Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank Deputy Deering for providing me with the opportunity to address this issue. The lack of consultant psychiatry services in Carlow is an issue he has brought to my attention on numerous occasions in various fora. To refer to the broader picture first, the Deputy acknowledged the worldwide shortage of consultant psychiatrists. It affects us here in Ireland also. I note that the Acting Chairman, Deputy Connolly, has a great interest in this area too. We are currently short approximately 60 consultant psychiatrists in Ireland. No matter what action we take and no matter how much money we spend on advertisements in medical journals in Australia, New Zealand and other countries, we cannot get sufficient cover for the positions we have created in recent years. We are putting adequate resources in place. If it was a question of more money, I could solve the problem overnight. We have increased the mental health budget from the €700 million provision in place when the Deputy first came to the House in 2011.

It is now more than €1 billion. Having put an additional €300 million into the mental health budget over the past five years, we still face the same challenges.

I am a firm believer that if we always do what we always did, we will always get what we always got so we have to move away from the issue of more money and resources because that is not the problem. There is a shortage, we have an over-reliance on the consultant psychiatry and we have to look at new ways of delivering consultant psychiatry. What I have done since becoming Minister of State is increase the number of training places for psychiatric nurses by more than 130 every year and I have introduced 114 assistant psychologists in the past year and brought 20 psychologists into the mental health system. We have also introduced ten advanced nurse practitioners, which are effectively one step below a consultant, to try to do as much of the work that consultants do as possible and to make sure that consultant psychiatrists are only doing the work that they absolutely have to do. We are trying to reorientate the system to be more proactive, to get more people into the system earlier, to ensure earlier intervention in the system and to get people detected at an earlier stage before they get to a higher level input. That is an ambitious target and that is the journey we are on.

I have also engaged extensively with numerous partners to try to bring about telehealth because that is what they are doing in Australia and America where they have the same difficulties as us. Telehealth works through screen to screen delivery of mental health services. A consultant psychiatrist based in Dublin can assess, diagnose, prescribe, treat and admit patients, if necessary. Many of our consultants provide cover in areas where we have gaps and as soon as I announce that I have a consultant psychiatrist for Carlow, there will be somebody else in the Deputy's seat in a few more weeks saying that there is a consultant psychiatrist missing in their area.

We need to look at the bigger picture, and recognise that we have a challenge here and that we need to look at how we do what we do, and that is why I have been championing telepsychiatry. We have made good progress and we will roll out a number of pilots this year in this area. I would love to hear from the Deputy's community health organisation, CHO, area and it is something that he might take up with HSE management in his area because we will make money available for people to apply to participate in a pilot project so that a neighbouring consultant psychiatrist can provide governance to the team that is working locally and cover without having to make a four or six-hour return journey by car. We can eliminate the travel and do it in a clinical, supervised setting.

Thanks to the Deputy continually raising this issue, he will be pleased to hear that we secured an adult psychiatrist in his area who started work the day before yesterday. It is a locum position and it is not the silver bullet that I wish it would be but it ensures that there is a service there as of this week for the short term and, hopefully, the medium term.

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