2026-05-06

I thank the Minister of State for taking this matter. I am disappointed that the Minister for Health - or a Minister of State with a health brief - is not here to respond to the debate. I have been informed by some of my constituents about unacceptable waiting times for occupational therapy. Occupational therapy is important for people who may have suffered an injury that requires their home to be adapted. An occupational therapist will visit a person's home and compile a report in respect of the disabled person's grant The relevant form cannot be completed without an occupational therapy report. The form will not be accepted by South Dublin County Council without such a report, so it is vital. I will speak about three of my constituents who received this news. I have their permission to mention them tonight. Larry is to turn 80 this year. He needs a stairlift installed in his home because he has a pacemaker due to a heart condition and is regularly out of breath. I contacted the HSE for Larry and the response I got was that he would be waiting 330 weeks for an appointment. That is over six years. The Minister of State has to agree that a six-year waiting list for an occupational therapist for anybody is unacceptable. I am lost for words that an 80-year-old man was told he must wait six years for occupational therapy. I was speaking to Larry myself and he told me that when you get to 80, you are lucky to think six months down the line, never mind six years. Angela is a woman in my constituency. She is not 50 and broke her hips two years ago. She has not been able to go up the stairs in her home since. She has told me she has to travel to her daughter's home in a different county just to be able to wash herself. She has also been told she will be waiting 330 weeks for an appointment. Sarah-Jane is a young woman in her 30s but she has mobility issues and needs the assistance of her 71-year-old mother to be able to shower. Her mother is finding this more difficult over time. Sarah-Jane was referred in March 2022 for an occupational therapy appointment so she could adapt her home. She was not told she would have one in 330 weeks like the other two constituents; rather, she was told there was no appointment date for her. She is not even getting an appointment in six years. Such delays are having an abject impact on people's quality of life. These are just three cases. I could mention more from my constituency. I have written to the Minister for Health and have requested that she urgently examine these cases and introduce the necessary measures. I do not know what the Minister of State's response will be, but if it is a matter of a staffing issue, it must be addressed urgently. Six years is far too long to wait. Furthermore, there is a postcode lottery for care in Dublin Mid-West. If the three people I mentioned were in a catchment area in the constituency with a different primary healthcare centre, I expect they would not have to wait so long. Care should be based on need, not on where you live. Also, it should not be based on the ability to pay. In the response I received for Sarah-Jane, the HSE advised her to go private. A public health service that is in place to serve the public is telling patients they should go private. The HSE also told Sarah-Jane she needs to recoup the costs from South Dublin County Council. I have been a councillor and know how South Dublin County Council works. It is not possible for residents in council homes to recoup the cost of private occupational therapists from South Dublin County Council. However, if Sarah-Jane lived in a private home and paid for private healthcare, she could recoup the costs. This is a two-tier system that discriminates against those who rely on the public health service. There is nobody who is not on the same page. I do not think there is a person in this House who would agree a six-year wait for an occupational therapist, so people's quality of life can improve, is acceptable. I am looking forward to hearing the Minister of State's response.

