Kathleen Lynch (Cork North Central, Labour)

I thank the four Deputies who added their names to this Topical Issue matter and the three who spoke on it. I am reluctant to read the prepared answer because if I do not know about mental health and what is being done with the aforementioned €35 million by now, I should not be here at all.

To take up Deputy Maureen O'Sullivan's final point, the gap between the publication of Barry Desmond's Planning for the Future report in 1984 and the appearance of the A Vision for Change framework in 2006 is unforgivable. It is a gap through which many people have fallen and is unforgivable. I will revert to this point later because I do not intend for such a gap ever again to exist, which is important. To a great extent, the A Vision for Change framework is a chart or table showing what is needed in community care and one must ensure it is fulfilled and carried forward. The Government's job concerns those posts and teams, as well as deciding what the present Administration will do with the money. In addition, the Government must begin to put in place a particular element to take us into the future beyond A Vision for Change. If the teams are in place, what will they be expected to deliver? I acknowledge I am jumping the gun slightly in this regard but Members must keep this point in mind. The Members who spoke have a particular interest in this subject and I reiterate this must be done.

Heretofore, on foot of a vote for a health budget in this Chamber and the putting in place of such a budget, it was divided up depending on the demographics and the population base and sent down to the four health regions. In the main, it was spent wisely. It was not the job of the Government to do this and those with responsibility to so do took it on and discharged it. However, an entirely different approach was taken in respect of the €35 million. As soon as it was announced, the usual e-mails were received in which people asked for their usual portion of the funds to be sent to them to enable them to decide what to do with it. However, they were informed this was not what was intended. Instead, a gap analysis was sought from them that would indicate where were the needed posts, how many psychologists, social workers and psychiatrists were required, as well as the location of the nursing posts that were required. This process has only been completed in recent weeks and it was only then that I signed off on what was to be delivered.

I listened to Deputy Troy asking where was the €35 million and metaphorically, it is in my back pocket. I still have the money, it still exists and it remains within the Department. However, the aforementioned personnel are now being recruited from existing panels that had been put together over the years and people now are being drawn from them. A difficulty arose in respect of psychologists because as Members will be aware, some panels were not sufficient and ran out of candidates. Consequently, it will be necessary to begin to re-interview in this respect. However, this will not be an issue because there is a sufficient number of qualified people operating in the private sector to do this and they can come over and work for the Government. A particular issue arose in respect of the Dublin mid-Leinster region, where those responsible did exactly what the A Vision for Change framework specified they should do in respect of beds and teams. However, the region then fell below the bar because of the exodus in February and March and it was necessary to convert some of the posts there to nursing staff because nurses are crucial in all this. The HSE has now managed to do that and I am about to sign off on the agreement in that area. Consequently, the four regions will have their teams, of which there will be 90 and the population-base will be 50,000 people per team. The teams will be put in place and this is being done as I speak. I would have loved for it to have been possible to do this last February but as I stated, this would simply have entailed splitting up the budget and sending it out to the regions and this was not considered to be appropriate. The Government is being extremely careful in this regard and this is how it is implementing this process.

There are obvious gaps in respect of things that were not done this year. I have been speaking to those involved and they are happy that these areas will be a matter of priority next year. I refer to old age psychiatry, intellectual disability and forensics. These are the areas that must be prioritised next year but this is not to suggest posts will not be made available next year to increase the size of teams in certain areas. This year, for instance, the Department is establishing 150 new posts in the child and adolescent mental health services, CAMHS, because it was known that a deficit existed in that regard. Those concerned informed the Department of the size of the deficit and of the requirements. As a result, 150 new posts were established and they are very happy with that. Similarly, 250 new posts have been established in respect of adult psychiatry and ten additional posts have been allocated to the national counselling service, which also was a commitment in the programme for Government.

I am very conscious that the budget for mental health services is never what one would wish it to be. However, I am equally convinced that if one spends one's budget well in a directed and particular way, one will get a greater service. I acknowledge I have gone slightly over time and did not mean to so do but I make the point that the gap between Planning for the Future and A Vision for Change must never be allowed to happen again. Consequently, we must start putting in place a group now that will look beyond the A Vision for Change strategy. Now the teams are in place, such a group should consider what they are expected to deliver and what is the service. The A Vision for Change framework was really about the table of requirements. I do not know what will happen next as I simply will be the person who will put in place the team. Hopefully, depending on its expertise and vision regarding what lies beyond A Vision for Change, that team will take it forward. Moreover, the Government is seriously contemplating putting into legislation the obligation to have such ongoing reviews and development.

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