Maria Corrigan (Fianna Fail)
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I thank the Cathaoirleach for giving me the opportunity to raise this matter and I welcome the Minister of State to the House.

I have tabled this Adjournment matter to try to obtain clarification on the allocation of moneys to the areas of mental health services and physical and sensory disabilities in the 2007 budget. Some confusion has arisen in this regard. The impression among organisations on the ground is that moneys that were specifically allocated to certain areas in the 2007 budget did not end up being spent in those areas. Indeed, it appears that some if not all of the moneys may have been spent on other projects or offset against the overspend of the HSE. If this is the case, it raises some serious questions. If it is considered by the Government of the day that moneys should be allocated specifically to certain areas, there is an onus on the HSE to ensure that the money is spent in these areas. Both of these are priority areas which require the expenditure that was allocated to them. I would appreciate clarification from the Minister of State on this issue.

I also have concerns about the sum of €50 million that was allocated to disability services in the 2008 budget. It is essential that we receive assurance from the HSE that every penny will be spent in this area in 2008. I understand there is a need for the HSE to have some flexibility in terms of delivering services. The HSE is accountable to us for its global Vote but its accountability in terms of specific items of expenditure that we allocate is not sufficient. We need to ensure that while the HSE is given the flexibility required to manage its budget, we are provided with assurances that if we consider an area to be of sufficient priority that we allocate specific moneys for it, the money is spent in that area.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I thank Senator Maria Corrigan for raising this important issue. I will take this item on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

I assure Senator Corrigan that the Government is committed to the full implementation of A Vision for Change and has accepted the report as the basis for the future development of mental health services. The report estimates that in addition to the reallocation and remodelling of existing resources, an additional investment of €151 million is required over seven to ten years. In 2006, an additional €26.2 million was provided for the development of mental health services in line with A Vision for Change. A further sum of €25 million was allocated in 2007. This represents one third of the estimated additional cost of implementing A Vision for Change.

The 2007 additional funding was allocated to enhance existing services and to develop new services including €7.95 million for the development of child and adolescent mental health services to improve both community and hospital based services, to facilitate the provision of early intervention services, to enhance the multi-disciplinary nature of existing child and adolescent mental health teams, to develop eight new teams and to develop 24 additional beds for the treatment of children and adolescents. A sum of €2 million has been allocated for forensic mental health services to enable the service to address the implications of the Criminal Law Insanity Act 2006 and the Mental Health Act 2001 and to develop additional places including residential places in the community.

In line with Reach Out, the national strategy for action on prevention of suicide, €1.85 million was allocated to develop and implement national training programmes, to complete the availability of self-harm services through accident and emergency departments and to implement a national positive mental health awareness campaign through the National Office for Suicide Prevention. This additional funding brings the total available in 2007 for suicide prevention initiatives to €8 million.

A total of €750,000 was allocated in 2007 for the further development of designated eating disorder services and commissioning services from agencies. This includes funding of €500,000 for a new consultant with a special interest in eating disorders at the Elmount Unit, St. Vincent's Hospital, Elm Park and €250,000 to enhance the expertise available to the existing community-based teams in Cork.

Funding of €12.45 million was allocated to develop a range of other services including €3 million to improve specialist mental health services for older people, the homeless and people with an intellectual disability, €3.1 million for second medical opinions and authorised officers required under the Mental Health Act 2001, and to develop further the service of assisted admissions under the Act, €1.5 million to support mental health promotion, advocacy and voluntary organisations, €1.1 million to support professional development and training and €3.75 million for a range of other initiatives including adult victims of past abuse, a liaison mental health service in acute hospitals, a national counselling service and a national service user council.

Implementation of the individual recommendations in A Vision for Change is a matter primarily for the Health Service Executive. An independent monitoring group was established in March 2006 to monitor and assess progress on implementation of A Vision for Change. It published its first report in May 2007 and found that despite some significant initiatives there is little evidence of a systematic approach to implementation. However, in September this year, the HSE appointed a full-time project manager to develop its implementation plan. This plan is expected shortly.

Mental health and the development of appropriate services are priorities for this Government and that has been reflected in the unprecedented increases in funding in recent years. It is estimated that approximately €1 billion will be spent on mental health services this year.

The proportion of overall health spending on mental health is frequently used to make a point on the adequacy of funding. However, it is not entirely valid to make that comparison because as the nature and scope of health services change, funding ratios automatically change. In addition, some 30% of people attending primary care have mental health problems, the cost of which is not captured in the €1 billion figure.

In budget 2007, the Minister for Finance continued the tradition built up over the years of providing additional funding for people with disabilities. The provision of this additional funding continues to support the national disability strategy. The national disability strategy emphasises equal participation in society by people with disabilities. The national disability strategy provides for a framework to support people with disabilities.

The strategy puts forward the policy of mainstreaming public services for people with disabilities. The main elements of the strategy are the Disability Act 2005, the Education for Persons with Special Educational Needs Act 2004, the six sectoral plans published by Departments, the Citizens Information Act 2007, and the multi-annual investment programme for disability support services.

Since the launch of the national disability strategy in 2004, €420 million has been provided by the Tánaiste and Minister for Finance, Deputy Brian Cowen, for additional health and personal services for people with disabilities. The additional funding provided in the budget is to provide for a range of service developments for people with a disability.

For each of the past three years the multi-annual investment programme funding has been used to create additional residential, day and respite places for persons with a disability. The additional funding provided in budget 2007 will provide 255 new residential places, 85 new respite places, and 535 new day places in the areas of intellectual disability and autism services. It also provides for the implementation of the plan to transfer persons with intellectual disability-autism from psychiatric hospitals and other inappropriate placements.

Regarding services for persons with a physical or sensory disability, the additional funding this year will provide for a further 80 new residential places and the resources for 250,000 extra hours of home support and personal assistance.

The additional funding of €50 million provided in budget 2008 continues this Government's commitment to developing services for people with disabilities and in 2008 we will also reap the rewards of the unprecedented investment in mental health in recent years.

I thank Senator Corrigan again for raising this important issue. Since taking up my position in the Department of Health and Children I am aware that she has been active in working with the Minister of State, Deputy Jimmy Devins, on being a vigorous advocate for the needs of people with disabilities. I thank her for her ongoing work in this important area.

Maria Corrigan (Fianna Fail)
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I thank the Minister of State for his reply and his kind words. It is clear from the moneys allocated that mental health and disabilities are a priority for the Government but did the HSE spend those moneys in the areas for which they were allocated?

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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My colleague, the Minister of State, Deputy Jimmy Devins, is anxious to ensure that the funding allocated for these services delivers real outcomes for the people who need them. The Minister of State, Deputy Devins, will be vigorous in his work in this area and I have no doubt that substantial improvements will occur in the lifetime of this Government under the stewardship of the Minister of State.

Pat Moylan (Fianna Fail)
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I thank the Minister of State, Deputy Smith, for attending here today. I wish him, all other Ministers and the staff a happy and holy Christmas.