Skip to main content
Normal View

Dáil Éireann debate -
Wednesday, 5 Mar 2008

Vol. 649 No. 2

Priority Questions.

Services for People with Disabilities.

James Reilly

Question:

78 Deputy James Reilly asked the Minister for Health and Children the action she will take to address the long waiting lists for assessment and diagnosis of children suspected of having autism, which now stand at up to two years, given that there is a three-year window of opportunity to intervene to allow a child achieve his or her full potential and that to lose two of these years waiting for an assessment would be catastrophic; and if she will make a statement on the matter. [9774/08]

The Government is committed to providing a high quality service for all people with a disability, as illustrated by the substantial investment in the disability sector in recent years. An integral part of the national disability strategy is the multi-annual investment programme, published in December 2004, which contains details of specific commitments in regard to the provision of high priority disability services in the period 2006 to 2009. These commitments include the development of new residential, respite and day places for persons with an intellectual disability and autism in each of the years covered by the programme. Additional funding was also provided to enhance the level and range of multidisciplinary support services available to adults and children with intellectual, physical and sensory disabilities and those with autism. It also provided for the recruitment of additional professional and support staff. The priority to date has been to enhance assessment and support services for children with disabilities.

Prior to the establishment of the Health Service Executive, different approaches had emerged throughout the State to service delivery for individuals with autism. There are early intervention services in many parts of the country, some of which are run by the HSE and others by non-statutory agencies, but there are inconsistencies in their approach and delivery. The HSE is committed to redesigning these services in line with its transformation programme and current best practice.

Intervention early in life can have a significant impact on the disabling effects of a condition or impairment. In recognition of this, Part 2 of the Disability Act 2005 was commenced for children aged under five years with effect from 1 June 2007. This provides parents of young children with disabilities with an entitlement to an independent assessment of their child's health and education needs and a statement of the services it is proposed to provide for that child. To date, more than 1,300 applications for assessment of need have been received and are being processed by the HSE.

Representatives of the Departments of Health and Children and Education and Science, the HSE and the National Council for Special Education meet on a monthly basis to address a range of issues, including matters arising from the ongoing implementation of the Disability Act 2005.

Additional information not given on the floor of the House.

This work includes planning for the roll-out of Part 2 of the Disability Act 2005 and the Education for Persons with Special Needs Act 2004 to children aged between five and 18 years and to adults. Issues in regard to the timely and appropriate provision of health and education supports for children with a range of disabilities, including autism, are being considered in the context of these discussions. Health related support services for children aged five to 18 years and for adults will continue to be enhanced to enable the HSE to meet needs identified for this group.

The recently established Office for Disability and Mental Health will focus on facilitating the delivery of integrated health and education support services for children with special needs, by further developing the existing mechanisms for co-operation and co-ordination between the health and education sectors.

I cannot tell from the Minister of State's response how he proposes to address this issue. There is a window of opportunity between the ages of three and six years where it is possible to make a significant impression on the ultimate outcome for an autistic child. However, a waiting list of up to two years means two thirds of this window may be lost to parents as they wait in frustration for a diagnosis. Many parents are going abroad to seek diagnostic services or doing so privately at extraordinary cost. This is unfair, particularly when we know that early intervention would mean that 50% of these children could move into mainstream education.

What arrangements are in place to provide speech and language therapy and behavioural therapy under the so-called eclectic model to which the Minister for Education and Science, Deputy Hanafin, has referred, in mainstream schools which provide special classes for children with autism? Two schools on the north side of Dublin, for example, have the classrooms, teachers and special needs assistants but cannot secure speech and language and behavioural therapy services.

The diagnosis of autism is outlined in the international classification of diseases and related health problems. There are five diagnoses under this umbrella. The overall estimated prevalence is in the order of 60 in 10,000 children. As I said, there has been a degree of inconsistency in the delivery of services throughout the State which the HSE is committed to correcting. To date, there is no agreed mechanism for interaction between the HSE and the Department of Education and Science and practices differ throughout the State. The recently established Office of Disability and Mental Health, which I have the honour of heading up, is designed specifically to tackle such problems as this. If the Deputy requires, I can discuss the issue further.

