meeting monthly over the past year. As part of the Minister of State's commitment to ensuring that the voices of children and young people are at the very heart of the work of the task force, a series of consultations with young people themselves has now commenced. The task force and the public consultation process organised by the Minister of State are very active. The detail of what the Deputy referred to in north Louth is a matter on which I can follow up. The overall picture is one of increasing funding and approval, sanction and recruitment of qualified staff to provide the best level of service for children and young people on a 7/7 basis so that nobody is left without attention when they need it.
I will repeat what I said, namely, that there is no child or adolescent mental health provision and no psychiatry of old age in north Louth. Is that acceptable? It cannot be acceptable. There is no adequate facility. There is a decrepit building which cannot even accommodate the extra staff that were brought into the area.
The Taoiseach mentioned A Vision for Change. It contained a recommendation to the effect that the proportion of the total health budget allocated to mental health should be progressively increased to 8.24%. Even that would be below international standards but it has never been realised. The lack of capital investment in mental health services in County Louth has resulted in completely inadequate facilities. How can a parent bring a child with depression 60 km from Carlingford to Drogheda for an appointment on, for example, public transport, which the Government is also cutting back? Why should an older person with perhaps a lifelong history of mental health difficulties be expected to travel 50 km from Omeath to services in Ardee? How can mental health providers be expected to do their job if they cannot even get a desk in Dundalk? When will an appropriate building be provided for mental health services in north Louth so that citizens can access essential and life-saving services?
Nothing is acceptable to Deputy Adams no matter how good or adequate it might be. What is acceptable, however, is the fact that the budget has increased from €826 million to €853 million for this year. What is acceptable is that 1,100 posts have been filled since 2011. What is acceptable is that 160 additional posts have been recruited and filled between January and March of this year and that recruitment campaigns are currently under way and being followed through diligently. What is acceptable is that sanction has been given for an additional 114 assistant psychologists to enhance early intervention primary care counselling services for those under 18 years of age in particular. What is acceptable is the development of a plan to improve 7/7 mental health care nationally. That has been progressed and is nearing completion. What is acceptable is that this has been prioritised in all areas and should be in a position to provide access to a weekend service for current service users, including those in north Louth and many other areas throughout the country. What is acceptable is that a full mapping exercise has been carried out. The HSE is consulting all health sector personnel and assessing the resource implications in order to develop costed actions.
I will follow up in respect of the particular issue Deputy Adams mentioned in north Louth but, overall, this was a Cinderella sector of society where there was not a voice to carry it forward. It is evident that this matter is now, and will continue to be, a central priority of the Government.
The Minister of State, Deputy McEntee, is doing very diligent work in this area and it is proving to be progressive. It is not yet there, by any means, in terms of it being a world-class standard but it is a very significant improvement indeed on what was left lying in isolation for so many years.
South Tipperary General Hospital has been operating continuously on a full capacity protocol for the last 16 months. According to the hospital manager, they have been unable to de-escalate the protocol given the persistent and chronically high numbers of patients on trolleys. I thank and praise the front-line staff of doctors and nurses and everyone else there.
There are recent and totally unexpected ward closures in the area. Some 18 step-down and rehab beds will be going this Friday in the wonderful geriatric unit at St. Patrick's Hospital in Cashel. The Sacred Heart unit at Dungarvan Community Hospital, which also is an excellent facility, will lose 11 rehab beds, three long-term beds and three step-down beds. This is just increasing the concerns of the staff and families of the patients in those facilities in the county and in west Waterford.
One measure that has been successful in addressing the problems of chronic overcrowding and long delays in our accident and emergency departments has been the introduction of ultrasound diagnostics in local primary care centres. In January 2017 the community healthcare organisation, CHO, area 5 implemented a short-term initiative whereby GPs could directly refer adult medical card and GP visit card holders for X-ray and ultrasound services to a number of identified providers. They are operating successfully in Limerick, Cork and Kerry but there is something wrong that we cannot do it in County Tipperary. This was supposed to be a short-term emergency measure, designed to relieve pressure on hospitals in the immediate post-Christmas period.
