Ceisteanna ó Cheannairí - Leaders' Questions

Before we start Leaders' Questions, I point out to leaders the orders to the House set out the time allowed. Can people please adhere to the time allowed?

Yesterday's vote in the British House of Commons is serious and grave and creates real uncertainty and anxiety. No clear or coherent view has yet emerged from the British political system of the type of Brexit that would command a majority of British parliamentarians. In our context we know a no-deal Brexit would be very damaging to the Irish economy, to the UK economy and to Europe as well. That is why we must double down in our efforts to be ready and prepare comprehensively for a no-deal Brexit.

In Ireland the Fianna Fáil Party's decision to continue with the confidence and supply agreement has spared us the mayhem, instability and uncertainty that is evident from the British system, which would have flowed if a general election had been precipitated here.

When it comes to Brexit the Government must be honest with the Oireachtas and the people. It needs to be honest about the potential impact of a no-deal Brexit on our politics, economic potential and social well-being. The Government needs to be honest about all the preparations currently under way concerning a no-deal Brexit. It should share all of its analysis in areas such as pensions and social protection, for example. It should publish its analysis of the implications of a no-deal Brexit on our budgetary projections on revenue and expenditure.

Yesterday's exchange between the Tánaiste and the Minister for Transport, Tourism and Sport are deeply worrying because it suggests the public are not being told the full truth for party political reasons. I get the same sense at times with the Government not revealing the full details of its plans for a no-deal Brexit. As the Taoiseach knows, the Minister, Deputy Ross, replying to a question about whether there would be checks on a truck travelling from Scotland to Larne and proceeding to the Republic, said, "I would anticipate that there would be checks." In reply, the Tánaiste said:

Yes, but we can’t get into where they’ll be at this stage. They could be in the sea, they could be... But once you start talking about checks anywhere near the Border, people will start delving into that and all of a sudden we’ll be the Government that reintroduced a physical border on the island of Ireland.

To that, the Minister, Deputy Ross, said, “Yeah, but I didn’t know what to say.” Clearly he did not do his homework.

This obviously was a conversation that was never meant to be public; the microphones were still on. However, it seems there is a private understanding and knowledge within Government about a border in the aftermath of a no-deal Brexit but at all costs that private understanding must not be shared with the public. Is that not a fair conclusion to be drawn from the exchange between the two Ministers? It is like the episode from Fawlty Towers, "Whatever you do, don't mention the war", but somebody forgot to tell the Minister, Deputy Ross. Who is telling the truth here? Were Ministers told not to mention the possibility of some checks being done or in place in the event of a no-deal Brexit? Is it the Government's position that border checks could be at the sea? How realistic is such a proposition anyway?

As a Government, we very much regret the vote that occurred last night in Westminster to reject the withdrawal agreement and the associated joint political declaration. A no-deal exit would be very bad for Ireland, for the United Kingdom and for all of the European Union. A no-deal scenario would leave us with no guarantee of there not being a hard border between Northern Ireland and Ireland. It would leave us with no protections on citizens' rights and freedoms and, of course, would have a major impact on jobs and the economy, particularly the traded sector, SMEs and the agrifood industry. Therefore we must do all that we can in the coming weeks to avoid a no-deal exit of the UK from the European Union, but not in a way that compromises our fundamental positions.

This is a problem that began in Westminster with the referendum on Brexit. We found a solution: the withdrawal agreement negotiated over several months and agreed by 28 governments. Now Westminster has rejected that solution. Therefore the problem lies in Westminster. I welcome that the British Prime Minister has said she will now engage with senior politicians from all parties to see if they can come together to find a way forward with a Brexit that commands a majority in the House of Commons. However, whatever they come up with must be acceptable to us in Ireland and the European Union as a whole.

The Deputy mentioned the budget impacts. The budget was planned and written with Brexit in mind. That is why we have provided for a budget surplus. That is why we provided for a rainy day fund. It is also why we provided for a 25% increase in capital spending, with €1.5 billion being invested in infrastructure in Ireland to give the economy a bit of a boost at a time when there is a risk, obviously, of a significant slowdown.