I am delighted the Minister of State is taking control and responsibility in this area. I ask that he devise a cogent, coherent plan to address this issue immediately. It is a matter of co-ordination. All the services and divisions are in place but they must be co-ordinated. I hope we will not have to wait for a report to issue and that the Minister of State will take action that will result in tangible change in the next three months.

A cross-sectoral committee has been established comprising representatives from the Departments of Health and Children and Education and Science, the HSE and the National Council for Special Education, which meets on a monthly basis. I have attended one of its meetings and intend to do so more regularly. By these means, we will ensure progress in this area.

Departmental Reports.

Jan O'Sullivan

Question:

79 Deputy Jan O’Sullivan asked the Minister for Health and Children when she expects the publication of each of the outstanding reports on cancer diagnosis and treatment, including the three reports on the Midland Regional Hospital, the report on the case of a person (details supplied), and those concerned with Cork University Hospital, Galway Regional Hospital and Barringtons Hospital, Limerick; and if she will make a statement on the matter. [9455/08]

I published two reports this morning on the Midland Regional Hospital, Portlaoise. The Health Service Executive is publishing reports on the clinical reviews this afternoon.

The investigation by the Health Information and Quality Authority, HIQA, into the care provided by the HSE for the named individual commenced in June 2007. I am advised that the draft report is going through the necessary legal verification process which includes consulting those referred to in the report. The pathology review in Cork University Hospital is completed and a report is being finalised by the HSE.

The investigation by HIQA into pathology services at University College Hospital, Galway, commenced in September 2007. While it is difficult to predict precisely when the work will be completed, it is hoped the investigation will be concluded in April and the report published as soon as possible thereafter.

In regard to the review of breast services in Barrington's Hospital and medical centre, the review team expects to finalise the draft report this month. Following the completion of the necessary legal requirements, the report will be submitted to me and the hospital management.

The incidents that gave rise to all these reviews highlight the need for swift implementation of the national quality assurance standards for symptomatic breast disease. Implementation of the standards will ensure every woman who develops breast cancer will have an equal opportunity to be managed in a centre capable of delivering the best possible results.

I do not know whether it is a coincidence that two of these reports have been published on the day this question is tabled, with a third to be published later this afternoon. We did not have much time to read the two reports published earlier today. Will the Minister take a hands-on approach to this issue? We tabled a motion of no confidence in her last autumn and I have not read or heard anything today to suggest we were wrong in that regard. The reports we received today expose a total shambles in terms of HSE management in the midlands. I have no reason to believe it is not the same elsewhere. There is an array of managers who perform different roles and do not report to each other. Even clinical directors report to different people than those to whom nurse managers report. Has the Minister undertaken any investigation of how management is operating in the HSE? Why has she approved the appointment of six senior managers above grade eight this year?

At the meeting on 28 August in Portlaoise why were there five managers but no doctor? Is the Minister not concerned about this? The initial response of the HSE which was posted on the Department's website seemed to indicate its intention to do something about the management of serious incidents. Clearly, there is no intention to do anything about how management operates in various hospitals.

Will the Minister take responsibility for the HSE, which she established? Clearly, it is a shambles. Does she accept that patients' lives are being put at risk because there is no clear understanding of what is going on? In the case of Portlaoise, why was there no triple assessment and no radiologist with expertise in mammography? Why were women's lives put at risk by the misdiagnoses arising from this?

