Trust paediatrics boss highlights 50% hike in special needs demand

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The paediatrics boss in the Western Trust says there’s been a 50 per cent increase in demand for special needs assessments over the past decade but no matching funding increase and there are now ‘massive gaps’ in the community paediatric service.

Dr. Gerry Mackin, clinical director of child and adolescent mental health services (CAMHS) said it was getting increasingly difficult to recruit paediatricians to help assess young people with special educational needs (SEN).

Colleague Mr. Kieran McShane, from the Health and Social Care Board (HSCB), said it was a matter of “significant concern” when they both briefed the Stormont Education Committee on the joint work health and education workers undertake to assess children for special needs.

Dr. Mackin said pressure on paediatrics was growing.

“The demands on our service have increased. In the 13 years that I have been in post, the number of statements requested has gone up by at least 50 per cent.

“There are multiple referrals: for example, a lot of children might get a statement in nursery school, there is a second request when they enter primary school, another when they go into secondary school and then, on transition, a further request for information.

“An awful lot of information is being requested, and, as you say, there has been no increase in the funding coming through into our service.”

The Trust boss said he recognised there were recruitment gaps across various specialities but felt it was particularly difficult to get GPs, for example, to move into paediatrics.

“We cannot get staff, and there are massive gaps in the community paediatric service across Northern Ireland.

“There are gaps in multiple specialties across Northern Ireland. It is linked into child protection, which is often not the most attractive specialty. Often, it also links into acute paediatrics. It is difficult to get people to work in the specialty.”

Dr. Mackin said many non-consultants formerly came through from general practice when paediatrics was “more of a nine-to-five job, which fitted in well with family life”.

But no more.

“GPs no longer have to do out-of-hours work, he said. “They can decide not to, and it has become much harder to get people to leave general practice and come to work in paediatrics.”

Mr. McShane agreed: “It is a significant concern. As Gerry said, community paediatrics are vital for us, not only for this area but for looked-after children, for children with complex health care needs and for child protection issues.”

Asked about difficulties recruiting speciality doctors and consultant paediatricians across all health authorities, Dr. Mackin said: “They are not there. We have advertised multiple times - locally, nationally and internationally.

“We recently appointed an agency to recruit from overseas, the idea being that we would interview via video.

“We have been through a very prolonged attempt. There is a similar issue

in acute paediatrics. Paediatrics is not a popular specialty because it is considered a busy specialty and it is considered hard. It is difficult.”