Professor Matthew Sadlier:

It is an adjacent issue. That is why we wanted the inspection of services to include the effect of national policy on the recruitment of staff. It must be remembered that Sharing the Vision, which is the policy to organise the mental health service, has not worked. We cannot fill 30% of the posts. They do not talk to the employment groups. They devise a service thinking that if it is built, people will work there, but we cannot compel somebody to work in the public service. Even if we say we are going to have a community centre in every parish in the country, people sometimes do not want to work in isolated rural areas. Would we be better off having a safer service that is cohorted in larger urban areas, rather than having an idealised service with nobody working in it that is operating in a dispersed manner as a rural service?

A doctor was being supervised by another doctor 50 miles away. If there was a service that was cohorted in the local urban area near the general hospital, we would have a better chance of recruiting staff and operating services. I know from my experience that it is much easier to supervise somebody who is in the same building as me than supervising somebody who I am on the phone to from a distance away. When we devise a national service, we need a concept that looks at the ability to recruit staff. We have to talk to organisations like the Irish Medical Organisation, the PNA, the social workers’ organisation and all the different professional bodies. We have to ask, “Do you think you will recruit people to work in these services?”, rather than devising the service based on an idealised model where we think this is the best way of delivering services but then the jobs are advertised and nobody applies for them, and we are left with a huge deficit of staff. Some 30% of consultant posts in psychiatry are not filled. There should be an analysis of where those posts are and what the reason is we cannot fill these posts. We can devise the perfect service but if we cannot recruit people to that service, it does not exist.