I will deal with the Deputy's last question first. Ms Ann Doherty, the acting head of the National Hospitals Office, highlights at the start of her report the fragmented nature of the service which is spread across three hospitals. The report should not be confused with that of Dr. Ann O'Doherty who did the clinical review which is also being published today. The Doherty report mentions that although there was supposed to be a policy of providing services in one location in the midlands, the Midland Health Board decided to provide services at three locations. The manner in which services were spread across three sites, contrary to medical advice, made it impossible to obtain the expertise needed. Until recently, over 30 hospitals were dealing with breast cancer. Such services were recently withdrawn from 15 hospitals because it was not safe to have such a large number of hospitals dealing with 2,500 new cases each year. It is not possible to recruit specialist clinical staff, or to put multidisciplinary teams in place, at so many hospitals. It is important that we implement the national control plan which recommends that we concentrate on eight designated cancer care centres. I have huge confidence in Professor Tom Keane who is overseeing the plan.

Serious issues are raised in the reports which I asked for and which have been published today. As I appoint the board of the HSE, it is accountable to me. I have huge confidence in the board which is responsible for the management of the HSE. The Fitzgerald report which I asked the board to produce after the ultrasound issue arose on 21 and 22 November 2007 states "problems arose from systemic weaknesses of governance, management, and communication". I said in my response to the board of the HSE, which I made public this morning, that I wanted it in the first instance to put a protocol in place to deal with these issues and ensure patients came first. The first thing that should happen when incidents of this nature occur is that there should be personal and direct communication with patients. It should not happen through the media or the political system. I want to ensure one person is in charge of ensuring the protocol is implemented. While I do not suggest the person should undertake the reviews in such circumstances, he or she should be responsible for ensuring the protocol is implemented.

I also want the board to be centrally involved in risk assessment. I have asked the chairman to ascertain whether the issues which arose in Portlaoise have wider application across the HSE. In particular, I want permanent personnel to be appointed to management positions which are currently vacant with acting personnel in place.

When will all that happen?

The Minister has not said she will take responsibility for changing the whole HSE system. She spoke about appointing more managers. At the meeting on 28 August last there were five managers with different responsibilities. Does the Minister not accept that the HSE is over-managed and under-staffed with clinicians?

I am not appointing more managers — I am simply asking the HSE to put in place a permanent management structure. The primary, community and continuing care unit and the National Hospitals Office, for example, have acting heads.

They are all actors.

There is an acting head in charge of information technology and an acting head in charge of human resources. In fairness, the HSE has gone to the market a couple of times and I understand an appointment is imminent in one case. It has not been easy to fill some of these positions. Some of those originally appointed to fill certain positions have moved on. The first thing I want to see is a clear management team permanently in position. The second thing I want to see is a clear line of accountability and responsibility. We have learned that nobody was in charge.

There is no one in charge.

A number of people were going to meetings.

There are too many managers.

The new cancer control plan would never have happened under the former health boards.

It might not happen yet.

It would never have happened.

The Minister will not take responsibility for anything.

There is no designated centre in the midlands. I could not imagine one of the old health boards deciding not to designate a centre in its functional area.

That was a designated centre.

Portlaoise was designated.

Cancer was being treated at three locations in the midlands, which was highly unsafe.

The Minister will keep defending the HSE.

Quality care could not be assured. That was one of the problems.

The HSE has been in existence for three years. Is the Minister taking any responsibility?

I certainly am. If somebody is trying to——

The Minister set up the HSE.

Twenty years ago Fine Gael called for the establishment of a semi-State body to deal with the unified health service.

The Minister might as well go back to the foundation of the State.

No organisation is perfect.

The HSE is certainly not perfect.

It is dysfunctional.

Nothing short of a unified system of delivery——

The health boards would have done a better job.

I do not accept that.

Ambulance Service.