In terms of plans for checks, we are obviously now implementing the no-deal plans. It is no longer contingency planning: we are implementing our no-deal plans. That provides for checks at ports and airports in Dublin and Rosslare. We are not planning for checks along the land border between Northern Ireland and Ireland, nor are we planning for checks in the sea. I cannot imagine how one would carry out checks in the middle of the sea. I think they can only be done at ports and airports.

Everything the Tánaiste has said is very consistent with our position that we stand by the backstop and we stand by the withdrawal agreement. His only concern - it is a genuine concern I have - in answering questions on this issue is that if one uses the wrong words or says things in the wrong way, people will misinterpret that as though one has some sort of secret plan to impose a hard border between Northern Ireland and Ireland; we have no such secret plan.

However, the Tánaiste said that the border checks could be at sea. I did not say that; nobody else in this House said that, but the Tánaiste said it to the Minister, Deputy Ross, albeit he thought he was saying it privately not realising it was caught on microphone. Now the Taoiseach is saying that clearly it could not be at sea. The Tánaiste went on to say that "But once you start talking about checks anywhere near the border, people will start delving into that and all of a sudden we’ll be the Government that reintroduced a physical border on the island of Ireland.” The emphasis was on "we'll be the Government", so whatever one does, do not mention the border. He was effectively saying to the Minister, Deputy Ross, "Don't mention it. For God's sake don't mention the border because we'll get tarred with it and that's the last thing we want."

Has that conversation happened with the European Union? Has the Government shared that view with the President of the Commission and with Michel Barnier? What is the Taoiseach's take on the exchange between the Minister, Deputy Ross, and the Tánaiste? In the aftermath of the budget the independent Parliamentary Budget Office made the comment that there are no projections in terms of revenue and expenditure.

I am not sure exactly what the Deputy is driving at. The Tánaiste was referring to checks on goods moving from the UK to Ireland. That is what the backstop provides for. The backstop and the withdrawal agreement provide for checks on the movement of goods between Britain and Ireland at the ports at Dublin, Dublin Airport and Rosslare and also at the ports in Northern Ireland. That is what the withdrawal agreement provides for. That is what the backstop provides for: checks on goods traded between Britain and Ireland.

Is that in a no-deal scenario?

On the budget, I mentioned already how the budget was planned with Brexit in mind. All the economic analysis we have so far from Copenhagen Economics and the ESRI, for example, indicate that there would be a slowdown in economic growth, but not that we would enter recession. Some people feel that is a little optimistic.

The projection from the ESRI, Copenhagen Economics and others is that in the event of a hard deal or no-deal Brexit, the Irish economy would slow down but not that it would go into reverse. That is why we built buffers into the budget, including a surplus and a rainy day fund.

Last night, as predicted, the Brexit withdrawal agreement negotiated between the British Government and the European Union was overwhelmingly rejected by the British Parliament. As was the case during the Brexit referendum debate, the vote last night again reflected an absolute disregard for the interests of Ireland and for the international obligations of the British State to honour and implement the Good Friday Agreement. Indeed, there is an unmissable hostility to Irish interests in some sections of the British political establishment. The level of Brexiteer delusion is perhaps best summed up by the commentary of the DUP leader, Ms Arlene Foster, when she claimed that we never had a hard border in Ireland. That is manifestly not true and it illustrates clearly that Brexiteers do not deal with reality. I am sure the Taoiseach does not need me to point out just how worrying that is because with every day that passes, we lurch closer to the possibility of a no-deal scenario and the return of that hard border.

Yesterday, prior to the vote in Westminster, the Tánaiste briefed us on contingency plans in the event of this situation. These contingency plans focus on east-west matters, which are important to protect trade and commerce between our islands. The Tánaiste said that the legislation required to deal with these matters will not be published until 22 February. Sinn Féin will assist in crafting and passing all necessary legislation but the Government is coming to all of this very late in the day. The Government needs to revise that schedule and Members need to see the legislation before late February.

