Topical Issue Debate

Child and Adolescent Mental Health Services Provision

I wish to bring an important issue about children's psychology services in Limerick to the attention of the Minister of State, Deputy Finian McGrath, and the Minister for Health, Deputy Harris, and I ask them to take immediate action. I am very disappointed that the Minister is not here to answer for his decisions but I know that the Minister of State will relay my concerns.

Limerick early intervention service and school-age teams have written to parents in the region to say that only urgent cases for those children who attend the school-age children's services aged six to 18 years in Blackberry Park can now be dealt with due to the lack of psychology staff and resources and all other children are to be put on waiting lists. This is completely unacceptable. These services are vital for children. Everyone knows that early intervention is key to addressing many problems. I have been in contact with the service in Limerick and this is the very last thing that it wanted to do. It is completely overwhelmed and understaffed and receiving no help. In this letter, urgent cases are defined as children who are self-harming or have suicidal ideas, children who are hurting others and children whose school placement is at risk of breaking. This should not be the standard at which we provide these critical services. It is completely unacceptable that children, other than those in these extreme cases, are expected to go on waiting lists.

I brought this matter to the Minister's attention in February when I raised concerns about the waiting lists and lack of staff in the service in Limerick. At that stage the figures showed lengthy waiting times for children. I had hoped that by bringing it to the Minister's attention action taken. It is clear, however, that nothing has been done.

This problem has escalated severely since then. The lack of staff and resources in this service in Limerick is astonishing. I have been in contact with the senior clinical psychologist in the school age service, Dr. Moore, who has worked in the service for nine years. She said that when she started the caseload was 120 children but that it is now 410. Despite this, there is just one full-time and one part-time senior grade clinical psychologist to deal with the massive workload. Staffing has not increased despite the trebling of the caseload. How is this allowed to happen? How is this continuing?

The Government is currently deciding how much money it can put away in the rainy day fund. How can the Minister of State tell me that hundreds of millions of euro are better used by being left sitting in a bank account than by giving a tiny fraction to this incredibly important service for children? What does the Minister of State have to say about this and what actions will he take?

I thank Deputy Maurice Quinlivan for raising this very important issue and highlighting this need. I am pleased to confirm that a Programme for a Partnership Government commits this Government to improving services and increasing supports for people with disabilities, particularly early assessment and intervention for children with special needs.

The programme for Government supports the Blackberry early intervention service in Limerick in providing a service to 410 children with very complex needs. A high proportion of the children on the caseload require urgent intervention. Following a recent review of the psychology service, all parents were informed of the need to prioritise the waiting list based on need and that a psychology intervention waiting list was being created. There are now two waiting lists for psychology intervention services - an urgent list and a standard list. Urgent cases will be prioritised for intervention and these include: children who are self-harming, to whom the Deputy referred, or who have suicidal ideas; children who are hurting others; and children whose school placement is at risk of breaking down. All other referrals will be placed on the standard psychology waiting list in order of date of referral to the service. The letter the Deputy refers to did not state that only extreme urgent cases can be dealt with. Children already involved with the psychology service will continue to receive their intervention as planned.

The HSE will continue to support Blackberry early intervention teams to deliver services in line with the service agreements. I support the Deputy's genuine concern. It is recognised that early intervention services and services for school aged children with disabilities need to be improved and organised more effectively. This process has started and is well under way. The HSE is currently engaged in a reconfiguration of existing therapy resources to geographically based teams for children aged from zero to 18 years. The objective of the new model of assessment and intervention is to provide one clear referral pathway for all children under 18 years, irrespective of their disability, where they live or the school they attend. In addition, funding of €5 million was provided in 2016 for the development of psychology services in primary care with a focus on enhanced counselling interventions for children and adolescents. The recruitment process for 114 assistant psychology posts and 20 staff grade psychologists is ongoing.

