Five organisations representing healthcare workers have issued a joint statement expressing concern over the safety of children's disability services in the HSE.
The bodies, which represent occupational therapists, speech and language therapists, social workers, physiotherapists and psychologists, have concerns over clinical governance, risk management and the "erosion of professional autonomy" within children's disability services.
This, they say, is leading to a situation where an individual health and social care professional is not reporting to a discipline-specific manager with an inherent understanding of their specialised roles within the disability services team.
Dr Marie Ó Mir of the Irish Society of Chartered Physiotherapists has said there are concerns that children are being seen in a structure that does not have proper governance.
Speaking on RTÉ’s Morning Ireland, she said there is no concerns around safety of the children but there are issues around the clinicians as they are not reporting to managers that are qualified in the area.
"Our concerns are that children are being seen by physiotherapists, occupational therapists, speech and language psychologists, and the social workers in a structure that doesn't have proper governance and proper supervision," Ms Ó Mir said.
"So, there's no, there's no problem with the safety to the children themselves, but there is risk to the people, the clinicians who are performing the services because what they're doing is they're hiring in people who are recent graduates, and not necessarily being managed by somebody from their own discipline."
She explained that a physiotherapist for example might be managed by an occupational therapist, a social worker might be managed by a psychologist.
"That's not necessarily the problem until you're asked to do a task that you're not experienced enough to do," Ms Ó Mir said.
"And when you go to your manager, they don't understand the nature of your profession.
"So, we're putting out a call to re-establish what we call discipline specific managers, so that every discipline is managed by somebody from their own discipline".
Dr Ó Mir said that children are being affected however due to the problem of recruitment and retention in posts.
"There is a 34% vacancy rate on average across all these professions," she said.
"Last year, 60,000 hours of therapy less were delivered. So, people are not moving into these posts because they're not supervised, they're not structured. So, the fallout then is that waiting lists and waiting times increase for children.
"Also, children may not be able to access exactly what they need because you could have somebody who's more junior and not experienced enough asked to perform a task that's not in their scope of practice to do so, they can't perform it.
"Because we haven't enough senior clinicians in the area, there's less diversity of treatments available to the children and then waiting times increase."
In relation to the reorganisation by the HSE called "Progressing Disability Services", she said it is a great idea and therapists do not want that rolled back.
"However we want proper structure in it," Ms Ó Mir.
"We want them to engage with us. They rolled out this Progressing Disability Services without any interaction with professional organisations and we could have told them in advance that if they didn't give proper support, they were not going to be able to recruit into these roles."
She said that unless the HSE restructures the governance, people will not move into those roles.
Dr Ó Mir said the clinicians have written to the HSE Clinical Lead Colm Henry asking for a meeting.
"What has happened is that all the groups individually have surveyed their members," she said.
"We've been receiving complaints and issues from our members. That's why we've driven to this. We've all contacted various people.
"There's been interaction, but there's been no meeting. So that's why we've come together as a collective and we want a meeting with Colm Henry's office, the Chief Clinical Officer to discuss this."
