A Cork member of Families Unite for Services and Support (FUSS) has said that the collapse of the Progressing Disability Services (PDS) programme “is not far off”.
It comes following the publication of the National Report of Children’s Disability Networks Team (CDNT) Staff Census and Workforce Review for 2022 which consists of a 35-page document outlining the staffing levels in Children’s Disability Services in Ireland.
On October 12, 2022, the HSE undertook a census and workforce review of all staff working in the 91 CDNTs across nine CHOs in Ireland and a review of all vacant posts.
The report showed that as the lead employer of CDNTs, the HSE retained 61% of its staff in 2022 with an overall vacancy rate of 39% across the 41 teams.
The total number of approved whole-time equivalent (WTE) was 2,102.62, representing a total of 2,102.62 posts within the service, an increase of 210.24 WTE, or posts, (11%) from 2021.
In CHO4, which includes Kerry, North Cork, North Lee, South Lee, and West Cork, the total number of approved WTE was 297.82 and the number of filled WTE was 218.92, meaning there was a vacancy of 78.90 WTE.
In comparison, non-therapeutic roles increased from 709.37 to 919.21, an increase of 209.84 posts.
In 2022, there was a reduction of 60,000 therapy hours for children.
A breakdown of therapy hours per CDNT showed that in Cork and Kerry there were 181,341.07 therapy hours available in total, a decrease of 6% compared to 2021.
The number of available therapy hours is calculated by taking into account the total hours worked per week per discipline within the service to estimate the total number of therapy hours available within those hours worked.
In the Bandon-Carrigaline-Kinsale CDNT, there were 15,028.90 therapy hours, a 12% decrease in 2021; Central Cork had 9,692.97 available therapy hours, a decrease of 9%; East Central Cork had 9,021.18 therapy hours available, a decrease of 16%; East Cork City had 12,111.41 therapy hours available, a decrease of 16% on the year previous.
North Cork City and Blarney had 8,733.27 available therapy hours, an increase of 16%; North East Cork had 8,253.42 available therapy hours, an increase of 1%; and North West Cork had 13,963.64, an increase of 3%.
South Cork City had 9,097.96 therapy hours available, a 6% decrease; South East Cork City had 13,096.07 therapy hours, an increase of 3%.
West Central Cork had 18,061.55 therapy hours available, the same as 2021 and West Cork had 15,048.10 therapy hours available, a 24% decrease.
Speaking to The Echo, a member of FUSS in Cork, Rebecca O’Riordan said the Census is “a clear warning that the absolute collapse of this system is not far off”.
“Over 700 vacancies and a total addition to the system of the equivalent of a mere 9.73 full-time staff positions since 2021. It is clear that there are wider issues within health and social care around recruitment but where is the focus on retention? Where is the urgency?
“Families are told again and again that this Government is committed to supporting families through this, however, they refuse to engage meaningfully with the very staff hired to support our children.”
The report also broke down the number of approved WTE (posts), filled WTE and vacancies in each discipline in within each CHO.
It showed that in CHO4, the total number of approved WTE for a speech and language therapist was 61.28. The number of filled WTE was 42.40, meaning there was a vacancy of 18.88 WTE, a 31% vacancy.
There was a 38% vacancy for a physiotherapist; 28% vacancy for a psychologist, 22% vacancy for an occupational therapist; 27% vacancy for a social worker in CHO4; 8% vacancy for administration staff; 12% vacancy for nursing staff; 14% vacancy for a Children’s Disability Network Manager (CDNM); a 100% vacancy for a dietician; 26% for a family support worker; no vacancy for a social care worker; a 36% for a care assistant; 44% vacancy for a play therapist; and no vacancy for a healthcare assistant.
Ms O’Riordan said staff on the ground are the ones turning up day after day to what she described as “unsafe workloads”.
“The staff on the ground are the ones dealing with extremely distressed families in increasingly harrowing circumstances. It is an insult to the staff and families that the Government are not doing more to address the issue of pay parity.
“It sends a very clear message - we’ll do anything to fix it, except pay the staff what they deserve while they deal with the repercussions of decades worth of dangerous levels of under-resourcing and poor planning.
“Families want to work in partnership with staff but we need the Government to come to the table and stop pretending this is anything but an emergency. We need to act now to ensure we do not lose any more staff and we need to have an open and honest conversation about how we support families in the meantime because we cannot keep going like this.
“We have an entire generation of children whose lives have been forever impacted by this. How many more children need to go into residential care due to a lack of community support? How many more children’s lives and potential must be irreparably damaged before we see this as an emergency,” she said.
The report highlighted that in response to the challenges articulated by staff and management at a national level, the HSE marketed CDNTs as a workplace of choice to potential employees on HSE candidate panels using promotional material in November 2022.
There are also rolling recruitment campaigns with employers’ talent searching in both the Irish and international markets for staff.
Speaking about the hundreds of worried families across West Cork impacted by the under-resourcing of children’s disability services, Social Democrats leader Holly Cairns said the waiting lists for CDNTs reveal “inconsistent services, resulting in a geographic lottery”.
“For example, figures from late last year show that there were 10 children waiting in the West Cork CDNT area, but this was 331 for the Carrigaline/Kinsale/Bandon area, including the 316 waiting over 12 months.
"The West Central Cork area, covering Ballincollig and Macroom, is almost as bad with 305 on the list, with 253 children on the list for over a year,” she said.
“We all know the importance of early interventions for children with complex needs and to have them waiting for just the initial contact is completely unacceptable.
“The detrimental effect that not getting the required therapies, on time, can have on children has been well documented, as has the benefit of early intervention. Accessing timely assessments and interventions can be life-changing.”
She said that “time and time again this comes back to staffing” and said recruitment “continues to be a major factor in the level of dysfunction within our disability services”.
“There is little point in the HSE announcing the approval of additional posts if they are unable to fill them.
“The Social Democrats previously called for funding for a Workforce Planning Strategy to help with the recruitment and retention of staff within Children’s Disability Network Teams. There also needs to be a full assessment of why these posts are not being taken up, despite national and international recruitment campaigns.”
She said that under-resourced teams are leading to over-stretched staff who feel they are not providing the care they want and are being “ethically compromised with the limited time they can give children”.