Darren O'Rourke (Meath East, Sinn Fein) | Oireachtas source

Colleagues, led by Deputy Mark Ward, will cover the Sinn Féin position on this issue and they will continue to engage with it. I want to focus on the issue of implementation and capacity within the system. In the first instance, I will stay local and draw attention to a response to a parliamentary question I got regarding east Meath and Ashbourne CAMHS services. It states that A Vision for Change, which we heard about in 2006 and which I remember as I worked in the health services at the time, recommended 11 clinical and two administrative staff for CAMHS teams. Currently, the team in east Meath and Ashbourne is operating at 50% capacity, or 50% of its recommended staffing level, due to the recruitment embargo over the past 12 months. Other Deputies will be familiar with the formula of words that follows because I think it is almost a red flag from the HSE. The reply states:

In light of the recently released HSE pay and numbers strategy, backfilling of vacant posts remains not permissible at this time. Louth-Meath mental health services endeavour to fill all vacant posts across all CAMHS services across Louth and Meath as soon as permission to backfill vacant posts is granted.

That, for me, is a significant concern and a red flag from the HSE. I have also had, unlike ever before, direct contact from front-line services and clinical staff saying "Stop. Something needs to be done here". There is deep concern, and I can reflect some of that from an email I received from a psychologist related to the recruitment embargo. She is working in the primary care sector. She notes that primary care psychology provides support for young people presenting with intellectual disabilities, anxiety, low mood, self-injurious behaviour, eating and sleeping concerns. It is evident, she says, that the lack of resources is having a detrimental impact on primary care services. She states:

I am concerned about the recruitment embargo. From my experience posts are not being filled. It has been noted that approximately 250 posts are currently vacant.

This psychologist wants to know who made the decision to cut the psychology posts within primary care services; how many posts in total are being cut within primary care services; in the event that previous vacant posts are made redundant, whether services be reported to be working to full capacity without the acknowledgment of these cuts; and why funding is currently being provided to outsource private assessments rather than being used to fill posts.

She goes on to say:

These decisions are resulting in extreme consequences on the mental well-being of young people, and their families, within my local area. More and more young people are presenting with mental health difficulties, resulting in school avoidance and self-harm. Without the appropriate professionals and psychological intervention their future quality of life will be impacted. They deserve better than this and for their voices to be heard! Mental support is not a luxury, it is a necessity, which has led me to have no choice but to speak up and advocate for their right to intervention and support.

I wanted to put that on the record, and the Minister of State will appreciate that it is a front-line clinical member of staff saying she has deep concerns. These are professional people committed to their patients and the people they are working with. It is very clear that they have real concerns. I flag that, as we are weeks away from the budget.

Usually, when we contact the HSE with specific questions we get generic responses. This is the opposite. We are getting very clear responses saying that the implementation of the recruitment embargo and the failure to backfill posts is going to have a severe impact on services, and it has to be addressed. If we do not have the capacity or workforce to deliver these services, reorganising the approach - no more than the implementation of A Vision for Change from 2006 - will not happen.

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