It is no secret that children's disability services are at breaking point. However, the sheer scale of the problem is shocking when you learn that almost 800 vacancies exist in children's therapy services across the HSE's primary care services and children's disability network teams.

Those 800 vacancies exist across physiotherapy, occupational therapy, speech and language therapy and psychology, with over 550 vacancies in the children's disability network teams and over 440 vacancies in the primary care services. This means that not alone are children enduring waiting lists for services, but they are also facing inordinate waits for assessment.

On his return to office, the Taoiseach told the Dáil that: "Our vision is to make Ireland the best country in Europe to be a child." Unfortunately, the reality is that unless drastic action is taken, that statement simply will not apply to children with a disability. I will give one example. John, who is non-verbal, has just completed junior infants and in the almost five months since he was diagnosed, not alone has he not received any form of service or speech therapy, but his family have not even been assigned a key contact. They have been informed that the children's disability network team assigned to him can "only facilitate critical clinical needs as they arise". How can anyone stand over a situation like this?

It goes further, because on top of this, we have an eircode injustice. The service a child receives is not based on disability, but on eircode. While the number of therapy hours provided by the children's disability network team covering south Roscommon increased by 55% in 2022, the number of such hours provided by the corresponding team for north Roscommon decreased by 26% in the same period, providing over a thousand hours less than its counterpart. We need to look urgently at the issues surrounding training, recruitment and retention, not just in terms of future needs, but also the needs of thousands of children today, who are currently deteriorating on waiting lists across this country.

I accept that there are difficulties with recruitment, but that is why we need to take a more flexible approach in our recruitment and retention of therapists. Across the children's disability network teams, almost 100 vacancies are unfilled because staff are on maternity leave. These are vacancies that did not arise without significant notice, yet it appears maternity leave cover remains unrecognised and unfunded within our disability services and across our health services. It is not custom and practice to backfill these vacancies. This has to stop.

I thank Deputy Naughten for raising this important issue, and I know it is one that we will all be familiar with in our constituencies, where parents come to us and tell us about the challenges they have in securing necessary assessments and treatment for their children. We are committed to finding and implementing real and tangible solutions to enhance services to meet properly the needs of children with additional special needs.

As we all know, children with complex special needs access therapy services through the children's disability network teams, CDNTs. There are enormous challenges in meeting demand for these services and I know this affects children and their families very adversely. Waiting lists for services are being driven mainly by a shortage of suitably qualified therapy professionals to staff the CDNTs, the management referrals, and the slow uptake of new technologies. Funding for over 600 full-time additional posts has been provided by this Government to enhance the capacity of CDNTs and to shorten waiting times. These additional posts are evidence of the Government's commitment to prioritising interventions for children with complex needs, as well as those in special schools. A targeted recruitment campaign has been developed. It will be launched next week for the remainder of the vacant senior therapy grades within the CDNTs across the country.

The HSE is seized of the importance of early engagement with the health and social care profession graduates coming out this year. All of the class of 2023 have been offered the opportunity to apply for employment through national campaigns. Interviews have taken place and recruitment panels prepared. Permanent job offers will be issued prior to their professional registration. By the end of next year, the HSE has targeted the recruitment of 550 professionals for children's disability services. We expect them to be made up of 260 graduates, 111 international recruits and 182 from a sponsorship programme.

How about offering part-time contracts that may suit therapists who are currently taking career breaks, in many instances for family reasons? I have spoken to several therapists who had actively considered taking up employment for a set number of hours per week, including evenings and weekends, enabling them to maintain their skills. Evening and weekend appointments would also assist families where parents are working and result in fewer hours lost for children. Many of these services are located alongside GP out-of-hours services, so the buildings are already open. We are now seeing health services like endoscopy providing out-of-hours appointments, so why not do the same for children whose potential is being wasted on waiting lists today? By delivering services innovatively, we could make it easier to recruit therapists, while also addressing the waiting lists and making a real difference to children like John.

I thank the Deputy for his suggestion and I will certainly ask the CEO of the HSE and the Minister for Health, Deputy Stephen Donnelly, to examine that. Certainly, the Government has no principled objection to part-time contracts. We issue them all the time across the public service. It does not always result in a net increase in the number of people working in these roles, because once offered, some full-time people go part-time, so there can be gains and losses on that. It is certainly something we are willing to consider, as is the use of out-of-hours buildings and facilities where there is space available. That makes sense to me and I think a lot of parents would welcome the convenience of being able to take their kids to an appointment in the evening when they are finished their own work. That is a good idea too.

I agree that the solution to a lot of these problems that we face with recruitment and retention in our health service, and other areas of the public service and private sector, is going to be innovation. It is simply the case that in the world whole, there are more vacancies for these skilled positions than there are people qualified to do them, and we have to embrace new technologies and new ways of doing things. A lot of things are being developed, particularly online and virtually, that can make a huge difference. It might not be appropriate for a first consultation, but for repeat consultations and so on it can make a huge difference too.