Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

It contained no reference to older people, which is amazing when one considers our increasing age demographic. Disability funding was not cut last year, but Sinn Féin claimed that in its document. There is no reference to the €12 million allocated for disability services for school leavers or the €6 million for therapy services for children up to 18 years of age. Neither did it mention any allocation for the rolling out of primary care.

Sinn Féin called for the extension of the BreastCheck programme, which I am glad to say is happening. It wanted funding for suicide prevention to be increased to €18.7 million. However, it also wanted to increase suicide crisis assessment nurses and nurses in accident and emergency departments, funding for whom, it must be remembered, comes out of the health budget. Suicide prevention is strictly about the message in different areas of health, and we are developing a new framework.

Budget 2015 provides for an additional €35 million to be ring-fenced for mental health services. This will bring to €125 million the total investment by the Government in mental health services since 2012. The additional funding will enable the Health Service Executive, HSE, to continue to develop and modernise our mental health services in line with A Vision for Change. The additional funding will be directed towards the continued prioritised development and reconfiguration of general adult teams, including psychiatry of later life, which had not been done until now, and also child and adolescent community mental health services, CAMHS, teams, which need to be bulked up. This will be delivered through further recruitment and investment in agencies and services to achieve a consistent service provision across all areas. It should not matter whether one is in Dingle or Donegal. The pathway to and the delivery of the service should be the same.

In addition, the funding will also permit urgent specialist needs to be addressed, including psychiatric intensive care, forensic mental health, mental health intellectual disability care and psychiatric liaison services. I am sure Deputy Dessie Ellis does not disagree with any of these provisions. Additional funding in 2015 will provide for prioritisation of investment in community services designed to respond to the needs of those with co-morbid mental illness and intellectual disability. Someone with a disability can sometimes have mental health difficulties. Investment will also be provided for services for homeless people with mental illness, bed capacity to respond to eating disorders and other secondary care, the development of a seed CAMHS forensic mental health team, the enhancement of capacity in adult forensic mental health services, the maintenance and development of the incredible Jigsaw services nationally, and the implementation of clinical programmes for mental health.

Additional funding will be provided for the roll-out of the Advancing Recovery in Ireland process. It is no longer the case that if one has a mental health difficulty it should be enduring or lifelong. People can recover, and the Government wants to ensure they have every opportunity to do so. Funding will address the physical health needs of those with severe and enduring mental illness. People with severe and enduring mental health problems tend to die younger. We must examine their physical health needs too. We will be integrating action in respect of Traveller mental health and the substance misuse strategy. There will be training for the prevention and management of violence and aggression and full implementation of the incident management policy.

There will be challenges with our aging demographic. With so much research into dementia, I believe we will find a way to either slow it down or cure it completely. We have a difficulty with delayed discharge from hospitals for older people requiring rehabilitation services. However, this is not confined to older people; it can also affect chronically ill young people. We have set aside €27 million to address this problem in the short term. The long-term strategy will examine intensive rehabilitation that can get people, whatever their age, back home into their own communities. It will also help those at home who have become immobile - bedridden, as it used to be called - to receive intensive rehabilitation care and get out again. It will involve grants for home improvements and housing adaptation, which have all been increased.

Deputy Dessie Ellis knows I do not stand in here slagging people off because I do not believe it gets anyone anywhere. We need to find solutions to the problems we all want to solve. Primary care will be rolled out with the co-operation of the Irish Medical Organisation and GPs. We will deliver free GP care to all children under six in the first quarter of next year with the co-operation of GPs and the IMO. Without it, it simply cannot be done. I hope the negotiations between the IMO and the Department will be successful, which looks as though it will be the case.

We need to take a more humane approach to discretionary medical cards. Members know of families that have extraordinary medical needs. While they may be over the financial limits to be eligible for a card, we need to take a more holistic view on all of this. I hope this will happen too.

I always say it is about the politics of the next impossible task. The following story describes this perfectly. There are two guys sitting down to breakfast. One says to the other that buttered toast will always land withe the buttered side down if it falls from the table. The other guy says it will be more a case of 50:50. The first guy proceeds to drop his buttered toast to the ground. It lands, however, butter-side-up. The second guy says that just proves it is always 50:50, to which the first guy says, “No, I just buttered the wrong side.” It is the same when it comes to the Opposition - no Government will ever do it right in its eyes. I believe we are doing a very good job in the difficult circumstances in which we find ourselves. I am very grateful that we have extraordinarily talented people in the Civil Service and public services to help us do that job.

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