James Reilly

Question:

80 Deputy James Reilly asked the Minister for Health and Children if, with regard to the recent decision by ambulance staff to vote for industrial action, she is truly committed to the development and expansion of a national ambulance service or if it is her intention to privatise the paramedic sector; if not, the way she plans to develop the national ambulance service and the Dublin Fire Brigade Service; and if she will make a statement on the matter. [9775/08]

My commitment to the continuing development and expansion of the ambulance service is clear from the extent of investment made in the service in recent years. Funding has been allocated by the HSE as part of the fleet replacement policy for the purchase of 67 new ambulances in 2006, 65 new ambulances in 2007 and 50 new ambulances this year. These figures represent a combination of additional and replacement ambulances. The HSE has embarked on a major recruitment campaign to strengthen staffing in the next three years. It has no plans to privatise the ambulance service. Private ambulance companies have traditionally been used to supplement the service provided by the HSE in the areas of non-emergency patient transport, inter-hospital transfers and some emergency ambulance calls. The work provided by private companies represents less than 4% of the total budget for ambulance services.

I do not consider that industrial action by ambulance staff is warranted. The HSE met SIPTU last May and later established a sub-group with a view to developing a national framework agreement on the role and function of private ambulance companies. I am advised that the HSE and Dublin City Council are discussing the requirements for developing an integrated ambulance service in Dublin. This is the best way to make progress. I look forward to the outcome of the deliberations.

Dublin Fire Brigade which has just 13 ambulances had 12 ambulances 20 years ago when the population of Dublin was at least one third less than it is now. It has gained just one ambulance to cater for approximately 200,000 additional people. Between 200 and 300 emergency calls are backed up at any given time. On 18 January 2007, 60% of Dublin Fire Brigade's ambulances which cover acute 999 emergencies were tied up at various hospitals. Their trolleys were being used in accident and emergency departments and they could not find a spare trolley to get away. When I asked the Minister a parliamentary question about this matter last year, I suggested spare trolleys be kept in portakabins on the grounds of hospitals in order that ambulance crews could continue their work. I said accident and emergency staff could treat patients on the trolleys on which they were brought to the hospital and ambulance staff could take the spare trolleys and go back on the road where they were needed if lives were to be saved. I did not understand the response I was given, which was that it was not safe to move patients off trolleys.

What are the Minister's specific plans for increasing Dublin Fire Brigade's fleet, something that needed to be done before now? We do not need another long plan. The national industrial secretary of SIPTU, Matt Merrigan, has pointed out that the sub-committee of representatives of union and HSE personnel established last year to discuss the introduction of private services had not reached agreement on the matter before the contracts were awarded on 27 December last. Why did that happen? Can the Minister confirm that the contracts awarded to private ambulance service providers will include transport services in emergency cases? Will they be limited to transport services in non-urgent cases? The Minister indicated that private operators might be involved in urgent cases. What action will she take to address the concerns of ambulance workers?

The Deputy referred to Beaumont Hospital the last time I responded to him on Question Time. As he knows, his comments on that occasion were subsequently contradicted by the hospital. We need to be careful when we are putting facts into the public domain through this forum. I mentioned that an additional 50 new ambulances would be purchased this year. That is a considerable commitment.

Will all the ambulances be operated by Dublin Fire Brigade?

No, the figure relates to the country at large. I do not have the breakdown for Dublin and the rest of the country because the Deputy did not request it in his question. I understand private ambulances deal with emergency calls in a small number of instances. As I said, less than 4% of the budget for ambulance services is spent on private services which have a role to play in supplementing the public service in that regard. The percentage of ambulance services provided by the private sector is much larger in many other countries, including the United Kingdom. Emergency services are generally provided by the public ambulance system and that will continue to be the case.

I stand over my statement that on a Sunday morning in May last year, before the general election, a man who collapsed near Rush had to wait 40 minutes for an ambulance. I was told that the delay happened because four ambulances were tied up at Beaumont Hospital. If the Minister cannot answer the question I asked about Dublin Fire Brigade today, will she communicate with me in that regard at some future stage? How many ambulances will be made available to the Dublin Fire Brigade ambulance service which is creaking at the seams in the next few months? Just one additional ambulance has been provided for it in the last 20 years.

