Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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369. To ask the Minister for Health the number of posts yet to be filled under A Vision for Change. [9911/15]

Kathleen Lynch (Cork North Central, Labour)
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A Vision for Change (2006) sets out a comprehensive framework for the development of all mental health services over a 7 – 10 year period. It recommends, broadly, a move away from the traditional institutional based model of care to a more patient-centred, flexible and community based service, where the need for hospital admission is greatly reduced while still providing in-patient care, as appropriate. This Government has prioritised the reform and resourcing of our mental health services in line withVision,and has significantly progressed this through the provision of €125 million since 2012 to underpin a range of new service initiatives to meet this widely agreed strategy objective.

A great deal of progress has been made with the accelerated closure of old psychiatric hospitals and their replacement with bespoke new facilities, better suited to modern mental health care. Progress also includes the development of child and adolescent services, shorter episodes of in-patient care, the adoption of a recovery approach in the delivery of services and the involvement of service users in all aspects of mental health policy, service planning and delivery.

A Vision for Change indicates a requirement for 10,647 WTE staff which, when adjusted for population growth, equates to around 12,240 WTE staff by 2016. However, given the changed economic circumstances since its publication, the Government has had to reduce the numbers employed across the public service in order to meet fiscal and budgetary targets. While staffing levels in the mental health service have fallen, there are positives that must be acknowledged. Many of the staff numbers lost were supporting the excessive numbers of beds which are no longer part of the service user recovery focused, modern, community based model for mental health. The overall reduction in numbers has been mitigated due to the priority ring-fenced Programme for Government investments since 2012. This has allowed the HSE to begin to re-balance the staff skill mix in mental health and to introduce new staff in the historically under represented disciplines recommended in A Vision for Change i.e. psychologists, social workers and occupational therapists.

The sustained investment in mental health since 2012 has resulted in over 1,150 new staff for the sector. As at the end of December 2014, of the 416 approved posts in 2012, approximately 95% (397) are now filled. Of the 477 approved posts in 2013, 78% (367) are filled. Therefore, approximately 86% of the combined posts over 2012-13 have taken up duty. The remainder of the vacant posts are at various stages of recruitment, with some difficulties in identifying outstanding candidates, primarily for geographic and qualification reasons. The recruitment of 225 approved allocated posts for 2014 has commenced with 4 having agreed start dates, a further 5 posts have been accepted, and the remaining posts are at various stages of the recruitment process. Discussions are currently taking place between the Department of Health and the HSE on the final allocation of the additional €35 million provided for mental health in Budget 2015. I hope to finalise the allocation of the additional funds with the HSE in the very near future.

It is acknowledged that in recent years, the retention of staff in the mental health service has been challenging, with the numbers employed fluctuating due to departures for various reasons, including redundancy, retirement or staff moving to take up employment elsewhere. However, the recruitment of these new posts, while challenging in the current environment, has enabled the gradual decline in posts to be arrested.