Dr. Rosalyn Tamming:

The issue of the evaluation of primary care at the same time did come up when the HSE was commissioning us to do this work. It was very much aware that it needs to be done as well but to do both in tandem would have meant a much longer process and urgency was felt at the time to apply to the CDNTs so that was what the HSE commissioned us to do. We have not got to this point yet, but as part of our proposal we will be talking to primary care and child and adolescent mental health services, CAMHS, specifically about the referral process and how it is working. That is a small part of it and does not in any way constitute a review of primary care.

We have heard of many examples of what the Deputy described, such as the shifting of waiting lists from one place to another. There was not a recruitment freeze for CDNTs but there was for primary care. Even the skill sets of some people in primary care may be not as specialised in paediatrics. There are a considerable number of issues there. We totally agree that needs to be reviewed.

The single point of entry that the representatives of the HSE talked about when they were before the committee last week will require another level of referral than what is there. The HSE is going to have to consider the overall process and staffing as part of that. It is a well-made point and I absolutely agree with all of the issues the Deputy has raised. There are problems with the national access protocol. It is applied differently in different places. We have at this point visited ten teams of the 14 we selected. It is coming up as an issue.