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

I will be as brief as possible. I will deal first with the cochlear implants. We had a very good meeting with the Happy New Ear group and the HSE staff members who are charged with putting the business plan together on how we would do this. That business plan will be completed by the end of June. It is a good timetable because the budgetary process will begin shortly after that. With the roll-out of the newborn screening programme, we will pick up children's hearing impairments at an earlier stage. I heard yesterday that these can be detected as early as three weeks. There are approximately 60 children born each year who have a hearing difficulty - maybe not profound, but nevertheless, something that could be helped by a cochlear implant. Those numbers will not go up; we are simply detecting them earlier. At present this is detected at between two and four years of age. We hope the numbers will not increase, but such conditions will be detected earlier.

There is an emotional and practical case being made for the benefits of having two implants in respect of balance and sound sensitivity. That was all taken on board. It would be in our best interest to wait for the business case to be made and, as well as the children we are picking up at an earlier stage and with whom we are now dealing on an ongoing basis, there is a waiting list for the second implant. It cannot just be for the people we are picking up now. We need to start dealing with the backlog of people who could benefit from two implants. Not everyone will opt for, or benefit from, it. We need to wait for the business case that is being put together. There may be different mechanisms to deal with the problem. We will need additional posts if we go with it. There may also be a mechanism to bring people in on a short-term basis. That expertise is being considered. We are moving on it. The group was very happy with the meeting yesterday, which was very open and honest. No commitments were given. Everyone here knows I am not in the business of doing that, but we are preparing a business plan which needs to deal with the two sides of the equation - the people who have one implant and need a second, and the people we are picking up at a much earlier stage. We will have that business plan in June and it will be well-placed for next year's budget.

Deputy Ó Caoláin asked about the mental health posts. We are above the recommended numbers of staff in the mental health sector - not much above, but we are above. The difficulty is that there are deficits in some areas and not in other areas. We are trying to deal with that and we have to take it into account too. We have almost completed filling the 414 posts. There are 42 posts unfilled, for a variety of reasons. They have been accepted by candidates who are going through the clearing process, but a few posts are difficult to fill for geographical reasons. People do not want to go to particular areas because their families are in other areas and some who are abroad want to complete the jobs they are in. Thankfully, very few posts remain unfilled.

In respect of the 470 posts this year, what we did about the first €35 million was different and took a little bit longer. I am very conscious of where I am saying this: we did not automatically divide it into four and send it into the regions. We told the four regions to tell us where the gaps were and to send in their business cases for those posts and then we would employ. That is what we have done with the 470.

One area has not sent in its business case in regard to what the service needs. It is not the same service. There is a different cohort this year, including old age psychiatry, intellectual disabilities psychiatry and forensics.

In the future where the service is delivered will be as important as who delivers it. We are building a new central mental hospital, which is long overdue, and four regional rehabilitation units which will ensure that people who are in the Central Mental Hospital but could live closer to their homes can be accommodated. Significant progress is being made. More than anything else, there has been progress on attitudes and where we are delivering services. The numbers are ahead of, rather than below, target, but not by much. There is still more to be done.