Staff ‘walking out’ of HSE over clinical governance concerns in child disability sector

Five organisations representing healthcare professionals have issued a joint statement expressing “significant” concerns with the impact of a restructuring of HSE children’s disability services in recent years.

The bodies, who represent psychologists, physiotherapists, occupational therapists, speech and language therapists and social workers, said the changes had led to shortcomings in clinical governance.

The five representative groups stated that, as a result, they had concerns about “the safety of children’s disability services within the HSE”.

Dr Marie Ó Mír, chief executive of the Irish Society of Chartered Physiotherapists, said the organisation had been raising concerns since services were restructured around two years ago.

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Under the changes staff no longer necessarily had managers who came from the same discipline, she said. “A physio could have a manager who was a nurse, a social worker,” she said.

The professional representative bodies were also “extremely concerned” with growing waiting lists for disability services, she said. “Waiting times have gone from a few weeks to as long as three years in some cases,” she said.

The changes from the HSE had not resulted in improvements in services, she said.

Staff were “walking out” and leaving the HSE as in some cases as they were not comfortable with the level of “clinical risk” they had to take on, she said.

Dr Ó Mír said the representative bodies wanted “proper governance structures”, which included professional staff having managers that came from their own profession.

The joint statement said staff felt the changes had impacted on the quality of services delivered to children.

The statement was made by the Association of Occupational Therapists, the Irish Association of Speech and Language Therapists, the Irish Association of Social Workers, the Irish Society of Chartered Physiotherapists and the Psychological Society of Ireland.

The groups said they had “significant concerns in relation to clinical governance, risk management, [and] the erosion of professional autonomy” in children’s disability services.

The statement said the issues were having a “direct impact” on the number of professionals leaving HSE services, which were already facing “significant waiting lists”.

“Meaningful and timely consultation with our organisations is required regarding current and future delivery of children’s disability services… Appropriate and urgent action is required,” the statement said.

In a statement, the HSE said the aim of recent reforms had been to deliver “fair access to services for all children with disabilities”.

“Before this policy, children in different parts of the country with the same needs could be given much more, or much less service than others, based on geography rather than need,” it said.

The HSE said reorganising children’s disability services into 91 network teams was “one of the most complex change programmes undertaken within our health service”.

“While we’ve made great progress, we have a lot more to do. Our focus now, in addition to filling staff vacancies, is on developing real and meaningful, child and family centred services,” it said.