Professor Matthew Sadlier:

I echo my colleague's sentiments. In regard to the appointment of people not on the specialist register, it comes back to the issue of recruitment and retention. Services are often faced with the problem that the alternative to someone who is not on the specialist register is nobody. In the service where I worked, when I was clinical director, which I stopped being about three years ago, there were something like 52 nursing vacancies, two or three consultant vacancies and a number of junior doctor vacancies. In terms of the budget, people have talked about capital spending previously. They are 100% right that we do need better infrastructure. However, in regard to human capital, a huge amount of the mental health budget is unspent every year. We have to look at that and at why we are designing services that people do not want to work in.