Kathleen Lynch (Cork North Central, Labour)

I am always reluctant to read a script. As the last script got me into so much trouble, I am even more reluctant. I am always reluctant to read a script when it comes to mental health, but there is an element of this that Senator van Turnhout needs to hear.

Dublin-mid-Leinster has had a significant shortfall of nursing staff in mental health services but compares favourably with other regions in terms of numbers of allied health professionals. The nursing staff ratio in the region is far lower than that of other HSE regions and the number of allied health professionals in Dublin-mid-Leinster, as I stated, compares favourably. It should also be noted that Dublin-mid-Leinster has made considerable progress in reducing acute bed numbers and usage in line with A Vision for Change. It is now at a point where existing acute bed numbers need to be broadly maintained to ensure a safe and regulation-compliant level of service.

What happened with regard to the conversion of the 31 posts was that Dublin-mid-Leinster had reached the level that A Vision for Change required far more quickly than any other region. Then, with the exodus in February and March, the numbers fell below the safe level that the commission recommends and insists on, and it was necessary to convert some of the posts into nursing posts. That did not affect the allied health professional posts; we managed to put those in place as well.

Senator van Turnhout was not the only one who was surprised at the weekend reports that the €35 million could possibly be used for other areas. That week, I had been in consultation again with the Minister for Public Expenditure and Reform, Deputy Howlin, and had it confirmed to me that the €35 million was still safe and sound in the Department. By the way, it is still in the Department. As normally happens with budgets for any health service, when the mental health budget and the €35 million were announced, the regional directors of operations, who do an extraordinary job in delivering the service, including in Dublin-mid-Leinster, contacted the Department and asked for the €35 million to be split and sent down pro rata. That is always how it is done: they state that their budget for last year was X and they need X this year, and they ask the Department to send it down. We said "In this instance, no". We asked them to carry out a gap analysis and tell us what they were missing, where it was missing from and what was required, and we told them that until the exercise was done, none of the €35 million would be released. That, as Senator van Turnhout can well imagine, takes a degree of work and investigation. Also, once it had been signed off, they then had to go away to recruit and appoint from existing panels. However, for some allied health professionals we did not have enough people on the panels, and some of the panels had run out as they only last two years. That has all now been done. The people will be in place by September and then the funding will be released. Some might say there is a lack of trust. However, we all know what happened to budgets for mental health in the past and we were determined it would not happen this time. They will be in place come September and we will have a full complement of allied health professionals. There are areas which did not get anything this year. Child and adolescent mental health services, for instance, got 150 new posts, but the payback is that it will have to treat persons between the ages of 16 and 18 because they are children. There are 250 posts in adult psychiatric services and ten new posts in the national counselling service. All of that is being put in place.

There were three areas in which we did not do anything this year. We have met with representatives of these areas; they know they will be prioritised next year, and they are happy enough about that. The areas in question are old age psychiatry, intellectual disability psychiatry and forensic psychiatry. We could not do it all in one year. It will be done over a period of years.

On the issue of data, as I have stated previously, we have real-time data for children - who is being treated, where they are being treated, what they are being treated for and by whom, what are the pathways involved and how long they will be in the service. These data are from a service that has been in existence for 12 years. In adult psychiatric services, we still do not have that type of detail. When one considers that such information used to be gathered by pencil and biro, and the systems we have in place now, one realises that such real-time information needs to be provided for adult psychiatric services as well. Some are good at it, some not so good. That is just not good enough.

Another difficulty we faced - the conversion of posts was part of this - was that, because the Mental Health Commission licenses the acute units, there are levels of staffing and so on that need to be complied with. We intend, under the review of the Mental Health Act, to license the community teams as well so that there will be parity.

I would like to have half an hour to talk about this. It is probably my favourite subject, and I think that tells Senator van Turnhout something about me. We are moving ahead. The capacity legislation, which will need to dovetail with the review of the Mental Health Act, will provide a safety net. There are already community mental health teams in operation; for example, in Cork North-Central, where Mr. John McCarthy lived. I am sure the Senator is familiar with the work being done there. The team is working extremely well and those who need them receive daily visits. I have received great reports about this service, which should be in place everywhere. I thank the Senator for raising this issue.