I thank the Minister of State for his response. To be honest I am disappointed. The Minister of State said that I said that only extreme urgent cases would be dealt with. He is probably right there, but the letter basically said that the waiting list for psychological intervention is likely to be extensive and it urged parents to seek support from other local agencies. Parents read that to mean that they were to find support themselves and get whatever other resources or funding they could find out about. Parents in Limerick are extremely concerned about this development. The services are critical for some children. When I raised this issue back in February the waiting list for school age services was huge. At that stage the number of children on waiting lists for school age assessment and intervention stood at 632. Some 577 children were on the school age waiting list for intervention alone, with 245 of these waiting for more than eight months for intervention. These are truly shocking figures.

The Education for Persons with Special Educational Needs Act 2004 states that every child with special needs is entitled to an education and the notion of inclusion is promoted in that Act. Inclusion, however, is not a reality on the ground as the supports are simply not there to allow for it. The solution is very straightforward. Limerick early intervention services and school age teams need more staff, more funding and more resources immediately. I urge the Minister of State to look into the case I have highlighted, to make contact with the HSE and to ensure the service is provided with what it needs to deliver its services for children in Limerick. I take this opportunity to commend the staff in the Limerick early intervention services and school age teams for working so hard for so many children with the few resources it has. The solution is straightforward and the benefits for these children and their families will be massive.

I thank Deputy Quinlivan for his question. I agree with him about commending the staff. They do an excellent job. I was in Limerick recently and I saw at first hand the fantastic work that is done with young adults with intellectual disabilities in respect of third level education and inclusive education. This is very much in line with the UN Convention on the Rights of Persons with Disabilities. I know Limerick is leading on that particular issue. The Deputy's concerns are genuine. We need immediate action. I will relay the Deputy's concerns to the Minister. I agree with him that services are critical. The shortage of psychologists is an issue. That is something we are dealing with in other counties as well. However, the process of recruiting 114 assistant psychologists and 20 staff grade psychologists is ongoing. That should improve the situation.

On the waiting lists, I have no difficulty in saying that the Limerick early intervention service is doing an excellent job. The fact that it is dealing with 410 children and that it has these long waiting lists is something we have to deal with. I also recognise that the first class early intervention services and the services for school age children with disabilities are paramount. There are challenges, however. I accept that. It is expected that the transition of services into multidisciplinary geographically based teams will improve waiting times for children accessing early intervention services. The HSE and partner agencies will remain fully committed to the delivery of needs-based services to children with complex needs within the mid-west disability services, based on evidence-based practice.

On a personal level, over the coming weeks we in the Department of Health will be having talks with the HSE in respect of the Estimates. I have put early intervention services in my top five priorities. I also have to deal with crises in emergency residential services for older adults with intellectual disabilities, but the issues the Deputy raised today are on my priority list. Many colleagues concur with the Deputy. There is great support for the issue in the House. They see the problem. We need to do it, but we also have staffing issues. We have shortages of people and recruitment issues. We are really working hard in going abroad and trying to attract many of our psychologists and speech and language therapists whom we lost over recent years back to Ireland. The Deputy can take it that I will relay his concerns and push that agenda.

Schools Building Projects Status

The town of Maynooth has experienced rapid growth in the past 20 years or more as a primary commuter town in north Kildare. The school-going population at secondary level has multiplied in that time so that the demand now extends to 2,000 secondary school places. In this context an application was made for an extension of the then secondary school, Maynooth post-primary school, in 2009. Unfortunately, at that point a very sorry saga began to unfold. After that application for an extension was made, it was decided that, rather than extending the building, a new school was to be built and that another new school was to commence enrolling in the town. Maynooth community college was announced in 2012 and commenced enrolment in 2014. The decision to proceed with these two schools as two new school buildings on the Moyglare Road in Maynooth was made and the process began. Unfortunately, even after those decisions were made the process was fraught with delay. After painstakingly getting from 2012, when the decision was made to open Maynooth community college, to 2014, when it began enrolment, and on to 2016, when the tender finally issued, a problem then arose with the tender. Indeed, one of the first meetings I attended after being elected to this House was a meeting with the Minister and the parents and staff of the schools on Maynooth education campus to discuss the issue of that tender. That tender was sent back to the drawing board to be revised and a new tender was drawn up and awarded to Sammon Construction in 2017. I was happy to join the Minister, other Oireachtas Members, Councillor Naoise Ó Cearúil, the local parent groups and school staff at the turning of the sod in 2017.

