Catherine Connolly (Galway West, Independent)
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I invite an Teachta Flaherty to discuss the future of the orthoptist service at St. Joseph's care campus, Longford.

Joe Flaherty (Longford-Westmeath, Fianna Fail)
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Ophthalmology.

Catherine Connolly (Galway West, Independent)
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Ophthalmology. There is a mistake here. I had not seen the word "orthoptist" before.

Joe Flaherty (Longford-Westmeath, Fianna Fail)
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I thank the Minister of State for taking the question. Parents across County Longford are becoming increasingly anxious and frustrated about the situation regarding the ophthalmology service at St. Joseph's care campus in Longford. Over many years, parents have always found the local service to be very efficient. It was a comfort and support to know it was on hand locally. There is a serious failing in oversight on the part of the HSE and there is simply no reason, if the service is on hold, that children who were attending St. Joseph's cannot now be seen in Roscommon or Mullingar until a vacant position in Longford is filled. I understand the ophthalmologist who was covering County Longford is still working in Mullingar and would be readily familiar with the cases in Longford. A source of further distress for many local families is that the orthoptist for Longford–Athlone left her post, and that vacancy is now going into a third month unfilled. It is very unsettling and worrying for parents to know two key posts have now been allowed to go unfilled. Are plans in place to recruit a new ophthalmologist in Longford? Will there be a replacement orthoptist for the Longford-Athlone region?

A busy clinic and region now has two vacant posts, with the service having closed overnight, it seems. Worried parents sense there are no plans to recruit replacement staff. The position of the HSE and the Department on this is now truly unacceptable. The people of Longford, specifically parents, are asking me whether the posts will be filled and whether the successful clinic in Longford is gone. With work on the St. Joseph's care campus in Longford about to start following unprecedented investment, it seems truly laughable that the HSE would, by sleight of hand, pull from the facility a service that had been working so well. The entire approach has been far from acceptable. Even if the service is lost to Longford temporarily, why have parents and service users not been given the opportunity to access similar services in Athlone, Mullingar or Roscommon rather than being referred to private providers? This is a serious failing in oversight on the part of the HSE. There is simply no reason children in the service at St. Joseph's cannot be seen in Roscommon or Mullingar until the Longford post is filled.

I understand the post in Longford was very successful and that the person in the role is working elsewhere in community healthcare organisation, CHO, 8, which is even more frustrating. It is very upsetting and worrying for parents to know that the two key posts have been allowed to go unfilled. What we require is a cast-iron guarantee that the service will be secured for County Longford and that the post will be filled. We need a definite timeline for when the service will be properly and adequately staffed. As an interim solution, surely the children I will refer to later and the many other children from Longford affected by this situation should have appointments scheduled without delay at appropriate clinics in Mullingar or Roscommon.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question. When I first saw the matter he was raising, I was wondering whether "orthoptist" was a spelling mistake. Apparently, it is not. An orthoptist is a health and social care professional who specialises in the assessment, diagnosis and treatment of squints or eye turns, eye movement disorders and childhood visual problems such as what we know as lazy eye. The Deputy's question is very good and an orthoptics service is a very important measure, for young children especially. I thank the Deputy for raising the matter.

All children, including those not covered by a medical card, receive a vision screen from a public health nurse while in national school. The HSE provides optical services free of charge to preschool children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.

An orthoptist is a health and social care professional who specialises in the assessment, diagnosis and treatment of a wide range of conditions affecting a patient's vision. Patients may be directly experiencing symptoms such as blurred or double vision, or they may exhibit outward signs, such as misalignment or uncontrolled movement of the eyes or abnormal head positions. Orthoptists are also involved in treating patients who have suffered from a stroke or head injury. Eyes are commonly affected after suffering a stroke or head injury due to their direct connection to the brain.

Regarding orthoptist services at St. Joseph's care campus, Longford, the senior orthoptist of the campus resigned from a permanent full-time post in October 2023. A derogation was sought to replace this post in November 2023, and to date approval for derogation has not been granted. The HSE secured part-time agency staff to provide the service from November 2023 until July 2024.

The HSE now reports that the orthoptist service at St. Joseph's care campus ceased in July 2023 due to maternity leave. Since the service has ceased, every effort has been made to secure more agency staff for this orthoptist post. Unfortunately, to date this post has yet to be filled.

The provision of appropriate eye care is an important aspect of our healthcare service and the HSE has advised that every effort is being made to ensure orthoptist services at St. Joseph's care campus, Longford, are restored. I will ensure that Department officials continue to follow up with the HSE regarding the restoration of this important service. The derogation to replace the post has to be made so a full-time orthoptist can be recruited. Families, especially those with young children with the conditions in question, cannot wait for the service. I will, therefore, follow up with the HSE on the restoration of this important service in the Deputy's county.

