Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Leas-Cheann Comhairle for giving me the opportunity to raise this very important issue. I have just attended a mental health launch by the Joint Committee on the Future of Mental Health. It was shocking to read the committee's report. According to the HSE's health capacity review, Ireland's hospitals need at least 2,600 new beds in the next 15 years. The review goes on to say the number could jump to 7,000 if HSE reform is not prioritised. There is no reform. It was also reported last year that more than 2,400 children were availing of child and adolescent mental health services, CAMHS. At the same time, Ms Anne O'Connor, national director of mental health with the HSE, made the astonishing claim that the problem is that CAMHS takes everyone because there is nothing else. Imagine, the director of mental health in the HSE said that. We should let it sink in. There is nothing else there. Ms O’Connor went on to say that in an ideal world the first step for a young person presenting with a mental health problem would be to get help in school and go to his or her GP to get access to primary care-based psychology or family counselling services. She said the HSE’s mission was in fact to keep people out of CAMHS. At every point of intervention described by Ms O’Connor, there are profound and systemic failures. Primary care, GP services, school-based solutions and family counselling services are all in near total disarray despite the heroic work of the front-line staff involved. The most recent report I have indicates that almost 220 children have been waiting for more than one year for access to CAMHS while at least 70 posts across CAMHS teams nationally remain unfilled. Meanwhile, the HSE continued to recruit all through the recession with three out of every four recruits being managers and pen-pushers. There is something rotten in the HSE when 70 posts in CAMHS are left unfilled nationally. According to the College of Psychiatrists of Ireland, at 6%, spending on the delivery of mental health supports in the context of national concerns on this issue remains scandalously low, particularly when compared with the UK at 12% and Canada and New Zealand at 11.5%.

There are a number of young children in my constituency who are incarcerated – I have to use that word – in South Tipperary General Hospital. I could name them - a Boyle girl and an O’Brien girl from Carrick-on-Suir. The parents have contacted me, particularly those of the Boyle girl. I apologise, she is a Kennedy and a 14 year old. This is her tenth week in a children’s ward in a general hospital where she is getting no treatment. It will be her 11th week on Monday. That is frightening, shocking and appalling. If it was a war situation, the Government would be hauled in for war crimes. It is a totally unsuitable setting. The nurses and other staff are doing their best but her mother or someone else has to sit with her all night and on a 24-7 watch. She is waiting for a bed in Cork University Hospital, CUH, or somewhere else. It is appalling. I have raised this with the Taoiseach over the past two weeks. It is the same with the O’Brien girl. She is 13 and has also been waiting several weeks. There have been four or five others over the past six to eight weeks in the same situation. These are adolescent girls. They are nearly adults but they are in a paediatric ward which is totally unfit and they are getting a small level of treatment each day from CAMHS. It is pathetic and disgraceful.

I attended the report launch today and heard consultants talking about the matter. I saw the sheer frustration felt by everyone present because of the inertia and lethargy of an inept and uncaring HSE. It must be disbanded in order to allow people access the services to which they are entitled. It is despicable to have these children in a ward that is so overcrowded. Those beds are needed for sick children. These young adults must not be left to languish in these conditions in a hospital which is unfit to deal with them. They need specialist treatment and they must get beds somewhere else. Something has to be done about the HSE in order that sense will prevail.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I apologise to Deputy Mattie McGrath on behalf of the Minister of State, Deputy Jim Daly, who cannot be here. I have been asked to take this matter on his behalf. I have taken notes because the initial issue submitted was so broad and the reply may not cover all of the matters to which the Deputy referred.

Mental health remains a priority care programme for Government. Since 2012, approximately €200 million, or 28%, has been added to the HSE mental health budget, which now totals over €910 million. This is a significant investment by any standard and the programme for partnership Government gives a clear commitment to increase our mental health budget annually as resources allow to expand and modernise all aspects of our services, including those in Tipperary. HSE mental health funding for Tipperary this year is in the region of €24 million. One of the strategic priorities for mental health in the HSE national service plan 2018 is to deliver timely, clinically effective and standardised safe mental health services in adherence to statutory requirements.

The provision of acute inpatient care to the adult population of north Tipperary, which is in community health organisation, CHO, 3, is provided between the acute unit in University Hospital Limerick, which has 50 beds, and the acute psychiatric unit in Ennis, which has 39 beds. The 44-bed department of psychiatry based in St Luke's General Hospital in Kilkenny is the designated approved centre for acute inpatient services for south Tipperary, which is in CHO 5. This enables all acute inpatient admissions for the CHO area to be managed at a single site. Referrals to the department of psychiatry are through a consultant psychiatrist who makes the clinical decision to admit on the basis of the level of acute presentation or need. In addition to the department of psychiatry, there is a dedicated psychiatric liaison team operating from the emergency department at St. Luke's. All service users presenting to the emergency department who require psychiatric assessment will receive that assessment within agreed timeframes in line with the relevant department of psychiatry and emergency department guidelines. Onward referral pathways are agreed with all service users upon completion of psychiatric assessment in the emergency department. Pathways can include admission to an acute unit, referral to a relevant community mental health service team or referral back to a GP.

