Dr. Shari McDaid:

I thank the Deputy for the question about the national information system. One would think there would be a normal audit trail in mental health where one would be able to track where money is being spent. Unfortunately, our understanding is that the HSE does not have a way of accounting for its expenditure by care group. Traditionally the HSE has accounted for its expenditure by region and down to county level. It is still the case that when it presents figures for the mental health services, it is presenting estimates. On the other side of the equation there is no information about the service provision. We know that the vast majority of mental health services are being provided in the community, but we have no information about how much provision is being provided, to whom and what the outcomes of that service provision are. Therefore, we have no idea of how well the money is being spent. In contrast to the area of, for example, physical disability or intellectual disability where there are long-standing databases that, on a national basis, identify at least the amount of need as well as the provision, there is nothing similar in mental health. Similarly, in physical health care one can identify waiting lists and find out how many people are waiting for a service and whether the waiting list is growing or shrinking, but we do not have the information for adult mental health. We have the information for children's mental health but we are looking for it to be extended to adult mental health.