Máire Devine (Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I thank Dr. Hillery for the presentation and the delegation for attending. It is great to see three women present, especially given the week that is in it.

I have a few questions. On public service and psychiatry and consultant psychiatrists, we learned in the earlier session that a senior consultant would earn approximately €185,000. The public would not understand and I suppose would not empathise with one who says that that level of salary is not attracting what we need. We went into the different reasons such as, for example, that perhaps it is more than just salary, but we all are recovering from the idea that €185,000 will not attract psychiatrists to a post.

I am not sure if we got the detailed breakdown from the CHOs or from the HSE of the amounts and contract duration of the temporary and agency consultants who are being employed, some of whom do not have the speciality of the post in which they are employed. I would be interested in that because it seems to be nearly double €185,000. It seems we are shooting ourselves in the foot by employing many different bits and pieces here and there. Agency staff, while dedicated, do not feel like a whole part of the team because they can be gone on a whim and perhaps their dedication to the area is not as robust as that of permanent staff. However, I would like to see those figures. They are significant in the budget about which we give out.

Dr. Hillery spoke of material change to allow doctors from other countries - he referred to India in particular - to come here and amendment of the Medical Practitioners Act. That is something practical that we can take on. It is like where eventually Bord Altranais agus Cnáimhseachais na hÉireann listened and changed. It took the unions several years but Bord Altranais agus Cnáimhseachais na hÉireann announced recently significant material change to its operation and recruitment. Bord Altranais agus Cnáimhseachais na hÉireann is taking in post-experience as opposed to training experience and training modules and it will allow many other nurses to apply. Perhaps we could work on the Medical Practitioners Act. Given that it takes a year, according to the previous group here before the College of Psychiatrists of Ireland, and two years, according to Dr. Hillery, to get a post through all the red tape and all the various committee stamps, sealed, signed and delivered and then eventually advertised, at which point maybe only one or two turn up for interview, it is such practical steps that we are here to look at, listen to and act on and we have got so many so far for the interim report that will issue towards the end of this month or next month.

Given that there is a new unit being built beside Portrane, I will focus briefly on forensic psychiatry. We have not done this previously, as there has been concentration on child and adolescent mental health. The level of incarceration in this country was significant in the 1940s, 1950s and 1960s, more so than in Russia. At one stage, we had 22,000 patients incarcerated behind asylum walls. That seems to have shifted now to the prisons and there is a significant number of prisoners with severe and enduring mental illnesses who are being incarcerated. On the forensic psychiatry part of it, will we be able to provide enough beds in the new unit? Would Dr. Hillery know that or can we find out? I refer to those waiting lists of 30 to 40 persons throughout the country who are either in prison or in other approved centres who cannot get into the forensic unit. Will the new unit accommodate all that is needed, given the increase in criminalising those with mental health difficulties? Its seems as though the pendulum has swung from incarceration in asylums to prisons. I do not want to overstate it but we need some correction on that.

The committee has discussed IT systems at length.

I know we cannot get IT. The public cannot get email addresses when they are looking for information on their children or to set up meetings with CAMHS. We seem to frown upon IT systems that will modernise things and make matters easier if we go with the flow and have a fit-for-purpose IT system and apps for the public and ourselves.

My final point relates to capacity. It is all about capacity. In part, recruitment and retention are about not being able to deal with the chaos because of the capacity issues that people find overwhelming. While they want adventure abroad, they also choose a caseload that can be managed where they feel they can do something worthwhile for their patients or those whose care they are entrusted to improve.