Séamus Kirk (Louth, Fianna Fail)
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Question 7: To ask the Minister for Health his plans to cut respite facilities in psychiatric units like those in Ballina, County Mayo; and if he will make a statement on the matter. [1177/12]

Kathleen Lynch (Cork North Central, Labour)
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The expenditure reductions necessary in 2012 will challenge all areas of the health system to provide continuity of services that is both appropriate and safe for patients. In common with other care areas, efficiencies and other savings will be required from the mental health service. However, I am glad it was possible to announce a special allocation of €35 million for mental health in line with the programme for Government.

Funding from the special allocation for mental health will be used primarily to strengthen community mental health teams in both adult and children's mental health services. It is intended that the additional resources will be rolled out in conjunction with a scheme of appropriate clinical care programmes based on an early intervention and a recovery approach. Some provision also will be made to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with the strategy of A Vision for Change. This necessarily will involve some rationalisation and re-organisation of services at a local and regional level.

Mental health services are continually reviewing the provision of service to their population to maximise the balance of service access within the available resources. Services include acute community mental health services, acute inpatient services, rehabilitation and continuing care. Some high support facilities also are used when required to provide respite care.

The case in Ballina referred to by the Deputy involves a community-based residential unit that provides inpatient and respite beds, as well as a day care centre and outreach services to patients with severe and enduring mental health conditions. These services are currently under review and a planning process for the future of mental health services for the area, which will include consultation with service users, is scheduled to commence shortly.

Billy Kelleher (Cork North Central, Fianna Fail)
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While I have stated publicly that the Minister of State has a strong commitment to the issue of mental health and the implementation of the strategy of A Vision for Change, what clearly is needed now is action beyond the words and commitment. It is beginning to become evident there already has been a downgrading of psychiatric services. While we welcome the ring-fencing of a sum of €35 million in this respect, the closure of the two ten bed units in Teach Aisling and the other facility in Ballina, County Mayo is an indication that the reverse of what A Vision for Change is about is happening.

Michael Kitt (Galway East, Fianna Fail)
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A question, please, Deputy.

Billy Kelleher (Cork North Central, Fianna Fail)
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Will the Minister of State agree that people are being centralised back into the system rather than being treated in the community in line with a proposal made in A Vision for Change? Clearly, the decision to close these two units indicates what was proposed in A Vision for Change is being reversed.

Kathleen Lynch (Cork North Central, Labour)
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The units are not being closed, rather the position is under review. On what is proposed in A Vision for Change, we have not got our heads around what community care means in the context of mental health services. For instance, there is a community-based team in Cork, the members of which visit people in their homes, of which I am sure the Deputy will be well aware, not only on a regular basis but when there are acute emergency episodes in order to maintain them within the community. That is what A Vision for Change is about and what we should be seeking to achieve, whether it be in Cork or Ballina, County Mayo. We need to examine seriously how we can keep people out institutions and maintain them in good health in their own communities. While there will always be a need for acute beds when people have acute episodes, such care should be for as short a period as possible in order that we maintain people in their own communities.

Billy Kelleher (Cork North Central, Fianna Fail)
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I read the Minister of State's comments on the late Sean McCarthy who was a champion of people with a psychiatric illness and a fond colleague and friend of ours in this House. It is clear that there is a downgrading of services, even though there is a commitment to ring-fence a sum of €35 million. On 15 December the Minister of State said the Department had sanctioned the lifting of the moratorium to recruit 100 staff, yet the HSE has paused such recruitment. What has happened in respect of that recruitment process? Has it been paused? Has the moratorium been lifted? What is happening with regard to the recruitment of an additional 100 staff, as announced by the Minister of State on 15 December?

Kathleen Lynch (Cork North Central, Labour)
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I did not say that. I said that in the previous two years there had been a lifting of the moratorium in order to allow provision to be made for an 100 additional places and that we needed to examine seriously how we could get specific posts back into the service. We still do not know how many will leave the service at the end of February. If the numbers who left in previous years are anything to go by and given the fact that psychiatric nurses, in particular, can leave at an earlier age, we will probably lose more from the psychiatric services than from any other sector of the health service. We will have to examine seriously how we organise the posts in the system that will be necessary to deliver on the measures contained in A Vision for Change. That is to what the figure of €35 million relates. It is not to fund capital programmes but specifically to fund additional posts.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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What steps does the Minister of State propose to take to address the situation in psychiatric services in the senior Minister's constituency of Dublin North and particularly the HSE's attempts to arbitrarily introduce changes for psychiatric nurses and in terms of patient care in breach of the rulings of the Labour Relations Commission? This could have resulted in industrial action as and from today, but, thankfully, it was suspended yesterday; however, the matter remains to be addressed. What steps does the Minister of State proposes to take to ensure it is addressed full on, while recognising that the crisis has been compounded by the closure of the admissions unit at St. Ita's Hospital and that there has been massive displacement of persons presenting for psychiatric services and mental health support services in north Dublin?

Kathleen Lynch (Cork North Central, Labour)
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Staff relations issues need to be dealt with under the mechanisms put in place. That has always been my belief and should happen. It is not the case that we are not aware of the issue, as we are very conscious of what is happening. We are keeping a close eye on the matter which I hope will be resolved, as such issues are usually resolved.

On there not being a unit available for admissions to St. Ita's Hospital, there are other units available. Again, this is about getting our heads around the fact that people do not always need to be admitted when they have an acute episode. We need to start to examine different ways of dealing with such persons.

Deputy Kelleher mentioned the late Sean McCarthy who has been a huge loss to the mental health community. He would have been the first to say and the person who convinced me that people in difficulty in terms of their emotional wellbeing did not always need to be placed in an acute unit. When the directorate is in place and we give it the sum of €35 million, we will see a fundamental change in how services are delivered to people with mental health difficulties.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I accept that, but we will need some additional staff.