Dia dhaoibh ar Lá Idirnáisiúnta na mBan. Tá súil agam go mbeidh bhur tacaíocht agam. Táim ag tosú leis na Saincheisteanna Tráthúla agus is é an chéad ceann, in ainm an Teachta Michael Moynihan, ná to discuss the lack of availability of State-owned lands for industrial development in Charleville, County Cork.
Saincheisteanna Tráthúla - Topical Issue Debate
Industrial Development
I wish all women a happy International Women's Day and thank them for everything they do for us and for society in general. The question I have this morning relates to land for industrial development in Charleville, County Cork. Over the past 20 or so years, the Railway Road industrial park in Charleville, which was designated as an industrial site, saw a number of initiatives such as the business expansion scheme. All the sites on it have been developed. Charleville is an engineering capital. It developed out of the old Golden Vale long ago. Significant engineering works happen there, many of which have products they are producing and servicing which are among the top in the world.
Over the past while, the last sites that were available from IDA Ireland on Kilmallock Road have been taken up by a local indigenous company. The sites that were developed on Railway Road are now all occupied. Charleville is the heart of Munster. It is midway between Cork and Limerick. It is extremely well situated for business and prospective growth. People come to us who are looking for IDA, State-owned land to develop industry in the environs of the town. We do not have that land at the moment. Over the decades, IDA Ireland sought land in provincial towns such as Charleville and elsewhere. Over the years, that land has been developed. We have come to a juncture where IDA Ireland, Enterprise Ireland and the Department must look at places like Charleville for further development. There is significant employment in the town. These indigenous industries provide significant potential for growth. They have contracts right across the globe for the product they are producing. Many are at the top of their field.
My question to the Minister of State is about what plans IDA Ireland, Enterprise Ireland and the Department have to source more land within Charleville for industrial development there. The Railway Road side has all the sewerage, electricity, water and broadband connections necessary, which have been developed over recent years. Is it possible to acquire more land adjacent to that or to get more land elsewhere in the town or its environs so that we can facilitate people who are looking at Charleville as a place to start their businesses? People have come to us about it, including Ian Doyle, a local councillor. They work extremely hard. We recently talked about how people come to us looking for land and we do not have that option available. What plans do the Department, the Minister, IDA Ireland and Enterprise Ireland have to develop further lands? It could be done in conjunction with the local authority, Cork County Council, which would be forthcoming. We need an overall plan to ensure land is available for industrial development in Charleville and its environs.
Gabhaim buíochas leis an Leas-Cheann Comhairle agus leis an Teachta. Guím gach rath agus gach beannacht ar an lá tábhachtach seo. I wish everybody a happy International Women's Day. It should not take a day. All of our good wishes should be given every day and we should learn every day. Is Seachtain na Gaeilge í freisin agus tá sé tábhachtach go mbainfimid úsáid as an Gaeilge gach seachtain den bhliain freisin. I thank Deputy Moynihan for raising this important issue on behalf of Charleville. I know he and Councillor Ian Doyle work passionately for the interests of the community in Charleville. I share his interest, not just in that region but in the regions generally.
Balanced regional enterprise development is a key priority of this Government. IDA Ireland shares this priority. IDA Ireland is targeting half of all investments to regional locations. At the midpoint of its current strategy, 260 out of 491 investments won went to regional locations, which is well over half of the figure. Foreign direct investment is not the sole contributor to addressing the challenges facing our regions, but it can have a significant impact in propelling economic recovery and realising more balanced growth, as Deputy Moynihan referred to. In 2022, the numbers directly employed in IDA multinational clients in Ireland reached 301,475, the highest foreign direct investment employment level ever, with employment growth in foreign direct investment companies recorded in every region of the country.
