Pa Daly (Kerry, Sinn Fein)
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Gabhaim buíochas le hOifig an Chinn Comhairle as an deis a thabhairt dom an cheist seo a ardú. I thank the Office of the Ceann Comhairle for allowing me the time to raise a matter, which is of deep concern to people in south Kerry.

The Minister of State is probably aware of this issue and I hope he will have a positive answer for the people who are waiting for one. As the Minister of State will be aware, a hub for outpatient psychiatric services in St. Anne's Hospital, Cahersiveen holds a fortnightly clinic for outpatient psychiatric services. It deals with psychiatric services, psychology, cognitive behaviour therapy, teen psychology, occupational health, social workers, elder care and community nurses. The service helps the most vulnerable people in south Kerry. One of the people I spoke to last Friday told me they have worked there at least 30 years, if not since 1991. We all know how important such services are, not just in rural parts but the entire county of Kerry.

The service deals with people from all over south Kerry, including Valencia, Castlecove, Dromad and Caherdaniel. We met people from the Iveragh Mental Health Association last Friday, including retired staff, who came to us to express their deep concern at the proposal to move the services to Killorglin. There is deep frustration. The ambulance service is seeking a permanent stand-alone space. From what I was told, there is a proposal on an interim basis, which means three to five years, to move services to Killorglin. People, quite rightly and understandably, have deep concerns about services being moved on an interim basis because they know what that will mean, namely, that they might never come back.

There is no primary health care centre in Cahersiveen. There is a massive shortage of GPs. It is unbelievable that services that were due to be expanded will instead be moved. No other site has been proposed. If the service is closed, inevitably people will miss appointments. People who depend on the services are reliant on public transport. Although that has improved, it is inevitable that a change in location will result in people missing appointments or will not turn up for them.

That will increase the burden on the already overstretched GP service. People may have to go up to the accident and emergency department in University Hospital Kerry, which is about 42 miles away and under pressure. This will all lead to an increased risk of mental health crisis in the area. The team there was hoping to develop and expand services. Not only will that aspiration be knocked back, but these services will be put back even further.

We did contact the HSE, but I am hoping the Minister of State will have a positive answer for me. I am asking that psychiatric services be retained in south Kerry. If there is a proposal to move them, then the HSE will have to justify it. I cannot see how it can do that and neither can the people down there see how it is going to do it. I am hoping, though, that the Minister of State will say this is not going to happen.

Mary Butler (Waterford, Fianna Fail)
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I thank the Cathaoirleach Gníomhach, Deputy Farrelly, for being in the Chair again. He is a regular on a Wednesday morning and it is much appreciated. I am surprised Deputy Daly is here because I thought he would be on his way to the High Court.

Pa Daly (Kerry, Sinn Fein)
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I am, but this matter is so important. I am going down straight after it.

Mary Butler (Waterford, Fianna Fail)
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It is not a question-and-answer session. While I was walking across to the Chamber, I was struck by how ironic it is that I am the first ever Minister of State with special responsibility for mental health at Cabinet, and the Deputy is trying to remove me, while here he is today asking me to come forward and find a solution for him. I was just struck by how ironic it is.

Pa Daly (Kerry, Sinn Fein)
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It is not about the Minister of State.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this matter. As he will be aware, operational responsibility for the delivery of mental health services at local level is devolved directly to the relevant HSE regional health area, RHA, which in this case is the HSE South West RHA, and across all areas. I am aware, of course, that the HSE always aims to work in partnership with all relevant stakeholders in the community in the design and delivery of mental health services to achieve positive outcomes for all.

In relation to the issue highlighted by the Deputy, the HSE has provided an update that there was a requirement to identify a more suitable location for the National Ambulance Service in the region - and we all understand how important the National Ambulance Service is, especially in remote and rural areas - to better support its operational needs and enhance service delivery for people in the region. A potential space has been identified by the HSE alongside the mental health services in Cahersiveen. We must again go back to the point that it is extremely important that we can provide the whole continuum of health supports as close to home for people as possible.

The HSE has informed my Department that there are no plans to relocate the mental health services at Cahersiveen to Killorglin. I am a little confused, though. Is the Deputy telling me he only represents the people of Cahersiveen and not the people of Killorglin? It is important to have mental health supports everywhere. I understand clarity on this matter is currently being addressed, with a senior HSE manager actively engaging with all relevant stakeholders to facilitate accommodation that meets the needs of both services. It is important we deliver both services.

As the Deputy can appreciate, having a suitable location for the National Ambulance Service to be able to serve the people of Cahersiveen and the surrounding area is incredibly important, and it is my understanding this is being achieved without any changes to the location of community mental health services. From what I am hearing, though, I am also conscious that the services are in Cahersiveen and Killorglin is not served by this service. Perhaps this is something I need to look at. I want to deliver mental health services for all people regardless of what area of County Kerry they live in. The Deputy seems to be focused on just one area.

Aidan Farrelly (Kildare North, Social Democrats)
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I thank the Minister of State. Respectfully, I remind Members not to discuss live court cases here and to stick to the topic.

Pa Daly (Kerry, Sinn Fein)
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I thank the Cathaoirleach Gníomhach. If we got some proper answers, rather than smart answers, from the Minister of State, then we would not have to go down that road. From the Minister of State's answer, I understand there is a requirement to find a more suitable location for the National Ambulance Service, but this does not have to be at the expense of the good services carried out in the Cahersiveen area. If the Minister of State would only focus on the issue at hand, we are not talking about Killorglin. There are already services in Killorglin. The suggestion has been from the HSE to amalgamate the Cahersiveen services into Killorglin. The Minister of State's divide-and-conquer attitude is severely misplaced. I am asking her for a guarantee that the services currently in Cahersiveen will stay there.

This is the concern of the people in the south Kerry area from Mountain Stage, beyond Glenbeigh, and all the way down to Dromad, Castlecove and Caherdaniel. That is the area currently serviced by this team in south Kerry. Killorglin and other parts of the county have their own services. The proposal is to close the centre in Cahersiveen and move the patients to Killorglin. This is not understandable and not acceptable. It has to be the case that services in the most peripheral areas of the State are maintained in those areas. I note what the Minister of State said in the reply regarding active engagement taking place. If the level of the reply the Minister of State has received is that there are no services in Killorglin and some sort of a civil war is taking place, then this is not what is happening and the Minister of State has picked it up the wrong way, whether deliberately or otherwise. I ask her, therefore, to re-engage with the HSE down there and ensure the services currently there remain in south Kerry.

Mary Butler (Waterford, Fianna Fail)
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I am glad there are services in Killorglin because I would be disappointed if there were not. My understanding is that the HSE manager is actively engaging with all relevant stakeholders to facilitate accommodation that meets the needs of both services, the National Ambulance Service and, of course, the mental health supports, including the outpatient psychiatric facilities that support very vulnerable people. It is my understanding that while there are plans to locate a facility for the National Ambulance Service in Cahersiveen, that is not expected to result in community mental health services in the area having to move. I understand these services are well embedded in the community and I will continue to engage with the HSE in the Cork-Kerry HSE area. As the Deputy will understand, the HSE is working in partnership with all relevant stakeholders in the community in the design and delivery of mental health services to achieve positive outcomes for all and it would not be positive to close this service or to move it.