The Mary Street Medical Centre in Clonmel is an excellent health care facility and primary care centre that been attempting to implement the use of ultrasound diagnostics to help patients receive treatment faster. In February of this year, after a lot of hard work, examinations and visits from HSE senior personnel, it was awarded a contract by the HSE to carry out such diagnostics. Astonishingly, this contract was only for the duration of 14 days and was subsequently withdrawn after just ten days. It must have been the shortest contract in the history of the HSE. This is despite the fact that it carried out 35 scans in the seven working days making earlier diagnosis possible, which benefitted patients, and prevented referrals to the overcrowded accident and emergency department in South Tipperary General Hospital. Patients and doctors alike praised the service but the HSE has refused to extend the contract, in spite of the detailed analysis of the success of the measure.
One patient who was helped by this ultrasound service was a lady who was diagnosed with a tumour in her womb but who thankfully has since had surgery to treat it. If she had to experience the 12-month delay for ultrasound in the public system, this lady’s outcome would have undoubtedly been far worse. This lady is a General Medical Services patient and would otherwise have had to pay for a scan, which she probably could not afford.
I hate waving things at the Taoiseach on his long good-bye, and I wish him well, but there was a lovely picture of the Taoiseach on billboards all over the State where he said he would end the scandal of patients on trolleys. Is the Taoiseach able to sleep at night when he thinks of this? I ask the Taoiseach to direct the Minister for Health, Deputy Harris - if he will not do it himself - to continue this wonderful service or to at least give it a three-month trial to see how successful it is. There were 35 patients done in 11 days. The Minister is not here. Tá sé as láthair. He is on the road working hard, but he should be here dealing with these issues.
Ar an mbóthar.
I know that, ar an mbóthar. Ag lorg vótaí. I wish him well in that also, but will the Taoiseach ask the Minister to bring some bit of sanity to this? I am getting comments from the side now and I have no earpiece like the Taoiseach. When the Minister for Social Protection, Deputy Varadkar, was in the Department of Health he did not do a whole lot there either.
This is a disgrace. This was a service that had a proven ability to deliver and to alleviate the crisis. It is a wonderful health centre that had made the investment. Will the Taoiseach please ask the Minister to give this a reasonable chance of examination and exploration to give the patients in Tipperary the same chance they have in Cork, Kerry, Limerick and elsewhere?
Sometimes I find it hard to pick up all of Deputy McGrath's words but I think I heard him say that he wanted some insanity brought into this-----
What was that?
I think I heard him say he wanted some insanity brought to the situation. That seems to be what he said.
The Taoiseach gets my meaning.
If I heard him correctly, the Deputy said that the situation requires that insanity be brought to bear.
I said no such thing.
Perhaps the sound is a bit off.
The Taoiseach is hearing things.
In any event, the Deputy's comments about primary care centres are in the context of a full programme of primary care centres being provided throughout the country. The theory is that people will be able to go to primary care centres to have medical needs which do not require treatment in accident and emergency departments dealt with and that this will help to reduce overcrowding in accident and emergency departments. When primary care centres are up and running they are required to be staffed and to have GPs available. There is little point in building them if they are going to be closed at 5 p.m.. The theory is that a person should be able to go to a primary care centre on a 24-hour basis, as is the case in so many other countries. This issue forms part of the discussions which the Minister for Health is having with the GPs in terms of their contracts and the types of facilities that they require in primary care centres.
According to the HSE TrolleyGAR system this morning, there were 331 patients on trolleys in acute hospitals nationally. While this causes distress to patients, their families and to front-line services, the recent data indicates that the national situation is improving, with approximately 5% fewer patients waiting on trolleys at the end of April this year as compared with the same period last year. Notwithstanding this improvement, these figures are still too high and the Department is working assiduously with the HSE to identify measures to reduce overcrowding in our hospitals and to provide key improvement measures that will continue to reduce trolley numbers and improve patient experience. Several hospitals were under pressure this morning, including the Mater Hospital, Beaumont Hospital, St. Luke's General Hospital, Kilkenny, Letterkenny General Hospital and University Hospital Waterford. Lessons have been learned over the last number of years. The winter initiative introduced in an effort to reduce emergency department overcrowding, in respect of which an additional €40 million was provided, brought about an improvement. Lessons have been learned from that and will be implemented into the future. A range of practical measures were included in that initiative, including the provision of 90 additional beds, aids and appliances for approximately 5,000 patients, 1,000 additional home care packages and 615 additional transitional care bed approvals.
