Catherine Martin (Dublin Rathdown, Green Party) | Oireachtas source

I thank Mr. Sullivan for his attendance and presentation. With the greatest respect, I think I speak for many members when I express my disappointment and frustration. I understand that Mr. Sullivan was invited to this committee on 17 April and we received a submission yesterday, less than 24 hours before the meeting. Before my election to the Oireachtas, I ran a student council with second level students and they knew that the agenda and submissions to the meeting came in a week earlier, and they were children aged 12 to 18 years. That is deeply frustrating. I was watching out for the submission over the last five days as I wanted to study it and I do not think the three page document that we received is good enough. Within the three pages, as Deputy Rabbitte has noted, there is nothing into which one can sink one's teeth. There are phrases such as "maintain stability during the transition", it tells us that over 90% of mental health needs can be successfully treated in primary care, when from previous meetings we know that we only have 37 general practitioners in Kilkenny, 41 in Kildare, 38 and Longford and there is a crisis in this area. I do not think that it is acceptable.

Given previous evidence that dedicated resources are needed within mental health to drive forward policy, will Mr. Sullivan explain why the decision has been taken to remove the national director for mental health?

In his submission, Mr. Sullivan pointed to an increase of 22% in mental health expenditure since 2013. That read to me like the kind of answer the Minister would give to me in response to a parliamentary question or something I would see in a Government party manifesto. Where is that money going? Over the course of this committee's work, we have heard of the huge numbers of staffing positions being unfilled, how people remain on practically indefinite waiting lists and it was reported yesterday that in just one month, there was a 10% increase of young people waiting for services for over a year. If there has been an increase in funding over five years, I would like to know where it is going and, more importantly, the reason it is not being felt by service users.

Mr. Sullivan stated there have been tangible results from the increased spending. What are they? Who will have the authority to set priorities for the mental health expenditure across the country?

How will the structural changes address the issues in recruitment retention and pay, as well as the lack of resources and poor working conditions? It is no good saying that we have increased spending and changed HSE structures when we do not have the front-line staff to provide care. Who in the HSE will provide the dedicated leadership on delivering and improving mental health services?

Mr. Sullivan stated that the "changes now being implemented within the HSE are designed to build on successes to date". Will he list some of those successes? We have 2,500 children waiting for their first mental health appointment. The child and adolescent mental health services, CAMHS, continue to operate at just 50% of recommended staffing levels. A recent report found that some third level education institutes have indicated a 41% increase in students seeking counselling over the past three years. There is now a six-month waiting list for counselling services in many institutions. When he speaks of successes to date, Mr. Sullivan will find many service users are not experiencing successes.

Last year, the Sláintecare report recommended that 10% of the overall health budget be spent on mental health, the 12 year old A Vision for Change document recommended 8.24%, yet currently we are at 6%. Is 10% achievable? When can we reach 10%. Should we aim higher? What will the HSE do to secure this budgetary allocation? Whose responsibility is it to get us up to best practice standards of 10%?