I want to raise the issue of obtaining an ankle-foot orthosis, AFO, brace for a child with cerebral palsy in Cavan. I was contacted by the mother of a four-year-old child who has cerebral palsy. Children grow very fast and muscle grows faster than bone. These braces become too tight and non-workable as a child grows, so they have to be replaced on a regular basis. The mother realised that she was outgrowing the brace last November so she contacted her CDNT and informed them of this. They referred the child for new braces to Ottobock, a company based in Cappagh Hospital that has an outreach clinic in Cavan. That referral was made in November. In January, she received correspondence that there was an appointment on 13 February, so already we have a two-and-a-half-month wait for this appointment. When the child attended the appointment, she met a very experienced person who measured her for the brace, and said if she could order it directly she would have it within a week. However, it could not be ordered directly because there is a requirement to get a purchase order from the HSE to cover the cost of the brace. She applied for the purchase order that day. It was granted last week, into the middle of April. We have a two-month delay in getting the purchase order. In the meantime, the child has outgrown the brace completely and can no longer wear it. She is trying to walk as best she can without the brace. Her mother and father have seen regression in her legs. Her physiotherapist has seen regression in her muscles and in her legs as well. Due to this delay, the child is suffering this regression. When the purchase order was granted and they contacted the mother, they wanted to order the brace straight away but the mother pointed out that two months had passed and the child had grown again since then. The brace may not fit so she needs another appointment. She has an appointment for this Friday to have the brace remeasured but they have informed her it could take three weeks after that before the brace is delivered. They are made here in Ireland but it will still take about three weeks. The mother is really worried. She has seen the regression in the child. She said that her daughter may now need to go for serial casting, although hopefully she will not. That would mean that she would have to go to Cappagh, get a cast on her leg, and go back the following week to get the cast off and see how much the leg has moved back into the correct position, and get another cast put on.

It is a procedure that would have been totally avoidable had the brace been ordered on time and given to the little girl to allow her to walk.

Now you might say that maybe this is just a once-off, but it is not because the mother had to wait three months last year for the same thing. This is the second time it has happened so it is likely happening to other children as well. I therefore want to highlight this. I ask for a much better procedure in having leg braces replaced. A mother should not have to wait months for an initial appointment, first of all. Okay, this mother allows time for that because when she realised that the child was growing out of the brace she notified the CDNT straight away to ensure that a new brace could be ordered, but there is no excuse for the two-month delay on a purchase order for something the child will need on an ongoing basis. When the mother tried to follow up on this to see who was responsible for this delay, she could not get an answer. She contacted Cavan General Hospital because she was told it was a matter for the paediatric department there. Everyone she talked to said, "No, it is not me, but I will try to find out who it is." She was passed from pillar to post, and it is not good enough, so I want to know what can be done about this situation.

I thank Senator Tully for raising this very important issue. I am taking this Commencement matter on behalf of my colleague the Minister for Health. I thank the Senator for the opportunity to address the House on this matter. As she has outlined, it is simply not good enough that somebody has to wait two months, going back and forward and back. Somebody should be able to make a decision there, so I thank her for highlighting this. I will bring it back to the Minister immediately.

I will outline in general terms the current position on the provision of aids and appliances. The HSE provides a wide range of aids and appliances free of charge to eligible people following assessment by a relevant health professional. These are provided through community services known as community-funded schemes and play a key role in assisting and supporting people to maintain everyday functioning and to remain living in their homes and local communities. A national list, including prescribing criteria, can be found on the HSE website.

Separately, under the long-term illness scheme, patients receive drugs, medicines and medical and surgical appliances directly related to the treatment of their illness free of charge. Under the drugs payment scheme, no individual pays more than €80 a month towards the cost of approved prescribed medicines and medical appliances. The DPS, as the Senator knows, is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for individuals with ongoing expenditure on medicines.

I turn to the specific issue raised by the Senator this morning. Officials from the Department have reached out to the HSE directly on this issue, and the latter is engaging with relevant personnel at a local level. As this matter is particular to the provision of specific service in a local area, it is a matter the HSE will need to investigate in further detail at local level. To that end, I invite Senator Tully to share any further detailed information regarding this case, if available, in order that Department officials can liaise with HSE colleagues to further investigate the matter.

Again, I thank the Senator for raising this issue and thank her in advance for any additional information she can share. Officials in the Department of Health will continue to engage with HSE officials on this matter and will be happy to provide the Senator with a further update should additional relevant information become available. There are people out there who are paid good money to deliver a service. For a parent or a child to have to wait two months and then, by the time they get the aid, for the child to have outgrown it is simply not good enough. I know the Minister will act with her officials to try to resolve this issue immediately. I thank the Senator for coming into the Seanad to raise it. She should not have to do so; it should have been sorted out on the ground and it was not.

I thank the Minister of State. I will certainly share the details with the Minister. I presume the Minister of State is talking about the Minister for Health, Deputy Carroll MacNeill. The little girl's mother did reach out to the Minister for Health on this issue and did not receive a response. She reached out to primary care and she reached out to the hospital. She contacted everybody and was, as I said, sent around from one person to the other, and nobody knew or would take responsibility for what had happened. She does not know if this was just a slip-up by one person who missed something on their desk and did not sign off on it or whether there is a backlog in how the procedure operates, so she does not know if she is the only one. However, the fact that she had to wait three months last year as well indicates that the system is not working properly in the interest of the child or of any children. She therefore wants this highlighted. Obviously, she wants the brace for her own child as quickly as possible, but she made the point to me as well that there is no screening at birth for cerebral palsy. Her child has turned four. While she and her husband realised there were issues or there was something wrong, she did not get a diagnosis until her daughter was two. If the child had been screened at birth, this could have been picked up faster and supports put in place faster because, as she said, as soon as she was referred to someone to be diagnosed, they could immediately tell that there were issues and it was most likely cerebral palsy. It is a matter of even just having screening or a scan at birth for this condition as well.

I will send on the details but I hope I will receive a prompt reply from the Minister's office on this.

Just before we get the Minister of State back in, I want to welcome guests of Deputy Cormac Devlin, students from Loreto Primary School, Dalkey, who are in the Gallery. You are all very welcome. Tá fáilte romhaibh.

Again, I thank Senator Tully for raising this and the attention she has given to this important matter. As noted previously, given the particular nature of the matter at hand, it is necessary for the HSE to investigate this in further detail. If the Senator wants, I will raise it with the Minister, Jennifer Carroll MacNeill. I will also raise it with her myself this evening when I meet her. If the Senator wants to send that information on to me as well, we will make sure that this gets dealt with as quickly as possible.

Again, I thank the Senator for raising this issue. If there are any blockages in the area, they need to be sorted out sooner rather than later.