Charleville and Cork County are marketed by the IDA as part of the wider south region, which includes County Kerry as well as Cork. There are 229 IDA companies in this region and 212 IDA-supported companies in Cork, employing 50,208 people. As Deputy Moynihan referred to, IDA has several business parks. In north Cork, they include Charleville, Millstreet, Fermoy, Kanturk and Mallow. The largest available land bank is Fermoy business and technology park, which has a total area of 8 ha. There are two IDA client companies in Charleville, RCD Engineering and SHV Energy, which collectively employ 260 employees. There are a further 11 IDA client companies located across north Cork, employing 1,700 employees.
The south west has a significant ecosystem of well-established companies across technology, life sciences, international financial services and, as referred to by Deputy Moynihan, engineering and industrial technologies. It has also won significant investment across all of these sectors over a sustained period, which has contributed significantly to employment growth and positive economic impacts on other sectors of the economy.
The IDA has regular engagement with client companies and stakeholders in the county, and throughout 2023, IDA Ireland will continue to market Charleville and the south west and will arrange corresponding site visits as required. I will follow up with IDA Ireland regarding the Deputy's remarks and seek to meet with him about land availability in Charleville.
Enterprise Ireland and the local enterprise offices also play a central role in supporting enterprise to maximise job retention and creation in all regions. Finally, nine regional enterprise plans were launched by my Department in early 2022 to reinforce regional enterprise development and job creation throughout the country. The south west regional enterprise plan encompasses Cork and Kerry and facilitates stakeholders to work collaboratively to strengthen the enterprise ecosystem and realise enterprise growth and job creation in the region. There may be possibilities under the south west regional enterprise plan to build on the engineering cluster in Charleville referred to by the Deputy. I am happy to work with him, the local enterprise office, Enterprise Ireland and the local educational institutions regarding that.
I thank the Minister of State for his reply. The issue here is how we build upon the successes in the engineering hub in Charleville that grew out of decades of Golden Vale. How do we make sure Charleville is available and able to have the critical infrastructure and land available if there is further industrial development? It is quite obvious there are people looking for land for development within the Charleville region. The land banks are there. There is very little left in Charleville. How do we ensure there is a collaborative approach between the Minister of State, the Department, Enterprise Ireland, IDA Ireland and the local authority? I welcome the Minister of State's remarks about working with us and I thank him for that. Everybody is willing to do this but we need to be able to bring everybody together to ensure land is available. The industrial and engineering works will continue to grow. We have seen the massive expansion in BCD over the past while and this company will continue to grow because it has the expertise and fantastic people heading it up. We need to ensure a land bank is available. I ask the Minister of State to bring about co-ordination between all the State agencies to ensure this land bank is available for further development in Charleville.
I am more than happy to work with the Deputy to facilitate that. The first place to start is with Cork County Council to see what available serviced land it has. Once we have an audit of available serviced land, we will engage with IDA Ireland and other enterprise agencies such as Enterprise Ireland and the Cork local enterprise office regarding available opportunities in Charleville. IDA Ireland is very clear that it will continue to market Charleville and north Cork, where nearly 2,000 people are in IDA companies. I am more than happy to facilitate a meeting of information and minds regarding available land banks. I cannot make any commitments today but I will follow up.
Schools Building Projects
Guím Lá Idirnáisiúnta na mBan sona ar gach duine. Mar a dúirt an tAire Stáit, an Teachta Calleary, is Seachtain na Gaeilge é fosta. Táim ag cur ceiste faoi fhadhb atá sa tír agus ag labhairt faoi na fadhbanna i mo chontae féin maidir le scoileanna a athchóiriú, síneadh a chur le scoileanna agus faoi scoileanna úra atá de dhíth. Táim ag labhairt faoi Ghaelscoil Na gCeithre Máistrí i mbaile Dhún na nGall, atá ag fanacht le 24 bliain anois. Tá an scoil lonnaithe i bhfoirgneamh sealadach. Níl sé sin ceart do na páistí, do na tuismitheoirí ná do na daoine atá ag obair inti, is iad sin, na múinteoirí, na special needs assistants agus foireann uilig na scoile. Tá an scoil ag fanacht ar an solas glas. Tá achan rud críochnaithe. Tá na tenders istigh. Tá an próiseas déanta ach tá an scoil ag fanacht ar an solas glas.
