The crisis within children’s disability network teams, CDNTs, is well known to all of us. Major problems around recruitment and retention have practically become embedded within the system. I was shocked by information I received from the HSE’s disability services yesterday. It reveals how stark the crisis has become across all nine community healthcare organisation, CHO, areas, especially CHO 8, which encompasses my constituency of Laois-Offaly. The staff vacancy rate ranges from 19% in CHO 3 to the highest level nationally of 43% in CHO 8. As I have said, Laois-Offaly is part of CHO 8. This means that almost half the children’s disability staff positions are unfilled in Laois, Offaly, Longford, Westmeath, Louth and Meath.

I am also informed by the HSE that while the largest discipline within the CDNTs is speech and language therapy, there are a staggering 162 whole-time positions vacant out of a total of 447. Even more shocking is the fact that there are 3,129 children waiting between three and 12 months, or more, for initial contact within CHO 8. I have made representations for many children, as have other Deputies in the constituency, but I am constantly being inundated with the concerns of parents, particularly in respect of children with a diagnosis of autism who are transferring to post-primary school but still have not had initial contact made with them. This is very serious and is letting down and failing the children. Almost unbelievably, 1,903 children have been waiting for more than a year with absolutely no first contact.

While I state these facts and bring them to the attention of the Tánaiste, I want to commend the skeleton staff who are doing their best in these services, which are stretched. It is not their fault. They are too few in number. I want to state that they are doing all they can but they need help. The only CHO area which has a worse record than CHO 8 is CHO 9, which currently has 2,302 children waiting more than a year. This is a crisis of frightening proportions. As I said earlier, children are being failed. Incredibly, as part of the reply from the HSE I was told the following:

Regardless of the nature of their disability, where they live, or the school they attend, every child with complex needs and their families have access to a full range of supports.

This was stated in the same response which confirmed that there are 707 vacancies nationally across all of the CDNTs. There is a clear contradiction there. Will the Tánaiste accept that the CDNTs are in catastrophic freefall? Will he outline what actions he and his Government will take to resolve the issues?

In the first instance, I accept that the situation is not at all acceptable in respect of disability services for children, and in particular in respect of access to therapies. The HSE has argued that it finds it very difficult to recruit and retain staff. There are fundamental issues in terms of the human resource management of therapists, particularly in respect of paediatric services.

The Government decided at the outset to transfer disability services, particularly for children, from the Department of Health to the Department of Children, Equality, Disability, Integration and Youth. The Minister of State, Deputy Rabbitte, has done very significant work in the intervening period in respect of the transfer and in dealing in an immediate sense with assessments, as she did in her first year in office, to accelerate assessments for many children in this respect.

Second, the work-out of the progressing disability programme, which was developed by the HSE in 2013, really only began to move between 2018 and 2019. This has resulted in a significant dilution of services in respect of special schools, in particular. In meetings late last year with the HSE, the Government decided that therapists would be assigned to special schools again to create access to the requisite therapists for children with severe and profound needs, in particular. That work is continuing. In my view, there has to be an engagement between education and health in respect of therapists. We need multidisciplinary teams in our special schools so that the needs of the children in that context are addressed, at least. More broadly, some CDNTs are working now. Clearly, as the Deputy has outlined, there are difficulties in CHO 8 and in other areas. I am well aware of them.

There is a particular issue in respect of recruiting into children's services as opposed to other services. Therapists are being recruited to areas like stroke services or other parts of the health service but it has been particularly challenging and difficult to recruit into services for children with disabilities and special needs. That is something which I know the Minister of State and the Government remain possessed of. We are very focused on endeavouring to deal with this, both on an interim basis and on a more long-term basis.

I thank the Tánaiste for his response but I believe serious urgency is needed here with what has happened. The HSE has confirmed that in CHO 8, some 3,129 children are waiting between three and 12 months. Those children are being failed. The Tánaiste has outlined the measures which are being taken and I acknowledge them. However, the HSE has confirmed to me that from an overall analysis of data from 2021 and 2022, there was an increase of just 2% in the workforce across all CDNTs. This information is coming from the HSE itself.

Like many others, I believe there are major cultural issues within the HSE which need to be addressed. A cultural problem exists at institutional level in the HSE. I have heard, as I am sure many others have, that people who train as therapists want to work in the private sector or to work abroad - anywhere but the HSE. That would suggest to us all that there are serious problems. I do not believe for one second that throwing funding at it will solve those problems. This needs to be looked at in depth and in detail. My point here is that children need to be given access to vital and basic services.

I thank the Deputy for raising this issue. I do not disagree with her basic points. I think funding will help, by the way, and we have allocated additional funding. Nevertheless, the Deputy is correct when she says there is a human resource management issue in respect of how therapists are dealt with and treated within the service, in respect of the quality of the work experience, and in respect of progression within the service. That is a human resource management issue.

A new CEO, who had been in Tusla, has taken over the health area. The new CEO will have a particular focus on children and their needs. I will be taking up these issues along with the Minister for Health and the Minister of State, Deputy Rabbitte.