Tom Neville (Limerick County, Fine Gael) | Oireachtas source

I wish to raise the issue of delays and waiting lists associated with child and adolescent mental health services, CAMHS, in Limerick and the mid-west. CAMHS are consultant-led, community-based services provided by six multidisciplinary teams in Limerick city and county. The city and county services cover an age group from zero to 18. Those in Clare cover zero to 18 and north Tipperary services cover zero to 17. I have read articles in the past that referred to ages zero to 16 in north Tipperary and Clare but that has obviously changed. That said, an age range from zero to 17 does not cover those aged 18, which is the age of adulthood. I would like clarification on this. If somebody goes on a waiting list at 16 and is on it for approximately two years, he is pushed over the 18 years threshold, thus implying he will never have got to avail of the child and adolescent mental health services.

In Limerick, the emergency and out-of-hours service offers a same-day assessment from Monday to Friday for children presenting in crisis. Consultant child psychiatrists provide an out-of-hours service to the emergency department in University Hospital Limerick but this is not replicated across the country. If inpatient treatment is required, the first preference is to admit the child to a dedicated CAMHS unit in Galway, St. Anne's. If the unit is experiencing temporary capacity pressure, then admission to a paediatric ward or public unit with special staffing arrangements in place is considered. That information is from the HSE itself. Why are there not CAMHS beds made available in Limerick? This was called for in this House some time back by my predecessor and also by me in one of my first speeches here. I have had no update on that. The circumstances that obtain have considerable implications for the people of Limerick and the mid-west. This obviously affects north Tipperary and County Clare also.

In Limerick central, there are 25 on a CAMHS waiting list. In Limerick east there are 56 and in Limerick west, which I represent predominantly, there is a waiting list of 63.

6 o’clock

The HSE has outlined the factors that are currently affecting the Limerick waiting list. One is the fact that two members of the west Limerick team are on extended sick leave, with a consultant on leave for over two months and a social care leader on leave for over six weeks. Why are some temporary staff measures not put in place to alleviate this? We do not know how long these people might be out of work. That is not their fault but I know from working in the private sector that there are flexibility arrangements whereby when somebody is out of work, somebody else can come in and take their place temporarily. It is a demand-led service. Another issue is that one psychologist on the west team was not replaced while on maternity leave and is due back at work before the end of March. Again, why is there no flexibility to alleviate this situation? Staff members who have resigned and have yet to be replaced on the Limerick team include one senior psychologist, a nurse, an occupational therapist and a community health doctor, CHD. All have been approved for replacement but why have they not been recruited?

Routine appointments were not scheduled for at least ten days to accommodate the move of the three Limerick teams to a new premises at Rosbrien Road during February 2017. That will greatly enhance the provision of the service and I welcome that. In addition, the HSE states that new referrals have increased by 15% from January to February 2017. There is an increase in demand but flexibility arrangements are not in place when people are off sick and obviously the recruitment arrangements have not been put in place to recruit staff. I would welcome clarification on these issues.

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