Colm Burke (Fine Gael) | Oireachtas source

I move amendment No. 2:

To delete all words after “Seanad Éireann” and substitute the following:
“notes that –
in line with the commitments in the Programme for Government 2011-16, the Government:
- is progressing the recommendations of A Vision for Change, including reducing the stigma of mental illness, ensuring early and appropriate intervention and improving access to modern mental health services in the community;
- notes that, in the context of primary care reforms, patients can access mental health services such as psychologists and counsellors in the primary care setting;
- notes that this Government has provided additional ring-fenced allocations for mental health in the period 2012-14, totalling €90 million;
- notes the ongoing closure of unsuitable psychiatric institutions, and the moving of patients to more appropriate community-based facilities;
- notes the ongoing reduction in the practice of placing children and adolescents in adult psychiatric wards;
- notes that a review of the Mental Health Act 2001 is currently being conducted, in consultation with service users, carers and other stakeholders, informed by human rights standards (and the introduction of a Mental Capacity Bill that is in line with the UN Convention on the Rights of Persons with Disabilities);
- notes the renewed focus given to the implementation of A Vision for Change by the establishment of the Mental Health Division in the HSE, with its own defined budget, and appointment of a National Director for Mental Health Services;
- notes the commitments and timelines contained in the HSE Service Plan 2014 for Mental Health including completion of recruitment, substantially achieved, of 2013 approved posts by Q2 2014, and the completion of recruitment of posts approved from Budget 2014 by Q4 2014;
- notes the reconfiguration of services towards a more community-based recovery-orientated model of delivery of service in all areas, including HSE West, HSE South and the Dublin North East regions;
- notes the 2012 Report of the Inspector of Mental Health which highlights the continued progress towards ending the use of outdated and unsuitable buildings to provide inpatient services and the continued development of child and adolescent units while, at the same time, acknowledging that the pace of change towards a modern, patient-centred, recovery orientated mental health service is slower than desirable; and
- notes the commitment to the National Forensic Mental Health Service (NFMHS) project, including the provision of a new National Forensic Hospital, for which planning is under way, and the provision of Intensive Care Rehabilitation Units (ICRUs) as part of this project.”

The Minister of State is welcome to the House. I thank her for the work she is doing and has done in this area, and I know she is fully committed to reform. However, reform is not something that is easily achieved. It is something that affects people directly, in particular those who have been providing the services. A Vision for Change was published in 2006. It is interesting that my colleague across the House seems to forget that his party continued to remain in office for a number of years after it was published. When we came in, the amount of change that had occurred was little or none.

It is interesting to read the extract from the executive summary of A Vision for Change, which states:

Specialist expertise should be provided by community mental health teams (CMHTs) - expanded multidisciplinary teams of clinicians who work together to serve the needs of service users across the lifespan. CMHTs should serve defined populations and age groups and operate from community-based mental health centres in specific sectors throughout re-configured mental health catchments areas.

Basically, the whole issue is about community-based teams, and that is what the Minister of State has been working through in this reform. I accept there will be change and that it will not be achieved overnight. The main point of the reform is the creation of a new division dealing with mental health, with its own budget and the appointment of a national director for mental health, which is proceeding. There is a whole reconfiguration of services, which is proceeding. The Senator referred to the budget. The budget for this year for mental health is of the order of €766 million, which is a substantial budget, so I am not sure from where my colleague across the House is coming. Yes, we would like to put more money into mental health services, and we would like to create all of the changes overnight, but, unfortunately, we also have to deal with what we inherited in regard to the economy and, therefore, we have a limited budget and we have to accept that. It is about using the budget we have in the best way possible and trying to bring forward the reform in the fastest possible timeframe.

For example, the Government in 2012 prioritised the creation of 1,100 posts - 414 in 2012, 477 in 2013 and 250 in 2014. Community health teams are to be made up of a number of different groups of people. However, there are difficulties in filling all of these posts because, in some areas, we do not have people with the required qualifications. For example-----