Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

I thank the witnesses for attending the committee.

It was stated a hospital must identify the need for an extra psychiatrist or clinician but then must make a funding case. If hospital management sees a lack of services which are needed, then there should be a common sense approach. For example, among psychiatric nurses, there is a significant concern that within the next five to six years more than 1,700 of them will retire. However, there has not been one mention of forward planning to fill those gaps. Between 300 and 500 positions need to be filled to bring psychiatric services to where they should actually be but there is a process where we cannot get applicants. How is it Tallaght and St. Loman’s have 43 vacancies, St. Joseph’s in Portrane, 58 vacancies, Waterford, 26, and Louth-Meath, 34? Is there somebody in control to say we need these vacancies filled?

It is also claimed there is an issue with money. I have encountered cases where common sense seems to disappear. For example, a young person is admitted to an accident and emergency department and is waiting for an assessment to CAMHS, child and adolescent mental health services, but the assessor is missing. There does not seem to be a process which will ensure the patient can be moved. Is that politics or is that under some mental health rule? That seems to be an overlapping problem. We have young children who are absolutely victimised and terrorised in an accident and emergency department because of the policy that if one cannot get it in one hospital, one will certainly not get it in another as the hospitals need to justify their numbers. There seems to be a big fudge.

We keep on hearing there is a problem with staff retention. I have spoken to qualified people around the country who have told me they cannot get a job in the services. There does not seem to be a common-sense approach.

One fifth of consultants in most psychiatry wards are working in non-permanent contracts. Professor Murray referred to the issue of consultants trying to balance between public and private systems. If they are trained at a cost to the State and contracted to the State, then they should spending more time in the public sector hospitals. Why can we not get the consultant psychologists and psychotherapists? It should involve a common-sense approach of stating a consultant is needed in ward A today and not ward B as there is an emergency. Why can we not do that?