Pat Gallagher (Donegal, Fianna Fail)
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We move to the final question, in the name of Deputy Thomas Byrne. I ask the Deputy to forfeit the 30-second introduction to the question. Doing so will give him an opportunity to ask a supplementary question.

Thomas Byrne (Meath East, Fianna Fail)
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33. To ask the Minister for Health when he expects the number of community CAMHS posts in CHO 8 to reach the level recommended under A Vision for Change. [48225/17]

Jim Daly (Cork South West, Fine Gael)
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The Government is committed to increasing the mental health budget annually, as shown by the substantial additional funding of €200 million for mental health from 2012 to 2018. The implementation of A Vision for Change has been given specific priority in recent years with the additional ring-fenced funding specifically aimed at modernising mental health services in line with the programme for Government commitments. A key focus has been the approval of some 1,550 additional posts to strengthen community mental health teams; enhancing specialist community mental health and forensic services, increasing access to counselling and psychotherapy; and developing suicide prevention initiatives. These posts are directly facilitating the policy of moving away from traditional institution-based care to a patient-centred, flexible and community-based mental health service. Staff recruitment and retention have been a challenge for the HSE for various reasons, with approximately two thirds of these posts filled so far in certain CHO areas. Recruitment continues and the HSE has also prioritised in particular the staffing of CAMHS units and community-based CAMHS teams.

There are currently 12 CAMHS teams in CHO 8. This represents 80% of its target resource set out in A Vision for Change. In recent years there has been a significant increase and investment in staff in the CAMHS service. CAMHS teams will continue to benefit from development funding in the coming years, supporting the implementation of Vision for Change recommendations.

The HSE national service plans of recent years also highlight the broad range of ongoing reforms in mental health services, including CAMHS. The Department of Health is currently advancing a review of A Vision for Change. Having commissioned an expert evidence review, completed in February of this year, an oversight committee was established to begin the process of updating our mental health policy.

Thomas Byrne (Meath East, Fianna Fail)
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If we were to listen to the Minister, the position regarding child and adolescent mental health services is absolutely fantastic and could not be better. That is not the experience of those in a crisis and those who need support in various aspects of dealing with their mental health. Figures provided to my colleague, Deputy Kelleher, at the Oireachtas committee showed there are ten community CAMHS posts available in CHO 8, as the HSE likes to call the region in which I live in Meath and Louth, Laois-Offaly and Longford-Westmeath. Under A Vision for Change, and allowing for demographic changes and the population changes with which we constantly seem to be playing catch-up, there should be 179 posts in place, so we are way below where we should be. Ten are in place; there should be 179. There are just not enough. There is a massive shortage in the north east and the midlands and it is having a really adverse effect on children's and young people's mental health. We are not living up to A Vision for Change or its recommendations. The Minister of State can talk about reviewing A Vision for Change, but it is not enough. We want in place what we need now to deal with the children and adolescents who need the services.

Jim Daly (Cork South West, Fine Gael)
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I am not sure which Minister the Deputy was referring to when he referred to a Minister who says everything is fantastic and wonderful and so on. No one is saying that. I am saying we need to acknowledge how far we have come with a view to improving and building on that further. We cannot always focus on the negative. That is merely the point I am making.

The answer to the Deputy's question is the very same as the answer I gave to his colleague. I am more focused on how we do what we do and more appropriate referrals of people to CAMHS and other such services. There are many inappropriate referrals. Many people are left on waiting lists and are not appropriately referred, unreferred or sent back down, and on a continual appraisal and priority basis they are being deemed not appropriate for a consultant psychiatrist. Not everyone with a mental health issue needs to see a named consultant psychiatrist. Many lower-level interventions that can happen can be just as powerful and appropriate for individual cases. I will continue to work with the Deputy and his party to make sure we reform how we do what we do to bring the CAMHS up to the standards to which we all aspire.

Pat Gallagher (Donegal, Fianna Fail)
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I call on Deputy Byrne to make a final short supplementary. Our time has expired.

Thomas Byrne (Meath East, Fianna Fail)
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The bottom line is, whether or not people are appropriately referred, in every case they are referred by their GP, so presumably a GP deems it necessary that they be put on the CAMHS list.

Has the Minister of State intervened to take people off the child and adolescent mental health service, CAMHS, list because a general practitioner, GP, was wrong? Has he put himself in a position to do that? Many children are missing out and much more has to be done to make sure they can get these services. We cannot say that we need to do things better and that people may not need a psychiatrist or consultant. These children and young people are missing out on a service that their GPs recommended as being necessary for their mental health. A more substantive answer than that is required, with an acknowledgement that we cannot just move this to voluntary organisations, if that is the Minister of State's plan. A certain amount of people need to see consultant psychiatrists or doctors in the CAMHS system.

Jim Daly (Cork South West, Fine Gael)
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I could not agree more. A certain amount of people will always need to see a consultant psychiatrist. My job is to ensure that people are appropriately referred and where they are not appropriately referred, my job is to ensure that we have policies so that does not happen and that those people do not clog up the system and prevent those who really need to see a psychiatrist from doing so. My job includes much more than just looking at negatives. I have to look at the whole picture and to realise the best system I can for the constraints we operate within.