I am glad the Minister of State is here. I am not going to do the usual "where is the Minister?". I am glad the Minister of State is here because this issue is relevant to her constituency. There is a major issue with the Department of Education regarding capital funding. My major concern is that if we stall 58 to 60 of the projects that are ready to go to tender or ready to go to construction, it will stall the system, planning will run out and we will end up with a situation where redesign will have to happen and it will cost more in the long run.
I ask the Government to use common sense here. We seem to have money for everything when we hit a speed bump along the road but even back in 2011, 2012 and 2013, when the country was in a worse situation than it had ever been in the past 50 years, we protected the education budget and allowed buildings to go ahead. We need sustainability within the Department because contractors need sustainability. Young construction workers in Galway and Donegal are making decisions. They might decide to go to Australia if we do not have long-term security in building.
My message today is quite clear. We need to re-instill confidence within the system with regard to schools like Four Masters High School that is ready to sign contracts, Moville Community College that was ready to sign documents three weeks ago, and St. Eunan's College in Letterkenny that was ready to go to tender to ensure these projects go ahead. There is a multi-annual budget. There is a figure of €860 million for the year. I accept there has been inflation and schools like Scoil Íosagáin in Buncrana have suffered because the contractor who was awarded the contract was unable to take it on because of escalating costs. This happens but they had to go back for planning. I accept there has been much disruption within the system and I know Department officials in Tullamore are working within major constraints but we need collectively as parliamentarians and as a Government to go to the Department of Public Expenditure, National Development Plan Delivery and Reform to get additional moneys because, even with small-scale projects, there has been a good deal of stalling. I know the Minister of State will use her own networks in her party to ensure we get these projects moving again because it is having a very negative impact on many schools.
I am taking this Topical Issue matter on behalf of the Minister for Education. The Deputy is quite right. I am in a similar position to the Deputy as my county has the same needs and pressures. I thank him for raising this matter as it gives me the opportunity to provide an update to the House on the current position regarding a number of school building projects that are on hold from proceeding to either tender or construction due to capital funding pressures.
The Department's capital allocation has always been under significant pressure and it has a strong track record of fully utilising it and in many years requiring supplementary capital funding to deliver urgently required school building projects. These pressures on the capital allocation have been compounded since the National development plan, NDP, allocations were determined in 2021 by the impact of high construction inflation, the increasing prevalence of autism and other complex special education needs that require the accelerated delivery of special educational needs provision at pace, and the urgent need to provide capacity for students from Ukraine and other countries under the international protection system. The national priority within the NDP for increasing the roll-out of housing is also adding to pressures on the Department's capital allocation given the knock-on impact for additional school provision requirements.
The Department's published NDP allocation for 2023 is €860 million. As part of its planning ahead for 2023, the Department is engaging with the Department of Public Expenditure, National Development Plan Delivery and Reform regarding capital funding pressures to continue to be able to support adequately the operation of the school system with roll-out of school building projects to tender and construction in 2023, including the projects referenced in the media reports.
Under the Department's large-scale additional accommodation scheme, 58 school building projects are currently on hold due to capital funding pressures. More than 180 school building projects were delivered during 2022, which included accelerated delivery of modular accommodation to support provision for 900 pupils with special educational needs. A total of 300 school building projects continued in construction at the start of 2023, most of which will be completed in 2023 or early 2024. This includes more than 40 new school buildings. All of these projects are helping to support the operation of our schools, are delivered to the highest standard, and are very energy efficient. This strong level of delivery is a key driver of capital pressures in the Department.