The Minister for Health has asked me to thank the Deputy for raising this important matter and for the opportunity to update the House on it. He has outlined it very clearly. On behalf of the Minister, I fully acknowledge that waiting lists for primary care therapies, including occupational therapy, are far too long. She recognises that people waiting years to access these services is simply unacceptable. It is important to recognise that overall activity within the eight core primary care therapies is significant, with approximately 1.3 million appointments having been provided across occupational therapy, physiotherapy, dietetics, psychology, speech and language therapy, audiology, ophthalmology and podiatry services in 2025. However, the HSE has advised that the increased pressure and demands on primary care therapy services are related to an increase in referrals, the increasing complexity of presentations, which of course leads to longer interventions, and challenges related to the recruitment and retention of healthcare professionals. The recruitment and retention of healthcare professionals, in particular therapy professionals, remain a challenge across the health, education and disability sectors and comprise one of the key causal factors impacting primary care therapy waiting lists. The HSE has advised that, in integrated healthcare area, IHA, Dublin South West and IHA Dublin South City and West, waiting times are particularly long because demand exceeds the current service capacity. In response, referrals are being triaged and prioritised on the basis of assessed clinical need so those most in need are seen as soon as possible. The HSE has confirmed that the IHAs in the Dublin Mid-West area continue to progress recruitment and service improvement measures aimed at reducing the current waiting times for primary care therapy services. However, the Minister acknowledges that a lot more needs to be done to reduce waiting times. To that end, the Department of Health is currently working with the HSE on a focused joint programmatic approach to primary care therapy waiting list management to put in place considerable standardised infrastructure to address both the long waiting times and long-term capacity planning. As part of this programme of work, in September of last year the Minister approved proposals to address occupational therapy, physiotherapy and speech and language therapy waiting lists through a national initiative supported by the enhanced community care programme. The goal of this initiative is to reduce the waiting times for these three therapies to less than ten months. The initiative aims to remove over 60,000 people from the waiting lists across these three therapies by the end of this year, with efforts currently under way in a number of IHAs. The initiative has been rolled out on a phased basis to include all IHAs nationally over the coming months. Initial results show a reduction of 12,700 patients from these waiting lists for physiotherapy, occupational therapy and speech and language therapy since the initiative commenced. It is very welcome news that both waiting list numbers and the waiting periods of those waiting longest are reducing. For the first time since 2021, waiting lists have decreased month on month over a three-year period. As the work continues throughout the year, we expect to see waiting lists nationally reduce and improved access times for all, including those in Dublin Mid-West.

I thank the Minister of State. She mentioned priorities, triage and how people are assessed. Larry, who is 80 and whom I spoke about, is not priority 1. He is priority 2, and that is why he must wait for six years. Angela, who broke both her hips and has not been up her own stairs in two years, is not priority 1. She is priority 2. Sarah-Jane, who has to rely on her 71-year-old mother to get washed, is also not priority 1. She is priority 2. Whatever this triage system is, it is not working because Larry, Angela and Sarah-Jane are falling through the cracks. To make a bad situation even worse, if Larry, whom I will use as an example, has to wait for six years for an occupational therapy appointment, he will probably have to wait a further three or four years to get the disabled persons grant from South Dublin County Council. Larry, who is 80 now, could be 90 before he gets the stairlift he badly needs to get up his stairs. That is simply not good enough in a modern society. The Minister of State spoke about waiting list reductions and said there were 1.3 million appointments. That is absolutely fantastic but the reality in Dublin Mid-West as we speak is that if you live in Palmerstown and are waiting for an appointment for a physiotherapist, you will be left waiting because the service is suspended. A parent of a newborn child will not receive developmental checks for his or her baby if they have to go to Rowlagh health centre. This is because of staff shortages. The average waiting time to see a psychologist for a child in my area is four years. An adult living in Lucan who wants to see a psychologist will not get an appointment. That service is suspended as well. There are currently over 7,000 children in my area alone who are overdue an appointment for an assessment of needs. If you live in Lucan, you can expect your child to wait over two years for a speech and language therapy appointment. There are also 800 children waiting for an appointment for child and adolescent mental health services. That is just in Dublin Mid-West. Whatever work is going on behind the scenes really needs to happen quickly because patients, including children, are being left behind. The problems that they have now, because they are not being addressed, are just going to get worse.

Again, on behalf of the Minister for Health, I thank Deputy Ward for raising this important issue and the cases of the various people he spoke about. The Minister fully acknowledges that the increasing waiting times for primary care therapy services is a source of real concern for service users, their families and, indeed, the Minister herself. As outlined, a national initiative is under way to address long waiting times for primary care, physiotherapy, occupational therapy and speech and language therapy and to reduce the numbers awaiting access to services significantly by the end of the year. Furthermore, the Minister has committed to building capacity in primary care. To support efforts to reduce waiting times, an additional 200 whole-time equivalents were approved for recruitment in primary care therapy services in 2026. The Government has also committed to increasing the number of college training places for therapy professions. In June of last year, the Government announced a major expansion in health and social care professional training places, with 461 new places to be delivered across nine priority disciplines. Occupational therapy places have increased from 125 in 2020 to 198 in 2025, which is an increase of almost 60%. In 2025, additional occupational therapy places were also created on a new tertiary programme. The Minister assures the Deputy that this Government is committed to ensuring that every person with therapy needs receives timely, high-quality care. The Minister continues to support efforts to address the waiting times for primary care therapy services, including occupational therapy.