Liam Quaide (Cork East, Social Democrats) | Oireachtas source

I thank the Minister of State for being here. I raise the issue of a long-standing and worsening crisis in my discipline of psychology, and in particular within primary care mental health services for young people, with reference to the programme for Government. There are vague references in the programme for Government to workforce planning and increasing capacity for child and adolescent mental health services but there is no mention of the main roadblock that has been placed in front of the resourcing of these services, namely, the pay and numbers strategy.

The official HSE recruitment embargo was lifted in July 2024. However, the Department of Health then introduced the pay and numbers strategy, which is proving to be, in some cases, just as restrictive to the recruitment of essential staff as the embargo itself. It has been roundly criticised by all the main unions and led to recent industrial action. The pay and numbers strategy is a very crude instrument to address HSE budget overruns that will not only cause harm to patients, but will also greatly reduce staff morale and will likely impact on the retention of staff. In June of last year, the Social Democrats party leader, Deputy Holly Cairns, revealed in the Dáil there were more than 5,000 young people waiting for an appointment with primary care psychology services in the south west regional health area, which is made up of Cork and Kerry.

Of these, 105 young people in Cork were waiting four to five years for an appointment. The primary care psychology services in Cork had been severely under-resourced for many years. Also, the roll-out of the progressing disability services programme meant large volumes of so-called non-complex referrals were redirected at the time to primary care services but there was no commensurate increase in staffing levels in Cork primary care at the time.

Cork's primary care services had a fraction of the required staff long before either the official embargo or the pay and numbers strategy were introduced. Instead of undertaking an extensive recruitment drive to address these shocking waiting lists, the HSE's first priority in July was the creation of a new layer of psychology management through a director of psychology role over all other psychology mangers in Cork and Kerry. This new managerial post could have funded two full-time permanent contract psychologists, each of whom would have had a substantial caseload. It was not until October and then November that front-line psychology recruitment for primary care in Cork was attempted by the HSE, still nowhere near meeting the level of need within those services, and unfortunately some of these posts were temporary contracts and have not been filled.

Recent briefings from the HSE and from our regional health officer, Dr. Andy Phillips, suggest they intend to address crisis waiting lists by redeploying psychologists from services that are in a relatively healthy state; in other words, robbing Peter to pay Paul to adhere to the regressive and nonsensical pay and numbers strategy. A constituent of mine was recently told in a service statement from primary care services in Cork that her child would be offered a service in October 2030, five years and nine months from the issuing of that statement.

Is the Government going to heed the grave warnings from all our main unions on the pay and numbers strategy and abandon it? Will it undertake a comprehensive recruitment drive for primary care services in Cork instead of plucking psychologists from other services where they are needed and potentially undermining those services? How does the Government expect to sustain services when it is keeping the stranglehold on basic recruitment in place?

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