Maire Devine (Sinn Fein) | Oireachtas source

Cuirim fáilte arís roimh an Aire Stáit. Unfortunately, the debate this evening will not be on positivity because we do not have that in this country. I will give the facts to the Minister of State. I have a key question for him and I implore him to respond to it. I will outline the key indicators regarding mental health services in the south-east region and across the State and I ask him to say how he will react to them. I have been monitoring the situation closely since last year, both in the Committee on the Future of Mental Health Care along with my colleague, Senator Freeman, and through parliamentary questions. This is my area of expertise, as it is for Senator Freeman. It is our niche and our passion. It is extremely important.

The time for rhetoric is over. If we do not act today, there will be another catastrophic abuse of human health on this island. In fact, it has already happened. Earlier today the Ombudsman for Children and the Mental Health Commission agreed that mental health services have already collapsed. I would need to consult a thesaurus to find what out what other words can be used after "crisis" and "emergency" because it has gone beyond those. We stand here and make grand speeches about the state of our mental health services, but I am tired of doing that. We do it once a week and then go away and wait for another story to break in the media. The Minister of State must outline exactly what the Department is doing to address this chaos. Otherwise this is a waste of time.

Dr. Moore, the specialist consultant paediatric psychiatrist in County Wexford, said there were supposed to be 30 clinicians working in the greater Wexford region, but just five and a half of the posts are filled. That is no surprise to the Minister of State. In December 2017 the CHO 5 area was the worst performing in the State and was at only 48% of the recommended levels in A Vision for Change. What did the Minister of State do between December and now to address the shortfall? I ask him to give specifics. He knew about the state of the services and he had time to begin to address them.His response to the effect that we will take the staff from Galway amounts to robbing Peter to pay Paul and is simply not good enough. Dr. Moore said there were no inpatient beds in Wexford and that when he needs a child to go to hospital, he fills out a form and faxes it with his fingers crossed in the hope of finding a bed. In the vast majority of cases children do not get beds and they never get them urgently.

Ms Margaret Brennan from south Wexford appeared before the Joint Committee on the Future of Mental Health Care. She is fighting for her children. During the discussion on the resignations the question was asked by the Chairman: "What now?" Ms Brennan said there is nowhere to go and that there is nothing there for her or families like hers.

The Department of Health glossy advertising campaigns claim that mental health is as important as physical health, but the actions are indicative of a different attitude. The 2012 mental health budget was 5.6% of the HSE budget, while this year it is 6.3%, a tiny proportion. The lack of investment is actually promoting stigma and is actively keeping mental health services on their knees.

I call on the Minister of State to address the details I have set out about his Department. It was extremely difficult to obtain some of the information. For example, a couple of weeks ago I asked for a simple breakdown of child and adolescent mental health services budgets. I was told that the HSE does not have that information. Yet, I know that variants of that information were given to the Joint Committee on the Future of Mental Health Care. The Minister of State may wish to keep the conversation around mental health as void as possible, but I will not let him do that because it would be a disservice to the 30 plus years I spent working in the services. I want the Minister of State to commit now to improving with urgency the record-keeping of the mental health division.

I attended a staff engagement group in the HSE yesterday morning. The group was made up of 60 or 70 ordinary staff, including porters, psychologists, staff nurses, GPs and other doctors. I am concerned about the impact of the negativity of the mental health services and – I will try to remain polite – the greed at the top layer of the HSE. They are terrified. When Tusla social worker staff left in their droves, they would not tell people that they had worked for Tusla because they were getting abuse in the pub and cinema and when they went out for meals. They held their heads in shame. I do not want that to happen to our wonderful HSE staff.

We have an opportunity for the director general of the HSE to be appointed. We do not want anyone helicoptered in, which is what happened in the past. We want experts, not only with managerial expertise but with clinical caring expertise. We want the interview panel to represent the voices of patients. It should comprise people with expertise who can judge whether a candidate is fit to run a caring health service in the country. How can anyone expect to finance an overhaul of the mental health division when millions of euro are being thrown to private profiteers? The Minister should note that the agency spend for the first three months this year alone was a little under €13 million in three months. That represents almost the entire increase of €15 million we were celebrating last year in the budget.

The Minister of State has failed. We have failed as legislators and as caring individuals in attempting to allow our children to live happy lives. We have failed in our responsibility for mental well-being in this country. We need to roll up our sleeves. I do not know how we do that because I am getting hoarse from asking for it again and again.