It appeared at last that things were moving on again for the Maynooth education campus. Disaster struck last month when the Sammon Group announced it was going into liquidation. Our sympathies are with the 200 workers from that group, many of whom are local to Kildare and Meath, and the company as a whole. The company had been in examinership for some months. Work on the site has ground to a halt. The school is half built and is at a standstill. It is in limbo, as is the entire school community. We understand that tendering must occur again. The school that was initially due to open in the new buildings in 2016 is now to open in 2020. It is no less than an unmitigated disaster for parents, students, staff and the entire Maynooth community.

It is worth noting the conditions in the existing buildings. The two schools, which are currently located in 18 buildings, towards the bottom of Moyglare Road, are at breaking point. They lack the physical capacity to take any more students. There is a one-way system in operation in the current school. Children must walk one way around in order to avoid bumping into one another. Including in poor weather, children have to go outside their building to move from one place to another. Transition year students are already being educated in the shopping centre at Manor Mills, which is separate from the school site.

Management and students have done their very best but can do no more. Even allowing for the delays, and had the tender re-awarded in 2017 progressed, it was hoped to be in the new premises by Christmas 2018. Now they face a best-case scenario of September 2020.

I pay tribute to the school principals, Siobhán McCauley and Johnny Nevin, for all the efforts they have made, along with the parent-teacher association and school community, to manage the situation to this point. They now need some clarity and direction, however. This is the third tender issued for the schools. One can say there is no point crying over spilt milk but it beggars belief that, considering the company was in examinership and with a liquidation quite likely, no contingency plan appears to have been put in place. What would happen if the very predictable outcome, liquidation, actually occurred? I fail to understand how that was not spotted by the Department or patrons. What are the next steps? How quickly can the school be delivered? Can the process be expedited given the delays that have beleaguered this project for almost ten years at this stage? What are the best and worst timescales? I seek answers to give the school community some comfort and clarity regarding the road ahead for the buildings that are so urgently needed.

I thank Deputy Lawless for raising this issue. Clearly, this is a very disappointing state of affairs. Nobody could have anticipated the Sammon Group going into liquidation but that is the situation in which we find ourselves. We have taken immediate steps to get this project back on track. Unfortunately, however, the implications of a change of contract are serious. I do not want to understate the amount of work that has to be done in this regard. The Deputy will understand that no builder would take over the project without the correct and detailed specifications and the schedule of works and drawings, and without certainty as to what is to be carried out. The State has to have such certainty in regard to what it is tendering. Therefore, a substantial amount of work has to be done. I have briefly summarised it in the statement that has been circulated. Surveys have to be completed and works need to be undertaken. This leads to an identification of the works remaining to be carried out by a new contractor. This is detailed work. This work is followed by revised drawings, together with updated work schedules. Tender documents based on the revised work schedules and drawings are prepared. The works are tendered to the market for a new contractor.

I would love to be able to tell the Deputy that this is simple and fast work. It has to be done painstakingly and accurately. My officials have met the Kildare and Wicklow Education and Training Board and its design team. We have a good team in place. It is working hard to limit the time it will take to deliver this project. A critical path has been worked out, with very tight timelines for the various elements.

In order to speed things up, we have agreed that a pre-qualification process for new contractors can be engaged in while the survey work is being done. Therefore, there will not be a hold-up in that regard. A tender notice has been published on the e-tenders website seeking expressions of interest from contractors wishing to be considered for the completion of the project.

Another notable development is that the design team has made arrangements to have the precast work in the main structure and the steelwork on the roofs completed, and this is expected to be done by August. This arrangement will mean the superstructure will be completed and certified and a neat site can be handed over to a new contractor. We believe that will help to accelerate the delivery of the project.

In the meantime, the identification of all other outstanding works to complete both schools is ongoing to make ready for the tendering among the pre-qualified contractors in due course. The current works programme indicates a re-tendering of the project to pre-qualified contractors towards the end of this year with a view to having a contractor back on site by the end of March 2019.

My Department has been closely liaising with Kildare and Wicklow Education and Training Board to develop matters and it will continue to liaise with the board until the project satisfactorily reaches completion. Officials are also working with the board to ensure the needs of the two schools in their existing accommodation are met until their new accommodation is available.

