Tom Fleming (Kerry South, Independent)

I will illustrate the situation at a local level in my constituency of Kerry South which mirrors the national situation. There is a continuing exodus of nursing staff from Kerry mental health services which has resulted in the loss of over 50 nursing posts over the past three years. There are a further 30 retirements expected before the end of February 2012.

This will leave the service chronically understaffed and even more dependent on overtime to deliver what is becoming an often basic and fractured mental health service for the people of Kerry. If the recruitment of nursing staff is not commenced before 2012 many parts of the service will have to be closed or abandoned as there will not be enough nurses to sustain even the most basic services in many areas.

At a national level, more than 1,500 psychiatric nursing posts have been lost from 2009-11. This is disproportionate to the reduction in staff numbers in disciplines throughout the public service. The resulting reduction in the budget for mental health services has seen expenditure fall from €800 million in 2006 to €700 million in 2011. As a percentage of the overall health budget expenditure on mental health has fallen from 8.5% in 1980 and 1990 to 4.9% today.

In comparison, Northern Ireland spends 11% of its health budget on mental health, well in line with WHO recommendations which advocate that 12% of a nation's health budget be spent on mental health services. In monetary terms for every euro spent on mental health in the Republic, €2.30 is spent in Northern Ireland. The Republic's current percentage spend of 4.9% on mental health puts it firmly in the third world league.

To further illustrate the point, the Irish mental health service have been described by the human rights organisation, Amnesty International, as a service under siege and compared it to the Gaza Strip. Overtime is currently being used throughout Kerry mental health services in an effort to staff the various wards and units. If the amount of money spent on overtime was instead diverted to the recruitment of nursing staff it would pay for 23 first year nurses with money to spare.

The spending of money on staff recruitment rather than overtime and agency staff as the first option would offer better value for money to the service and the country. It is obvious that the current recruitment ban on the direct employment of psychiatric nurses by the HSE is costing more and is therefore counter-productive. To alleviate the current chronic shortage of psychiatric nurses I propose the extension of the timeframe for the implementation of the revised pension lump sum calculations based on the public service pay cuts. It would stem the rush to retire before 29 February 2012 and allow for a more controlled and orderly departure of staff nearing retirement.

If the moratorium on the recruitment of psychiatric prices was lifted 1,000 psychiatric nurses could be recruited by the HSE on a cost-neutral basis. The implementation of these proposals would have an immediate positive impact on mental health services at a local level in Kerry and nationally.

I thank the Minister for his reply to a parliamentary question I tabled. I asked him to provide capital funding for the replacement facilities to be put in place to complete the necessary closure of St. Finan's Hospital in Killarney. I ask him to pay special attention to it. The commitment he gave that the money will be made available sounds positive. I expect him to honour the commitment.

See this speech in context