Mick Wallace (Wexford, Independent)
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7. To ask the Minister for Health the rationale behind the differences in mental health spending per capita in the various regions; and if he will make a statement on the matter. [27699/15]

Mick Wallace (Wexford, Independent)
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As the Minister is aware, I have raised this issue previously but as nothing has changed on the ground, I have to continue raising it. Why is it that in 2015 mental health spending per capitain the Wexford-Waterford region is €148 compared to €223 in Carlow-Kilkenny-south Tipperary, €198 in Mayo and €206 in Galway-Roscommon? Will the Minister explain the regional variation? Given that Wexford has one of the highest suicide rates in the country, I find it difficult to understand why there is such a discrepancy.

Leo Varadkar (Dublin West, Fine Gael)
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Historically, there has been significant variation in mental health funding across the country. This was influenced by the location of major mental health institutions and different priorities on the part of health boards over the years.

The establishment of the HSE mental health division in mid-2013 created a national management structure for all mental health services. In 2014, the division commenced a process of developing financial information specific to mental health services. This exercise included the validation and costing of approximately 9,000 staff working in HSE mental health services nationwide, representing about 80% of total spending on mental health services. This work is continuing. As there is no single financial ICT system available to the HSE, such validation is labour intensive and difficult to achieve with full accuracy.

This financial analysis has been combined with population figures adjusted for deprivation to inform decisions regarding the allocation of new funding in 2014 and 2015. In this way, the HSE mental health division is moving towards population-based funding through reassigning discretionary funding in favour of comparatively under-funded services. The information and methodology will continue to be refined in order to support funding allocations and arrive at a situation where mental health spending per capitais more consistent. It is recognised that such allocation processes have to be phased in to allow time for costs to be adjusted in line with national norms.

The Deputy may wish to note that, in response to Parliamentary Question No. 22548/15, the HSE in its reply of 30 June 2015 gave detailed financial information for mental health, broken down by geographic area for the years 2013-15, inclusive. I will arrange to have a copy of this information sent to the Deputy.

The Deputy will appreciate that the Government has made significant efforts to prioritise and modernise mental health care nationally. While the concept of geographic equity is to the fore in allocation decisions, other practical realities have to be taken into consideration such as the need to address delays in accessing services and the need to introduce alternative community based models of care.

Mick Wallace (Wexford, Independent)
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I thank the Minister. I am aware there is more positive thinking about how this issue should be dealt with. In 2006, A Vision for Change was launched on the basis of 8% of the health budget being spent on mental health when in fact it only reached 7.2%. It has since been cut back to 5.2%. According to the World Health Organization, mental health illness accounts for more than 15% of the disease burden in developed countries. It is reckoned that 11% of Irish people have personally experienced mental health problems. I agree that putting resources into the community is the way forward. In Wexford, there are four units that work well and are open from 9 a.m. to 5 p.m. After 5 p.m., people have to go to an accident and emergency unit in Wexford and if they are referred to Waterford, they have to go through the accident and emergency unit there before eventually being admitted to an acute unit. Until we sort out the services in the community, will the Minister agree that in the meantime there is a need for acute units in Wexford?

Leo Varadkar (Dublin West, Fine Gael)
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I am not sure it is ever a good idea to set a crude percentage figure as to what percentage of the health budget, or any budget, should be spent on anything. The reality is that some health care is more expensive than others. One of the areas that is enormously expensive is cancer because of the cost of the new medicines that become available every year. Even though fewer people may have cancer than have mental health problems, the cost of treating each cancer patient is always going to be very much higher than the cost of treating somebody with common mental illnesses, such as depression. That is an issue that needs to be borne in mind in setting financial targets.

In terms of actual cash, the mental health budget for 2012 was €711 million; in 2013, it increased to €737 million; in 2014, it was 766 million; and in 2015, it is €792 million. It is clear there has been a substantial increase in non-capital funding for mental health in recent years. I am sure it is not enough but it is a significant increase during a period when so many other things have been cut back.

Mick Wallace (Wexford, Independent)
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In 2010, before Wexford was merged with Waterford, there were 31 acute beds in St. Senan's hospital and 44 in Waterford, giving a total of 75 beds. Today, there are just 44 because St. Senan's has closed and the population has increased by 20,000 in the region. I am aware there are five beds in Newcastle in north Wicklow. It appears that the service in Wexford has decreased. Most of the indicators show that Wexford is a more deprived region than most and with almost 24% unemployment, one can understand why that is the case. On the ground, there is significant concern that the resources available are not matching demand. Perhaps the Government would look at the issue again and see whether something can be done even in the short term.

Leo Varadkar (Dublin West, Fine Gael)
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I was not prepared for questions from the Deputy on Wexford specifically. I do not have a briefing on it with me but certainly I will convey his comments on the matter to the Minister of State, Deputy Kathleen Lynch, and perhaps she can speak to the Deputy.