I acknowledge this is a disappointment to people. Maynooth is an area I know very well. As Deputy Lawless said, I was present when the site was opened and noted the optimism that accompanied the opening. It is disappointing that we had a setback but I am confident that the team we have in place will get this major project back on track. It is the largest project of this kind ever undertaken by the State, with 2,000 pupil places. We will endeavour to get it back on track as quickly as possible.

Based on figures I sourced locally, we are still facing a two-year delay. I thank the Minister for his reply but he does not appear to have given a date or detailed timeline for the new build. It may be a case of "once bitten, twice shy" but we need some clarity and assurances on the new timeframe to allow the parents, school community and school management to begin to plan and make the necessary arrangements. What supports will be given by the Department to the schools to manage the accommodation for the next 18 months, two years or three years? What is the timeline? As I said, this is already a crisis.

Given that this is the largest schools building project in the history of the State, how hands-on has the Department been? How hands-on does it intend to be? Have lessons been learned? How is it possible that a company entering examinership in the midst of such a large, critical State project did not trigger contingency planning immediately? In the private sector, one would imagine it would happen immediately. I fail to understand how it was possible.

I asked what supports will be provided. More than anything, we need assurance given to the school community, town, students and parents that this will be taken in hand, that the Minister will be hands-on in managing it, and that the Department will take it under its remit to ensure there are no further delays. After ten years, and three tenders - third time lucky - we cannot afford to slip again. Will the Minister commit to meeting interested parties, as needed, to give those assurances and to involve himself personally in this project as it proceeds to completion, as I hope it will? Those assurances, after ten years of delay and disarray, are badly needed and extremely important for the town of Maynooth.

The Deputy must bear in mind that an examinership is a court process designed to help the company to recover. It is not a liquidation whereby everyone goes in and seizes sites. Under the examinership, work continued on the Maynooth site. It was the one site that the examiner sought to continue to progress as other efforts were made to deliver the project. Clearly, the best outcome would have been that the examinership would have succeeded and that the contractor would have been able to complete the work. That was clearly the alternative. What we now have to do, as I outlined in my few comments, is some very detailed work to certify exactly what has been completed and what remains to be done. That involves detailed survey work, detailed specifications, detailed design and detailed drawings, which we simply could not have done during an ongoing examinership.

We took steps to ensure that the State’s interests were protected throughout the period. Given the failure of the examinership, we are working to secure the best outcome.

As I indicated earlier, the contractor will go on site in March 2019 and the scheduled completion date is June 2020. It is the intention that this will be adhered to. That will take the co-operation of everyone involved.

We will seek to accommodate the schools in any way we can, whether it is through temporary accommodation or other assistance which may be necessary. This is an important project. I assure the Deputy that I will take a close personal interest in it. I have arranged that my Department will keep me updated of the critical path which has been set out in order that, if there is any slippage, we can consider other steps to address it. I am confident in the team put in place. I hope we can deliver. I fully understand the Deputy’s concerns, which are shared by the Acting Chairman.

Enterprise Support Services Expenditure

Meath is a great county. It is well located and has good land. Its people are well educated, industrious, creative and conscientious. While it is a given that every Member will regularly come into this Chamber and claim that his or her county needs further funding, this is not a typical Member's whinge.

Meath is unique in that it is an outlier when it comes to State funding and investment. There are 28 local authorities in the State. In the context of practically every single investment criteria, Meath is last on the list. Louth, Kildare and Wicklow are comparable to Meath in terms of both distance from Dublin and population size. In 2017, there were 1,419 IDA Ireland jobs in Meath. In Kildare, there were 9,282. That is six times the number of IDA Ireland jobs in Meath. Louth and Wicklow have significantly smaller populations than Meath, but they had 3,702 and 2,264 IDA jobs respectively. Westmeath, with one third of the population of County Meath, also has double the number of IDA Ireland jobs.

Meath has the highest number of commuters in the country. This morning, more Meath people left the county in order to get to work than actually work in the county. Navan is the largest town in the country without a rail line. If we are going to assign to Meath the status of commuter county, the Government should at least put in the infrastructure to allow that to happen. Bus Éireann services in the county over the past six months have been a joke. No other county sees its bus services fail continually to show up and leave commuters stranded for hours. This creates a radical difficulty with hundreds of hours wasted on commuting. It also costs Meath people significantly when they have to commute outside of the county.

