Dáil Éireann debate -
Tuesday, 27 Mar 2001

Vol. 533 No. 3

Adjournment Debate. - Psychological Service.

Mr. Stanton

I wish to thank the Ceann Comhairle's office for allowing me raise this matter this evening and I am grateful to the Minister for Health and Children for coming into the Dáil to take this debate.

I was first made aware of this a while ago but last Monday the current situation in regard to the health board was brought home to me dramatically. A mother rang me. She has a child who will soon be six. His doctor has referred him to the child guidance clinic and she was told that, as things are at the moment, she will have to wait almost three years before she will be seen. I want to be helpful and supportive. I know there is a lot of work in the pipeline and that many plans have been made and money made available. I want tonight to ask and encourage the Minister to take a personal interest in this area. He should do everything possible to ensure that these services are brought on stream as quickly as possible. This particular lady is only one of many. I understand that at the moment there are 277 waiting on that list in Cork. The professionals there are working very hard but they need support and they need it urgently.

The Minister is aware of the working group's report on child and adolescent psychiatric services published last February; it will cost about £90 million to implement. I would encourage and support the Minister in getting all that work completed. It is very urgent. This particular mother is suffering terrible stress. She is afraid the child will be nine before he will be seen. She cannot afford to go privately though she would be willing to take a second job. She is under such stress that her own health is at risk. She asked me to go public with her name and that of her child. I will not do that but I will send the information to the Minister and I have already been in contact with the health board and it is doing all it can to help. This is most urgent.

We have to intervene at the earliest time when we identify these difficulties children have. The working group's report says that 500 per 200,000 children are affected by attention deficit disorder. Why is this happening? I have dealt with children like that in another capacity and when they reach adolescence it is extremely difficult on them, their parents and their teachers. There is also a need for liaison between schools, community and families in dealing with this. There should be training for families and support for parents, otherwise these children are condemned to a life possibly in jail or worse. I do not want to make a political issue of this but I want to encourage and support the Minister to put maximum resources, effort and time into this issue. It is most urgent.

Minister for Health and Children (Mr. Martin)

I would like to thank Deputy Stanton for raising this matter on the Adjournment and for his constructive comments. I take this opportunity to appraise the Deputy in relation to the development of child and adolescent psychiatric services in the Southern Health Board area.

In the Southern Health Board child and adolescent psychiatry services are provided jointly by the Brothers of Charity and the board. In March 2000, the board published a comprehensive development plan for child and adolescent psychiatry services for the period 2000-02. This plan makes provision for a total of ten community based, multi-disciplinary consultant led teams for the area. The present position is that the Brothers of Charity have part or all of three teams in place. The board has one consultant led multi-disciplinary team in post and two additional consultants have been offered posts and it is hoped they will be in a position to commence shortly. Steps have also been taken to recruit staff for these two teams. This will result in a total of six community based consultants and part or all of their teams being in place throughout Cork and Kerry later this year.

The recruitment of the additional consultants and their teams will enable the board and the Brothers of Charity to make progress in relation to waiting lists that have developed in recent years. We are looking at historic deficits here and are trying to catch up as quickly as we can. A clinical priority system is in place at present and appointments are based on this system. In addition, the board has requested the Local Appointments Commission to commence the process of recruitment of six additional posts of psychologist. These additional posts will enhance the board's generic psychology service to children and adolescents in the board's area. A lot here does depend on the success of the recruitment campaign. We have had a shortage of psychologists in terms of availability and I have been working at national level to try and develop manpower force in both short and interim steps to improve recruitment and in more medium term perspective to improve supply.

In the past two years, additional revenue funding of approximately £1 million had been provided to the board to enhance services in line with its development plan. The board's development plan also provides for the development of a 20 bed in-patient child and adolescent psychiatric unit for the region. The board has located a suitable building and in consultation with the Department of Health and Children, the Department of Education and Science and the Brothers of Charity is currently finalising the brief for the building. It is expected that work on the upgrading and restructuring of this unit, to be based at Bessborough House, will commence later this year.

At national level, I am pleased to inform the Deputy that significant additional funding of £18.64 million has been provided this year for the development of mental health services generally and £3.2 million of this has been directed towards the development of comprehensive child and adolescent psychiatric services. I would also like to draw the Deputy's attention to the fact that £150 million is being provided under the National Development Plan, 2000-2006, for mental health services. This funding has been made available for the development of acute psychiatric units attached to general hospitals, day hospitals and day care facilities, community residences and intensive care units for the disturbed mentally ill. Five in-patient units for children and adolescents will also be developed and funded under the NDP. At present, three of the units are at the planning stage, including the unit at Bessborough House referred to earlier, and project teams have been appointed to oversee their implementation.

The Deputy has already referred to the working group which was set up last year to make recommendations on the development of child and adolescent psychiatry. The first report of the group, which I have made available to each Member of the Oireachtas and other interested parties, recommends a significant increase in the number of consultant led multi-disciplinary teams throughout the country. It also recommends that priority should be given, in the first instance, to the recruitment of the required expertise for the completion of existing consultant led multi-disciplinary teams. Additional funding required to fully implement the recommendations of this report will be the subject of discussion in the annual estimates campaigns in respect of 2002.

We have attempted to make progress and it is a matter of spending the resources we have made available this year. If I can be of any assistance in relation to the cases the Deputy has identified we will do our best to alleviate the distress of the parents concerned.