Other key achievements under the school building programme in 2022 include strategic initiatives put in place to support planning for school provision requirements; the setting up of 16 regional education and language teams, REALTs, to facilitate enrolment of 15,000 children from Ukraine; necessary smaller scale refurbishment and maintenance in 1,000 schools; and 16 deep energy retrofit pathfinder projects ongoing in partnership with the Sustainable Energy Authority of Ireland, SEAI. Strategic initiatives put in place to support delivery include use of project manager supports, procurement frameworks, a variety of delivery mechanisms, and a strong pipeline of projects.
It is also important to note the Department was very successful in accommodating 15,000 pupils from Ukraine. These pressures have resulted in the need for the Department's planning and building unit to assess its work programme and priorities for 2023 in the context of its available funding. This review is ongoing.
It is important also to say that when the Taoiseach took Leaders' Questions yesterday, he said there would be that collective effort to go to the Department of Public Expenditure, National Development Plan Delivery and Reform to seek additional funding exactly to speak to the point that we need to ensure stability and confidence within the schools and for the builders who tendered on those projects.
I thank the Minister of State. I will list a few of the schools for the information of the Department of Public Expenditure, National Development Plan Delivery and Reform, and for the Department in Tullamore. They know these, and much good work has gone into these: Gaelscoil Na gCeithre Máistrí in Donegal town is ready to start construction; Moville Community College in north Inishowen is ready to start construction; St. Eunan's College in Letterkenny is ready to go to tender; Pobalscoil Chloich Cheannfhaola has an application for a school building which is at the very early stages; at Scoil Cholmcille at Kilmacrennan a construction company has been appointed for an autism spectrum disorder, ASD, class extension; two classrooms for special education needs were announced in 2019 for Scoil Naomh Baoithin at St. Johnston in Lifford but are still waiting approval; Scoil Niall Mór in Killybegs has been waiting on stage 2A for a number of months; Scoil Naomh Fiachra, Illistrin, is currently at stage 2B, planning stage, but there is a concern around whether there is sufficient money to complete this project; Loreto Milford, has the stage 2A report submitted for a proposed extension and was offered prefabs, but this is not a solution for growing numbers; the Royal and Prior Comprehensive School in Raphoe had funding committed back in 2019 and it is looking for progress there; Scoil Íosagáin in Buncrana had to go back for planning because of problems with the awarding of the contract, but it is back on track and needs reassurances as well; the Crana College campus has applied for an 11-classroom extension; the principal at Cranford National School was also in touch with me this morning; Deele College in Raphoe was ready to go to planning last summer and had to bin its application and the design team with 12 to 18 months gone, and its numbers will be 750; and there is also Scoil Naisiúnta Caiseal na gCorr in Gortahork.
I mention these because if we stop any form of funding in that current system, we will lose out on all of the work that has gone in so far and all of the taxpayers' money that has gone into investment, design teams, architects, quantity surveying and all of that work. If we stop that, we are back to duplicating this work and it will cost in the long run. I am aware the Department of Public Expenditure, National Development Plan Delivery and Reform works on multi-annual budgets, but we need to find a better system. I am glad to hear the Minister of State's words today that there is a collective solidarity around this issue at Cabinet and around Government. School communities have been patient, in particular those schools with projects that have been waiting for the green light to be switched on. That is what I am thinking.
Gabhaim buíochas arís leis an Aire Stáit as teacht go dtí an Teach inniu agus as an am atá sí ag tabhairt dom. Guím Lá Idirnáisiúnta na mBan sona di agus don Leas-Cheann Comhairle. Bainigí sult as tríd an bhliain, ní hamháin ar lá amháin.
Táimid thar am ach tá an Teachta chomh dearfach sin.
Go raibh maith agat.
The Minister, Deputy Foley, fully understands and appreciate the concerns raised about the roll-out of school building projects. The Minister can assure the Deputy that the Department is very conscious of the need to support the operation of the school system and intends to provide clarity for individual schools about their school building projects as quickly as possible. In that regard, the Minister and the Department are very appreciative of the ongoing engagement with colleagues in the Department of Public Expenditure, National Development Plan Delivery and Reform. There is a collective piece.
