Jim Daly (Cork South West, Fine Gael) | Oireachtas source

The Chairman will appreciate I will not go into this type of discussion here. I will not negotiate the GP contract across the floor with anybody or go into its details. I have made some points on this. I addressed the National Association of General Practitioners, NAGP, over the weekend and I am merely reiterating some of the points I made to the GPs there. It is not in my gift. I will not be leading those negotiations and neither would it be appropriate or helpful for me at this stage to start entering into such discussions at that level.

Deputy Kelleher also mentioned child and adolescent mental health services, CAMHS, in Munster. I am aware of the challenges, particularly in the Cork area. One of the biggest issues we still have in mental health is recruitment, and we are blue in the face from listening to it on every Topical Issue and parliamentary question, but it is a fact. If one always does what one always did, one always will get what one always got. If we continue just to acknowledge that challenge and to struggle on, we will be in the same place for a long time to come. My attitude as Minister of State with responsibility for mental health is to look at how we do what we do and look at a new way of doing it. The future of mental health, from looking at international best practice and what is done abroad, is to look at online delivery of the service. This is the space we need to go to. It does not make sense for a consultant psychiatrist to leave Cork to travel to Castletownbere to see somebody given the amount of time it takes. These are posing real challenges while we want to have a seven-day week service and availability in every area. If we look at a model where somebody with a mental health issue can go into his or her local primary care centre where there is an interactive screen and he or she can speak to a mental health professional, whether a therapist, psychologist or psychiatrist and avail of the services online, that could be a new way to revolutionise and radically look at how we deliver online mental health services. I have asked the HSE to trial the online delivery of mental health services and to select a primary care centre where we can start to trial this. We need to consider this.

There is an ancillary issue, which is the management of waiting lists. Various people manage their waiting lists in various ways. There is huge disparity in various parts of the country where the numbers and percentages are broadly the same, such as 70% filling of posts and a certain number of people coming through, but there are various ways of managing it. Every list must be prioritised on an immediate basis. If someone presents with a serious mental health issue that person must be seen immediately. I heard the report with Brian O'Connell yesterday to which the Deputy referred. Nobody should be told he or she has to wait seven or 12 weeks. There is supposed to be continuous prioritisation. The consultant psychiatrist in charge of the team is supposed to look and assess. There are various ways to do this to deliver the service. I am aware of the issue and, ultimately, the solution will be to continue with this. We should not, as politicians, continue to accept recruitment is a challenge. It is a challenge, but there are ways around everything and the online space offers enormous potential.

Long-term planning for staffing is something on which a certain amount of work has been done by the HSE. A staffing skill mix has been looked at and a review was launched recently into nursing in particular. I also take the point that we should look at the challenges that will come from a range of illnesses that will present, such as obesity, diabetes and chronic illnesses, and not just look at particular skill sets.

Deputy O'Reilly raised the issue of scoliosis and the detailed action plan. I will have to come back to her on that. As she knows, there was an initiative last year and an additional €10 million was put into it. A new theatre was opened in Crumlin and its capacity is to be increased this year. It went from carrying out 220 procedures in 2016 to 321 procedures in 2017, which is a 46% increase. It will take time to catch up. When one launches an initiative one does not get an immediate result and return. It takes a bit of time. Work is ongoing and I will get the Deputy more details on the action plan.