Dr. John Hillery:

We are equally concerned about those changes in the HSE. The committee will remember that in A Vision for Change it was envisioned that there would be a czar for mental health, similar to the approach taken in cancer services which has been very successful. Cancer services have improved exponentially since this approach was taken, but the same never happened in the mental health service. However, we did get a national director within the HSE, but we are not sure what will happen now. We have a very good national director, with whom we have a good relationship, but she is to be given a broader remit. We do not know what will happen, particularly given the focus on psychiatry. The people Dr. Kennedy has just mentioned are often left out. I refer to people with a chronic and enduring mental illness. We see them as valuable members of society who are able to recover, but they are often left out of the discussions. That is a worry for us and we are not sure how things will turn out. We would appreciate public representatives addressing this issue, too, because the czar for psychiatry and mental health was never appointed. At least, we were given a designated lead and the term was used. Having it used in a high position in the HSE was really important because perceptions are very important and it has been fruitful.

We also have concerns about accountability and what will happen to the finances. Mental health services not seen like cardiology or neurology services. It is not the case that a certain amount of funding is allocated to psychiatry and a certain amount to primary care services. As Dr. Plunkett put it more eloquently than I could when we were discussing it earlier, I will ask her to outline the issue again. We are worried about a further dilution in the new set-up.