There is a range of other mental health services for adults in Tipperary. These include, for example, psychiatry of old age teams, non-acute beds, day hospitals and day centres, community mental health teams and high, medium or low support community residences. There are three CAMHS teams operating in Tipperary; one in north Tipperary and two in south Tipperary. The CAMHS acute units at Eist Linn in Cork, and Merlin Park in Galway, which has a total of 42 beds, serve the Tipperary catchment area.

The Minister of State, Deputy Jim Daly, recently met with Oireachtas Members, and various local representatives, to discuss current and future provision of mental health services in Tipperary, including reviewing bed capacity. He also visited mental health facilities in south Tipperary in February last. Deputy Mattie McGrath can rest assured that the Minister of State will continue to closely monitor the development of all mental health services in Tipperary, particularly in the context of progressing new service developments agreed under the HSE service plan and through additional investment for mental health provided by Government. I will come back on other issues raised by Deputy Mattie McGrath.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State, Deputy Jim Daly, for coming to Clonmel to meet us. He seemed to make an effort. However, if the Minister of State, Deputy Catherine Byrne, continues to read out stuff officials write for her, we will change nothing. It is pure and utter balderdash. We do not have a single bed in Tipperary for mental health services. The Minister of State may talk about Ennis and Kilkenny but units there are overcrowded. The HSE is spending €400 million of the mental health budget every year on medical treatments for illnesses but just €10 million on psychological and counselling services while the Ministers of State in the Department and the Minister, Deputy Harris, read repots and listen to balderdash and baloney from the HSE. These are mandarins who are not accountable. CHO managers and others move on in a chain. Mr. O'Brien is going off into the sunset and leaving also. Meanwhile, unfortunate children and others with mental health issues would be in a wasteland but for volunteers, the suicide watch people in Clonmel and all of the other organisations doing such great work in this area. It is unbelievable that the Minister of State should come to the House and read out such rubbish replies and that she or another Minister of State will do so again next week. I do not mean any disrespect to the Minister of State personally but ministerial officeholders must take charge of the HSE and its budgets and demand accountability. They must listen to front-line workers and stop hiring more mandarins and pen-pushers.

Three out of every four new recruits to the HSE is a manager. It is despicable, out of control and morally, and in every other way, wrong. To deny these young adolescent girls and boys these services and have them languishing in hospitals is wrong. It is wrong that their parents and their families at home are traumatised because of this upset too. However, all we get are toilet paper replies like this. It is disgusting.

At the report launch today, the entire health committee attended. Several clinicians told us the system is so broken and rotten they cannot change it. They said there is no accountability. What are the jobs criteria for these HSE managers? They have not a clue what they are trying to manage. Above all, they have no empathy. It is devastating that we are going to put up with this and continue listening to it from the HSE. It does not care about the people. All it wants are offices. We have a hospital in Tipperary which is closed up and is a bed-free zone. That is how the HSE operates. Its managers are all about furthering their careers and to hell with the people and the services.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I assure Deputy Mattie McGrath that I do not take it lightly when I am asked to read from a prepared statement in the Chamber. I am sure the Minister of State, Deputy Jim Daly, can reply to the Deputy personally. I will ask him to do so. To claim money is not being poured into the mental health services is wrong. This year the budget allocation is €910 million.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

It is being misused.

Bernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Minister of State to reply without any interruption.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Up to €24 million will be put into funding mental health services in Tipperary this year.

I understand the concerns the Deputy has raised and his frustrations. I can hear them. I am not deaf.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

What about the parents?

Bernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Minister of State to reply.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

It is not nice to come down here to be ridiculed.

Bernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Correct.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have read a statement-----

Bernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Minister of State should not encourage the Deputy.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

-----from-----

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

When Ministers keep giving these replies, we will respond like this.

Bernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Deputy has had his say.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have read a statement from the Department. Whether the Deputy agrees with the statement is a different case.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

I do not agree with it.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

To accuse me of not being able to reply back is not fair, however.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

Not the Minister of State personally.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I understand the Deputy's frustrations and concerns. I will take them personally to the Minister of State, Deputy Jim Daly. To claim the Government does not take mental health services seriously is wrong.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

It is a fact.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I totally disagree with the Deputy, as somebody who has personally been affected by a family member who has had to use mental health services in the past two years. I can stand over the care provided by my local mental health service to my daughter, who was struck with bad post-natal depression. The service was provided in our community. That is what I was trying to relate back to the Deputy in the Minister of State's reply.

The Deputy's issue was very broad and I may not have been able to cover some of the questions he raised. I will bring his concerns back to the Minister of State.

As a parent whose daughter suffered from post-natal depression over the past two years, I have to put my hand on my heart and say I am proud of the public health service in my own community.

Mattie McGrath (Tipperary, Independent)
Link to this: Individually | In context | Oireachtas source

Thanks be to God.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The people in it are working hard and are extremely professional. I doubt anybody who works in mental health services goes into it for any wrong reason. They do it to help people with mental health issues.