Gerry Adams (Louth, Sinn Fein)
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Níl aon rud pearsanta ann ach tá mé míshásta nach bhfuil an tAire féin anseo. An uair dheireanach a bhí Saincheist Tráthúla agam, ní raibh an tAire ann ach an oiread agus bhí mé ag caint ar an ábhar seo ansin fosta.

The Minister of State might not be aware of it but there are no child and adolescent mental health services, CAMHS, in north Louth. Sin é. Children who need CAMHS must travel to Drogheda for them. Despite the best efforts of the staff at Ladywell Daycare Centre in Dundalk it is impossible to deliver proper and effective community mental health services from a facility that is old, decrepit and unfit for purpose. I have been raising my concerns about this issue for years.

A new primary care centre for Dundalk was first announced in 2008 when the HSE advertised for expressions of interest to develop a centre. Over ten years later, not a brick has been laid. Information from the HSE, the Department of Health and the Minister has been confused and conflicting. In November 2016 I was advised, in response to a parliamentary question, that it was hoped the operational lease process for the primary care centre would be completed in the first quarter of 2017. In August 2018, I was told that the planning application would be submitted by the end of 2018, work would commence in 2019 and the centre would be open early in 2020. In April, in response to another Topical Issue matter I raised, the Minister of State at the Department of Housing, Planning and Local Government, Deputy Phelan, indicated:

Louth-Meath mental health services are currently looking at a new town centre location in Dundalk with a view to providing improved CAMHS to north Louth. The HSE is hopeful that this will come on-stream toward the end of the year.

This was news to everyone. It is was the last anyone heard of it.

When I queried this information, I was told, in a letter Mr. David Walsh, the national director of community operations, last week, that disability services are now seeking space in the primary care centre. There was no mention of the town centre location. While I would welcome disability services being in the primary care centre, why was this not part of the original plan? I was also told that this new development has resulted in a requirement to review the project, that this has resulted in a delay and that the new updated proposal will require additional approval from the HSE property resource group, that is, the additional space that is now considered required. Last Friday, two days later, I received a letter from the Minister which states that a preferred provider was identified and a letter of intent issued last August. The Minister repeats that the Dundalk primary care centre is at design stage, but he makes no mention of the disability services now being part of the proposed centre. He does not mention the need to review the project or that the project will be delayed. It would appear that the Minister does not know what is happening with Dundalk primary care centre.

Incompetence has been a mark of this Government. Such incompetence leaves the most vulnerable in our society behind. The lack of child and adolescent mental health services for the young people of north Louth is unacceptable, as is the way the Government has failed to address the need for a primary care centre for north Louth and Dundalk. Can the Minister of State clarify the current timeline for the design stage of Dundalk primary care centre? How long will the review take? What are the cost implications? Will a new letter of intent be required and does this mean there is to be a new process and so forth? When will construction commence and what is the expected opening date now for Dundalk primary care centre?

Catherine Byrne (Dublin South Central, Fine Gael)
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On behalf of the Minister, I thank Deputy Adams for raising this issue and for affording me the opportunity to provide further clarification. I understand that the issue here is that Deputy Adams believes that the information provided in a direct reply from the HSE to Parliamentary Question No. 170 of 23 January 2019 from his colleague, Deputy O’Reilly, conflicts with a response provided to him by the HSE in reply to Parliamentary Question No. 1817 of 24 July 2018 concerning the development of a primary care centre in Dundalk. I am informed that the HSE has replied to Deputy Adams directly on this matter in a letter dated 12 June in response to a parliamentary question that he tabled on 16 April. I also understand that, following his submission of a representation, the Minister sought clarification on this matter and responded directly to Deputy Adams on 14 June last.

As the Deputy may be aware, the HSE has responsibility for the provision, maintenance and operation of primary care centres and other primary care facilities. The executive's response to the Deputy's original question in July 2018 outlined that under the operational lease mechanism, the HSE had identified a preferred provider for the provision of the centre in Dundalk, that HSE estates had issued a letter of intent to the successful applicant and that initial meetings had taken place to progress the design layout. It was intended that works would commence in 2019, subject to planning permission, with an expected opening date early in 2020.

Confusion has arisen following the question submitted by Deputy O’Reilly in January of this year which sought information on the number of operational and planned primary care centres across the country. In the response provided by the HSE, Dundalk primary care centre was not included in the "Under Construction" or "Advanced Planning" appendices. The reason for this apparent discrepancy is that circumstances have changed regarding the development of Dundalk primary care centre. The HSE has advised that subsequent to the reply issued to Deputy Adams in July 2018, the disability services division advocated strongly for space in the primary care centre. This meant that the project had to be reviewed and, as such, it is now categorised as being in the design phase and does not meet the requirements to be included in the advanced planning category. Hence, the centre was not included in the list issued to Deputy O’Reilly in response to the parliamentary question tabled in January 2019 as that list included only centres which are under construction or in advanced planning.

Clearly, the circumstances pertaining to the development of the centre in Dundalk have changed and this has resulted in a delay. I have no doubt that Deputy Adams and the local community in Dundalk are disappointed by this but the HSE has offered assurances that it is the correct strategic move for long-term plans for care delivery in Dundalk. The HSE is following the required internal protocols to take account of the additional space requirements and hopes to have the additional approval submitted, as appropriate, in the coming months. At that stage, the time lines of the project would be laid out more precisely and I understand that the HSE has already indicated that it is happy to update the Deputy as appropriate.

It is unfortunate that the change in status of this project has caused some confusion and that the project will not be delivered as originally scheduled because of an expansion in scope. Nonetheless, I assure the Deputy that it is still very much the intention to develop a primary care centre in Dundalk and that work is ongoing to deliver this project so that we can fulfil our vision of delivering better care, closer to people’s homes, in their local communities.

Gerry Adams (Louth, Sinn Fein)
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Having studied the reply and listened intently to the Minister of State's reply, it would have been better had she just said, "I do not know". She should have said that she does not know when there is going to be a primary day care centre for Dundalk or when the young people of north Louth are going to have CAMHS closer to their homes and in their local community. Given that the Minister of State is here just to read out the reply, it is obvious that neither the Minister, the HSE nor the Department of Health knows either. Nobody knows and that has been the mark of the frustrating process of letters, parliamentary questions, topical issue debates and all of the other methods we use to try to get information. I will be updated "as appropriate" in the period ahead. In the meantime, citizens of the Republic, particularly vulnerable young people, are denied the care they need close to where they live and the health professionals who work day and night are denied the buildings, facilities and resources they need to do their job properly. It is no accident that disadvantage in communities gives rise to additional mental health problems, particularly among young people. A short reply to the effect that "I do not know" would have saved ink and paper.

Catherine Byrne (Dublin South Central, Fine Gael)
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I thank Deputy Adams, who took the words out of my mouth. I was going to say that I do not know the answer to the questions he posed. That is why I have taken note of them and will bring them to the attention of the Minister and ask him to reply to the Deputy directly.

In terms of the written response from the Department, it is apparent that confusion around the status of the project has arisen because the intended timeline for delivery was amended to enable disability services to be provided from the centre in addition to the services originally identified. It should be stressed that when the centre opens it will include primary care, mental health and disability services and will be a real asset to all of the people of Dundalk, young and old. I am sorry that I do not have a reply to the list of questions Deputy Adam's posed. However, I will tell the Minister that the Deputy would like a more comprehensive reply.