It is also important to say that, over the past three years, the Government has invested €2.6 billion in school buildings. This is a record level of investment that has helped to add capacity and to modernise existing accommodation in schools throughout the country. I have no doubt the Minister is listening to Deputy McHugh's contribution this morning. I nearly feel compelled to list into the record all of the schools in my area, but I will not because there is such pressure. I have discussed this with the Minister and I will bring back the Deputy's contribution.
Medical Cards
Chomh maith leis an Teachta McHugh, gabhaim comhghairdeas le gach duine mar gheall ar International Women’s Day.
Téann a lán daoine gach bliain, nó gach seachtain, ag iarraidh freagraí dá ngearán leighis. Faigheann siad endoscopies agus colonoscopies chun freagraí a fháil dóibh féin. Sna laethanta roimh na mion-obráidí seo, b’éigean dóibh troscadh a dhéanamh agus beagáinín leighis nó cógais a thógáil.
Many patients seeking answers for medical difficulties are sent for an endoscopy or a colonoscopy. Sometimes it could be for ulcers, flux or blockages, and sometimes pre-cancerous lesions or ulcers can be found with an endoscopy or colonoscopy. A person may have an inflamed bowel, colitis or pre-cancerous polyps. It can be very stressful for patients when they are trying to find this out. In advance of the procedure, they usually receive a prescription in the post for the preparatory medication such as Picolax or Klean-Prep. Some people say the cost of these is not huge, but nonetheless they can vary between €20 and up to €50. Different pharmacies charge different prices. It has come to my attention in recent weeks that these costs should be covered under the medical card scheme. It seems, however, they are joining an increasing list of medications prescribed or actions carried out by GPs for which patients are expected or asked to pay despite qualifying for a medical card. There was one woman in her 70s who informed our office she had asked her doctor to postpone the appointment for a few weeks because she needed to save up the money for the pre-procedure medication. Over recent years we have seen charges for blood tests becoming common. Many GP practices are now being purchased by larger medical groups, which would be run on a for-profit basis. This is likely to continue and this type of situation is likely to become more common. We need centralised GP contracts. We need to have an audit of these charges faced by medical card patients.
Moving towards the ending of the two-tier system is the aim of Sláintecare, to which the Government remains committed. I heard the Minister mentioning this this morning on the radio. Part of this plan includes augmented medical card eligibility, increased entitlement to GP care, a reduction in prescription charges, and a GP contract manifesto to support chronic disease management.
Will the Minister of State confirm there will be no price to pay by medical card patients for this type of medication and by people who must obtain blood tests?
If a person is entitled to a medical card, he or she should not have to shoulder the burden of increased charges before facing into a procedure that can only add to the stress on him or her.
I thank the Deputy. I am taking this matter on behalf of the Minister for Health, Deputy Stephen Donnelly. The Minister and I are committed to supporting our national population-based screening programmes. The programme for Government contains a commitment in respect of expanding the age range for BowelScreen to those aged 55 to 74 years. The HSE plans to commence screening of those aged 59 years this year, in addition to the current age range of 60- to 69-year-olds. A report published by National Cancer Registry Ireland, NCRI, in September 2022 shows the positive impact of the BowelScreen programme on cancer detection in Ireland and notes that the programme is effective in detecting cancers earlier and saving lives.
With our population living longer lives than ever, many of us will undergo one of these procedures at some point. For the investigation to be most effective, the bowel must be as clean as possible. To achieve this, patients are prescribed medicines to help cleanse the area prior to the procedure. The HSE has statutory responsibility for medicine pricing and reimbursement decisions under the Health (Pricing and Supply of Medical Goods) Act 2013. The HSE's decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds on the advice of the National Centre for Pharmacoeconomics, NCPE.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the formal reimbursement list. Reimbursement is for licensed indications that have been granted market authorisation by the European Medicines Agency or Health Products Regulatory Authority, HPRA. The Deputy kindly clarified his question with examples of two products, namely, Picolax and Klean-Prep. In accordance with the 2013 Act, the companies marketing these medicines must submit applications to the HSE to be added to the formal reimbursement list. As they are not on the reimbursement list, they cannot be reimbursed under the community drug schemes.
