Mr. Tom Maher:

Deputy Browne asked a specific question on the expanding role of other disciplines. We absolutely agree that is necessary. We would have trained nurses to become clinical nurse specialists and advanced practitioners. The same applies to occupational therapists, social workers, clinical psychologists, speech and language therapists and dietitians. We have the full range in St. Patrick's. We use them to the best of their ability. We have approximately 350 clinical staff, of whom 30 to 35 are doctors. There is multidisciplinarity across the entire service. As we train people to higher levels, we use their skills in tasks such as referring between teams and doing specialist assessments. We see the value of enhancing people's roles and not relying on a GP, a consultant psychiatrist or a nurse. We use the broad spectrum of disciplines. We have to. The Mental Health Commission specifies exactly what should comprise a multidisciplinary team. It includes as a core team a consultant psychiatrist, nurse, psychologist, occupational therapist and social worker. However, we would include on enhanced teams cognitive behavioural psychotherapists, psychodynamic psychotherapists, family therapists, speech and language therapists and dietitians because we realise that mental health is a continuum into physical health.

In response to the question on how we look after somebody's physical health, we have established in St. Patrick's in our approved centre, which is the name given to our inpatient services, a primary care service, in other words a GP service for our inpatients in order that they get adequate physical health care at a sufficiently high quality rather than having to transfer people out to other services in accident and emergency departments. We take advantage of other disciplines and we realise their importance.