Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I welcome the opportunity to speak to the service plan for the health service. I agree with some of the commentary on what needs to be done in the health service and the challenge facing the Heath Service Executive and Department of Health. As Deputy Maureen O'Sullivan acknowledged, we are, for the first time, advancing a planned service. Some areas have made much greater progress than others in this regard. The areas with which I am most familiar are mental health and disability services and services for older people.

In the areas of disability and mental health, my main aim has been to ensure people are removed from institutions and, where this is not possible, to provide for sufficient inspection safeguards for such institutions. That we have managed to pull this over the line through the establishment of the Health Information and Quality Authority and the provision of residential places for people with disabilities is a significant achievement.

We are also continuing with our programme of closing mental health institutions. It is sometimes thought that this job has been done now that the large Victorian institutions such as St. Senan's Hospital in Wexford, Our Lady's Hospital in Cork and St. Columba's Hospital in Sligo have been closed. That is not the case because many smaller units also need to be reconfigured. We are in the process of doing this.

Approximately 95% of the posts provided for in 2012 have been filled. In today's Topical Issue debate, a Deputy spoke of the need to allow recruitment to take place at local level in highly specialised areas. We are examining this issue and the barriers that surround it. It is of little value recruiting someone to a post in the Central Mental Hospital if he or she is waiting to move to Tralee when a post becomes available there. These types of barriers and structural issues need to be examined. The same position pertains in respect of the posts provided for in 2013. We have not yet started the process for 2014 because a business case must be made in terms of what is available and where the gaps are. This applies not only in the areas of nursing and psychiatry but also psychology, speech therapy, occupational therapy and specialised nursing posts.

I am asked to account for myself more frequently than other most other Ministers because I have responsibility for mental health. This is understandable given that mental health services are starting from a very low base. I repeatedly point out that we are doing our best and moving as quickly as possible. While I understand there are barriers in place, I am also annoyed by the resistance to change we encounter. Everyone is in favour of the strategy A Vision for Change until it reaches their patch.

The message we send out in respect of mental health is very important. Anyone who knows anything about mental health will be aware that those who have a mental health difficulty are very sensitive to the message that is sent out. While I do not have a problem if people argue that we have not done this or that or that we made this or that promise, the negative messaging must stop for the simple reason that one cannot ask people to seek help and, at the same time, send out a subliminal message that help is not available.

I may have to return to the House to beat myself up for making the following prediction. This year, for the first time, we will not have a crisis caused by people leaving school in the summer and failing to find training places. We have allocated €12 million specifically for this purpose and emergency placements. This type of forward planning is in place for the first time.

Furthermore, despite the circumstances in which we find ourselves, we have secured €4 million for disability services for children aged up to 18 years. This money will be used to ensure children who are not attached to a particular service and wish to be mainstreamed will have access to the same services and will not have to sign up to a particular service to obtain a service.

We have also reallocated €23 million from the fair deal scheme to enhanced home care packages. If I or any other Deputy is asked where we want to end our days, our preference will be to spend our final days at home or in the community. We are making progress and taking a more enlightened approach to doing business.

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