In regard to the particular issue raised by Deputy Mattie McGrath, I will ask the Minister to follow up on the matter for him.
I thank the Taoiseach for his response. If I did mention the word "insanity", I did not mean to do so. However, what is going on in the HSE is definitely bordering on insanity. It is proposed to close two facilities, one in Cashel, which is north of Clonmel, and another in Dungarvan, which is south of Clonmel. Both are excellent care facilities. The Taoiseach's spiel of announcements is all waffle. We know from the National Association of General Practitioners conference held at the weekend that local GP services nationwide are at crisis point and on the verge of collapse. FEMPI cuts of up to 38% and the massive number of GPs emigrating are having an impact.
On the Taoiseach's point that the primary care centres will have to be open 24-7, the facility I am speaking about was not allowed to do that when it had a contract, albeit it was only a 14-day contract. That contract was withdrawn after eight days despite the huge success of the facility in terms of reducing pressure on the local accident and emergency service. If that was not an insane decision, then I do not know what it was. According to expert analysis, the facility provided expert treatment services. Having recruited additional GPs and staff who were told on a Friday evening that they were to start work the following Monday, the contract was withdrawn. That is a waste of money and resources.
The Mary Street Medical Centre is a wonderful facility. Other facilities in Clonmel have invested hugely in equipment to enable them to provide diagnostic services. These services could help to reduce overcrowding in accident and emergency departments, provide people with quicker access to results, thereby reducing long-term damage to people's health, result in huge savings to the State and also reduce stress on families. The HSE is confused. Will the Taoiseach ask the Minister to allow this centre a three-month trial of operation? There are similar services in Limerick, Cork and Kerry and they are operating successfully. What is wrong with Tipperary? It is the biggest inland town in the country with, consistently, the highest number of people on trolleys at South Tipperary General Hospital, better known as St. Joseph's hospital. The Mary Street Medical Centre can provide this service. We need to allow the people in the primary care centres to do their work without having one hand tied behind their backs. These people want to do the work and they are able to do it. They are professionals who have invested and they have all the staff required to carry out the service.
There is nothing wrong with Tipperary or its people but I am sure they are a little disappointed after Sunday.
A little.
They will try to come back at the Reds the next time.
Deputy Mattie McGrath did not turn up.
We are at the job a long time.
I will ensure that the Minister for Health, Deputy Harris, comes back to the Deputy about the particular issue he raised. When facilities are provided, either by the taxpayer or through PPPs, they are provided for a particular purpose. It is up to management to make them work in the best interests of all the people by giving the best level of service. I take the Deputy's point.
The priorities are backwards.
If all the facilities are there, they should be made to work in the interests of people. I will ensure that the matter is followed up with the Minister for Health.
The HSE is deliberately and flagrantly breaking the law by denying children with disabilities their statutory entitlements to assessments of needs. The Disability Act 2005 provides for an assessment of the health and education needs of person with disabilities and provides for services to meet those needs. Section 9(5) provides that the executive shall cause an assessment of applicants to be commenced within three months of the date of receipt of an application. The background information and supporting documentation refer to the need for services to be provided early in life in order to ameliorate a disability. The Act provides that the assessments must be started within three months of the application and that the HSE must complete the assessment within three months. That is a legal requirement on the HSE as set out in the legislation. Unfortunately, that is not the situation that obtains nationwide. The legal entitlement of children with a disability is being breached routinely by the HSE. Children are not being assessed within the three-month period and there are huge delays in assessment. The service is broken and there must be an immediate solution to the problem.
The current situation for children in terms of assessment of needs is totally unacceptable and I will give a few examples. A child was referred for assessment on 8 September 2016 but a letter from the HSE states that the child is currently scheduled for assessment in September 2018. Another was referred for assessment on 19 January 2017 but the HSE letter indicates that the waiting time for assessment is approximately 24 months. A third child was referred in January 2017 and was told by the HSE that the assessment would commence in April 2019, a full 27 months away. This is simply not good enough. That child is now over three years old and will be over five years old in two years' time.
Early intervention is absolutely crucial in order to ensure that children with disabilities are properly looked after and have services provided for them. Vulnerable children with disabilities are being mistreated by the HSE and are being denied their legal rights. Does the Taoiseach condone the routine breach of the law by a State agency, namely, the HSE? What does he propose to do about it? Will he instruct the HSE to abide by the law and ensure that every child is assessed in accordance with the law?
