Lack of forward planning on therapy provision: Let’s stop repeating the same mistakes

by Atrish Sanchez

The benefits of therapy, in all its forms, are endless, and well documented. Not only can therapy develop positive self-concepts, improve social skills and academic performances, but it can increase motivation, build functional skills, social skills, communication, mobility, and many other things depending on the therapist’s speciality and the needs of the person.

The shortage of therapy provision in all therapy areas due to the low number of therapists in relation to the number of people requiring therapeutic assistance is a pressing concern that this Government has not been able to resolve. This issue has also been spoken about in length by different people within our community. The Government cannot claim that they have not had sufficient warning about this long-standing issue. It is not a new one and it becomes ever more pressing as the number of children needing this type of intervention grows yearly. The failures in this area can in no way be attributed to the fantastic therapists employed by the GHA but rather, in my opinion, to the inability of this Government to display the forward planning that is needed to manage this issue accordingly and, in a time- sensitive manner. 

Therapists have long been stretched and found it hard to cater for the needs of all the children and adults needing their input, meaning that 1:1 therapy provision has been extremely scarce and on rotations, which are often very far apart. The shortage of therapy has not only affected those children in St Martins/Early Birds, with those in mainstream schooling arguably feeling the shortage of therapy even more severely, and young adults also suffering the shortage of speech therapy, even more intensely. This shortage creates an overspill which affect all children within the community and not only children with neurodevelopmental needs. Therapists work with children and adults that have all types of needs, children who have lisps, or those who have handwriting issues, (just as two very basic examples) and the shortage of therapists and resources would logically lead one to assume that these issues are also not being addressed promptly.

Parents are also being deprived from the tools that in the past were available, such as Makaton Courses, that assist them as communication tools with their children and which have not been offered to them for quite some time. Therapists have for some time instead carried out most of their work within schools to access as many children as possible within the classroom settings, but even this is becoming difficult because there are not enough therapists to meet the demands of all children within schools needing their input. The situation has exacerbated to such a level that therapists are no longer able to cope, and some children are not even receiving this therapeutic input in school, with teaching staff that are neither qualified as therapists or employed to carry out these duties, having to do what they can in relation to this with whatever input they receive from extremely stretched and overworked therapists. The workload of these therapists is immense, we do not often appreciate it and the valuable work they do, and they are often on the receiving end of desperate families who are rightly angered by a system that should be working better.

In more recent times we have seen therapists leaving for sabbaticals, and therapists retiring, all from the different therapeutic specialities, making these issues even more acute. Never has the lack of forward planning been better demonstrated by the fact that despite knowing with significant warning, and knowing full well that the replacements of Therapists are often locums that they need to source from abroad, the Government did not feel it appropriate or indeed wise to advertise enough of these vacancies, (more than just to cover the immediate replacements but indeed to expand the teams) and well in advance to ensure a proper hand over period from one therapist to another and to slowly allow children and their parents a chance to familiarise themselves with the new staff.

It is also important to note that the issue of employing Therapy Aids, which are Therapy Assistants that work in a similar way to Learning Support Assistants, as a solution to assist in alleviating with the workload, delivering more therapy to more people and helping therapist who are extremely stretched, has been ventilated in many quarters for several years. It has indeed been expressed and requested by the very same therapists working within the GHA to the Government on numerous occasions and forward planning would have meant the vacancies would have been advertised a long time ago in effort to employ these assistants to help resolve some of these issues. This would have demonstrated a measure of an effort or an attempt to resolve part of this issue years ago.

It is a positive step that Internal Occupational Therapy Assistant Posts have now been advertised for applicants employed within the GHA, Civil Service, GDC Officers, Agency Workers and so forth. It is unfortunate however, that the problem needs to become so acute, that so many children and young children have had to and continue to miss out on therapeutic services that are clinically proven to make a difference and that parents need to become so public and vociferous about their concerns. It is also a great shame that families must wait for election year for the Government to take this small step which has been requested and urged from the Government on so many occasions, even by the professionals themselves. Let us hope that they now advertise similar posts for the remaining Therapy Specialties.

This small step is only a drop in a vast ocean of issues that need to be realistically and effectively addressed to create better and efficient services and provisions for those with neuro developmental needs and more widely for all children needing therapy too. It is of course alarming to now read the latest press release by the Government which attempts to place the blame of this long-standing issue on difficulties experienced in the UK surrounding the recruitment of Speech and Language Therapists. If anything, this only proves that the Government, who has always been equipped with the growing numbers of those needing therapy (a number that has been growing significantly), should have already come up with effective plans and forward-looking solutions. It is even more alarming to read that the Government should think that they are faring relatively well in this area. It would be interesting to see what tools the Government has used to come up with the conclusion: has an independent commission or body carried an assessment to verify this as a fact? The picture painted on the ground from affected persons is a very different one to this rather incredulous statement made by the Government in their latest press release.

And of course, as I sit here and watch all of this unfold, I cannot help being reminded of the similarities and the mistakes they keep repeating which say extremely little about the Government's ability to look to the future and plan. It reminds me of the debacle we all witnessed last September with the incredible display of mismanagement and lack of forward planning in relation to the start of school term and the very late appointments of LSA’s. It reminds me of the quick and last-minute reaction in the face of public criticism. It reminds me of the lack of forward planning and mismanagement in relation to many SNLSA's who have still not had their agreements honoured, an issue raised by the Leader of the Opposition recently in Parliament. It reminds me of a particular school that was recently built with very little forward planning and has become too small far too soon. 

These are only a few examples of very real social issues that affect far too many of us and our children. However, let us be clear on one thing, the inability of a government to look to the future and plan affects ALL of us. Gibraltar deserves a government that finally changes from one that looks back and responds to one that looks forward and plans. This might be a challenge, but if we can finally achieve this and get on with what needs to be done – we will be able to set and achieve the transformational goals that create a better Gibraltar. I see none of this happening – I only see the same mistakes repeated time and time again.

Atrish Sanchez is a member of the GSD executive.