Joe Flaherty (Longford-Westmeath, Fianna Fail)
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I thank the Minister of State. I appreciate her undertaking on that.

What is most disappointing is that the Department or agency has not come back with any indication or commitment on whether the children attending the service at St. Joseph's can now access the same service in Mullingar or Roscommon, which at most will be 20 or 30 miles away. It is also extremely troubling that while a derogation was sought in November 2023 to replace the permanent post from which the orthoptist resigned in October 2023, it still has not been approved. I agree with the Minister of State that it is critical to have this matter resolved.

While we are bandying around job titles and descriptions, the reality is that at the back of all this, and really affected by it, are a large number of young children. I will give examples. Rían, a determined little boy who will be five in December, was attending a private practice in Dublin where he was advised to wear an eye patch daily. He was referred to Roscommon to have a review appointment in July. When his family contacted the service in Longford, they were told it was not available anymore. Emma, who is now seven years old and is a fun-loving young girl, enjoyed attending the service in Longford and was making incredible progress. However, when her family checked on her July appointment, they were advised the service was no longer available and directed to seek a private consultation.

It is unacceptable for these parents and for rural Ireland.

I appreciate the Minister of State's commitment. I ask her and the Minister for Health to work with us to ensure the derogation is lifted and we can fill that post in Longford but also, more importantly, the children attending those services can access the same service in Mullingar and Roscommon until the post is filled.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy. This is a very specialised service. It is important to note that the orthoptist service ceased in July 2024 due to maternity leave. In fairness to the HSE in the area, after the senior orthoptist resigned in October 2023, even without the derogation, agency staff were used to continue until July 2024. Unfortunately, while every effort is being made to secure more agency staff to continue this specialised service, this has been unsuccessful to date, which is the worrying aspect of this. I believe that if the derogation were to be sought and passed, it would be a full-time position for somebody who might be interested in taking it on.

I will take this away and have my officials engage with the HSE in the area to see, first, whether this derogation can be sought and passed and, second, whether the post can be offered in a full-time capacity, which may encourage somebody to take it up.

Catherine Connolly (Galway West, Independent)
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I remind Members there are three Topical Issues remaining and one Deputy is here. I will move on to Uimh. 3 in ainm an Teachta Donnchadh Ó Laoghaire, to discuss plans for the regeneration of flats at locations in Cork city.

Neale Richmond (Dublin Rathdown, Fine Gael)
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I am not taking this Topical Issue. I am taking Nos. 2 and 4. Sorry.

Catherine Connolly (Galway West, Independent)
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Are you not?

Mary Butler (Waterford, Fianna Fail)
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I have only one. Apologies.

Neale Richmond (Dublin Rathdown, Fine Gael)
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It is a different Minister. Sorry.

Catherine Connolly (Galway West, Independent)
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Are there no multi-functioning Ministers tonight?

Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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I am sure this is not the Minister of State, Deputy Richmond's fault, but it was communicated to me that he would take it.

Neale Richmond (Dublin Rathdown, Fine Gael)
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I am just not taking it. Sorry, I am here for Topical Issue No. 2, which is a different one.

Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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I was specifically told that he would be taken the Topical Issue I was raising.

Neale Richmond (Dublin Rathdown, Fine Gael)
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I was not given a script, sorry. I was not told I would be taking it. We might contact the Whip's office and get clarity for the Deputy.

Catherine Connolly (Galway West, Independent)
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I will repeat, we have completed Topical Issue No. 1, the Deputy raising Topical Issue No. 2 is not here, the Deputy for Topical Issue No. 3 is here but no Minister is here to respond, and the Deputy raising Topical Issue No. 4 is not here. I am going to allow one minute for both the Minister of State and the TDs to turn up.

I am sure the Ceann Comhairle will give priority to Deputy Ó Laoghaire to make up for this.

Neale Richmond (Dublin Rathdown, Fine Gael)
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On my own part, I cannot apologise enough to the Deputy. I was not aware I was to take this debate. No script was sent to me by the Department of Housing. I would happily have taken it had the Department asked me. There was a breakdown in communications somewhere, so it is a massive apology to the Deputy. If anyone else comes to take the other two Topical Issues, I am more than happy to try to rectify it. I appreciate how serious the issue is to the Deputy.

Catherine Connolly (Galway West, Independent)
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I am going to adjourn. We have waited long enough. I apologise to the Member.

Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein)
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I may take it tomorrow so.

Catherine Connolly (Galway West, Independent)
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B'fhéidir. Níor phioc mé iad, ach phioc an Ceann Comhairle iad. Sin deireadh le gnó na Dála don lá inniu.