I hope the ongoing deliberations between SIPTU which is raising issues in this regard, the HSE and Dublin Fire Brigade will be resolved. That is what I said. I do not have figures for the breakdown of the 50 new ambulances being provided this year but I will make them available to the Deputy when I get them.

Health Service Staff.

Jan O'Sullivan

Question:

81 Deputy Jan O’Sullivan asked the Minister for Health and Children when she will address the shortage of speech and language therapists, occupational therapists, psychiatrists, psychologists and other health professionals that is causing children to have to wait years for assessments and interventions which are crucial to their health, education and social development; and if she will make a statement on the matter. [9456/08]

The Government has invested heavily in the education and training of health care personnel in order to secure a good supply of graduates to provide for the health care needs of the population into the future.

Since the establishment of the Health Service Executive, the number of speech and language therapists has increased by 215 to 712, an increase of 43%, and the number of occupational therapists has increased by 320 to 1,025, representing an increase of 45%. In addition, there are 18 more psychiatrists, excluding consultant psychiatrists with a special interest in adult learning disability, which is an increase of 42%, and a further 184 psychologists, an increase of 36%.

Training places for speech and language therapists have increased by 336% since 1997, from 25 to 109, and training places for occupational therapists have increased by 297% since 1997, from 29 to 115. Training places for clinical psychologists has increased by 396% since 1999, from 23 to 114.

In addition, there has been a steady increase in the number of higher training posts in psychiatry at senior registrar grade over the past ten years. There are currently 97 senior registrar posts approved and funded within the national higher training scheme in psychiatry, of which 28 are child and adolescent psychiatry training posts. In recent years, the Department of Health and Children has made additional funding available via the postgraduate medical and dental board to the Irish psychiatric training committee to assist in the further development of psychiatric training in Ireland.

The Government has made a major investment in these services and in the professionals who provide them. Part 2 of the Disability Act 2005 commenced for children aged under five years with effect from 1 June 2007 and entitles people with disabilities to, among other things, an independent assessment of health and education needs and a statement of the services which it is proposed to provide. The implementation of this legislation has placed additional demands on the services of health professionals.

I am aware there are waiting lists for some services and I expect the HSE to manage this in a proactive way.

Additional information not given on the floor of the House.

The Government has also made it clear that public health and social services must be managed within the funds provided by the Oireachtas and to achieve, at a minimum, the service activity specified in the HSE's annual national service plan.

My Department is working closely with the HSE to ensure effective workforce planning into the future. A joint working group on workforce planning was established in June 2006 and includes representatives of my Department, the Departments of Finance and Education and Science, the HSE and the Higher Education Authority.

Research is being conducted by FÁS, under the auspices of the expert group on future skills needs of the labour market in health care, which aims to identify current and future shortages of health care skills. FÁS is currently undertaking a detailed analysis of 11 professions, including speech and language therapists, psychologists and medical consultants, and this study will be completed during 2008. This builds on earlier work undertaken by FÁS in 2005.

The Government is committed to identifying and enhancing the health-related support services for children and is also committed to building on the significant developments that have taken place in recent years.

I will speak about my own area because I know it best. Is the Minister of State aware that the child and adolescent mental health services in the Limerick area are dealing now with applications from 2005? Anybody coming in since then will be waiting approximately two years. We are speaking about young children who need these tests done so they in turn can get help with various issues involving education and so on.

Is the Minister of State aware there is no occupational therapist at all for those aged over ten years in the school system in Limerick? Is he aware people are waiting up to two years and more for occupational therapy services for young school children? In most cases the people just give up and go private if they can afford it. Even if people can afford private care, I believe it is almost impossible to get a private OT.

Is the Minister of State aware there were 183 unfilled occupational therapy posts, according to an answer given to my colleague, Deputy Roisín Shortall, in January of this year? Will the Minister speak to his colleagues in the Department of Education and Science about the crisis position on getting support for children in schools? People cannot get the necessary tests in the health service for the supports they need in the education service.

