Tony Gregory (Dublin Central, Independent)
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Question 277: To ask the Minister for Health and Children her views on queries (details supplied); and if she will make a statement on the matter relating to the provision of mental health services in budget 2009. [39593/08]

Olivia Mitchell (Dublin South, Fine Gael)
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Question 282: To ask the Minister for Health and Children if she will allocate the promised €25 million for mental health services in order to achieve the goals of A Vision for Change; if she will put in place adequate mechanisms to ensure that it is spent accountably; and if she will make a statement on the matter. [39614/08]

Olivia Mitchell (Dublin South, Fine Gael)
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Question 283: To ask the Minister for Health and Children the steps taken by her to implement recommendation 19.11 of A Vision for Change; and if she will make a statement on the matter. [39615/08]

Róisín Shortall (Dublin North West, Labour)
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Question 289: To ask the Minister for Health and Children the amount she will allocate the mental health services in accordance with the provisions as set out in A Vision for Change; the mechanisms put in place to ensure accountability in spending of these funds; the steps she has taken to implement recommendation 19.11 of A Vision for Change; and the action to date taken by her on the recommendations issued by the sub-committee on the adverse side effects of pharmaceuticals. [39700/08]

John Moloney (Laois-Offaly, Fianna Fail)
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I propose to take Questions Nos. 277, 282, 283 and 289 together.

Substantial resources have been invested in mental health services. Overall spending on mental health services in 2007 amounted to €1 billion and this level of funding continued into 2008. It is also important to bear in mind that some 90% of mental health problems are dealt with in primary care.

The estimated additional cost of the implementation of 'A Vision for Change' the Report of the Expert Group on Mental Health Policy is €150m over 7 — 10 years. A total of €51.2 million has been allocated since 2006 which represents over a third of the overall requirement. Under the Health Act 2004, the Health Service Executive is obliged to operate within its overall vote. In this regard, it took steps to ensure that it met this objective in 2007 by delaying some of its planned developments, including developments in mental health. I am advised that of the €51 million provided in 2006 and 2007 for the implementation of 'A Vision for Change', about €30 million has now been invested. In addition, the recruitment of 8 additional child and adolescent teams and the commissioning of 14 additional beds for children and adolescents is underway.

I wish to assure the Deputies that this Government is firmly committed to the development of mental health services in line with 'A Vision for Change'. Implementation of the recommendations of the Report is a key priority for the Office for Disability and Mental Health. By working in partnership with the HSE to achieve the agreed targets, the Office is bringing a new impetus to implementation. Funding will be provided in 2009 for the recruitment of 35 therapy posts for the child and adolescent mental health service. In addition, once-off funding of €1.75m is being provided for suicide prevention initiatives and for mental health projects supporting service users and carers. I also wish to point out that implementation of 'A Vision for Change' is dependent to a much greater extent on the remodelling of existing resources than on new additional funds.

Implementation of many of the recommendations in 19.11 of 'A Vision for Change' is the responsibility of the HSE. In relation to research the Department of Health and Children provides funding to the Mental Health Research Unit (MHRU) as part of the Health Research Board's overall allocation. The Unit manages and reports on national information systems in the mental health area e.g. the National Psychiatric In–Patient Reporting System (NPIRS). Support has been provided to develop WISDOM — a system which will capture information on inpatient and community care service activity. Research is also an integral part of the work of the Health Service Executive and the Mental Health Commission.

In relation to the Report on the Adverse Side Effects of Pharmaceuticals, April 2007, I am advised that the Irish Medicines Board (IMB) initiated a process to carefully examine the various items raised. This assessment was completed in November 2007. The outcomes of this assessment have been communicated to my Department and I am advised that proposals concerning conduct of clinical trials and post authorisation studies are already provided for in legislation and are the subject of a range of initiatives.

Regarding the handling of Adverse Drug Reaction (ADR) reporting, a number of items highlighted in the Oireachtas report reflected submissions made by the IMB and the consultant's assessment drew attention to the following opportunities which are currently being progressed by the IMB:

further development of stakeholder education strategy to include safety issues across the organisation,

expanding the current IMB adverse reaction education and awareness programme to a wider healthcare professional base, members of the public and to enhance the profile of the topic in the media,

targeted campaign focused on improving awareness of adverse reaction reporting among health professionals and the public,

the publication of high level adverse reaction data.

I am also advised that the IMB has developed a website which has the capacity to take on-line reporting of adverse reaction reports. This system is fully operational and reports are being taken from both health care professionals and patients. The website can be accessed at; http://www.imb.ie/EN/Safety--Quality/Online-Forms/Human-Medicine-Adverse-Drug-Reaction.aspx

The position in relation to the establishment of a Patient Safety Agency is that a Commission on Patient Safety and Quality Assurance was established to develop clear and practical recommendations to ensure that quality and safety of care for patients is paramount within the healthcare system. The Commission's Report — 'Building a Culture of Patient Safety' was published on 7th August 2008. It contains 134 recommendations spanning across almost every area of the health service including a number relating to the reporting, managing and learning from adverse events in the health system generally as well as some recommendations in the area of medication safety relating chiefly to the Irish Medicines Board and other bodies with a stake in the medication sector.

The implementation plan endorsed by the Commission recommends the immediate establishment of an Implementation Steering Group (ISG) and five expert subgroups relating to specific subjects. The advantages of this model are that it immediately builds on the structures already in place and can deliver results quickly. On this basis, the establishment of a new patient safety agency is not proposed.