Adjournment Debate.

Mental Health Services.

Deputy Dan Neville

I thank the Ceann Comhairle for allowing me to raise this issue on the Adjournment. I welcome the Minister of State with responsibility for mental health and disability services, Deputy Moloney, to the House to reply. There is an urgent need to invest in services for child and adolescent psychiatry. It is not acceptable that more than 2,600 children and adolescents are on waiting lists for mental health services, with more than one quarter of those waiting more than one year to access those services. It is accepted that early intervention and treatment are crucial to full recovery from child and adolescent psychiatric difficulties. Children have a right to enjoy the highest possible standard of mental health. They have the right to enjoy a sense of well-being, control over their lives and the ability to realise their potential. Good health comes from having a balance between all aspects of life, social, physical, spiritual and emotional.

To vindicate the right to mental health, children need a supportive environment for themselves and their families, and appropriate support and services when they experience difficulties. However, the reality is that children's right to mental health is not being vindicated. For example, in a shocking violation of their human rights, children continue to be treated in adult inpatient units. They face unacceptably long waiting lists to access services and there is patchy service provision across the State. Official responses fail to meet basic needs and there is a lack of focus on early intervention and promotion that could prevent future problems. With no national directory of services, navigating the system can be a nightmare for children and their families. Insufficient supports are provided for Ireland's most vulnerable young people, namely, those in the care and youth justice systems. The mental health system fails to effectively link with education in the early years — the first point of contact for children outside of the family — which is a crucial missed opportunity.

Children's rights must be respected so that every child is able to reach his or her full potential. This is not a pipe-dream but a vision that should now become reality. The Government must support best practice and move towards the provision of mental health services for children from early childhood up to early adulthood. Today's children are tomorrow's workers, parents, teachers and leaders. We must invest now in their well-being; to do otherwise violates their rights and makes little economic sense.

New consultants appointed to deal with growing waiting lists in child and adolescent mental health services have only one third of the front-line staff required and often have no premises from which to work. Despite having the fourth highest rate of suicide in Europe among 15 to 24 year olds, the latest Health Service Executive figures indicate, as I referred to earlier, that more than 2,600 children and adolescents are on waiting lists for mental health services, with more than one quarter of these waiting more than year. Only 55 of the promised 99 community mental health teams have been delivered. Despite the appointment of additional consultants, a lack of resources means there are significant limits to what can be achieved. Unpublished details from a recent report show that managers of child and adolescent mental health services raised serious concerns about their inability to deliver comprehensive services because of pressure on staff.

The Government's framework for mental health provision, A Vision for Change, identified the deficiencies in existing child and adolescent psychiatry services. For instance, it acknowledges that child community mental health teams and services are well below the norms recommended by the working group on child and adolescent psychiatric services. The document also points to the inequitable variation in the distribution of child services throughout the State and acknowledges that dedicated adolescent mental health services are virtually non-existent on a national basis. A Vision for Change asserts that paediatric liaison services are not available in the majority of major hospitals outside the three national children's hospitals in Dublin. It also accepts that mental health services for autism and autism spectrum disorders are not always accessible and that there are insufficient inpatient and day hospital facilities and no dedicated child and adolescent forensic teams. The Minister must fast-track the provision of these services without delay.

Minister of State at the Department of Health and Children (Deputy John Moloney)

I thank Deputy Neville for raising this important issue. I begin by reaffirming the Government's commitment to providing 100 beds for child and adolescent services during the term of A Vision for Change. The latter is a ten-year programme, launched in 2006, and, as such, it is a work in progress. I propose to outline to the House the progress to date in the area of child and adolescent psychiatric services.

A Vision for Change provides a framework for the development of mental health services and proposes the development of a comprehensive child and adolescent service for children up to the age of 18 years. Traditionally, adult mental health services were responsible for 16 to 17 year olds and admissions to approved centres in that age group were to adult facilities. The Mental Health Commission recently issued an addendum to the code of practice relating to the admission of children under the Mental Health Act 2001 which seeks to ensure that by 1 December 2011, no child under 18 years will be admitted to an adult psychiatric unit. We intend to meet that commitment.

