Jillian van Turnhout (Independent) | Oireachtas source

I concur with my colleagues, Deputies Kelleher and Ó Caoláin, on the Midland Regional Hospital report. As we will have dedicated time for this as a committee, I would now like to focus on some of the questions I raised, which are of critical importance.

My question No. 14 concerns the children and adolescent mental health service, CAMHS. I raised this because of a report produced in March 2015 by Dr. Helen Buckley, chair of the national review panel on children who died in the care of the State. The report was about 26 vulnerable children and stated that three out of four teenage girls who died by suicide were known to our child protection services and, for lengthy periods before their deaths, were on waiting lists for psychological services. According to the individual reports on the circumstances surrounding 12 of the deaths, at one point before taking her life, one of the girls, called Jennifer in the report, had been on a waiting list for psychological services for two years. Her mother had tried to access mental health services the week before she died. This happened last year. It is not something historical. Another case concerns a teenage girl, named Zoe in the report, who had been in and out of State care in childhood. Her case with the social work department had been closed months before she died by suicide.

I am hearing more and more that there is an urgency to close cases rather than being absolutely assured that the child is getting the services she or he needs. Dr. Helen Buckley states that mental health difficulty is very prevalent among people and their parents. Referring to waiting lists, she states that two years is the treatment time she is seeing in the cases she is looking at. She further states that young people in critical conditions are often receiving very limited treatment. This is echoed by the child care law reporting project led by Dr. Carol Coulter and her team, which gives us an insight into child care proceedings in the courts. This project reports on very recent cases and the characteristics and demographics mirror all those interplaying factors identified by Dr. Buckley.

I am frustrated by the lack of urgency within our mental health services. We know from the Royal College of Surgeons in Ireland that by age 13, one in three young people is likely to have experienced some type of mental disorder. By the age of 24 that has increased to one in two. How we deal with it at that age frames how we deal with it for life. Getting it right at that age is critical for our lives. When I talk to community-based organisations on the ground, they say the pathways for getting to the services are extremely difficult. For example, I was talking to a person in Tallaght who told me that although Jigsaw and Headstrong employ a consultant psychiatrist, they cannot refer directly to CAMHS but have to refer the young person to a GP who can then refer them on. It does not make sense when they have a consultant psychiatrist who specialises in the field. They say to me they do not have a waiting list because they do not tolerate a policy of any waiting list. For someone who is experiencing severe mental health issues, even 12 weeks seems a long time in that critical phase.

I could make the same speech on this issue as I made four years ago. From talking to the organisations on the ground, I do not know where it is going, particularly in respect of services outside the 9 a.m. to 5 p.m. period. What are youth workers to do and how can they get help for a young person? The issue needs more attention.

On question No. 12 regarding the hospice friendly hospitals programme, I am surprised there is no mention of the HSE palliative care co-ordinators. This was in the joint committee's report on end-of-life care. We had a really good engagement with the HSE on that report and I am surprised it has not been mentioned. Perhaps we could have more detail on that.

I was very disappointed by the answer to question No. 13 and I believe a more detailed answer will come. It gives the impression that things are happening but, sadly, they are not. We only have seven months left in four-year policy programme to get to our implementation plan. The programme has been there for four years and we have seven months left but we still do not have the implementation plan. This is about stroke survivors and rehabilitation care. It is totally unacceptable that we do not have that yet. I agree that health service funding can be part of the problem but much of what is required could be delivered through reorganisation. We must do much more about this, as we have seen a deterioration in service in the lifetime of this Government rather than an improvement. This area needs extra focus but I will await a further answer.

I ask the Minister about the children's hospital. I welcome his statement and his visit to Great Ormond Street Hospital. In the media there is a very strong focus on the geographical location but this committee's understanding, having visited the site, is there is an idea of satellites, consistency of services and outreach. It has not really been conveyed to the public. Has there been a decision on the maternity hospital, as it is important to consider the site and the services in play? I repeat my welcome for free GP care for those under six; it is a prevention and early intervention step, and it is a very positive move to a rights-based approach to health care. I want to see all children getting the health care they need when they need it. The health checks have been required for a long time. I hope we can get to the children who are in abusive cases or neglected much earlier in life. That is a critical issue.

I also welcome the HSE statement on alcohol-related harm. A policy is being developed where there will be no interaction with the drinks industry, which is welcome. I hope the Departments of Health and Education and Science, as well as other Departments and the Child and Family Agency, will follow suit with a similar statement.