The Tánaiste had nothing to say, however, on contingency planning to protect our all-island economy, citizens' rights and the Good Friday Agreement in the event of a crash Brexit. Last night, as has been said, the Tánaiste and Minister for Transport, Tourism and Sport were at odds in respect of checks on goods crossing the Border in the event of a no-deal Brexit. The Minister, Deputy Ross, said that there would be checks but the Tánaiste said there would not. They cannot both be right. Who is right? Is it Deputy Ross or is it the Tánaiste? The reality is that in the absence of a backstop, there will be a hard border and there will be checks. The Taoiseach has skated around this issue time and again. Is it not now time to say out loud that in the absence of a deal, there will be a hard border and to reassert that this is an unacceptable, indeed, an unconscionable situation for us? It is time to state clearly that the Taoiseach will not, under any circumstances, accept a hardening of the Border and the chaos that would follow from it for citizens in their daily lives.

I ask the Taoiseach to state unequivocally that the backstop remains the bottom line, that he will defend that position and that there will be no resiling from it.

The Deputy's time is up.

I also ask him to set out the Government's plan to protect our all-island trade and economy, our society and our peace agreement in the event of a no-deal, no-backstop Brexit.

I very much agree with the Deputy's initial remarks. We had a hard border between Northern Ireland and Ireland. I remember it well. During the Troubles and prior to 1992 when the Single Market came into effect, I remember very well crossing the Border as a child and in my early teens. There were customs checks. I remember the 24-hour rule and I remember seeing soldiers, and I never want to see any of those things ever again on our island between Northern Ireland and the Republic of Ireland. That is why I have been working so hard to secure an agreement over the past year and a half.

In terms of the legislation, we expect to have the heads of the Brexit omnibus Bill within the next two weeks - ideally by the end of next week. That will give a very clear picture as to what is in the legislation. Of course, we will be open to input at that point from Opposition parties as to whether it covers everything that needs to be covered. We anticipate having the final Bill ready for publication on 22 February 2019. It is a big task, which is why the legislative programme that we produced yesterday contains only six Bills on the priority list for publication this session, three of which are explicitly linked to Brexit.

Words are not enough to avoid a hard border between Northern Ireland and Ireland. I hear people saying all of the time, in various analyses, that there will not be a hard border just because nobody wants one but it does not work that way. The only way that we can avoid a hard border between Northern Ireland and Ireland into the long term is by having an agreement on customs, a common customs territory or customs union and regulatory alignment either between Northern Ireland and Ireland or all of the UK and the European Union. That is what we negotiated in the withdrawal agreement and the backstop, namely a common customs territory and regulatory alignment so that there would not have to be a hard border between Northern Ireland and Ireland. It is not good enough for those who rejected this agreement to just say that there will not be a hard border because everyone says that there will not be one or because nobody wants one. We must have a political agreement that involves a single customs territory and regulatory alignment. There are lots of ways of doing that. There are Northern Ireland-specific solutions and there are UK solutions but that is what has to happen if we are to secure an agreement and ensure that a hard border does not emerge on our island.

In response to the Deputy's direct question, I will absolutely defend the backstop but the backstop is there as a means to an end. Let us not forget what the backstop is, namely a legally operable guarantee that the mechanisms will be put in place to ensure no hardening of the border between Northern Ireland and Ireland. It is the outcome that we need to achieve and I stand by that, absolutely.

I am well aware of the intent and the content of the backstop and welcome the Taoiseach's assertion that he will stand by it. I take it that this will remain the case, irrespective of overtures or pressure that might come from the British Government or from other quarters. The backstop is necessary, as the Taoiseach correctly said, to avoid a hard border. It logically follows that in the absence of a backstop, the Border will harden and that will result in many things, including checks as goods crossing that border. The Taoiseach has again failed to set out the contingency in that eventuality, which is not one that I or anyone in this House wishes to come to pass. What happens then? The contingency legislation for east-west matters has been dealt with and we will see that legislation shortly but the big question remains. What happens regarding the Border on the island of Ireland, not least in the context of the consequences for the Good Friday Agreement? What is the contingency plan for that? Let us make no mistake about it, as sure as night follows day, if there is a crash Brexit and there is no backstop, a hardening of the Border will follow automatically.

