Tipperary 'faring worst in post-code lottery for child psychology supports'

The growing number of children on waiting lists in north Tipperary for psychology supports through the North Tipperary Children’s Disability Network Team (CDNT) has been highlighted in the Dáil by local TD Jackie Cahill.

Deputy Cahill raised this issue and highlighted the fact that 339 children remain on waiting lists to see a psychologist, while two full time psychologists posts remain vacant in the area.

Deputy Cahill questioned the Minister for Disabilities, Anne Rabbitte, in relation to this issue and called for an end to the postcode lottery, whereby different levels of services are available in different regions around the country, with north Tipperary fairing far worse than most other regions.

In raising this issue in the Dáil last week, the Thurles TD said: “I recently received a response to a Parliamentary Question I submitted to the Minister for Health, where I was informed there are currently seven whole time equivalent psychology posts in the area. However, with further enquiries, I came to learn that two of these posts are currently unfilled and as things stand in north Tipperary, we have: two senior psychology posts filled, two staff grade psychology posts filled, two vacant staff grade psychology posts, and one psychology post filled.

“Furthermore, the North Tipperary CDNT currently has a caseload of 1,473 children and 339 of these children are on waiting lists for supports. North Tipperary also has 42 children requiring an ASD assessment, and until this assessment is carried out, it is next to impossible for the parents to get the supports and early intervention help they need for their children.”

The Fianna Fáil TD continued to state that the HSE could not answer his questions in relation to the length of time or additional resources needed to clear these unacceptable waiting lists.

“The HSE were unable to tell me how many additional psychology posts would be necessary in the north of my county to clear the waiting list of 339 children as it currently stands. The HSE was also unable to tell what the caseload figure for each psychologist in the area is, as the number of clients requiring psychology input changes on a daily basis," he said.

Deputy Cahill said that he had serious concerns that the HSE was failing to fill the two vacant psychology posts, one of which has been vacant since March 2022. As long as those posts remained vacant, the waiting lists are going to continue to grow, and families and young people are going to be left without the intervention, supports and attention that they need and deserve.

“The psychologists that are already in the filled posts are doing their best and I am by no means criticising their work, but they are under too much pressure, they are being assigned to great a workload, and those in need are not being seen in a timely manner to get the assistance and interventions that they need at a young age," he said.

The Government TD highlighted the concerns of the families affected, saying: “From speaking to numerous families affected by this across North Tipperary, I know that this is a deep cause of frustration and concern for a huge number of people. Particularly in the case of looking across county bounds, or even parish bounds, when other areas are serviced by better services under a different healthcare region. I see this in Tipperary where there is a divide between the North and South in terms of disability services for children, as the county falls within two separate healthcare regions.

“A person’s eircode should not determine the level of care that they can get. A parent certainly shouldn’t have to see their child waiting and not progressing in life as they should while they wait for these essential services, when children in other areas are getting interventions much sooner. But that is unfortunately the case for early intervention services all too often in north Tipperary.

“This postcode lottery needs to be tackled,” stated Deputy Cahill.

He continued: “Minister, with 339 children on waiting lists in North Tipperary and a team of 5 whole time Equivalent Psychologist positions expected to cover this workload, this is only going to see this issue exasperated.

The Fianna Fáil representative questioned the Minister in relation to the HSE’s plans to tackle the growing waiting lists, which current stand at 339 children. He also asked when the vacant positions will be filled, how long it will take to clear the backlog and he called for an explanation from the HSE on their failure to fill the vacant psychology posts to date.

Concluding, Deputy Cahill said: “Minister, if it is a case of additional renumeration being required to fill these positions, or better administrative supports, so that the psychologists can be freed up to do their jobs to their best of their abilities, then packages need to be put in place. The children of North Tipperary need better, more efficient, more reliable, and more supports in this area.”

In response, Minister Rabbitte acknowledged that the system to date has been challenging for all stakeholders involved, but especially the families affect.

Minister Rabbitte went on to acknowledge the work of the professionals currently in positions, who are working under “tremendous pressure”.

The Minister also stated that the retention of staff in key senior positions is a priority for her, and highlighted instances in other regions where experienced staff have been allowed to progress to more senior positions, and in doing so, the HSE was able to retain its talent pool in this area while also opening up the more junior positions to new entrants into the field.

The Minister also stated that she wished to register on the record her apologies to families affected by the concerning delays and that the new PDS system in place is intended to tackle the postcode lottery, so that equitable access to services is available in all parts of the country.

She also stated that PDS has seen a concerning “levelling down” of services to children and their families in many areas.

A point of particular concern to Deputy Cahill is the fact that CDNTs nationally are experiencing an average vacancy rate of 28%. The Minister also stated that funding is not the outstanding issue, with her securing additional budgets for the HSE in recent years, but recruitment and retention of staff remains the ongoing factor affecting areas such as North Tipperary, where waiting lists continue to be far too high.

Deputy Cahill has committed to continue working with Minister Rabbitte and HSE officials to see these essential resources put in place for north Tipperary, so that the area would see the same level of supports as other parts of the HSE Mid-West region.

Deputy Cahill was pleased to welcome the Minister’s direction to the HSE to move through panels and fill as many vacant positions as possible by the end of this year.