John McGuinness (Carlow-Kilkenny, Fianna Fail) | Oireachtas source

It seems like another week, another scandal of outrageous proportions. Everybody in this House will speak about it and will demand action of one kind or another. It is a reflection on the system itself. I agree with Deputy Nolan when she said that the State is broken. It is true. The administration of this State is broken, and particularly the administration of the HSE. We have to come to a point in this House where we agree that it has to be reformed. The 1926 Act and the other amending Acts associated with the Ministers and Secretaries Act have to be reformed. In the Minister of State's statement she went down through the vast amounts of money that have been allocated to the HSE for all sorts of purposes, yet we have all of these issues that have emerged during the course of time and that show the system in complete disarray.

I will not ask the Minister of State tonight what she is going to do about it. She has done it. She has allocated the money. I am going to ask the Secretary General of the Department of Health and all of the HSE managers what they are doing about it. How much of this happens on their watch? They must not give me the excuse that we cannot get professionals to come in. That is a lame excuse. Managers who are good and decent and being paid well do not put forward that excuse. They plan ahead; they have a strategy. They know the issue they are dealing with and they respond.

In every single CAMHS area, and I can speak for Kilkenny and Carlow, there is a crisis. Young people are not being afforded the services that have been demanded for them. Then we have the community groups, the not-for-profits, being funded to step in where the HSE has failed. If it was successful we would not have the likes of Teac Tom filling the gap and providing the services. How can we tell someone who is on a waiting list for a mental health disorder that it will take a few months or a year? That is what is happening. Those who are in management positions are looking on.

The department of psychiatry in Kilkenny is simply not fit for purpose. In it there are excessive amounts of drugs being administered to patients who are unfortunate enough to be there. When they are released into the community there are no supports for them, none. One autistic teenager was lying on the couch in his own home for 28 months because he could not get services. Other services not withdrawn by the HSE but are poorly funded and poorly managed. One allocation of €54,000 in supports for a child with autism is not being fulfilled. Where is the €54,000 going? What is the case manager doing? What is the manager within the region doing? I have a good colleague, Councillor Joe Malone, who intervenes with families and helps them. He does not go to the HSE, he goes to Teac Tom and other organisations like that to get the support that is needed.

The State should be ashamed of itself. Those who hold these positions of management, responsibility and obligation should be ashamed of themselves. They are getting the money from Government. They have the policies in place. Why are they not delivering? Why is someone not coming forward and telling us that the department of psychiatry in Kilkenny is simply not fit for purpose and we need to replace it with a modern, state-of-the-art building? Why are we not planning ahead? Other speakers have said it. There will be a tsunami of health issues among our young people and those who have been affected by Covid heaped on top of all of those who have been affected by the financial crash, the loss of their home and the break-up of their families.

Meanwhile, we articulate all of that here. The Minister of State, Deputy Butler is doing her best. What are the rest of them doing? Why is it that we cannot name someone in the House and say, "You are responsible for this area and this what you should be doing. Shame on you. If you cannot do your job then get out of the system." Pass it over to somebody who can do it. Let us have a recruitment drive. Let us change the 1926 Act. Let us have a plan for the department of psychiatry in Kilkenny. Let us help our young people to help themselves. They are quite capable of doing that. I ask the Minister of State to turn up the heat on the Department and insist on the best paid Secretary General in the system finding out what exactly is going on and what can be done about it. We have to deal with the community issues. Where we lack the services we have to put them in place. We have to put action to our words in this House or we are never going to get real results.

In the private hospital it is also true that if a young person goes in there, he or she is likely to be stuffed with drugs and locked up from one end of the day to the other. I know of a case where they did not even see the person they were under, the psychologist or whatever who was looking after them, yet they were there for three months at a cost of nearly €45,000 a month. All they got out of it was drugs. They were saved by the community in their own county. Where is the management in our system? It is a health issue and a management issue; it is not a financial issue. Let us root out those who are not managing and get down to the real brass tacks of supporting community initiatives and good management. That in turn will support the young people we are talking about here and others.

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