This is an important subject. The Government has prioritised disability by appointing Deputy Finian McGrath as Minister of State at the Department of Health to sit at the Cabinet table and articulate the concerns and anxieties relating to this area on a regular basis. Disability funding has increased over the past year and early intervention services and services for school-age children with disabilities need to be improved and organised more effectively. This process is well under way and the HSE is engaged in reconfiguring its therapy resources into geographically-based teams for children aged from birth to 18. The objective of the new model of assessment and intervention is to provide a single, clear referral pathway for all children, irrespective of the disability they have, where they live or the school they attend, as evidence shows that is an important element of progress.
Some €8 million in additional funding was invested in 2014-2015 in order to provide 200 additional posts to support the implementation of that model. A further €4 million in additional funding was allocated in respect of 75 therapy posts in 2016 and it is expected that as this reconfiguration of services takes place it will have a significant impact on the HSE's ability to meet the needs of children and young people in a much more efficient, effective and equitable manner.
In 2013, 260 front-line primary care staff positions were approved.
That included 52 occupational therapists and 52 speech and language therapists. The aim is for that recruitment to continue which will lead to a reduction in waiting lists and times. A further €4 million was provided in that regard in 2014.
Since the June 2007 commencement of Part 2 of the Disability Act 2005, the HSE has endeavoured to meet its legislative requirements as specifically referred to by Deputy Healy. The number of applications for assessment under the Act has increased each year since it was introduced. It is anticipated that in excess of 6,000 applications will be received this year. It can take a significant period to determine accurately the nature of a disability which a child might have. Although there has been continual investment in this area, there are significant challenges in meeting the statutory timeframes which apply to the assessment of needs process. The Minister of State at the Department of Health, Deputy McGrath, is dealing with the delay in assessments. He is trying to resolve those delays by direct consultation. There is an ongoing recruitment campaign to combat the issue of staff shortage. The Minister of State is working with the HSE to deal with this in order that the requirements of the Act can be met by the HSE and there are no delays beyond the period for assessment and determination of a disability.
The Taoiseach has not answered the question. The HSE, which is a State agency, is breaking the law. I asked the Taoiseach if he condones that and if he will ensure that does not happen in the future. Unfortunately, since this Government has come to power and Deputy Finian McGrath has taken responsibility for the issue, the position has disimproved. We have gone from a situation where there was reasonable compliance with the law to one where we now have a waiting time of two years for the commencement of an assessment. The situation is being ignored. It has been raised in this House by several Deputies through parliamentary questions and as a Topical Issue matter. It has been ignored. The Taoiseach's answer indicates that it is still being ignored. The current situation is that where an assessment of need has not been completed, there are consequent delays in the provision of children's services such as speech and language therapy and the appointment of special needs assistants and resource teachers. The inaction of the HSE is unacceptable, deplorable and illegal. Does the Taoiseach condone that illegality and what he will do to ensure the HSE abides by the law?
It is not acceptable for any State agency to be outside the legal requirements of what it has to do. The Minister of State at the Department of Health, Deputy McGrath, who has special responsibility for disability issues, sits at the Cabinet table, has a substantial budget and is working assiduously to deal with this issue. If there are 6,000 assessments to be carried out this year, more than 100 must take place each week. Many of these assessments are quite complex and take a period of time to assess accurately.
I am concerned with assessments that have not been commenced. People have been waiting two years.
As the Deputy knows, parents have every right to know the nature and scale of the disability that their child or children may have to deal with. The Act itself-----
They are being left in limbo.
Will Deputy Healy please allow the Taoiseach to finish?
There has been much collaboration between the health and education sectors on the issue of children's disability. That is facilitated by the cross-sectoral team and the implementation of the Disability Act. That team comprises representatives of the Department of Health, the Department of Education and Skills, the Department of Children and Youth Affairs, the HSE executive, the National Council for Special Education and the National Educational Psychological Service. As Deputy Healy is aware, a detailed report was compiled by Mr. Eamon Stack, chairman of the National Council for Special Education, which sets out a progressive way of dealing with the issue. While waiting lists are unacceptable and should not exist, the Minister of State is at the forefront of dealing with the delays. In the near future, it is hoped the law in terms of assessment for children will be fully complied with, unlike the current situation where children have to wait for longer than they should.