As I said, A Vision for Change will be implemented over a period of seven to ten years and must therefore be viewed as a work in progress. As part of the process of implementation there is a need to expand the child and adolescent service to enable it to cater for 16 and 17 year olds. In this regard, the Health Service Executive has prioritised the development of child and adolescent services and there have been significant improvements in those services in recent years. For example, inpatient capacity has more than doubled since 2008 and we now have 30 dedicated child and adolescent beds- ten in Galway, 12 in Dublin and eight in Cork. I had the great pleasure last year of officially opening the new child and adolescent units at St, Stephen's Hospital, Cork and at St. Vincent's Hospital, Dublin. In addition, two-20 bed units are under construction at Bessboro, Cork and Merlin Park, Galway. It is anticipated that construction will be completed on both of these developments and the beds commissioned in 2010. Further beds will be provided in the context of the Health Service Executive's mental health capital programme. I hope to provide more specific details in this regard on 1 March.

Budget 2010 provided for a multi-annual programme of capital investment in high priority mental health projects consistent with A Vision for Change, to be funded from future disposals. In 2010, the Health Service Executive may proceed to dispose of surplus assets and reinvest an initial sum of €50 million in the mental health capital programme. Provision for continued funding of the programme will be made in the 2011 Estimates and subsequent years, in the light of the previous year's programme of asset sales. However, in providing more child and adolescent beds, I am conscious that we must take care to ensure our services do not become imbalanced in favour of inpatient treatment. The capital programme will therefore also provide for community facilities in terms of day hospitals and outpatient clinics. Only those children with the most severe disorders should be admitted as inpatients and, when admitted, the aim of the service must be to discharge the child back to his or her family and ongoing care in the community at the earliest possible date. The establishment of further multidisciplinary child and adolescent mental health teams is therefore a priority for the Health Service Executive. At present there are 55 teams in place throughout the country and a further eight are in development. The development of additional community-based services coupled with the provision of additional inpatient capacity represent significant progress in the provision of mental health services for children and adolescents.

The Health Service Executive launched the first annual report on child and adolescent mental health services last October. This report provides a comprehensive picture of the stage of development of Child and Adolescent Mental Health Services as well as providing important information on the young people presenting with mental health issues and how the nature of their condition changes with age. As this is the first report of its kind, many of the measures in the report do not have historic comparators and therefore it is too early to draw trends. However, the executive now has comprehensive information from which to monitor the mental health of children and adolescents, and this will inform the development of services that respond to their needs. The data will also enable the HSE to determine what is being delivered for existing resources, review resource distribution and, importantly, to develop minimum datasets, key performance indicators, standards and care pathways. Information is now to hand which indicates how the needs of children change as they mature and this will help to inform policy and service planning for the years ahead.

I thank Deputy Neville for raising this matter. I reaffirm the commitment that the target number of child and adolescent beds specified in A Vision for Change is 100. I hope we can deliver on that within the timeframe involved.

Departmental Staff.

Deputy John Browne

Through the Acting Chairman I thank the Ceann Comhairle for allowing me the opportunity to raise this issue.

The busiest social welfare local office in the country is in Cork and the second busiest is in Anne Street, Wexford. There is a major difference in the two offices. The social welfare local office in Cork has twice the number of staff as the social welfare local office in Wexford. Approximately 21,000 claims are being processed in the social welfare offices in Wexford which leads to its own problems in trying to get decisions. While the office has an excellent staff and at present may not be answering TDs queries, I have always found the staff in the social welfare offices throughout County Wexford to be very helpful and supportive and going beyond the call of duty to ensure people's entitlements were dealt with as efficiently and as quickly as possible.

Like many other counties, Wexford was very much dependent on the building industry which is in a state of collapse. As a result a huge number of applications for jobseekers' allowance has been made to the Department of Social and Family Affairs in Wexford town by PAYE workers and small building contractors, electricians and all those who were self-employed in the building industry. Many are waiting months on end for assessments and decisions which is causing severe hardship to individuals and families.

I ask the Minister to explain the reason for the low level of staff in the Wexford office dealing with practically the same number of applications as the Cork office. The Minister must act to ensure the Wexford office gets adequate staff to ensure all the applicants for social welfare benefits are dealt with efficiently and as quickly as possible and get a decision within a reasonable timeframe.

