Gino Kenny
Ceist:5. Deputy Gino Kenny asked the Minister for Health if he is aware of a severe shortage of public health nurses in Dublin Mid-West; and if he will make a statement on the matter. [19873/24]
Amharc ar fhreagraThursday, 2 May 2024
Ceisteanna (5, 22)
Joan Collins
Ceist:22. Deputy Joan Collins asked the Minister for Health the emergency measures the Government will put in place to ensure developmental checks resume in Dublin 8, 10 and 12, given the severe lack of child developmental checks in the area. [19450/24]
Amharc ar fhreagraFreagraí ó Béal (11 píosaí cainte)
This question is on the severe shortage of public health nurses in the Dublin Mid-West area. This is not an isolated situation and it is the same across a lot of community healthcare organisations, CHOs. I would like to get the Minister's thoughts on the shortages, especially in Dublin Mid-West.
I propose to take Questions Nos. 5 and 22 together.
I thank Deputies Kenny and Collins for raising this matter. On the back of their questions I engaged with my officials and the HSE on this. As per the questions, they are accepting there are shortages affecting the child development checks in Dublin south and Dublin west. The public health nurse service is experiencing significant shortages in Dublin south and west and the HSE has said recruitment is especially challenging. It has advised the local services is working to ensure those with the greatest need in the community are prioritised and that site-specific contingency plans continue to be refined monthly.
I fully recognise the frustration and worry of parents who are struggling to access the routine checks. I emphasise that if any parents have an active concern about their child they should contact their GP or local health office. We want to ensure the delivery of the full range of services provided by the public health nurses. We are progressing several initiatives at a national level within both my Department and the HSE to address the challenges with recruitment. There is an embargo in place, which the Deputies will be aware of. It is having an effect. This is one of the areas it is having an effect on. Before the embargo there were challenges with public health nurse recruitment into these teams and it is something the HSE is looking at to see what additional supports can be put in place. One of the advantages of moving to the regions this year is they will be able to deploy and redeploy healthcare professionals on a priority basis. What I see happening here is the inverse care law, meaning the communities and the families who need the additional public health supports the most are getting it the least. It is not something we are satisfied with at all and I am engaged with my Department and the HSE to increase the amount of public health nursing services available because I fully accept it is a real worry for parents.
This has been going for a number of years. There are parts of Lucan, north Clondalkin and Newcastle where parents of newborns and infants have had no checks on their children. That can only be a bad thing. I was looking at the trend in the last five years when it comes to public health nurses. There has been a steady decline in retention of them. That is very worrying because, as the Minister knows, a child needs at least three to four developmental checks throughout their first four years and if they are not getting them things will be missed. That is extremely worrying in the context of newborns and infants This has to be acknowledged and rectified because otherwise certain things, especially around children, will go unnoticed and that can only have detrimental effect on children and parents.
It sounds a bit like "Groundhog Day". I have been raising this issue for the last year. I raised it in last March and April in relation to the Curlew Road, Armagh Road and Old County Road health centres. We were told that two teams were to be put into Armagh Road, or rather that there were 4.6 public health nurses between Armagh Road and Curlew Road and they were going to be put into the former centre. Two of them would be looking after the child developmental checks and two would be looking after elderly persons' care. We were advised at the time that one person would be retiring and another would be going on maternity leave, bringing the figure down to 2.6. They certainly have not been able to keep on top of the needs of the community. I raised it a couple of weeks ago with the Minister but I have had more people contacting me about their child not getting the developmental checks. People have been waiting for 24 months. One parent was told they would be lucky to get a four-year developmental check. There needs to be a serious approach to this. I was told recruitment was a problem last time and it is still a problem. Nothing seems to have been done in the meantime to deal with this urgent issue for children.
I thank Deputies Collins and Kenny. This is a serious issue and I fully accept the Deputies' representations. I absolutely take Deputy Collins's point. We cannot have children not getting these developmental checks, we cannot have parents who are worried and we certainly cannot have the kinds of delays the Deputy has referenced. I will commit to taking this up at a senior level within the HSE this week to see what measures can be put in place. If there is a certain area that is significantly understaffed, and there is, we need to look at deployment from other areas. It is simply not enough to say that a certain community will just have to deal with these delays while services in other communities are fully staffed and getting what they need. I will commit to raising this directly with the HSE and asking for a rapid temporary solution. I imagine such a solution would involve some deployment from other areas. We will also see what can be done to accelerate hiring and to deal with maternity cover, which was another issue Deputy Collins raised. I am certainly not going to stand here and say that the status quo is sustainable because it certainly is not.
I received a response to a parliamentary question on the issue of public health nurses in Dublin Mid-West. I was slightly shocked at the response from the HSE. It said that, in that particular area, Dublin Mid-West, it had not recruited one public health nurse. It is a really damning indictment of where we are at if the HSE cannot recruit one. Zero have been recruited. There are obviously factors contributing to nursing staff, highly educated and highly motivated people, deciding not to go into this service. There has to be other incentives to encourage people who have been educated in this field to go back into public health nursing. Public health nursing is of enormous importance not only for infants, as I have mentioned, but for elderly people. If they are not getting that treatment in a primary care setting, that can only be detrimental to their health and to society.
The Minister replied to me last May saying that the HSE had established a community nursing national oversight group in 2022. What has that group done? We have known that there is a crisis in public health nursing for the last two, three and four years. What are we doing to fundamentally resolve that issue? It is a postcode thing. Children in areas like Drimnagh, Crumlin, Walkinstown and Islandbridge are not getting their developmental checks. I have also had to represent a number of elderly people who are trying to get support in their homes. You are running around on a helpline and going from one person to the next. It is just not good enough. I thank the Minister for saying that he will raise this. Will he get back to us directly at that point to let us know what is happening in the area and what emergency supports he is going to give to make sure these children get their checks?
I agree that it is not good enough. We need a resolution to this and we need it more quickly than one is now coming about. I will raise it with the HSE and come back to the Deputies with a note. If they would like, I will set up a meeting with HSE officials so that they can explain exactly where we are. Other parts of the country are not experiencing this difficulty. Some might be but there are plenty of well-staffed public health teams all over the country. We have invested a huge amount in public health and massively increased our community-based teams, including the primary care teams and older persons teams. There has been very substantial investment. I want to better understand why we have such a specific recruitment problem in this area because, as I have said, other parts of the country are very well served and very well staffed. I will revert to the Deputies with a note. Following that, if they would like a sit-down meeting with the community teams in the HSE, they can let me know and I will certainly arrange one.
GPs will not accept parents going to them to look for developmental checks. Parents have tried that. That is not an option.
I am not proposing that they ask GPs to do the developmental checks. What I mean is that, if parents see something with their child that they are concerned about, they should go to the GP. I am not asking the GPs to replace the public health nurses in providing the general checks.
It is left to the parents to ascertain if their children are not well.