Mr. Tom Maher:

The budget for mental health care in Ireland as a percentage of overall health spend reduced from 13% in the mid-1980s to 6.2% in 2015. The comparable budget for mental health care as a percentage of overall health spend is 12% in Britain and Canada and 11% in New Zealand. St. Patrick's mental health services recommends the implementation of the recommendation in A Vision for Change that the mental health budget should represent at least 8.24% of the overall health budget. The future health strategy must be informed by and include all stakeholders and must be conducted in a way that ensures buy-in from service users and their families. It is essential that we find a way to actively include families in the care system while protecting the rights of service users. We note that the UN Committee on the Rights of the Child, in its concluding observations at the start of 2016, urged consideration of the establishment of a national specialist independent advocacy service for children under the age of 18 who are in receipt of and engaging with mental health services in Ireland. We are recommending the establishment of such a service.

There is no definitive model of an integrated health care system that ensures patients have access to high-quality and efficient care. However, enough research is available to indicate that a number of principles are associated with the successful integration of such services.

These include issues such as maintenance of a patient focus when integrating services, providing standardised care delivery through inter-professional teams, the implementation of performance management systems across all employees, the availability of information systems that fully support the integration of services, strong organisational culture and leadership, strong clinical and corporate governance structures and sound financial management. St. Patrick's suggests that any proposals to integrate primary, secondary, tertiary and community health care services be informed by these key principles.

St. Patrick's has worked with health insurers to develop a funding model for all ambulant care in ambulatory care settings. This model should be considered and included in any new strategy. The independent sector has an essential role to play in the delivery of a world-class health service and it is therefore vital that any strategy includes involvement of this sector.