To make matters worse, there are six contract workers in the Department of Social and Family Affairs in Wexford. In recent weeks they have been given notice which will expire within a couple of weeks. This is a crazy decision, obviously taken by some bureaucrat in the Department's Dublin office. Some of these staff have worked there for two years. They are experienced in how social welfare claims are dealt with. They are au fait with how to deal with applicants as quickly as possible. I ask the Minister to ensure these contract workers remain in place until such time as the embargo is lifted and we can get permanent staff in Wexford. I appreciate an embargo is in place. I appreciate also that the Minister for Social and Family Affairs will find it difficult to get agreement from the Minister for Finance to get extra staff. Surely in the present climate given that 1,000 people in Wexford town and approximately 3,000 across County Wexford are awaiting decisions on social welfare claims, the Minister must ensure there is adequate staff to deal with claims.

I welcome the Minister of State, Deputy John Moloney, who is very efficient in his own field and does a wonderful job. However, the Minister for Social and Family Affairs must explain to me and the people of Wexford the reason for inadequate staff in the social welfare local office in Wexford town and, more important, the reason she is threatening to withdraw the contract staff who do such a wonderful job in the Wexford office to supplement the permanent staff. I ask the Minister of State, Deputy John Moloney, to convey to the Minister, Deputy Mary Hanafin, my request that these contract workers remain in place and that the people of Wexford who have suffered enough through making applications for social welfare be dealt with with dignity and within a reasonable timeframe to ensure their claims come through.

Deputy John Moloney

I apologise to the Deputy that the Minister for Social and Family Affairs, Deputy Mary Hanafin, cannot be here to respond to the Adjournment debate.

I wish to explain on her behalf that no staff of the Department of Social and Family Affairs are being made redundant, either in Wexford town or any other location. From time to time, the Department recruits temporary staff for a variety of reasons. Temporary staff are primarily recruited to cover temporary absences of permanent staff arising from maternity or adoptive leave or long-term illnesses. On occasions temporary staff are used to cover permanent vacancies when there is likely to be a significant delay in getting permanent replacement staff. There are two types of contract offered to temporary staff, that is, contracts for a defined purpose and contracts for a defined period. These types of contract are used to ensure transparency of circumstances giving rise to the need to employ temporary staff. It is not possible for the Department to offer contracts of indefinite duration as this would lead to the accrual of unintended employment rights. Additionally, it is not possible or permitted for the Department to recruit temporary staff directly into permanent positions.

In 2008, two temporary clerical staff were recruited on a defined purpose contract to serve in the social welfare local office in Wexford to cover the absence of two permanent members of staff. One of the two was recruited initially on a three-month defined period contract. That person was then retained on a defined purpose contract to cover for that absence. Subsequently, both staff absences became permanent vacancies.

Permanent staff, through redeployment from other Government Departments, have now been sourced for the two permanent vacancies and both persons on temporary contract have been given two weeks' notice to expire on 26 February 2010, following an overlap period to allow for the training of the new staff.

In order to deal effectively with the increasing workload the Department of Social and Family Affairs has tackled the issues in a number of ways. Additional staff have been assigned to the offices including investigative staff, centralised decision making sections have been set up in a number of areas and a number of process improvement initiatives have been introduced.

Social and Affordable Housing.

Deputy Seán Sherlock

I raise this issue because a meeting of the northern committee of Cork County Council took place yesterday at which a decision was announced to dispose of up to 106 affordable units, under the auspices of Cork County Council, 51 of which are to be disposed of through local auctioneers and the remaining 55 through the social leasing schemes announced by the Minister of State at the Department of the Environment, Heritage and Local Government, Deputy Michael Finneran, some time ago.

I am concerned that these houses will not sell on the open market. There is not a snowball's chance in hell that they will sell on the open market. There is an over supply of affordable houses within local authorities and, particularly, within the northern division of Cork County Council. I am sceptical about any attempts by Cork County Council to use the social leasing scheme because that will come under the ambit of the housing associations. Anybody who takes up residence in any of those 55 houses which come under the social leasing scheme will never have an opportunity to purchase those houses. Any person who may be on an affordable housing list and who may be eligible for financing will not consider going down that road if it means that for the duration of that lease he or she cannot own the house. I am also of the view that the 51 houses it is proposed to sell on the open market will not be sold.