I urge the Minister of State to talk to the Minister for Education and Science about this as there may be a way around the problem. It is possible the young people will not have to get all these tests in order to get the supports they need in the education service. It is a crisis which must be responded to. If children lose these early years, they lose the chance to progress.

I take the points made by Deputy Jan O'Sullivan although I do not have the statistics for her own city and county.

I am sure they are similar in other parts of the country.

I will pursue the specific issues raised by the Deputy and come back to her in writing very shortly. On child and adolescent mental health, the Health Service Executive will establish eight child and adolescent mental health teams during this year.

An important lesson learned from the activities of the HSE during the course of 2007 is the fact that there is a need to monitor employment levels and service needs at an area level. That agreement has been made with the HSE at central level and it is also involved at area level with the relevant trade unions. It is very important the service plan which has been published and approved by the Health Service Executive be monitored from the start of this year. The Department and Government have laid particular emphasis on the need to ensure therapy positions are filled.

Over the past number of years, as I outlined in my initial reply, there has been significant investment by the State in human resources and in upskilling people to ensure we have people qualified in these different disciplines. We must ensure those services are provided for the patients who need them and the Department is involved, sharing a working group with the Health Service Executive, as well as frontline professionals in developing an action plan for the short, medium and long term. This will ensure adequate services for these therapies throughout the entire State.

We do not have them. That is the problem.

At present the Department and the Government are determined to ensure we come to the position where services are equal and adequate. Over the years, the Deputy would have made the call, as I would have, from different sides of the House to train more people in different disciplines.

I will allow a brief supplementary.

Is the Minister of State aware that because of the Disability Act and the EPSEN Act, there is now huge pressure on the provision of assessments? The Government cannot just publish legislation and not put in the personnel to deal with the need. Is the Minister of State also aware of how vital it is for a young child to get the necessary supports at an early age, and the negative effect of having to wait two or three years for an examination they needed at a particular time?

I am fully aware of the need for early intervention in instances where children need particular assistance. As Deputy Jan O'Sullivan knows, Part 2 of the Disability Act 2005 will be commenced in respect of children aged five to 18 in tandem with the implementation of the Education for Persons with Special Educational Needs Act, commonly known as EPSEN.

Representatives of the Department of Health and Children and the Department of Education and Science, as well as the Health Service Executive and the National Council for Special Education, meet on a monthly basis to address these particular issues. As the Deputy is aware, the Act in respect of children under five commenced in June 2007.

Mental Health Services.

Dan Neville

Question:

82 Deputy Dan Neville asked the Minister for Health and Children the way she will ensure that the allocation of €25 million in 2006 and €25 million in 2007 for the introduction of the recommendations contained in A Vision for Change is allocated for this purpose in view of the fact that €23 million of the €50 million has been spent in other areas; and if she will reconsider her decision not to allocate additional resources in 2008 to continue the introduction of recommendations bearing in mind that A Vision for Change is explicit that a minimum of an additional €25 million is required annually for a six-year period to allow implementation of the mental health service expansion and improvement objectives outlined in the policy. [9504/08]

Under the Health Act 2004, the HSE 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.

However, I understand from the HSE that some of the mental health services funded in 2006 and 2007 will be put in place in 2008. These include the provision of eight additional consultant child psychiatry teams; the provision of 18 additional beds for children and adolescents at St. Anne's, Galway, St. Vincent's, Fairview, and St. Stephen's Hospital, Cork, to increase the bed complement from the current provision of 12 to 30 during 2008; and the construction of two 20-bed units for children and adolescents in Cork and Galway. Construction on these units is expected to commence in 2008 and be completed in 2009.

A Vision for Change is clear that new funding should follow implementation. The estimated additional cost of the implementation of A Vision for Change is €150 million over a seven to ten-year period. A total of €51.2 million has already been allocated since 2006, which represents over a third of the overall requirement.

