James Browne (Wexford, Fianna Fail) | Oireachtas source

I have a number of questions. It was announced in the budget that €35 million would be allocated for mental health services but we found out later that only €15 million would be available to be spent. The reason given by the Department of Health was that it was not possible to spend the other €20 million. Is that a decision of the HSE? Does the HSE stand over that, that is, there is no where to spend €20 million on mental health services, if it had that additional amount this year? When is it expected that the HSE service plan will be delivered?

A motion was passed two weeks ago that stated that any unspent money allocated to mental health would be retained year on year. Has that been communicated to the HSE? Is Mr. O'Brien confident that the €15 million that has been allocated to the HSE will be drawn down and spent on mental health in this 12 months?

Let me describe the morass of trying to get information. I had two people online this week trying to find out the geographic areas of the 14 mental health teams. I went online and spent all day Saturday and Sunday doing research on mental health. It was impossible to find out online where the 14 mental health teams were. This committee has allied health professionals, trade union professionals, lawyers and yet six months into this process, we are still finding new layers of structures in the HSE. It is impossible to find out how the system actually works. One example is from the HSE website. If one looks up mental health services, one will see that information is only provided for one area, Limerick, north Tipperary and Clare. If one lives outside those areas, one will not find out anything about the services. The page on infant mental health is blank. There is another page on mental health services in one's area, but it only is corporate waffle. There is a link to more corporate waffle and then it links back to the first page. It is a loop and one cannot find out the structures of the health services in the country. To find out the health services available, one would think that by putting in one's eircode, the website would bring one to the services in that area. Instead, professional researchers cannot find out the information.

Currently the Corporate Manslaughter (No. 2) Bill 2016 is going through the Seanad. When a similar Bill was enacted in the UK, it dramatically changed accountability in the NHS. Is this Bill on the radar of the HSE? Is Mr. O'Brien preparing for the very serious decisions that will fall from it? One of the issues with the HSE is the lack of delineation of people's roles in it. I often find that one gets a commitment from a manager and when the manager moves on, the new manager will say it has nothing to do with him or her. Under the Corporate Manslaughter (No. 2) Bill, management churn would no longer allow staff movement to effectively negative the decision, or the lack of decision-making.

The leader of the mid-west hospital group states she would have no difficulty giving money from her budget to the community. That is because of the incentive. If she transfers money to primary care facilities, they can keep people out of hospital, which drives down the waiting lists. The primary care managers then know they can get people into the hospitals quicker. There is an incentive.

One point that keeps coming up week after week is the perverse incentives in the health care system to encourage people to simply waste money. I have heard the arguments about the different alignments for hospital groups and community health organisations. Let us look at the services in County Wexford. If one has mental health issues in north Wexford, one goes to Wicklow while if one is in south Wexford, one goes to Waterford. We are in the Ireland East Hospitals Group but the county councillors sit on the health committee for the southern group. It is just all over the place. The Wexford manager must be driven demented going from one area to another trying to co-ordinate everything.