I propose that there must be a greater degree of flexibility on the part of the Minister when dealing with local authorities in respect of housing issues. If the 106 houses to which I refer were advertised as rent-to-buy type lettings, they could then be occupied, which is extremely important. After two or three years, the occupants could then decide whether they wished to purchase those houses.

In one estate in the Mitchelstown area there are 20 houses, ten of which will be disposed of through the social leasing scheme while the other ten will be disposed of through the affordable housing scheme. For every day these houses remain unoccupied, problems arise in the estate to which I refer. If its is left to auctioneers to try to sell these houses in a market in which no one is buying, I contend that they will remain unoccupied for some time.

I put it to the Minister of State that a degree more flexibility and lateral thinking would provide people who are living in the area with the opportunity to rent those houses. They could do so through the social housing schemes or through a rent-to-buy scheme, under which they could eventually decide to buy if the opportunity arose. This would constitute a more common-sense and practical approach to dealing with the issue of unoccupied houses in certain estates.

Deputy John Moloney

I am taking this matter on behalf of the Minister of State at the Department of the Environment, Heritage and Local Government, Deputy Finneran. I thank Deputy Sherlock for raising this important issue and I welcome, in particular, support for the temporary use of unsold affordable units to accommodate households in need of social housing.

In the first instance, it should be recognised that there will always be a certain level of stock of unsold affordable units on hands at any given time, whatever the prevailing housing market conditions. The slowdown in sales of affordable housing has moved in step with the process of correction in the wider housing market. Prices of affordable homes provided by local authorities under the various affordable housing schemes, including Part V, were typically priced at around 25% to 30% lower than market prices. As market prices fell — in some areas they fell rapidly — this differential has been eroded or cancelled completely. This, coupled with the very strong surge in delivery of affordable units in 2008, particularly under Part V, resulted in a significant increase in the stock of affordable housing units for sale by local authorities.

Early in 2009, it was estimated that approximately 3,700 units were available for purchase. However, by that time the Department of the Environment, Heritage and Local Government had already begun working with local authorities and the affordable homes partnership to ensure that effective measures were in place. Last April, the Minister issued comprehensive guidance to local authorities which provided them with a wide range of options to ensure that unsold units would be brought into effective and early use.

While the priority was still to sell affordable homes to eligible purchasers, in circumstances where this proved to be impractical in current market conditions, housing authorities were asked to undertake a comprehensive evaluation of the options for dealing with these properties, including their deployment for social housing purposes where appropriate and having regard to the principles of sustainable communities. Specific options put at the disposal of authorities in this regard include the sale of units under the incremental purchase scheme, use of the units to provide social housing supports for an initial period of five years or, in exceptional circumstances, the transfer of unsold affordable units into permanent social housing stock.

Since that guidance was issued, considerable progress has been made on both sales of affordable homes with, despite the difficult economic and banking climate, over 1,300 affordable homes sold in the first nine months of 2009, and the deployment of a further 1,300 unsold affordable homes for other purposes, including temporary use under the social leasing or rental accommodation schemes. As a result, the number of units on hands has now come down to just over 1,000. This excludes those which are in the process of being sold or which have been earmarked for use for other housing purposes. Local authorities with remaining stock on hands — including Cork County Council with a total of 135 units remaining unsold — are actively considering the options available to them to bring these units into use as soon as possible. The Department of the Environment, Heritage and Local Government is also considering the feasibility of introducing a rent-to-buy scheme in a small number of local authority areas.

The comprehensive range of options introduced last year has achieved considerable success. The immediate focus for affordable housing is on carrying forward those measures to ensure the most effective deployment of the remaining unsold stock. This will continue to be informed by the need to match existing vacant stock with the needs of those requiring housing supports, whether affordable or social.

School Staffing.

Deputy Brian Hayes

It is a disgrace that the Minister for Education and Science is not in the House to take this important matter, which has been raised by three of the four Members representing Dublin South-West. This matter came to the attention of the House both last week and the previous week. We are dealing with it in a serious way but the Minister for Education and Science is not present. That speaks volumes.

