Maire Devine (Sinn Fein) | Oireachtas source

Thank you for your presentation. I have some quick-fire questions. The HSE representatives referred to 90% of mental distress or ill-health being dealt with in primary care. The primary care team will be seen to be led by the GP. How involved are GPs in this? What information and encouragement is being fed to them? Primarily, the work of the primary care team is to promote well-being in order that we do not get to the crisis stages. The idea is to have early intervention.

Has the HSE engaged with An Bord Altranais to discuss the possibility of the board altering its criteria for registration in this country? We know at least 100 nurses have attempted to register but have been refused because of the strict criteria on the educational and experience modules. This needs to be revamped. Experienced nurses were turned away. They are now in other services but we need them in our services, as the members of the deputation know.

My next question relates to estimating the number of people in the Central Mental Hospital and the number of people in prisons. The number of those with mental health issues has sky-rocketed. I know the deputation addressed this earlier. Reference was made to the Central Mental Hospital, where the 93 beds are always full. I know there is a waiting list as well. Has the ten-bed facility in Dundrum reopened? I raised this question last year. Have the difficulties been sorted out? Did the HSE get the staff?

Has the HSE ever thought of allowing or employing psychiatric nurses to sit in the courts and Garda stations? A successful trial along those lines took place in London. Obviously, the idea is to get mental health issues at the first level of presentation along with some crime or alleged crime.

What contracts are the HSE offering to staff now? Are they flexible? The deputation referred to flexibility. Are they permanent? Do the contracts encourage and set out a career path or opportunity? Does a nursing contract have a clause to the effect that by so many years the employee will be eligible to become a clinical nurse specialist or advanced midwife practitioner? We know those roles can take a heavy workload from the mental health multidisciplinary teams. That is the way we need to proceed with experienced staff.

Has the HSE looked at the unsuitable environment of accident and emergency departments? I imagine we all agree on this point. While the GP might be the first port of call, where is the first port of call after 5 p.m., at weekends and out-of-hours? These are times when the greatest prevalence of mental distress is seen or is at its height. Has the HSE looked at alternative models for emergency services to be offered with particular emphasis on people in mental distress?

Will the witnesses name the 40 areas which do not offer services seven days per week?