John Moloney (Laois-Offaly, Fianna Fail)

I am pleased to have an opportunity to speak on the budget debate. I do so from the perspective of my position as Minister of State at the Department of Health and Children with responsibility for equality, disability issues and mental health.

I reassure people that even though we are in a tight budgetary situation the commitments given by the Government under the programme for Government and the multi-annual investment programme will be honoured. While it is not relevant to recall what commitments have been delivered to date, nevertheless, it is important to remind the House of what has been achieved under the disability strategy in the multi-annual programme and to reaffirm the Government's commitment to continue that strategy.

I refer to the multi-annual investment programme in terms of the services provided to date and more importantly the funding for the future. I will also deal with the EPSEN programme and clarify the matter contained in the budget statement regarding the efficiency saving of the 1% reduction in funding towards voluntary groups.

To date, under the multi-annual programme 980 residential places have been secured, and 313 new respite places and 2,500 new day places were created. I am the first to acknowledge that speaking about what happened in the past is not good enough in terms of what will happen in the future. I reassure the House that I am not trying to make a big deal of the fact that we are announcing a €20 million investment programme, €10 million to the Department of Health and Children and €10 million to the Department of Education and Science. I recognise the huge demand on existing services.

I reassure the House, as this issue has cropped up in recent debates, that the funding to which I refer will be ring-fenced specifically for use by the Department of Health and Children in the area of disability and mental health services. There has been some negative comment suggesting funding approved by the Government for these services goes into what is often referred to as the HSE black hole. I assure the House and those interested in this area that the €10 million allocations for health and education will be used specifically to fund new posts. Not alone is the funding ring-fenced but, more importantly, the positions agreed have been agreed with the HSE. Unlike what happened last year, the advertisements for the recruitment of 125 additional therapy posts in the disability and mental health areas will begin immediately. I do not say this to gloat over the €20 million that has been allocated. I am reasonably assured on this matter, but obviously the funding for the multi-annual programme is not in the package this year.

The funding agreed will take into account the commitments made for education for persons with special needs. Within the present budgetary constraints education for persons with special educational needs, EPSEN, cannot be funded. However, the €20 million allocated for therapy positions represent EPSEN under another name. The benefit of this additional funding will include much needed therapy posts which will be allocated within the disability sector and will include speech and language therapists, occupational therapists and physiotherapists for children's disability services.

I refer to the 35 additional posts for child and adolescent mental health services. This will include clinical psychologists, occupational therapists, speech and language therapists and social workers. There will be some new additions to the existing multidisciplinary teams and rather than have groups worrying about the commitment to ring-fencing funding, as was the case last year, staffing levels will remain intact.

I refer to additional funding under the mental health budget allocation. Some €1.75 million has been allocated for suicide prevention. Regrettably, the incidence of suicide is on the increase and the figures for this year will demonstrate this. It is opportune, timely and proper to further invest in suicide prevention and I look forward to an early meeting with Mr. Geoff Day of the National Suicide Prevention Office to discuss how we can optimise the level of spending in this area.

The commitments under A Vision for Change must be speeded up. We are moving from the old structure to the new community-based structures in psychiatric services. This is typified by what is happening throughout the State with the new acute psychiatric units. I commit, as I have previously, to beginning the process of meeting with the 12 psychiatric hospitals in the State. We expect to have closure plans in place before the end of this year. The funding secured from the sale of these properties will be ring-fenced.

The efficiency saving of 1% in funding of non-statutory services requires clarification and I wish to allay fears that may exist concerning this funding. Some €1 billion goes towards the voluntary sector and non-statutory groups each year. I have met with some of these groups in recent weeks. I have assured them that I do not wish to force an amalgamation. The proposal is an efficiency measure made in the hope that we can discuss the matter with these groups in the coming weeks and arrive at a conclusion where groups may share front-of-office facilities, back-up facilities or whatever else. The important point is that we will, hopefully, secure the services of an independent chairperson who will examine the process of seeking the efficiency measure. We will invite people from the disability and mental health services sectors to sit on the commission that will seek the efficiencies. I have no difficulty backing up the statement that the process is about efficiency, not about reducing the level of commitment in that sector. More important, it is not about forced amalgamations. This will not be a dead of night process, it will be an open, transparent campaign where all the people involved will have the opportunity to provide input. The relevant groups will receive support as they investigate the process of amalgamation.

I refer to the estimated cost of implementing the recommendations in A Vision for Change. I do so not in the context of taking funding from the disability sector or other support services in that area. A Vision for Change proposed funding amounting to €150 million for a seven to ten year programme. It is dependent to a great extent on the re-modelling of the existing resources. There is some doubt outside the House about how we can, on the one hand, commit to a change in the delivery of mental health services and, on the other hand, divide scarce resources in the budget. I make the commitment that at present the HSE is preparing an audit value of the existing properties. The process will be transparent. The resulting figure will be completed by the end of this year. The closure plans have now begun. I called to the constituency of the Leas-Cheann Comhairle a fortnight ago and met with the staff of St. Senan's Hospital. I am pleased to say to the House it has moved far more quickly than any other facility and has its closure plan agreed. I intend with all the energy I possess to deliver similar closure plans with the help of the hospitals involved, as was the case with St. Senan's Hospital, and to return to the House early in the new year to explain how A Vision for Change can become a reality with the use of the assets.

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