Gerard Craughwell (Independent)
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I welcome the Minister to the House for the debate on this matter. On 25 March, an independent report into the deaths of 12 children in State care or known to child protection services severely criticised the State's social work and mental health services. Four of these cases concerned young women between the ages of 14 and 19 with emotional difficulties who had taken their own lives. Three of them had been on lengthy waiting lists for psychological services. Dr. Helen Buckley, chair of the national review panel said that one of the girls was unable access to mental health services in the days leading up to her death, which is a damning indictment of our health service. In explaining delays in psychology services, Ms Anne O'Connor, HSE director of mental health services stated it was the lack of psychological candidates and not HSE funding that was causing the delays.

I have been reliably informed that, in November 2014, there were 27 vacant HSE psychology posts in disability, mental health and child and adolescent mental health services but, at the same time, more than 80 counselling psychologists were available on the HSE psychology panel. It appears, therefore, it is not the shortage of suitably candidates but a change in the appointment criteria that is causing this serous and, in some cases, life threatening backlog. Up to 2009, counselling psychologists were actively recruited in all areas of mental health and currently they work in all areas of the HSE, some at senior levels. Given the changed recruitment procedures, they would now be unable to apply for posts they hold. The HSE has never given a reason or evidence for the basis of this change. The professional body for accreditation of psychologists, the Psychological Society of Ireland, PSI, stated, "No candidate should be excluded from applying solely on the basis of their named professional qualification in psychology".Counselling psychology professionals have made countless representations to the Health Service Executive to request a statement on its rationale for such restrictive eligibility criteria, but none has been given. In a statement obtained under the Freedom of Information Act, a 2013 report of the Commission for Public Service Appointments, CPSA, concluded that in the event of the HSE not adopting the position of the Psychological Society of Ireland in respect of the eligibility criteria, it needed to provide a robust case to support its position. To date, I am unaware of any supporting case having been made, and I respectfully request the Minister to take up the issue with the HSE.

I am aware, however, of a long-established relationship between the HSE and the clinical psychologist profession in Ireland, which has evolved from an apprenticeship model in which the HSE sponsored the training of clinical psychologists and their subsequent placement in posts in the HSE. However, I argue that this model, which was designed to meet the service needs of the HSE and has worked very well for clinical psychologists therein, no longer adequately meets the now urgent service needs of the sector. The time has come for a different, more flexible, expanded and, if necessary, more bespoke recruitment process. Each year the country produces clinical and counselling psychologists of the highest calibre, and it is regrettable, even scandalous, that posts remain unfilled as young people die because of the failure to resolve this recruitment issue.

To sum up, I will ask the Minister a number of important questions. Why were the eligibility criteria changed in 2009? Who made the decision to change them? Who sanctioned this change and why has the HSE sought to recruit clinical psychologists from abroad while refusing to employ counselling psychologists who already have passed HSE interviews and remain on the panels? How was this situation allowed to develop when there are serious waiting lists and people are in dire need of professional medical help? Although there are already fully qualified counselling psychologists on the panel, no appointments are being made. I respectfully ask for the Minister to intervene in this serious situation because, to paraphrase an old adage, service directors differ and patients die. There is far more at stake here than posts and disputes over eligibility criteria.

Leo Varadkar (Dublin West, Fine Gael)
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I thank Senator Craughwell for raising this issue today. As the Senator will be aware, psychologists employed by the health service play an integral role in the delivery of a wide range of psychological services. These include working with children and their families who present with developmental, emotional or behavioural difficulties and others who have intellectual and physical disabilities. Services also include working with adolescents with a wide range of difficulties from adjustment problems to serious mental health issues and working with adults who present with mental health problems, including anxiety, depression and mental disorders.

The HSE employs professionally trained psychologists, including counselling psychologists, clinical psychologists and educational psychologists, in a range of roles across the health service. Psychologists working in the health service provide their services in a number of different ways - as part of a multidisciplinary team of health professionals, as part of a network of health professionals or as sole health professionals providing a service to a client. They provide services across a broad range of settings, including community-based health centres, residential centres, nursing homes and hospitals.

Under section 22 of the Health Act 2004, the HSE has the authority to appoint persons to be employees and may determine their duties. This includes appointments to psychology services. The HSE is bound under section 22 of the Act to conduct recruitment in accordance with the provisions of the Public Service Management (Recruitment and Appointments) Act 2004, which is underpinned by codes of practice. The Commission for Public Service Appointments is the independent body established in 2004 to ensure that these codes of practice are adhered to. The HSE's national recruitment service conducts all recruitment activity for the health service, including recruitment to all positions in the psychology service. The HSE is responsible for determining eligibility criteria for recruitment purposes, and this has been fully acknowledged and accepted by the CPSA.

As the Senator will be aware, it has been the HSE's intention to undertake a review of the recruitment and selection criteria for psychology grades in the health service. A working group is being established by the HSE and it is expected that the work will commence within two weeks. The terms of reference are currently being finalised and it is hoped the group will deliver its recommendations within six months. In the interests of service users and their families, I, along with the Minister for State with responsibility for primary and social care, welcome the consideration the HSE is giving to this important issue, and we look forward to receiving the group's review report, once completed.

Gerard Craughwell (Independent)
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I accept what the Minister says and I understand his own concerns in this area. However, as Minister for Health, he has responsibility for the HSE. The establishment of a working group to report on this matter now is a bit late in the day.

There are vacant posts in the system and there are people available now to fill those posts. I cannot for the life of me understand why we cannot go ahead and fill them. There are people on the panel and there is absolutely no reason this cannot be done, other than a blockage, for some reason or other, in the system. The Minister could, I am sure, do a little bit more in this regard. Perhaps he would not mind doing so.

Leo Varadkar (Dublin West, Fine Gael)
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Just because people are on a panel, it does not mean they are available or want to take up a post. Often, people on panels, when offered a job, either are no longer available or they do not want the job or to move to the location of the job. It is not the case that just because people are on the panel they will necessarily be willing to take up a post.

Gerard Craughwell (Independent)
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There are many people on the panel.

Leo Varadkar (Dublin West, Fine Gael)
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When it comes to this decision, the HSE must be satisfied that people are suitably qualified for the position they are being asked to take up. This is not a matter on which I have the authority to issue a ministerial order, or on which I would be comfortable doing so. It is a matter for the working group to determine whether it wishes to change what it deems to be acceptable in terms of qualifications. The group will comprise senior psychology managers in the HSE and human resources professionals. It will also include an independent chairperson external to the HSE and will consult with key stakeholders, including the Psychological Society of Ireland, educational bodies and staff representative bodies.

It is worth pointing out that the Psychological Society of Ireland, PSI, is a non-statutory organisation. There is no statutory requirement for psychologists to be registered with the PSI in order to practice in this country. Membership of that organisation is entirely at the discretion of individual psychologists, which is very different from the Medical Council or other similar bodies.

Gerard Craughwell (Independent)
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Can the Minister offer some solace in terms of membership of the group including a counselling psychologist?

Denis O'Donovan (Fianna Fail)
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The Minister has outlined his position clearly. The Senator has had a good run at it and should appreciate that the Minister himself came to the House to respond to the matter.

Gerard Craughwell (Independent)
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Go raibh maith agat.