The Deputy is way over time.

What will the Taoiseach do? I agree with him that his should not, under any circumstances, be the Government that reimposes a hard border on the island of Ireland. However, that begs the question again: what does the Government do?

I beg the Deputy to acknowledge that she is over time.

What does the Taoiseach propose to do? What is the contingency in that set of circumstances?

The Government of the United Kingdom - and the United Kingdom - has given the people of Ireland and Northern Ireland a commitment that Brexit, which is its policy, will not result in a hard border between Northern Ireland and Ireland. We have come up with the solution. We have it in the withdrawal agreement plus the backstop. That is how we avoid a hard border between Northern Ireland and Ireland. It is now for those who have rejected that solution to honour their commitment to us that there will be no hard border between Northern Ireland and Ireland by coming up with an alternative solution that does exactly what it needs to do. The ball is now very much in their court. I do not believe they will be able to come up with an alternative solution. I do not believe they will be able to come up with something that departs very differently from what has been agreed, unless they fundamentally change their red lines in relation to the customs union and the Single Market.

We stand by the withdrawal agreement. We stand by the backstop. Westminster has rejected it.

It is now up to Westminster to come together to develop a solution to what it believes is a Brexit it can pass through the House of Commons. Whatever it comes up with must be acceptable to the European Union and Ireland.

Last night, the Government shot down reports that it plans to table fresh pay proposals to nurses next Monday. In doing so, it brings the country closer to a national pay strike of more than 40,000 nurses, the largest strike organised in the country in quite some time, which Solidarity will support to the hilt. If my constituency of Cork North Central is anything to go by, the nurses enjoy the overwhelming support of the general public, who believe that they are entitled to a pay rise and understand that higher pay for nurses will make for a better health service.

Last week, the Taoiseach tried to pose as a representative for patients when he urged the nurses not to start their strikes on a busy Wednesday. That had no effect on public opinion. How hollow his words were when everybody knows his Government presides over hospital waiting lists of more than 700,000 people. He can recruit support for his stance from the corporate media or some trade union leaders who should know better, but he will not recruit support from the general public because they firmly support the nurses. In fact, the Government will be the loser if it continues to take a hard line. If the Taoiseach does not understand that, he is living in a bubble.

One of the reasons working-class people support the nurses is that those people support what the Taoiseach calls knock-on claims. Every worker in the country, public and private sector alike, deserves a decent pay increase. Many are struggling with the cost of accommodation and childcare, while the working poor, who are struggling just to make ends meet, desperately need one. The Taoiseach will say the country cannot afford it, but a financial transaction tax on shares and derivatives would raise more than twice the funding needed to meet the claim. A tax of 2% on household wealth of more than €1 million would raise more than enough to settle other claims. Record private sector profits show the affordability of pay increases above the current rates. If the capitalist market cannot afford decent pay increases in the fastest-growing economy in Europe, perhaps working people cannot afford the capitalist market.

Is the Taoiseach prepared to consider a U-turn on nurses' pay before it is too late, and before he provokes a major national strike, which, apart from anything else, will do his Government serious harm?

The Government acknowledges and is aware of the fact that two of the three unions that represent nurses have voted to strike. They have done so by a large margin - 95% - which indicates the depth of feeling among nurses and midwives about their terms, conditions and pay. The Government understands that, and we will engage with all three unions that represent the nurses and midwives with a view to avoiding strike action, if at all possible. There was a meeting between employers and unions yesterday, and there will be a meeting of the public sector pay deal oversight committee, I believe, on Friday. There will be engagement, therefore, and we will do all we can within reason to avoid strike action simply because of the impact it will have on patients. A midweek strike will have a significant impact on patients. It will be necessary to wind down activity probably from the middle of the day on Tuesday, and circumstances may not return to normal until some time on Thursday. It will result in thousands of operations being cancelled and thousands of patients not getting the appointment with the specialist they may have waited to see for a long time, which we want to avoid. Even if it is cancelled at the last moment, as strikes sometimes are, it will be too late to reschedule everything, which is why we will engage through the normal mechanisms between now and then to try to avoid strike action.