Aside from HSE reimbursement, individuals may be entitled to claim tax relief on the cost of their medical expenses. This is at the standard rate of 20% and includes medicines prescribed by a doctor. People may also be entitled to an additional needs payment from the Department of Social Protection. This payment is awarded on the basis of a means test of a person’s weekly income. Its purpose is to meet essential costs that a person would otherwise be unable to afford. If these products are to become eligible for reimbursement, the companies marketing them must be encouraged to engage with the pricing and reimbursement process in Ireland.
The script I have been provided with in response to the detail of the question submitted by the Deputy clearly indicates that a company must submit an application in order to be part of the list. There is a need in this regard. We have a bowel screening programme in place. It is fairly clear that a problem like this could be addressed in a timely fashion.
I thank the Minister of State for the clarity she provided. We all have jobs to do from here on in, the first of which will be to engage with doctors who are prescribing these medications in order to ensure that if other medications are on the list, people, particularly medical card patients, will be directed to those ones. We must also engage with the companies if there is an easy fix in the context of them getting on the list. I have come across cases where it perhaps suited companies not to be on a particular list. However, we will certainly be able to take that up with them because prescription charges are essentially a tax on ill health.
While the Minister of State made some helpful suggestions regarding the additional needs payment, there can be delays. Sometimes if people are waiting for answers, particularly if there is suspicion there may be cancer or a precancerous condition involved, it is certainly something that should be dealt with at the point of access.
We have recognised this tax on ill health in our manifesto. We feel it is easy to identify who needs a medical card and why they are entitled to one. On a more general level, we should push forward with the Sláintecare recommendations to give medical cards to members of the Defence Forces who have to leave due to medical conditions and to all cancer patients. We should grant unconditional medical cards to those with disabilities in addition to, as the Minister of State indicated, expanding these schemes.
I thank the Minister of State very much for her answer. We have a little bit more work to do. I will take the matter up with the relevant bodies.
The Minister appreciates the importance of the issue. The procedures involved are necessary for maintaining good health and should be performed when recommended by a doctor. It is unfortunate that patients are placed in this difficult position. The Government appreciates the contributions of the pharmaceutical industry to public health in Ireland. However, the industry's engagement with the process for medicines such as these is essential to improving patient outcomes. The State and the HSE cannot compel companies to make pricing and reimbursement applications. The Minister is hopeful that with encouragement from the clinical community, progress can be made here.
April is bowel cancer awareness month. The programme encourages men and women aged from 60 to 69 to take up the offer of screening. Screening offers the chance for early detection before symptoms develop, which often means treatment is more effective than is the case with later diagnosis. The Minister and I are committed to and ambitious about the desire to improve cancer outcomes in Ireland through early detection of disease. I look forward to the Deputy's support for events relating to bowel cancer awareness month in April, which will no doubt raise awareness of the benefits of everybody engaging in early screening processes. I thank the Deputy for raising the matter.
Disability Services
I wish all the women in the House and across the complex - and I better mention my wife Helen at home - the very best of luck on International Women's Day.
The children's disability network team, CDNT, staff census and workforce review was published during the week. To be truthful, its contents are troubling to say the least. Of the 2,102 approved full-time equivalent places, a staggering 707 are still vacant. That equates to a national average of 34%. I want to focus attention on the areas that cover north and south Tipperary, namely, community healthcare organisations, CHOs, 3 and 5 and their CDNTs. As I said, the average staffing vacancy rate for 2022 was 34% nationally. In CHO 5, which covers south Tipperary, the vacancy rate was an astonishing 42%. If we go more local than that, the vacancy rate for the CDNTs operating in Clonmel was 37%. In Cashel, it was even worse at 39%.