Meath has the lowest business rates base per capita in the country. If one adds that to the crap local government investment we get from the Government, it means we have the lowest expenditure per local authority per capita in the State. Meath’s spend in this area is 61% of the national average. Expenditure on housing and building by Meath’s local authority is 45% of the national average. Spending on recreational amenities is 43% of the national average. Spending on water services in Meath is 60% of the national average. County Meath has the lowest number of gardaí deployed in the State. Whole swathes of Meath would have no more than a handful of gardaí on duty at any one time. Meath is the only county without a divisional headquarters. True to form, Louth and Meath are at the bottom nationally for funding for mental health services. Meath has the lowest local authority expenditure and the lowest number of county council staff per capita. That has a radical effect on the level of service delivery in Meath.

Why is it that such inequalities exist an hour from Dublin? Logically, there should be some level of equality with regard to the delivery of funding. When will the Government change that?

One of the headline targets of A Programme for partnership Government is to deliver sustainable full employment across all regions of the country with 200,000 jobs to be created by 2020, 135,000 of which will be outside Dublin. The Government is working hard to achieve the most even possible distribution of foreign direct investment across the country. IDA Ireland is focused on that goal and is targeting an increase in investment of 30% to 40% in every region as part of its strategy for the period 2015 to 2019. Significant progress is being made towards these objectives, with 45% of all new IDA Ireland client company jobs created last year being outside Dublin. There are now over 122,000 people employed across 649 firms in IDA Ireland client companies outside the capital.

IDA Ireland markets Meath as part of its mid-east region, which also incorporates Kildare and Wicklow. The wider area is home to 56 multinational companies, 17 of which are located in Meath. In terms of direct investment in the form of grant aid, a total of €1.84 million has been paid to IDA Ireland client companies in Meath since 2013. There has been some significant investment in the county in past two years, with Shire announcing plans to expand its global biotechnology manufacturing capacity over the next four years. It is expected that this will lead to the creation of approximately 400 permanent jobs at Piercetown, County Meath. This news followed Facebook’s announcement in January 2016 of the construction of a new data centre in Clonee. Construction for the €200 million data centre is currently taking place with over 1,000 workers now on site daily.

The county’s proximity to transport hubs and population centres is among its key strengths. IDA Ireland is working hard to secure new investment for Meath and it continues to draw the attention of investors to the county.

It should also be emphasised that foreign direct investment only forms one part of investment in regional locations. Indigenous enterprise is responsible for a significant portion of employment growth, especially outside Dublin. Enterprise Ireland-supported companies continue to perform well in the regions, with a 5% increase in employment reported in Meath in 2017. Enterprise Ireland has approximately 500 client companies in the mid-east region with 170 of these located in County Meath, employing some 7,300 people. Enterprise Ireland has invested almost €8 million in the period from 2014 to 2017 in these companies. Last year, Enterprise Ireland supported companies created 650 jobs in Meath. When losses are taken into account, a net gain of 309 jobs was recorded. This is an increase of 4.2% on 2016. Some key Enterprise Ireland client companies include Kepak, Nurendale, Largo Foods, Kilsaran Concrete and Xtratherm. In June, with the support of Enterprise Ireland, I announced College Group’s €10 million expansion with the construction of a new biofuel facility in Nobber, with the creation of 90 construction jobs and an additional 25 long-term job opportunities for graduates. Enterprise Ireland also co-funded the establishment of three community enterprise centres in County Meath. In January 2016, we launched the mid-east action plan for jobs to support enterprise and employment across Kildare, Meath and Wicklow. This plan aims to increase employment in the region by 10% to 15% by 2020, resulting in the delivery of 31,500 jobs.

Substantial progress is being made in the mid-east. Since the start of 2015, 22,800 more people are in employment in the region. The mid-east now has an unemployment rate of 5.4%, lower than the State rate of 5.7%. In 2017, Enterprise Ireland jobs increased by 4% in the mid-east while IDA Ireland jobs across the region grew by 6%.

