Mr. Damien McCallion:

I might address that at a high level first and then my colleagues may come in. With regard to what we are seeing across all services, we unquestionably have a particular challenge on the east coast and not only in respect of mental health services. I mentioned earlier that annual turnover has risen from 9,000 to nearly 13,000. Post pandemic, we have seen a lot of people who could not travel during that pandemic, although they previously might have, now travelling overseas. We all know healthcare professionals working in Australia, Canada and so on. We are trying to set up portals and various other means to keep in touch with those people as they may decide to come back. During our lives, many of us have worked away but come back to Ireland. We are trying to do things at that very high level. In fairness to staff, it was a very tough two years in light of the Covid pandemic and how people were denied many other opportunities. That has definitely been a factor. We also know there is a certain amount of pressure on CAMHS waiting lists and that staff in any service want to meet people's needs when they arise. Dr. Burke or Dr. Niazi may wish to talk about the specific issues within CAMHS but, at a HSE level, it is our intention to connect to people so that, if they decide to come back, they will know where the opportunities are. We are keeping connections with them whereas previously people who went away may have just relied on word of mouth. A lot of effort is going into maintaining that connection and keeping people aware of what is available. This is particularly the case for consultants but we intend to extend it to other areas. People can register and see what is coming up in case they hit that point. The factor we worry about is that, having just moved because of the interruption of the Covid pandemic, these people may spend a number of years away, which means that it could be a number of years before they begin to flow back.

However, as I have said, it is not the only factor. There is almost internal competition in that we are investing in primary care and some people are opting for roles in that area so, separately, the team is looking at whether there are additional incentives we can offer to people to come into CAMHS. I refer to sponsorship and other measures that might assist.