Dáil debates

Thursday, 31 January 2008

Priority Questions

Mental Health Services.

3:00 pm

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 3: To ask the Minister for Health and Children if it is the policy of the Government to implement the recommendations of A Vision for Change; the reason funding allocated for mental health services has not been spent on those services; the reason moneys realised from the sale of property assets associated with mental hospitals here have not been reinvested in the development of capital projects envisaged in A Vision for Change; and if she will make a statement on the matter. [2925/08]

Photo of Jimmy DevinsJimmy Devins (Sligo-North Leitrim, Fianna Fail)
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The report of the expert group on mental health policy, A Vision for Change, which was launched in January 2006, provides a framework for action to develop modern, high quality mental health services over a seven to ten-year period. The Government has accepted the report as the basis for the future development of mental health services. The Health Service Executive has primary responsibility for implementing the recommendations of A Vision for Change.

Operational responsibility for the management and delivery of health and personal social services was assigned to the Health Service Executive under the Health Act 2004 and funding for all health services has been provided as part of its vote. The Department of Health and Children has been advised by the Health Service Executive that the additional €51.2 million development funding was not used as planned because of competing expenditure pressures and the overriding obligation on the Health Service Executive to live within its approved overall allocation. As a result, some of the planned developments in mental health services have been delayed. However, some of these developments will proceed in 2008, for example, the recruitment of eight child and adolescent mental health teams and the provision of 18 beds for children and adolescents.

In regard to the sale of property, I assume the Deputy is referring to The Lie of the Land report recently launched by the Irish Psychiatric Association. The report gives examples of proceeds of assets allegedly lost to psychiatric services over a 20 to 25-year period. A small number of assets disposed of in the past two years are identified. A Vision for Change is very clear on this issue and recommends that resources, both capital and revenue, should be retained in the mental health service. It also recommends that the full economic value of psychiatric hospital buildings and lands should be professionally assessed towards identifying appropriate future use and maximum value and benefit. The value of these assets significantly counterbalances the capital cost of the new mental health services infrastructure requirement. I have asked the Health Service Executive to provide for me a report on The Lie of the Land report, especially in so far as it relates to the disposal of assets in the past two years.

The Minister for Health and Children, Deputy Harney, has also made it clear to the Health Service Executive in the context of its service plan for 2008 that there can be no question of diverting capital or development funds to meet expenditure pressures arising in regard to core services. I will meet the Health Service Executive shortly to pursue these issues.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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A Vision for Change recommended the establishment of one child and adolescent mental health team per 50,000 people. In total there should be 78 teams but only 47 teams have been established and of the 47 teams only 60% of their staffing complement is in place. That is appalling, given that there were 3,598 children on waiting lists at the end of 2007, with approximately one third waiting more than 12 months for assessment. These are our children; these are our future.

A Vision for Change also recommended that there should be 100 inpatient beds for children and adolescents and in 2006 the Minister of State's predecessor, the former Deputy, Tim O'Malley, promised 80 beds would become available by 2007. To date we have only 12 dedicated child and adolescent beds but we are to get an additional 18 beds this year. Like so many other things we will wait and see whether it will happen.

We now have a problem because of the Children Act where a young person is considered to be a child until the age of 18 years. We have no adolescent service in Swords, the fastest growing town in Ireland with a population of 40,000 and expected to reach 100,000. We have no adolescent service for young people between the ages of 16 years and 18 years. Adult psychiatrists do not feel competent to deal with them and the junior adolescent service does not have the resources to deal with them. In effect, they have no service as GPs have stopped referring them.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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Does the Deputy have a question please?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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The question is coming. Last week the Irish Mental Health Commission revealed that almost half of the €50 million allocated for the implementation of A Vision for Change, to which the Minister of State referred, had been spent in other areas. On "Prime Time" the Minister was not able to tell us how much of the €50 million had been spent on mental health. Can the Minister explain why moneys allocated for the implementation of A Vision for Change are not being used for this purpose, why there is no allocation of the €25 million for the implementation of A Vision for Change in the budget of 2008 and why mental health services are being stripped of their assets?

I wish to add a supplementary question on the psychiatric unit in Beaumont Hospital which was promised over 25 years ago. A unit was built, but it was used because there was overcrowding in the hospital and now there is equipment stored in it. A further application was made a couple of years ago for a psychiatric unit and now the co-located hospital, although not built entirely on it, impinges on that site and makes it unusable.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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I must call the Minister.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I ask the Minister to give an undertaking, as was given on page 177, chapter 17, of his document, A Vision for Change, that the moneys released will be ring-fenced and that we will not have a situation where the money goes elsewhere and where there are, in St. Ita's in north Dublin because there is no psychiatric admission unit in Beaumont Hospital, 24 patients in a unit with one single room while 23 acutely psychotic patients must lie with 3 ft. between their beds. It is a disgrace.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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The time allocated for the question is exhausted.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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This is the Cinderella of the health service and it has been ignored.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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Although there is not time for the Minister of State to reply, I ask him to make a brief one.

Photo of Jimmy DevinsJimmy Devins (Sligo-North Leitrim, Fianna Fail)
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I would be delighted to respond. Obviously, we do not have enough time to go into all of the questions. On the child and adolescent services, Deputy Reilly correctly stated that there are 12 beds at present. In the past two weeks I have visited St. Vincent's in Fairview and St. Anne's in Galway and the beds in St. Anne's are ready to be opened while construction is under way in St. Vincent's in Fairview and in St. Stephen's in Cork. I can guarantee to Deputy Reilly that by the end of this year there will be 30 beds. In addition, the 20-bed brand new unit in Merlin Park in Galway has just received planning permission and the 20-unit building has gone to tender in Cork. We expect that those two 20-bed units, allowing for the normal construction delays and planning permissions etc., should be on stream by the middle to the end of 2009. I guarantee that 30 beds will be operational for child and adolescent psychiatry by the middle to the end of this year.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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A far cry from 80.