Paudie Coffey (Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to the debate on this matter, which is impacting citizens and patients in my area of the south east. I welcome the Minister of State, Deputy Jim Daly. As previous speakers said, he is always prepared to face up to his responsibilities as a Minister. Unfortunately, I have to agree with other speakers with regard to the unacceptable situation that has developed in mental health services in the south east and the manner in which the HSE allowed the service to reach a crisis point.

The HSE must be held accountable. It was my understanding that with the development of the new pillars, especially with A Vision for Change and the establishment of the mental health pillar, the director of mental health services and the hospital boards, there would be more accountability in terms of how the HSE is managing and deploying resources from the funding the Government is putting in place. We all agree that mental health services have always been the Cinderella of the health service in this country. I acknowledge the efforts the Minister of State and the Government are making to address that in terms of investment and reform. However, it is unacceptable that vulnerable patients, particularly children, who require immediate and urgent intervention or professional support are being let down by the health services and the HSE, which is charged with managing the services. I urge the Minister of State to call in the relevant managers and those responsible in the HSE.

The Minister of State outlined the immediate temporary measures that have been put in place to respond to the crisis in mental health services in the south east. There is a temporary deployment of consultant psychiatrists from Galway to the south east in order that the specialist teams in CAMHS can continue to operate. I commend those specialists. I have met the specialist nurses, occupational therapists, psychologists and others who work under the consultant psychiatrist and they are overburdened with work. They need additional supports to allow them to make interventions when they are required. This is not just about money. It is about accountability and reform in our health service. We will have to crack the nut some day and I hope the Minister of State, Deputy Jim Daly, and the Minister, Deputy Harris, will do that and hold the HSE to account in order that it delivers the service it is charged with delivering for the citizen.

I have had reason to visit the CAMH services in Waterford, and I am aware that the Wexford situation is especially challenging. The services have successful outcomes for the people who access them. I have spoken to families who have managed to do that. They acknowledge the service and support they get and commend the staff. However, it is so sad to see resignations taking place and people being overburdened due to a lack of resources or services. We must approach this in a different way. For some reason, the HSE always allows matters to develop into a crisis when there should be red flags and alarm signals long before that. We had an excellent debate in the House on mental health services only a year ago, when we brought specialists in from all sectors to outline the challenges that face mental health services.

I believe the Minister of State is doing his best, but we must do more. We need to haul in the people who are often faceless. They are not the psychologists, psychiatrists or the occupational therapists who are at the coalface. They are the managers. The ratio of managers to front-line staff in the HSE is simply wrong. We need to get to the bottom of why this situation is occurring. I commend the Minister of State on his efforts and I will support him in trying to reform the health services. I will support him in the forthcoming budget where he will be fighting for additional funding to invest in mental health services. We do not wish to see this issue arising again either in the south east or in any other part of the country. The Minister of State must haul in the people in the HSE and hold them to account. In addition, the hospital boards are supposed to be overseeing the operational efficiency of the HSE. If that system is to operate as intended, those boards must also haul in those who are responsible.

Ultimately, we must support the people on the front line and the vulnerable patients who need access to services. We can talk as much as we wish in the Seanad, the Dáil or anywhere else but we must reform the system to deliver services where they are most needed. The Minister of State referred to new technology, digital access and information technology. We must utilise those technologies. Four new primary care centres have been built in my constituency. One is in Waterford city in the grounds of St. Otteran's Hospital, a former mental health institution. The other three are in Dungarvan, Tramore and Carrick-on-Suir. They are new, state-of-the-art buildings which have the facilities and capacity for outreach mental health services. We must get the professionals who are delivering the service on board and reform the system by putting the front-line resources in place, away from the management, and utilising all the resources available, be they buildings, IT or professional human resources. I will work with the Minister of State to achieve that but I urge him to keep his focus, and that of the HSE, on resolving the issues in the south east and providing what is so badly needed there at present.