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

First, I thank the witnesses for attending. Second, I love their honesty. I can sense from some of them that they are angry and feel disappointed and let down. I understand that people who work within the services are fully committed. I suppose it is like trying to bake a cake in that if one does not have all the ingredients initially, one will not get the cake one wants.

I will refer to a few matters. The witnesses spoke about funding, the demographics, the postcode lottery for services and so forth. They also referred to the CAMHS teams. Is it an 11-a-side team or a 15-a-side team? We never get that because it is always work time equivalents. When they spoke about audits and the like, I suspect the issue that is arising out of a full audit of the 70-odd so-called CAMHS teams we have is how many of them can be put into the premier league to play against each other. I suspect there are perhaps three that are fully staffed. We are met with the Department saying that we have X amount of CAMHS teams but that it has an issue with staffing and so forth. It is total misinformation.

I have worked in committees previously. In the previous Dáil, I was lucky enough to be a member of the Joint Committee on Future of Mental Health Care and I was also privileged to work on the Sláintecare report. There is one bugbear I have, and this is a question for all the witnesses. If we are so under-resourced, I think it is an Irish thing where Paddy will not buy into it unless he sees it. If we want a new community centre, he wants to see what the building looks like first before he will support it. What I am trying to say, and I have appealed to two or three Ministers about this over the years, is that we should start rolling out pilot projects. We have access to a lot of data. We know where in mental health there could be a spike in suicides. It is very simple. In my town between 2000 and 2002 there were 59 suicides in one area. That should have put up a red flag straight away that we need to put resources into that area to nip it in the bud. Our guests spoke about primary care. I am a firm believer in it, but we have a situation where we are now at a crisis level and people who could have got early intervention have now escalated to what we will call the "fullstop.com". There is no going back, but they cannot move forward. We have a massive crisis there.

It goes back to funding. How many are in the teaching profession at present, how many psychologists or psychiatrists are being taught, is there a limit on numbers? Do we have to look at all of that? There are certainly incentives. I have seen this in England. Even for basic nursing, one particular city has on-site campus accommodation for the nurses so they can afford to work and live in the area. We cannot get a trainee to come to Dublin and expect him or her to pay extortionate rents while basically living on nothing and working in an over-stressed and over-stretched job when somebody can go to Australia or Dubai and have all the incentives, as well as the opportunity to progress. I will look at the brass tacks, because the witnesses have covered so much in this regard. Through parliamentary questions, I have seen evidence of posts being advertised for more than 13 years that will never be filled.

How is it they can fill agency posts but we cannot fill permanent posts? I would love an answer because that is a bugbear. What about the value of funding a fully staffed, fully resourced pilot project and show it to people, the Government - it does not matter what Government will be there - and the HSE how and where it works? Then we could start replicating it and use a common-sense approach. If you are in County Cork and County Donegal, it is probably cheaper than in Dublin city. You would have to find an equalisation or incentive from there.

The three main questions are around how we can get people to fill agency posts when they are needed. I do not want to bring it up now but I would like to revisit what Dr. Hanlon said during the first round of questions. I suspect there is some danger in the lack of support in the hospital and ward setting. I heard Dr. Brides speaking on the GP side of things. Either the GP or the Garda is the first port of call. I heard her say GPs do not have an option to send them anywhere because the service is not there. She is right. It has been happening for years and years. I am tired of hearing about retention and recruitment. The reason they cannot be recruited or retained is because they will not pay them. Second, who wants to work in a toxic system? Third, the only thing that you get is blame, and that is totally wrong. It is very frustrating. There are any number of parents who are roaring at us that they cannot get their children into X, Y or Z, and it is correct to say that in the private sector, if a parent has cash, it does not seem to be an issue. How do we find a balance?

What do the witnesses think of the pilot project? Could it work? Why are we getting agency staff but not permanent staff? Is a tsunami of mental health issues coming down the road not only for patients but also for staff in the system? It has been said we are talking about this for ten years. If we are not going to invest now, do we just close the book and let it crash or what do we do? There is a lot in that.