Brendan Ryan (Labour)

Cuirim fáilte roimh an Aire Stáit. I welcome the Minister of State. The document is impressive and important. There is an adequate supply of copies and it is a pity one was not automatically sent to each Member of the Oireachtas when it was published. I had to seek my copy, which was provided expeditiously by the Department. Since I have a three-volume assessment of tax breaks that arrived automatically I do not know why an equally important document about our mental health services did not also arrive automatically. That is a comment for the future, not a criticism.

It is difficult not to inject a tone of scepticism, not cynicism; I am not a cynic. Nobody could survive 25 years in politics if he or she were entirely cynical. One would find something better to do with one's time. While there is a wonderful plan here — I have some reservations about some aspects of it — when there is a shortage of funds the mental health services are the first to be cut, and when funds are available they are the last to be funded. I have observed this and, when I have not, it has frequently been brought to my attention domestically. This is for the human reason that while a public patient who cannot access, say, a heart bypass operation is prepared to go on a public platform and complain, a person suffering from severe depression who cannot get a hospital bed is unlikely to be able or, more important, willing to so the same. Mental illness becomes invisible and is therefore the easiest area to neglect. That is an appalling comment on the management of our health services. It suggests that when the management of the health services needed to cut costs it did not use objective criteria of comparative priorities — I do not say that cutbacks are ever right — but looked for the easiest areas. A person paid to manage should not do what is easiest but what his or her managerial authority says are the right things to do. This was not done.

For a programme of change on this scale we first need the creation for me and others like me of the confidence that those who manage this will do so properly and on the basis of the objective priorities identified here, not on the priorities of the service providers such as psychiatrists, psychologists or occupational therapists. We also need the funding, which I think the Minister said would be provided. While he acknowledged and identified the €25 million extra that is to be provided in 2006 he did not quite say the Government is committed to providing the funding to do everything the report requires. I would like to hear from a Minister that we are committed to the full implementation of this and that the necessary resources will be provided.