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

I will deal with the questions posed by Deputies Kelleher and Ó Caoláin. We are continually hearing that the posts relating to mental health have not come on stream. I wish to place on record the exact position in this regard. We received an allocation of €20 million this year. I accept that the programme for Government contains a commitment to the effect that €35 million would be provided each year. I am convinced that we are not finished in the context of mental health and I have been provided with assurances in respect of next year. I will not discuss all of the usual matters relating to mental health - the difficulties that arise, where we should be treating people, etc. - because these have been well ventilated.

It is important to state that on 30 September last the recruitment process had been completed in respect of 378 - or 91% - of the 414 posts in this area. There are a number of posts in respect of which there have been difficulties in identifying suitable candidates. This is due to factors which include the availability of qualified candidates and geographic location. The recruitment process has reached various stages in respect of the remainder of the posts. Some €35 million was allocated in respect of mental health in Budget 2013 in respect of the continued development of our mental health services across a range of headings, including the further development of forensic and community mental health teams for adults, for adults, children, older persons and mental health intellectual disability. A total of 477 posts have been approved in the context of implementing these measures and as of 30 September, the recruitment process had been completed in respect of 19 - or 4% - of these posts. Some 236 - or 49% - are in the final stages of recruitment process. A further 149 - or 31% - are at various stages in the recruitment process. This means that some 85% of the 2013 allocation are in the recruitment process, with the balance undergoing HR approval. The HSE's national recruitment service is currently working to ensure that the remaining posts will be filled as soon as possible from the existing panels - or through competition in the absence of such panels - at the earliest opportunity. Options to enable more local recruitment are being considered and will assist in filling specific posts.

I wish to provide an example of where we currently stand in respect of posts. As long as people keep stating that posts are not being filled, this will appear to be the truth. It is not the truth, however. For example, a total of 21 posts were allocated to Galway-Roscommon health services. Some 19 of these have been filled and two remain to be filled. There is a difficulty with regard to specific posts relating to particular areas of interest. I refer, for example, to very specialised disciplines such as forensic psychiatry, services for older people and intellectual disability. However, another difficulty arises. If we continue to recruit from a general panel in respect of mental health services, those who apply will obtain posts but these may not be in either the areas in which they are interested or in the locations in which they wish to live and work. Let us consider the example of someone who is recruited to a position in Dublin but who wishes to work in Cork, which I can understand. When a post becomes vacant in Cork, the person in question would be entitled to fill it. As a result, a vacancy would arise in Dublin.

There is a particular problem with regard to forensic psychiatry. People are recruited from the general panel and are obliged to undergo very intensive training in order to get up to speed in this area. When posts then become available in disciplines in which they are interested, they tend to move on. We are considering putting specific panels in place and advertising the fact that specific posts relate to particular services. There are difficulties but these do not relate to the bulk of the posts we are trying to fill. We have made great progress filling many of those posts but there are problems in respect of niche specialist areas, which is understandable in the circumstances.

I agree with Deputy Ó Caoláin in that there will be a difficulty in the future in the context of beds. A decision has not yet been made as to whether this issue will be dealt with in the context of the public or private sector. However, a substantial amount of work has already been done and we are aware of the number of beds that are going to be needed. A great deal of the work in this regard has already been done in conjunction with Atlantic Philanthropies and in the context of the The Irish Longitudinal Study on Aging, TILDA. I will provide the Deputy with some statistics in this regard. The target in respect of home care packages was 10,870 and in June 2013 output had reached 11,031. The latter was 1.5% ahead of target. The target in respect of home help packages was 50,000 or thereabouts and in June output had reached 45,739. This was 1.8% behind target. Of course, it must be recognised that home care and home help packages relate to different cohorts. The target for day care was to provide 21,460 places and in June output had reached 21,460. So we were exactly on target in this regard. We are also on target in the context of respite, with some 600 beds being provided. On the nursing home support - or fair deal - scheme, the target was to fund 22,761 older people and in July 22,303 had been funded and an additional 863 had been approved for funding. We are, therefore, also on target in this regard.

We have challenges in regard to our ageing population. I agree with what Deputy Ó Caoláin said about the awful term "bed-blockers", because the situation is clearly not the fault of people who need to move to a more appropriate service. I am not convinced that we can meet that challenge entirely with the provision of long-stay care. It will require a combination of elements. That is something we will have to examine, although it may require the provision of rehabilitation which would be carried out in the community rather than in the hospital where, it is of very little value when one goes home. We have a difficulty in this respect. It is not something we are neglecting. We have done substantial work on it. I do not believe the solution to it comes down to the provision of long-stay beds, even though that must be part of it.