The Minister of State might say that vacancies are not as bad in CHO 3 with a 19% staffing vacancy rate. That area also has the lowest allocation of staff and had no additional positions allocated last year. A 19% vacancy rate for that area is atrocious. CHO 5, on the other hand, had a higher number of posts approved; it was up 16%. There was no change in the number of filled posts, however. Consequently, it has a vacancy rate of 42%, which is way above the national average.
The Minister of State will outline the number of additional positions the Department is trying to fill and I appreciate that. The fact is that in CHO 5, where more spaces are being made available, the rate of vacancies can often be even higher. This is due to the Department’s inability to recruit staff because of the additional workload they are expected to shoulder due to the high rate of vacancies and issues with pay parity. Indeed, there are roles where there were fewer staff now than there were even in 2021.
In CHO 3, the number of occupational therapists is down by five. In CHO 5, the number of speech and language therapists is down by five. These are just small examples. Despite more than 25 new posts being allocated, in CHO 5, the rate of increase in actual posts available is 0.01. Across the entire south east, the number of dieticians has not changed. I will get to that matter later. It is also appropriate to point out that more than 500 of the 707 posts vacant last year existed in 2021. It is clear that the Government’s approach is not having the effect it should.
This is what families are faced with. They cannot get the timely services they need and many have had no choice but to get themselves in debt or go private. I cannot tell the Minister of State the number of parents who have done just that or the number who wish they could afford to do so.
Has data been collected from exit interviews to get feedback from workers with a view to identifying how best to address their concerns and issues of pay parity among providers?
Can the Minister of State indicate whether she has faith in the progressing disability services, PDS, programme or if she believes in an independent review with an alternative system in mind? For families who have spent money that they do not have to spare, will there be financial relief for them and for family carers or can provision be made through the National Treatment Purchase Fund?
I thank the Deputy for raising this important issue for discussion. As Minister of State with responsibility for disabilities, I want to acknowledge that is has been challenging for many stakeholders, particularly the children and young people who use the services
I again take this opportunity to reiterate my sincere regret about the delays being experienced in the provision of services. There are major challenges in recruiting and retaining staff in the healthcare sector, especially the therapy professionals required for children’s disability services. This is leading to vacant posts in CDNTs across the country. To support the effort to appropriately staff and resource CDNTs, the HSE staff census and workforce review provides invaluable data. It is the second time in a year that we have had that, so at least now I have a comparable figure. When I got it the first year, it was the first time it had ever happened. Now that I have it two years in a row, I have comparable data.
The 2022 CDNT staff census notes an average vacancy rate of 34% across CHOs nationally. However, this is to be understood in the context of an increase in approved posts. An overall analysis of the data from 2021 and 2022 demonstrates an increase of 11% in the number of posts and also a 2% increase in the CDNT workforce. I acknowledge that this is minuscule. This increase has been achieved in a context where there is an average turnover rate of 9.6% in health and social care professionals in the past year. That goes to the exact point that the Deputy raised to the effect that staff are employed, find that their workload is difficult, heavy and challenging and are leaving as quickly as they are coming in. As with other areas within disability services, south-east community healthcare, SECH, in CHO 5 and community healthcare area 3 HSE mid-west in CHO 3, both of which service the requirements of County Tipperary-based children and families, are continuing to experience significant recruitment challenges. The Deputy is right. The vacancy rate for north Tipperary is 23%. It is 15% for east Limerick, 37% for Clonmel and 39% for Cashel.
The CHOs continue to progress posts out to current national panels and continues to prioritise local recruitment campaigns. However, the 2022 staff census shows some areas of improvement, with the number of therapy hours pertaining to the north Tipperary CDNT increasing by 26 % from 2021. In order to mitigate recruitment issues, the HSE is also currently taking measures nationally to encourage recruitment and retention of staff in CDNTs.