The loss of ten teaching posts and between eight to 12 SNAs from St. Joseph's Special School in Balrothery, Tallaght, will make it impossible for the school community to exist. What has been put forward by the National Council for Special Education is nothing short of a butchering exercise on the part of a quango that has been asked to do the dirty work of the Minister for Education and Science.

Many believe that the current review of SNA provision nationally is nothing more than an exercise in cutting back support to the most vulnerable children in our education system. Specifically in the case of St. Joseph's, I am asking the Minister for Education and Science to hold off on the impending removal of four SNAs from the school on Friday next, 19 February. I am also asking him to hold off on the removal of a further four SNAs by 12 April. I request that he and the NCSE work out a solution to this issue.

The Minister for Education and Science has the power to stop this madness. I ask him to visit the school in order that he might see, at first hand, the work of the school community. I also want him to see the profound educational disabilities that affect many children in this school. In such a school environment, teaching and care resources can make all the difference. The Minister's decision to effectively demolish the resources of this school make a mockery of the alleged commitment that is afforded children under the Education for People with Special Educational Needs Act. This is an Act of the Oireachtas that is now frozen in time.

Taken together the impeding loss of SNAs with the possible reduction of ten teaching posts from the school represents an outrageous loss of essential teaching resources. It is implied that many of the children in this school could function perfectly well in mainstream school settings. This is patently untrue and is nothing short of nonsense. The NCSE has made it clear to the school authorities what exactly it requires in respect of documentation. The Minister should now order new psychological assessments if he considers that the information supplied is incomplete. The arguments surrounding documentation supplied to the NCSE constitute nothing more than a red herring. I and my colleagues demand a stay of execution. I reiterate that it is a disgrace that the Minister is not present to take this matter.

Deputy Pat Rabbitte

I understand that, in the current climate, it is necessary to make both savings and cuts. However, it is indefensible to suggest that those savings and cuts should be made on the backs of the most vulnerable in society. I intend no disrespect to the Minister of State, Deputy Moloney, when I agree with the assertion on the part of Deputy Brian Hayes that the Minister for Education and Science should be present.

I sincerely hope the Minister of State will not read out a script supplied by the Department of Education and Science which mirrors the contents of a letter I received earlier today from the Minister for Education and Science. The relevant sentence in that letter reads, "There is absolutely no question of SNA posts being removed from schools where they continue to meet the scheme's criteria". It is the latter phrase which undermines any value the letter might have. The NCSE is going to find that St. Joseph's does not meet the scheme's criteria. As the principal in the school has made plain, it is not possible to measure mild learning disability merely by ticking one box. There are many factors that constitute learning disability in these circumstances.

This school has an outstanding record. The parents fought over the years to make it the type of school it is today. It is unthinkable that the Minister should intervene in the middle of the school year and impose cuts like this. I join with Deputy Brian Hayes in pleading with the Minister to defer consideration of these cuts until there is an opportunity to sit down with the Minister, because it is the Minister and not some quango who has the power — by making one telephone call — to stop this from happening to St. Joseph's Special School at Balrothery in Tallaght.

Deputy Charlie O’Connor

I welcome this opportunity to join my colleagues in raising this Adjournment debate matter. I thank the Ceann Comhairle for his courtesy in the matter and the Minister of State, Deputy John Moloney, will not be offended when I state that I too am disappointed and upset that the Minister was not able to be here. The matter I put before the Ceann Comhairle sums up my views on this issue — I call on the Minister to postpone and review the decision of the special educational needs organisers of the National Council for Special Education on the teaching posts and special needs assistant allocations at St. Joseph's Special School at Balrothery in Tallaght, which is in my constituency.

I will not repeat what my colleagues have stated. We have all been to the school and we have known it for a long time. The Gallery is packed, which is very unusual at this time of night. Teachers, parents and pupils are particularly concerned about this difficult situation. It is very important to emphasise the point that has been just made. I cannot get my head around why anybody, and certainly a professional body, would take a decision to cut staff numbers — if that is what is proposed — in the middle of a school term. I cannot get my head around it but perhaps more experienced colleagues might be able to do so.

