Michael Ring (Mayo, Fine Gael)
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I thank the Cathaoirleach. I raise this issue because there is great concern across County Mayo. Staff and patients have been notified that major cutbacks in the county's mental health services will take place. This is a cause of great concern for the most vulnerable in society in particular.

I attended a meeting last Monday at which representatives of the Health Service Executive confirmed there would be major cutbacks. They stated that they had expected to receive €1 million more than they actually received last year. The funds allocated were the same as the previous year's allocation. Given wage increases and costs in respect of fuel and the overall running of the hospital service, the representatives stated they simply cannot run it. The HSE now is obliged to begin to cut back on the services. It is outrageous that the first people to be affected are those with mental illness, who are the weakest in society. They will not be able to induce people to go out and protest or fight their corner for them. Shame on the Health Service Executive, the Minister, the Government and the county's health board for allowing this to happen.

A number of services were being provided. Although 90 hours per month were made available, those affected have been told that from 1 July they will be reduced to 12 hours per month and some of the services that were available will be lost. They had therapy, art classes, writing classes and gym classes to assist people with mental illness who needed to become fit. Such people also were taught how to feed themselves and how to read and write. What is happening is a scandal. It is wrong that at a time when one is told there is so much money in the country, the first people to be targeted are those with mental illness. I ask the Minister of State to contact the relevant HSE general manager and insist that whatever cutbacks must be made must not be inflicted on the weakest. Such cutbacks should not be made where they will hurt people's health or where they will affect those who are the weakest in society.

It is a disgrace the available services will be taken away and such people will be left without them. If Members do not protect those in society who are in most need of protection, why are they in this House? This is the reason the people felt disconnected last week from politicians and the decisions that are made. Decisions such as this are made by faceless people in the HSE and those on the ground are obliged to suffer. I refer to the staff, the families of those who are disturbed by mental illness and the people who must depend on the health service to look after them.

This reason there was a "No" vote last week is because Members have given away all the powers of this House. They have given them away to the HSE, which will not answer anyone and is not responsible to anyone in this House. The Minister has washed her hands. I call on the Minister of State, the Government and the HSE to provide the necessary funding to retain the exisitng facilities for the most vulnerable in societ.y If one is unable to protect them, there is no point in having a HSE or a health service.

Máire Hoctor (Tipperary North, Fianna Fail)
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I will take this matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank Deputy Ring for raising this matter on today's Adjournment and for giving me the opportunity to reaffirm the Government's commitment to mental health.

The document, A Vision for Change, represents our action plan for the development of a quality mental health service. The estimated additional cost of implementation is €150 million, that is, €21.6 million per year over seven years, or €15 million per year over ten years. The report is clear that new funding should follow implementation, and in this regard a total of €51.2 million has been allocated since 2006. Thus, in the first two years of a seven to ten year implementation period, one third of the overall requirement has already been allocated.

The development of our mental health service is not solely dependent on extra funding. The substantial existing resources within the mental health service must be remodelled and reallocated, and only then can we deliver a modern and efficient service. It is necessary, in the context of the ever-increasing demands for health resources, that health expenditure be closely monitored to ensure that services demonstrate both effectiveness and efficiency. Before any further additional funding is provided, it is essential that the HSE is in a position to demonstrate that the funds allocated for mental health services are efficiently used and that the substantial changes in the organisation and delivery of services envisaged in A Vision for Change are developed in a timely and appropriate fashion.

Owing to competing expenditure pressures and the overriding obligation to live within the approved overall allocation, some of the planned developments in mental health services in 2006 and 2007 were delayed. While this is disappointing, I note that some of these developments will proceed in 2008. I am also confident that there is scope within the HSE's overall allocation to deliver further service enhancements in 2008, over and above those outlined in its service plan, through improved performance, productivity and the realignment of existing resources.

The unprecedented investment in mental health services, which has trebled since 1997, has allowed for real improvements in this area. There is now a much greater focus on community services and the provision of multidisciplinary teams, early intervention and many other services. This modernisation and reform of services is in line with what patients want and need. It is real progress and we are determined to build on this reality. We are not yet where we want to be, but we are getting there. Each person receiving mental health care now has an individualised care plan, designed in consultation with the person and his or her therapeutic team. This care plan, which may or may not include complementary therapies, identifies the person's needs and another plan is then agreed to meet these needs.

The delivery of health services was assigned to the HSE under the Health Act 2004. In view of the budgetary situation, it was necessary to review the provision of complementary therapies in Mayo. In some instances where the therapies were not considered essential, they were reduced. I have been assured that each individual case is being closely monitored and will be reviewed in the event of a negative impact on the patient being clinically identified.

The Government's decision to establish the Office for Disability and Mental Health reflects its ongoing commitment to developing a more coherent and integrated response to the needs of people with disabilities and mental health problems. The office will support the Minister of State with responsibility for disability and mental health, and will facilitate cross-agency and cross-departmental work to deliver real benefits to clients and service users in the future. It will bring a new impetus to the implementation of A Vision for Change, working in partnership with the HSE and other stakeholders to achieve the implementation of agreed targets.