There are substantial resources already invested in mental health. In addition to the extra funding required to finance A Vision for Change, existing resources need to be remodelled and reallocated. Implementation of A Vision for Change is dependent to a much greater extent on the remodelling of existing resources than on new additional funding. Additional investment must be phased in parallel with the reorganisation of mental health services and resources. In view of the significant additional investment in 2006 and 2007, it is entirely appropriate to pause and review the issue to ensure consolidation of the investment to date.

In the context of ever-rising demands for health resources, mental health expenditure should be closely monitored to ensure services demonstrate both effectiveness and efficiency. Before any further additional funding is provided, it is essential the HSE is in a position to demonstrate that money allocated for mental health services is efficiently used and that the substantial changes in the organisation and delivery of mental health services envisaged in A Vision for Change are progressed.

The newly established Office for Disability and Mental Health has a remit to drive the implementation of the recommendations of A Vision for Change and I will be meeting the HSE shortly to discuss what measures can be taken with immediate effect to ensure progress in this regard.

That is a most creative piece of presentation to cover up a lack of spending and an abandonment of the recommendations in A Vision for Change. Was the Minister of State consulted over the decision of the HSE to reallocate €23 million from 2006 and 2007 to something other than what the Government and the Minister designated it for? The Minister stated that up to early December, €51 million had been allocated in 2006 and 2007 and A Vision for Change was being implemented. We now discover that €23 million of that was hived off. When did the Minister of State sanction this change? A Vision for Change explicitly recommended non-capital investment of an additional €25 million each year for seven years.

Does the Minister of State agree that the decision to provide no extra funding for 2008 is an abandonment of that recommendation, of the Government's expressed policy of implementing all the recommendations and, in effect, of the mental health service? A Vision for Change explicitly recommended that resources, both capital and revenue, in the mental health service must be retained by it.

In January, the Irish Psychiatric Association identified 17 incidents of asset stripping of our Victorian asylums and lands over the past two years. Will the Minister of State explain why he sanctioned this as it is against expressed Government policy since 1984?

I was not consulted in 2006 and 2007 for the simple reason I was not in this job. A Vision for Change is Government policy. As the Deputy knows, we have set up a monitoring group in the Department to closely monitor implementation of A Vision for Change. The most recent report, an interim report, for which I specifically asked on assuming this office, stated that responsibility for A Vision for Change in the HSE lacked the clarity associated with the recommended national mental health service directorate. I outlined a few more issues, all which are available in the Department. The HSE board approved its implementation plan for A Vision for Change on 14 February last. The plan outlines the key priorities which will be implemented——

Two years later.

I agree with the Deputy that it is too slow. The HSE now has an implementation plan.

It is two years since A Vision for Change was published. In those two years, the Government and the Minister regularly paraded the commitment to, and implementation of, A Vision for Change. We have now been informed the plan was only sanctioned on 14 February of this year. How can we believe anything the Minister of State says if that is the case? In early December, the Minister expressly said that €51 million was spent in 2006 and 2007 on the implementation of that plan. We now find out that €27 million was spent and not €51 million. Will the Minister of State address the issue of asset stripping?

As I said, the HSE board approved the implementation plan in February of this year. It includes that the definition and clarification of catchment areas be made clear; modernisation of the mental health infrastructure; community based mental health teams; child and adolescent mental health teams; mental health services for people with intellectual disability; and mental health information systems.

As I said to Deputy Reilly, the office was set up in January of this year and it will support me in exercising my responsibilities. I will meet Professor Drumm shortly and will look for a more ambitious approach. We will work in partnership with the HSE and other stakeholders to agree the implementation levels over the coming years.

I presume the report to which Deputy Neville referred was the Lie of the Land. It outlined the examples of proceeds of assets which were lost to the psychiatric services over a 20 to 25 year period. A small number of assets were disposed of in the past two years which were identified. I have asked the HSE to explain the report to me.

Top
Share