It is important to point out again that we have a pay deal, not only with nurses and midwives, but with all 300,000 public servants. That pay deal runs until 2020 and provides for pay increases between now and then. We want to pay those increases because we want to pay our public servants better as they deserve to be paid better, but we need to do it in such a way that it is affordable and fair, recognising what is happening in the wider economy and recognising the wider political situation, particularly relating to Brexit. I note the comments of the Leader of the Opposition about how Brexit may have an impact on the public finances in the months and years ahead.

The Deputy said it was his analysis that this dispute could lead to knock-on claims across the public service, which may well be correct, but that would leave us with a bill for hundreds of millions, if not billions, of euro in pay increases, which we cannot afford. As is always the case with populists of the left and right, they present easy answers and simple solutions such as a financial transaction tax but that would just drive financial transactions to other financial centres. It would not bring in the money that the Deputy believes it would, and it is disrespectful to nurses and midwives considering going on strike to present easy answers like that which he knows are not true.

Once again the Taoiseach has tried to play up the question of inconveniences to patients as a way of making his case against the nurses' strike. Before coming to the Chamber, I looked up this morning's trolley watch figures. They have fallen slightly, but for the third consecutive day the figure is in excess of 500. The Taoiseach and the Government have no credibility in trying to pose themselves as champions of patients in the context of the dispute.

Similarly, the Taoiseach tried to bring in the issue of Brexit in making his case against the strike. Working people will not be impressed by that in any sense, and the Government will not get away with using Brexit as a way of standing against the rights of working people.

There is one rule for the people at the top and one rule for ordinary working people on the ground. The bosses of the top 20 ISEQ companies are paid 33 times more, on average than their staff's salaries. Some of the chief executive officers have wages of more than €5 million. The Taoiseach will shrug his shoulders and say it is because of market forces, but he will ignore that the labour market demands that nurses be paid. They are paid 20% more in the private sector. They should be paid the going rate to avoid the strike. If there is any discomfiture, inconvenience or worse to patients as a result of a strike, it will be due to the hard line taken by the Taoiseach and his Government.

I care deeply and profoundly about patients. I am a medical doctor by training, I worked in the public health service - and never in the private health service - for seven years, I have been a Minister for Health, and I am the leader of the Government. I care deeply, therefore, about how strike action may impact on our patients. I care about patients and how they might be affected, and I care about taxpayers, whether they work or not, because people who do not work also pay taxes. Any solution, agreement or pay deal must be paid for by taxpayers one way or the other, and any strike will have an impact on patients.

I fully accept there are far too many patients on hospital trolleys. We will continue to do all we can to reduce the number. There is one area, however, where we have made undeniable progress, namely, in reducing waiting times for people who need a hospital operation or a procedure. The numbers waiting more than 12 weeks, which is the target set in the Sláintecare plan, is now at a five-year low, but strike action will impact on that. Operations will be cancelled and the enormous progress we have made in reducing waiting times for hospital operations and procedures may be reversed. I do not want that to happen, which is why we will engage with the unions to try to avoid strike action, if at all possible.

There is a mental health and suicide crisis in Wexford. Everyone does not present with suicidal ideation, and it is not always possible to identify signs that someone might be suicidal, but there seems to be an incredible lack of an emergency response to those who do so.

Kenneth Rowe took his own life just over one year ago at the age of 32. Before Christmas, I read a letter from Kenneth's sister in this Chamber and I shall repeat one line from it:

Imagine our despair that in spite of an urgent referral from Waterford to Summerhill Community Mental Health Services, [Wexford] Kenneth’s appointment was for six weeks later. The wait was impossible ... Kenneth fought so hard to stay alive for everyone and everything he loved. But he didn’t make it. He ended his life 19 days before his appointment at Summerhill.