Again, the Minister of State lumped Meath in with that mid-east region. I identified in my first contribution that there are radical inequalities even within that mid-east region.

The second thing the Minister of State did was what his Government does regularly, namely, when we show a systematic problem, a Minister points to the exceptions that prove the rule. Of course there are individual cases that are against the trend to which I have referred, but the trend is still significant and needs to be addressed.

The other issue is that the Minister of State failed to address the question of Government investment in County Meath. In this regard, local authority expenditure in Meath is €537 per person. We are the only county in the State for which the figure is less than €600. In Cork, that investment is €1,217 per person. Why should a Government preside over well over double the allocation of investment in one county over another? The most frustrating thing about this trend is that it is actually getting worse. Year after year I have brought up this issue. We have a heap of Fine Gael Deputies in County Meath. Probably the only statistic we excel in is Fine Gael Deputies per capita. Perhaps that is why the problem exists in the first place. It is deeply frustrating. Those Fine Gael Deputies have told us to raise the revenue locally. To do so in respect of increases in rents, parking fees, etc., we would have to raise our revenue generation locally by approximately 180%, which would radically squeeze people in Meath.

The heart of this problem, which has not been seen, is that there has been a 78% increase in population in Meath in 20 years. We have seen the largest increase in population of any county during that period, and the central government model of funding does not take into consideration this demographic change whatsoever. As a result, Meath people contribute approximately €4,100 per capita yet get far less back per capita from the State in investment. I do not begrudge any other county its investment. I commend any county on securing investment. All we are looking to do is equalise the investment per capita throughout the State in order that the people in Meath get a fair shot of IDA investment, EI investment and State investment. If this is not done, Fine Gael will continue to stuff, hammer and shaft people in Meath. I call on the Minister of State to ensure that per capita investment change is made under this Government.

Deputy Tóibín was selective himself at the beginning of his reply. He talked about IDA investment and the reduced number of IDA investments in County Meath. He is correct when Meath is compared with other counties in this regard, but may I compare the Enterprise Ireland record? He did not mention that. There are 7,302 people employed in Enterprise Ireland client companies in Meath. Let us compare that to Wicklow, which he mentioned, and Louth. Louth has 6,121 people employed in Enterprise Ireland client companies.

Louth has a smaller population. Louth and Wicklow-----

No. Let us talk about the counties now. The Deputy mentioned the counties and the IDA. I am going back to the indigenous sector because it is extremely important. IDA-----

The Minister of State will find-----

Excuse me, Deputy Tóibín. We realise the IDA goes into hubs all over the country, and every Deputy here, including me, has concerns about IDA jobs. We would love to see more of them in the regions. As I mentioned in my statement, it is important to concentrate on the indigenous sector and Enterprise Ireland. Let us talk also about the local enterprise offices, which I have not mentioned yet. They created, I think, 284 jobs gross in Meath last year. They are a very important part of our job figures in County Meath. Why? They have penetrated almost every community because they encourage start-ups and entrepreneurs and they work in conjunction with the local authority.

What is the Department figure for Kildare?

The Deputy mentioned the Garda in his contribution. I have the Minister for Justice and Equality alongside me. I am informed by the Garda authorities that the new divisional headquarters in the Meath division is to be based in Navan. The 2021 programme provides for significant works at the existing divisional headquarters, namely, the complete demolition of the existing cell block as well as the construction of new cell blocks and overhead office accommodation in Garda stations. Therefore, Meath is not being totally ignored.

There is no divisional headquarters-----

Regarding the Government's 2014 national planning framework, there is an ambition to reverse rural decline. This includes County Meath as well as the other counties. It is extremely important for us that we reach our targets in job creation and balanced regional development. Of the 200,000 jobs we say we will create - we have created a considerable number up to now - 135,000 will be in the regions, and Meath will be included in that.

I appreciate the Deputy's concerns. I would do the very same if I were in his shoes as a Deputy elected in the area to ensure that Meath gets its share of investment, but he needs to refer as well to the positives that are happening in County Meath.

The Minister of State cannot argue with the facts I gave him.

I understand where the Deputy is coming from.