5 October 2002, Thurles Institute Campus
The NAMHI Parents’ Committee hosted their eighth annual seminar at the sparkling Thurles Institute Campus, with a comfortably-lavish lecture hall, a mid-day meal of country-portions and earnest interchanges among the delegates. The difficult issue of therapy services was covered from all perspectives—parents (Mary Hambleton and Eamon Dwyer), funders (Frances Fletcher and William Beausang from the Dept of Health and Children), service agencies (David Kieran of St Anne’s Services, Roscrea), professionals (Carmel Murray, physiotherapist with the Mid-Western Health Board), and training bodies (Dr Mary Garrett, UCD School of Physiotherapy, Clóthra Ní Cholmán, TCD Dept of Clinical Speech and Language, and Kathy Cremin, TCD School of Occupational Therapy.
There is a universally agreed shortage of therapeutic services in Ireland; the fundamental sources of the problem, and suggestions on how best to ameliorate it, are matters for considerable debate. William Beausang outlined the ‘global’ figures, steps being taken to implement the Bacon Report—accepting the difficulties in training, recruiting and retaining therapists. The three academics in occupational, speech and physio- therapies outlined the curricula followed by their respective students. They emphasised the catch-22 dilemmas in securing suitable clinical-placements for an increasing number of students, under the supervision of a far smaller number of practising therapists (especially those working in the area of intellectual disability). Carmel Murray detailed her crippling workload as a rural-based physiotherapist, and the frustration of being unable to cope with the legitimate needs of the health board’s client population. Voicing the perspective of a service provider, David Kieran, CEO of St Anne’s Services in Roscrea, said that it is necessary to change and adapt the traditional one-to-one ‘patient model’ of service, in order to improve access to the expertise of professional therapists. He proposed a model of ‘professional consultant’ therapists, who assess client needs, and train and review the work of ‘hands-on’ people—both staff and family members. Parents Eamon Dwyer and Mary Hambleton sought innovative ways to ‘fast-track’ the training of more therapists, and to train parents to become more expert too. Eamon pleaded for others to have ‘the sight to see what we see’—in the desperate and continuing needs of children with severe and profound disabilities. In his remarks at the close of the Seminar, NAMHI Vice President Stephen Kealy pointed out that the present inadequacies in therapeutic services are the consequence of the lack of a national policy, particularly on a system of early intervention services.
The NAMHI Seminar day had, in some ways, the feel of a therapy session itself! Every shade of emotion and debate was aired. Individual parents pulled no punches in voicing their criticisms and despair at the present inadequacies; in some cases their anger reached a level of distrust. Therapists staunchly defended their professional standards and training; they are equally frustrated by the limited availability of their services, and they are earnestly seeking innovative solutions. The other end of the tunnel isn’t yet in sight, it seems—we still await more therapy training/academic courses (and, of necessity, practitioners will be taken from ‘the field’ to become professional trainers); ways must be found to improve the availability of clinical placements; newly qualified therapists must be encouraged to enter the area of intellectual disability; and health and disability service providers must construct work-settings which will ensure therapists’ professional career development. Several tall orders, but the climb has at least started.