Dan Neville (Limerick West, Fine Gael)

I am pleased to support the Labour Party motion. Of course, the Irish people are entitled to a health service that will deliver excellence, equality and efficiency and in which a person's financial means is not a barrier to receiving the most appropriate and best medical treatment. The health service should be treated as a community service.

The Minister of State, Deputy Tim O'Malley, is responsible for disability and mental health services but he did not mention mental health in his speech. One in four people at some stage of their life will suffer a psychiatric illness. The level of service in the psychiatric services is deplorable, yet throughout the Minister of State's speech on the health service, he did not mention psychiatric services. Mental illness can be debilitating and occasionally life threatening, as is the case with physical illness.

The impact of conditions such as depression, anorexia or schizophrenia extends beyond the individual to families and communities and can be the cause of great unhappiness. Although mental health is central to our well-being, the treatment of mental illness and the promotion of good mental health do not receive the same attention, investment and resources as physical illness.

It is over 20 years since the report on the mental health services, Planning for the Future, was adopted as Government policy. The cornerstone of the recommendations in that report was the establishment of multi-professional teams for service delivery in the psychiatric services. However, as the report from the Mental Health Commission stated two months ago, nowhere in this country have fully staffed teams been delivered. Community based care was another central feature of Planning for the Future. However, admission rates do not reflect a substantial shift in focus to a community approach and readmission rates are persistently high.

Large tranches of the 20 year old report have still not been implemented. The Government must be held accountable by the public for its failure to implement this national policy and the reduction in the proportion of the health budget allocated to mental health from 11% in 1997 to 7% in 2006. This report was accepted as party policy 22 years ago but was not implemented. Last January, a new report, A Vision for Change, was accepted and the Minister says it will be implemented. How can we have confidence that it will be done if a 22 year old report, 50% of which was included in A Vision for Change, was not implemented?

There are still not enough beds for those who need them, resulting in young teenagers being treated in adult psychiatric wards. This happens in the Minister's constituency in Limerick. There are still no early intervention programmes which would make a real difference for those who develop serious illness.

Fine Gael and the Labour Party have committed themselves, in government, to delivering an effective and well resourced mental health programme that will be directed as a policy towards recovery. Recovery involves a way of living a satisfying, hopeful and productive life even within the limitations caused by psychiatric illness. The proposed policy of Fine Gael and the Labour Party will build and foster positive mental health across the community and provide accessible, community based, fully staffed, multi-disciplinary services for people with mental illness. The provision of these services will be brought at least to a par with the provision of general health services, both in hospital and community services.

The commitments include putting in place multi-disciplinary community mental health teams, thus reducing the need for inpatient care. Early and consistent intervention is the most effective way of helping those experiencing mental illness to recover or to manage their personal situation. The Minister must close the psychiatric institutions that are inappropriate for their purposes, as he promised in March 2005. However, a reply to a parliamentary question I tabled last May — 14 months after the announcement was made — indicated that not one institution was identified.

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