I thank the Minister of State, Deputy Murnane O'Connor, for coming in. This is a serious and profound issue I will raise, based on the latest figures from the HSE for people awaiting physiotherapist services in the south-east health region. The figures show 6,693 people have been waiting for those services for more than 12 months.

In the Minister of State's area of Carlow, Kilkenny and Tipperary, there are 295 people. In the south Dublin and County Wicklow area, there are 100 people, but in the Waterford and Wexford area - Wexford is my county - 4,404 people have been waiting more than 12 months. Something has clearly broken down in the HSE if two thirds of all the people in the Dublin and South East health region who are waiting more than 12 months for physiotherapy are based in Waterford or Wexford. Unfortunately, we do not have a further breakdown of how long these people have been waiting. The figures are capped at waiting more than 52 weeks.

The reason I tabled this Commencement matter today is to offer a solution to this, which is to allow qualified athletic therapists, who are regulated by Athletic Rehabilitation Therapy Ireland, to engage with the HSE to free up physiotherapists by allowing athletic therapists to do work coinciding with, not replacing, physiotherapists by working alongside them. These people are qualified, having studied for a level 8, four-year degree from DCU, SETU in our area, or ATU. At the moment, approximately 150 graduates are coming out of colleges having done a four-year degree. They are recognised, certified athletic therapists and they have told me through their representative body, Athletic Rehabilitation Therapy Ireland, that there has been engagement with the HSE about allowing them to work within the HSE structures, but the engagement has not successfully led to them being allowed to work. Given the enormous waiting lists in my area, the south east, and in general, a review of this should be carried out. I would be interested in hearing the Department of Health's position about allowing these professionals to work in the health service, particularly given that they have four-year degrees and are approved and qualified as having a regulated, recognised position. Also, currently the NHS allows them to play an important role in the UK.

I thank the Senator for highlighting this important issue. I saw the figure for Wexford of 4,400. That is a lot of people waiting. In my area of Carlow-Kilkenny there are 295 so I can see where the Senator is coming from.

I am taking this Commencement matter on behalf of the Minister for Health, Deputy Carroll MacNeill. The Minister for Health is aware of athletic therapy as a profession and Department of Health officials have engaged with Athletic Rehabilitation Therapy Ireland, ARTI. Athletic therapists complete training in sports and injury rehabilitation. In line with workforce optimisation policy, the Department continues to focus on population health need and maximising the available workforce to meet that need safely. In this context, Department officials attended the World Federation of Athletic Training and Therapy World Congress hosted by ARTI in October 2025. This included engagement with ARTI and representatives of the British Association of Sport Rehabilitators. The Senator said this is happening in London.

Regarding HSE waiting lists and physiotherapy, physiotherapists complete training in musculoskeletal, neurological and respiratory conditions across health and social care settings. Primary care physiotherapy services for adults and children are delivered through community healthcare networks. In line with addressing more complex care in the community, the Minister has prioritised physiotherapy waiting lists. In 2025, more than 511,000 patients were seen in physiotherapy services. As of April 2026, more than 170,000 patients have been seen in physiotherapy services. Approximately 91,000 patients were awaiting assessment by a physiotherapist at the end of April 2026. These patients identified for physiotherapy have a range of conditions and complexity.

The Department of Health is working with the HSE on a focused programmatic approach to primary care therapy waiting lists, putting in place considerable standardised infrastructure to support systematic responses to primary care waiting lists. As part of this work, a waiting list initiative is under way to address physiotherapy, occupational therapy and speech and language therapy waiting lists and to reduce the waiting times for these therapies to less than 39 weeks.

There is a concern with the waiting lists. I totally agree with the Senator in that regard. This initiative is designed to ensure appropriate and safe care.

The latest available data, from February 2026, shows that since its commencement more than 5,000 people waiting over 39 weeks have been removed from primary care therapy waiting lists. The Sláintecare implementation strategy emphasises the importance of community-based care. One of its main objectives is to enable individuals to maintain their health and independence within their homes and communities. As the Senator will know, we are very much focused on primary care units and having units in everyone’s area. We are looking at them as much as possible. It is about the right care in the right place at the right time.

The programme for Government sets out a priority to place greater focus on exercise and well-being as a preventative and rehabilitation measure. It also sets out to examine ways to support the provision of community-based clinical exercise programmes nationwide. Work is under way with the establishment of pathways in healthcare to direct people with chronic disease into physical activity programmes in the community as part of their treatment.

In acute hospitals and primary care centres, the focus is on treating complexity and care is largely managed by physiotherapists. Many exercise and physical activity programmes are delivered outside of these settings. Contribution to these community-based exercise programmes may be from a range of professionals with expertise in physical activity, including athletic therapists. This is what the Senator was speaking about.

The Minister has committed to a meeting with athletic therapists in the coming weeks. This is to have further engagement. It is a good way forward. I thank the Senator for bringing this up today.

I welcome the Mayor of Austin, Kirk Watson, to the Seanad, as well as his delegation of guests. They are guests of the Minister of State, Deputy Robert Troy. They are very welcome. I am sure the Minister of State is looking after them very well.

I thank the Minister of State for her response. I welcome the fact that the Minister will engage with the athletic therapists’ representatives. Perhaps, after that meeting, we can see progress on it. This is a unique opportunity to assist in tackling the waiting lists. I am particularly struck, as I said earlier, that people living in Wexford or Waterford will be ten times longer on the list than those living in Carlow, Kilkenny or Tipperary. Something has clearly broken down in the HSE model when it comes to providing physiotherapist services in Wexford and Waterford. I urge the Minister of State to take this issue back to the Department and her officials and to engage with the HSE to see what exactly has gone wrong, how it can be fixed and how the waiting list in Wexford, comprising 4,404 people, can be reduced.

I assure the Senator that the Government has a steadfast commitment to improve public health. As mentioned, the programme for Government sets out a commitment to place a focus on exercise and well-being as a preventative and rehabilitation measure and to examine ways to support the provision of community-based clinical exercise programmes. It is also recognised that future health services require new approaches.

The Senator is right that we need to review this. This needs to be reviewed. I will definitely be going back to the Minister, Deputy Carroll MacNeill, in this regard. I was going to read the statement but it basically says the same thing. We need to get this review done. As I said, the Minister will have a meeting. That is important. The Senator can be assured that either my office or that of the Minister will come back to the Senator with an update on the progress going forward.