One of the points made to us all by the principal on behalf of the school community was that they remain willing to review their mission, to look at the education needs of the area and to respond in a co-operative manner and that it would be much less difficult to achieve this if the threat of drastic staff reductions were removed. Irrespective of what the script of the Minister of State says, that is the message we want to get to the Minister, Deputy Batt O'Keeffe. These decisions should be parked and reviewed and I ask the Minister to carry out that investigation and to respond to us in a positive way.

Deputy John Moloney

I apologise for the fact that the Minister cannot be here this evening and I will read the response on his behalf. I thank the Deputies for raising this issue as it gives me an opportunity to clarify the position on some of the matters raised.

The Deputies will be aware that the Department requested the National Council for Special Education, NCSE, to review all special needs assistant, SNA, posts because it had become clear that a number of SNA posts were in schools where the care needs of the pupils in the schools concerned did not justify such an allocation.

The NCSE, through its network of special educational needs organisers, SENOs, is at present carrying out a review of SNA allocations in all schools with a view to ensuring that the criteria as outlined in the Department's Circular 07/02 governing the allocation of such posts are properly met. SENOs are communicating the outcome of the review directly to schools as the review progresses. The allocation for any school and any adjustments to that allocation depend on a number of factors such as the number of pupils with care or medical needs leaving, the number of new pupils with such needs and the changing needs of the pupils. It is expected that the NCSE will have completed the review by the end of March.

St Joseph's Special School is a designated school for children with mild general learning disability. I understand that the school has 89 pupils enrolled and a total staff of 20 teachers and 17 SNAs. The NCSE commenced a review of the SNA allocation in St. Joseph's in October 2009 and the results of the review were confirmed to the school on 8 February 2010. The NCSE has advised the school that it is to reduce the number of SNAs by four and that this should be achieved by 19 February. The NCSE has also advised the school that it will not alter the level of teaching staff in the school for the remainder of the current school year.

The NCSE is committed to engaging with the school authorities and all other relevant State agencies to manage the situation in the short term and to ensure a sound basis for staff levels in the interest of pupils. I understand the NCSE intends to meet with the school authorities shortly in this regard. The Department has already indicated to the NCSE that it is prepared to attend a meeting with the school if this is considered helpful. I understand also that the NCSE is arranging to meet with parents individually in consultation with the school authorities.

I want to emphasise what is really important here. The terms and criteria for the SNA scheme have not changed. Where the criteria justify, additional posts are being allocated. However, where the criteria are not met, there may be a reduction in an SNA allocation. There is no question of posts being removed from schools where they meet the scheme's criteria. However, there is also no question of posts being left in schools indefinitely where they are deemed to be surplus to the care needs of the pupils.

The Deputies are fully aware that the Department has prioritised the provision of special education supports to schools. This is a key Government policy. However, this does not mean that resources allocated in response to various historical factors are retained in schools ad infinitum. At a time of constrained resources it is essential that we ensure that public resources are deployed as effectively as possible. Resources left in an area that are not in accordance with criteria mean public resources are not available for another deserving area.

I am sure that the Deputies share the Minister's concern to ensure there is a consistent application of policy on the allocation of special needs supports throughout the country and this is all that is happening at present. The Department can assure the Deputies that supports will continue to be made available to schools which have enrolled pupils who qualify for such support, and children with special educational needs will continue to have access to an appropriate education in line with the Department's policy. Schools will continue to be allocated additional teaching and SNA support in line with current policies. These policies have not changed.

With regard to the role of special schools, the National Council for Special Education expects to be in a position shortly to provide to the Department a copy of the research it has commissioned concerning the role of special schools and special classes. Ultimately, it is expected that advice received from the NCSE will assist the Department with policy formulation on the role of special schools and special classes. The Department is anxious that the skills and expertise these schools have accumulated in supporting children with special educational needs is utilised to best advantage in providing for such children. The Department looks forward to receiving the report from the NCSE.

On behalf of the Minister, I thank the Deputies once again for raising this matter.

The Dáil adjourned at 9.10 p.m. until 10.30 a.m. on Wednesday, 17 February 2010.

Dáil Éireann debate - Tuesday, 16 Feb 2010