Professor Joyce O'Connor:

We can implement change because we know what we need to do in each area now. We need to put a system into primary care. We need to get all the resources working together and put in one or two liaison officers in that area who will work with GPs and utilise all the areas of health care. I agree that GPs are the gateway. People go to GPs for help so that is a very practical way of doing it. We should insist that all the actions in this report that are starting on 1 January 2018 are implemented. We should follow this through. They are specifying they will do certain things and they have to be done.

The HSE has no information system. We do not know who gets care, what happens and what the outcomes are. It is a priority for it to set up an information system. In the commercial world, they say data are money. Data are knowledge. We do not know what is happening. That is absolutely critical. The approved clinician is somebody who goes through a process of training and development. Using their expertise they are made the responsible clinician in certain situations. The approved clinician would work in this area. For people who are in CAMHS, the consultant psychiatrist would probably be that person because they are dealing with severe mental health disorders. It gives other people in the team the capacity to make decisions and to move things on. At the moment, the consultant psychiatrist has to sign off as the responsible clinician for all cases. Having an approved clinician is working very effectively in the UK where they have the process and training. In tandem with the choice and partnership approach, CAPA, a multidisciplinary approach would make an enormous difference because the appropriate people would be seeing people at a different level of intervention and they would be able to sign off rather than always waiting for a psychiatrist. The issue is it clogs up the system. Psychiatrists, who are very well qualified, could then spend their time dealing with really serious cases, which is why they are in psychiatry. Other people, such psychologists, nurse practitioners and counsellors could become approved clinicians. Is that clear?