These measures include: targeted national and international recruitment, to include an agreed relocation allowance where appropriate; apprentice and sponsorship programmes for therapy grades; employment of graduates as therapy assistants as they await CORU registration; and expansion in the number of therapy assistants in the system, with the HSE supporting individuals to return to education to qualify as therapists. These measures were not in place 12 months ago. You can see the influence of the Minister in the Department in the context of the agile, pragmatic approach taken to leading and to supporting the HSE to work differently in its recruitment campaign. We need rolling recruitment campaigns, but we also need to work with the people who are here to support people to come back into education or into assistant roles. The assistant role is incredibly important. If you have a physio who writes out a six-week programme for a child and can only see the child once in six weeks or once in ten weeks, the services of an assistant who can make sure that the programme is being done properly are invaluable. This is the type of post we need to put in place in our CDNTs in order that we can start to retain the staff.
I thank the Minister of State for her response but the figures she laid out generally relate to positions that are vacant. The vacancy rate among speech and language in CHO 3 is 17%. In CHO 5, it is 46%. That is nearly half of the available posts, and the number of staff has reduced by five in that area. The vacancy rate for occupational therapists in CHO 3 is just 25% - a reduction of 5% on the 2021 figure - but CHO 2 has a 50% vacancy rate. Among psychologists in CHO 3, a quarter of posts are vacant. In CHO 5, at 48%, it is nearly half. These are just some of the figures in the report.
Then there is the case of dieticians, which I have raised here before. In CHO 5, which extends across the south east, there is one post filled out of eight allocated to CDNTs. The vacancy rate is 88%. That is a national scandal. I appreciate what the Minister of State is doing and what is happening, but I have raised the matter of a child in Cashel, my town, with avoidant restrictive food intake disorder, ARFID, in this House many times. That family is one of those who are fighting for services in an area where there is one dietician across the CDNTs. That is wrong on every level. According to the figures in the report, the situation is not improving. That family is caught again and again, and it is not fair on them.
I would appreciate if the Minister of State would answer two final questions. If she cannot answer today, I will contact her office. Does the Minister of State intend to roll out family forums nationwide or only in selected CHO areas? In light of the damning figures in the census reports for 2021 and 2022, will she address the need to develop a strategic workforce plan to train, recruit and retain therapists for the posts currently unavailable to families in Tipperary and in constituencies across the country?
I will answer those two straight questions. On family forums, the answer is "Absolutely". In addition, I plan to go back to having my ministerial meetings with each of the CHOs. That is happening.
On workforce planning, the Minister for Children, Equality, Disability, Integration and Youth, Deputy O’Gorman, is away this week. It will be one of our key objectives in the Department to develop a workforce plan in respect of disabilities. It is also important that we focus on retention. You can see from the staff census that we are getting people in but we are not retaining them. The turnover is far too high in our disability network teams. We need to retain them. We are doing exit interviews but it is exactly as the Deputy is saying: because we have too few staff on some of the teams, people realise that it is a far bigger challenge than they had envisaged. We are doing that, but we need to bolster the teams, not only with occupational therapists, physiotherapists and speech and language therapists but also with assistants. Furthermore, we need to look at the position relating to the social care model, social care workers, social care assistants and social workers, and link with family workers. We also need to have behavioural therapists and music therapists. We need the full gamut. It is not a case that one size fits all.
I am at one with the Deputy when it comes to dieticians. When you train only 29 dieticians in a year, there is no wonder we have a shortage. The children who apply for the dietician role in the CAO will need 615 points and then they will go into a lottery. That is the number of spaces we have. We need far more places on dietetics. It needs to be completely expanded. We need to have a complete suite of measures on this. It is not only dietitians but we need nutritionists and an understanding of food therapy. I agree with the Deputy and 29 is too few. We need multiples of that.