John Paul Phelan (Carlow-Kilkenny, Fine Gael)
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When I was a Member of the other House I had cause to lament when a Minister for the relevant Department was not in attendance to deal with my Adjournment matters. I have no argument with the Minister of State, Deputy Costello, but there are enough Ministers of State in the Department of Health to allow one of them to deal with the response to my matter which is particularly important.

I refer to the provision of psychological services across the country, in particular, the hiring practices used by the HSE for the recruitment of psychologists. The Minister of State may have to correct me but since 2009 the HSE has imposed a block on the hiring of counselling and educational psychologists to fill positions which are filled only by clinical psychologists. This is despite the fact that the same primary degree qualification applies to all and despite the fact that everywhere in the western world both counselling and educational psychologists are hired to fill vacancies in health services. The policy of the HSE is strange given that so many psychology posts remain unfilled across the country, not least in my own part of the world. Approximately 20 posts remain unfilled. This means that the HSE is recruiting specifically clinical psychologists from other jurisdictions - from the UK in particular - while qualified psychologists with an educational or counselling background have to leave here and are hired by the NHS to do the same job in the health service of our nearest neighbour. In earlier business today the House discussed reform of the health service and new governance for the HSE. This very strange practice of recruitment is like no other in any country that I know of, and should be discontinued.

Sixty counselling psychologists passed a HSE interview between 2009 and 2012 and have been placed on a panel for employment, yet because of the bar that exists, they cannot be hired. Crazily, despite the fact that students on placement from college who are not fully qualified either as educational or counselling psychologists can work alongside students of clinical psychology, only clinical psychologists can be hired by the HSE because of the existing practice in the Republic. Effectively, all counselling psychologists must travel to other jurisdictions to get work. Many are working in the United Kingdom, including Northern Ireland, and in Australia, Canada and other countries. While this is happening, we are advertising overseas. We cannot get enough graduates from overseas to fill the vacancies that exist here.

Only approximately 70 clinical psychologists qualify annually in Ireland. Last year, there were more than 90 vacancies to be filled. As a consequence, approximately 20 vacancies remain unfilled despite the fact that the HSE held a further recruitment drive in the United Kingdom in November. We have been unable to get more than two suitably qualified people to fill the vacancies. I ask that the Department and HSE change the recruitment policy with regard to psychologists.

Joe Costello (Dublin Central, Labour)
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I thank the Deputy for raising this Topical Issue. I apologise on behalf of the Minister, who cannot be present.

Psychologists perform a wide variety of roles across the health and social care services and provide a very important service to service users across a wide spectrum of need. A working group was, therefore, established within the HSE to agree appropriate eligibility criteria for the recruitment of both staff and senior psychologists to best meet the needs of service users across all areas of the public health and social care services. This working group involved principal psychologists from all parts of the HSE together with service managers and it was supported by human resource professionals. The group examined the broad spectrum of clients that the HSE serves and made a determination on which type of qualification would be appropriate for different service areas.

The working group decided that educational psychologists would be appropriate to work only in disability services for children. Their qualifications equip them to deal with a broad spectrum of clients within that group. They are qualified to provide services to children of all ages with an intellectual, physical or sensory disability. The HSE has established on the basis of the service requirements of different client groups and areas across the health service that the qualification of counselling psychologist equips the holder with the necessary skills to provide services to adults in the primary care and community care settings. The working group determined that clinical psychologists were eligible to work with all client groups across the health service.

There has been recruitment for clinical psychology posts in the mental health service recently. These posts are restricted to clinical psychologists in line with the recommendations of A Vision for Change. A Vision for Change sets out in great detail the role of clinical psychologist within the community mental health teams which deal with a wide range of mental health problems among adults, children and adolescents. They also form an integral part of specialist mental health teams. Since the publication of A Vision for Changein 2006, the mental health service has invested an additional €1 million per annum and dedicated 50 whole-time equivalentposts to clinical psychology training at four third-level colleges, namely, TCD, UCD, NUIG and the University of Limerick.

Thirty-four clinical psychologists graduated in 2011. The graduates are being employed to complete the community mental health teams as set out in the HSE's national service plan. In 2012, the €35 million dedicated from within the programme for Government commitment has been allocated to employ 72 clinical psychologists for general adult mental health teams, with a further 23 clinical psychologists for child and adolescent teams. Detailed plans are currently being prepared to determine how the additional €35 million for community-based mental health services will be utilised in 2013. It is expected that further clinical psychology posts will be required in 2013, as indicated in the policy in A Vision for Change.

The Minister is committed to the ongoing development, subject to overall resource constraints, of mental health services and to the recruitment of the most appropriate mix of health professionals to meet the varied needs of service users across the health and personal social services.

John Paul Phelan (Carlow-Kilkenny, Fine Gael)
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I agree with large parts of the Minister of State's response, including in regard to the need to retain the €35 million provided under the programme for Government for mental health services in general. Perhaps I would be able to get more information on the decision of the working group if a Minister from the Department of Health were present. Why has the HSE working group on the hiring of psychologists adopted a completely different policy from the one that exists in health services everywhere else in Europe and farther afield? There are 20 psychologist vacancies, although the 60 counselling psychologists on a panel will never be allowed to fill them as a result of the criteria drawn up by the HSE working group. No similar criteria exist anywhere else. The Minister of State's answer is wholly inadequate from that perspective.

I have dealt with an individual who was hired by the HSE as a counselling psychologist in the area of child protection prior to 2009. Now he can never even apply for vacancies that arise in that area because of the mistaken guidelines published by the HSE's working group. Vacancies remain around the country and much-needed psychological services are not provided, yet qualified psychologists must travel around the world to get work. We must advertise positions in other jurisdictions because we maintain a strict interpretation resulting in the decision that only clinical psychologists can be hired. I really do not understand how we can justify this position.

Joe Costello (Dublin Central, Labour)
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I thank the Deputy for those additional remarks. The HSE working group comprises principal psychologists, service managers and human resource professionals. They concluded that educational psychologists would be able to operate solely in the area in which they have expertise. They agreed the same for counselling psychologists but stated clinical psychologists could work with client groups across the health service. Since the publication of the report, the Department has put in place the necessary training and educational measures for clinical psychologists to implement the policy in A Vision for Change. All the decisions that have been taken were in the context of the implementation of the current programme for Government.