Maureen O'Sullivan (Dublin Central, Independent)

That is to be welcomed. I acknowledge the positive incentives, the multidisciplinary mental health service teams, the child and adolescent community teams, the inpatient units and the ensuring of access to quality psychotherapy and counselling services. People need these and they should not cost a fortune.

Deputy Catherine Murphy referred to suicide prevention. I mentioned previously Oasis Counselling Centre in my constituency, which centre is part of the Deora project. It is a small well-managed project and allows for direct access for those in difficulty, particularly those presenting with suicidal tendencies and addictions. Many counselling services will not take on people who are suicidal if they are also experiencing addiction.

Another example of best practice is St. Michael's House. It deals with very vulnerable people. It has a well-focused budget that is not wasted on administrative expenditure. Sometimes the micro can inform the macro, rather than the other way around.

The staff losses in the public sector will present a major challenge. The Taoiseach referred this morning to personal choice but this choice was encouraged by financial incentives, resulting in the loss of much expertise and knowledge. Those with knowledge and experience should have been incentivised to stay. The scheme ought to have been phased rather than establishing a specific date in February.

The risk assessment and impact study should have been carried out before the event and not afterwards. A voluntary group to which I belong asked us before the budget to examine the consequences of cuts of 5%, 10% and 15%. We had the answers on how to cope with each of these. Delivering a high-quality service depends on having a high-quality staff. The plan refers to "new models of care" as a means of obtaining more from the reduced budgets, but there is detail missing in this regard.

I very much welcome the dedicated subhead in the Estimate pertaining to children and families. The funding for prevention is vital. It was interesting to read the section on promoting and protecting health. This relates to health inequality. There is a clear link between socioeconomic status and health behaviour. Emphasis must be placed on prevention. The longer young people stay in school, the better their health options. We must not cut education expenditure and preclude them from staying in school.

The health responses to drugs and addiction have been generally included in the social inclusion and care group but they need to be identified clearly in respect of mental, primary and population health. This means the clear inclusion of alcohol in the national substance misuse strategy. The publication of that strategy is necessary because alcohol and other substances have a considerable impact right across the health service.

A young man who was suicidal and had an addiction tragically committed suicide when, on becoming 18 years of age, he was transferred from an excellent youth service to an adult unit. The system has to work for the person, not the other way around. In my constituency, the fifth person in a family was buried yesterday as a result of drug addiction. These are the issues we have to tackle.

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