Verona Murphy (Wexford, Independent) | Oireachtas source

I thank Sinn Féin for bringing forward this motion to allow us another opportunity to place the spotlight on the systemic failures within CAMHS. I want to refer first to something noted in the motion in regard to 140 “lost” cases in just one team, which no doubt, across all teams, adds up to hundreds of “lost” cases nationwide. If I was a patient or a parent or guardian of a patient whose case was lost somewhere among the dense overgrowth of the HSE bureaucracy, I would want answers and accountability. Has the Minister identified how these cases were lost or are the failures in the system still present which would allow the continued losing of cases? Has the Minister identified what individuals were responsible for these errors? Have policies and procedures been put in place to ensure that such errors do not re-occur? Has anyone been disciplined or held accountable for these mistakes? I hope that, in response to the motion, the Ministers of State might provide some answers to those questions but since they relate to responsibility and accountability, I am fearful that they will just become rhetorical questions that will go unanswered.

One year ago, I had the opportunity to speak on a Sinn Féin motion related to the Child and Adolescent Mental Health Services. On that occasion, I highlighted that I believed there was a general apathy or lacklustre attitude towards the solving of these problems. To be fair, it is mainly the continuous representation from the floor that the Government took action and ordered the review. To highlight the lack of staffing, I compared it to the Luas, Dublin Bus or Irish Rail, which would be in chaos every morning if they did not have enough drivers. A schoolroom would struggle to function if it did not have enough teachers and our ambulance service would fail if it did not have enough crew members. Yet, when we do not have the right staffing levels in CAMHS, it does not hit the headlines like it would for these services.

In 2020, the Government supported the motion from the Regional Group to protect mental health services but, unfortunately, little has been done in the interim to address the issues highlighted with CAMHS. The HSE mismanagement of CAMHS is leaving vulnerable children at heightened risk of mental health difficulties. The current system is not fit for purpose. Children and their families are being tossed aside and, inevitably, some of these families will end up presenting their children to emergency departments somewhere, following an attempt to take their own lives. This is a very difficult thing to say but it is the reality of what happens when the proper services are absent. Some of the stories I have heard about our services amount, in my mind, to neglect and that must be rectified.

One thing that does worry me about this motion is the call to legislate to prevent children from being placed in adult wards. Unfortunately, with the current state of affairs, where there are no paediatric ward places available, the only option is to put a child into an adult ward. The reality has to be recognised that, regardless of how less than optimal it might be, at least care of some description, even if it is in a less than ideal setting, is surely more useful than no care at all. I have great sympathy for those who have to make these decisions in our hospitals on a daily basis and I would not like to see their job hamstrung by legislation which might prevent some sort of care being administered. While I agree with the principle outlined in the motion, it would come down in such a case to scrutiny of the detail of how that would operate in reality, or what exceptions would be made in exceptional circumstances.

The motion also calls on the Government to develop a joined-up, proactive and comprehensive health and social care workforce strategy to increase education places and training opportunities between the Department of Health and the Department of Further and Higher Education, Research, Innovation and Science, the HSE regional health areas, hospital groups and the higher education institutions. This is crucial. We can only continue to expand mental health services successfully if we have the proper qualified personnel to fill the roles. This starts with a long-term strategy to have sufficient places in college courses and opportunities for people to upskill in these areas. Almost every CAMHS-related issue comes back in some shape or form to staffing. Staff turnover and the inability to get staff in the first place are preventing services from operating as they should. I have highlighted that problem many times. In County Wexford we are trying to source a paediatric dietician and child psychologists. We are always just one resignation away from having to go months, if not years, without the filling of vital posts.

Yesterday, I provided the details of an eight-year-old boy whose guardians have been told that he does not meet the criteria despite being referred by his family doctor three times to CAMHS. I appreciate the Department is looking into this but the family needs a timely answer and also an answer as to who made this decision without even seeing this young man. It would mean he is on no waiting list when he clearly needs immediate attention. I am mindful of the issue that arose in the media at the weekend. I caution both Ministers of State to be mindful that not meeting the criteria does not in the future get declared as a strategy to keep numbers off waiting lists.

I regard that as an intent to cause harm, and very serious indeed. It is disturbing that 15 children with eating disorders in Wexford are currently without a dietician. These are children. The two Ministers of State, Deputies Rabbitte and Butler, and myself are parents. When we hear figures, they are figures, but these are children. They could be the children of the Ministers of State or my children, but they are all meaningful individuals who need care and attention. I put my faith in both of the Ministers of State.

See this speech in context