I have spoken to the parents of a number of children who have presented with suicidal ideation and who have had to wait for more than two and half years to get the supports they have needed from the child and adolescent mental health service, CAMHS. Dr. Kieran Moore resigned from his position as consultant child psychiatrist almost one year ago and we still do not have a replacement. Anne O'Connor, the national director of mental health services in the HSE said in 2017 that CAMHS had become a catch-all service in the absence of other services. It was never designed to be a catch-all service but to cater for children and adolescents with severe and enduring mental health illnesses. Children who do not need to be are funnelled into CAMHS because alternatives are not there. Anne O'Connor said that young people should be able to go to their GPs in order to get access to a primary care-based psychology or family counselling service. The waiting time for primary care child psychology services in Wexford is more than three years. This is despite the fact that four newly created assistant psychologist positions were filled in the last year in Wexford. A three-year wait is hardly good enough.

In its final report, the Joint Committee on Future of Mental Health Care expressed serious concerns at "the lack of accessible counselling services and [that] the money spent by the State on the services is insufficient, as compared to expenditure on psychotropic medication." The report also states, "Evidence also supports that there is an over reliance on medication as a response to preventing 'mental ill health' issues in the absence of alternatives in primary, community care levels." The Ombudsman for Children informed the committee that children have identified a rush to medicate in their treatment, which is incredible.

The lack of adequate community and primary care mental health services in Wexford is a serious problem. The pace of change is painfully slow. It is too slow for some. Kenneth Rowe was one of those. I realise that suicide figures nationally are down but they are still incredibly high in Wexford and it is one of the most concerning issues in the county. Do we need more resources? Do we need a different approach? I know it is not easy but I put it to the Taoiseach that whatever it is we are doing, it does not seem to be good enough.

I thank the Deputy. I am very sorry to hear about that gentleman and his experience. I am aware that Deputy Wallace raised the matter in the House previously. I doubt that any Deputy has not in some way been affected by suicide or does not know someone who has taken his or her own life. We all know the enormous grief this causes and the effect it has on families and friends. It is a grief that never dies; it goes on forever. As Deputy Wallace stated, this is an area in which there has been some progress in recent years. The number of people in Ireland taking their lives has decreased by 30% since 2012. Suicide rates in Ireland are now roughly at the EU norm. Statistics such as this mean nothing to anybody who has had suicide touch his or her life. I acknowledge that it does vary from place to place within the State, but I do not have that particular breakdown in front of me.

In the context of what it can do, the Government is committed to developing mental health services in the broadest sense, namely, for the health service and for education in the context of well-being and resilience, which are very important. The budget for mental health will approach €1 billion, which is very large and which is acknowledged by experts, such as Senator Freeman, as being more than is spent in many other similar countries. It provides an additional €55 million for the development of services in 2019. We need to make sure this money gets to the patients and to those who need it most.

There are 2,560 children on the CAMHS waiting list. The HSE is prioritising those who are waiting more than 12 months, which is some 295 children. All aspects of CAMHS will be improved as part of the service plan in 2019. This will include: better out of hours cover and 7-7 cover where possible; progression of day hospital care; development of specialist teams, for example for eating disorders; and improved prevention and early interventions. There are now 70 CAMHS teams and three paediatric liaison teams. The Minister of State, Deputy Jim Daly, who is the lead Minster for this matter and on issues of mental health, will meet the HSE on 23 January to review progress on all aspects of CAMHS, including waiting lists. I will ask him to raise Wexford as a particular black spot when it comes to these matters. We now have 114 assistant psychologists hired and 20 psychologists recruited for the primary care services. These were recruited throughout the course of last year. We hope that the full year effect of them being employed now will make a difference in waiting times.

Some 2,500 people were referred to counselling in primary care in 2016 and 2017 in community health organisation, CHO, 5. Some 950 people were referred to the self-harm intervention counselling programme in the same years. I asked the HSE for the numbers of people being prescribed antidepressant medication for those same years. It gave me the numbers of 249,500 people in 2015 and 390,000 for 2016. This is just the data of those who use medical cards and it represents a 36% increase. We know that medication can be helpful but the number of people on antidepressants is totally out of sync when compared to the numbers who receive counselling. Any psychiatrist who believes in the idea of recovery will tell us that antidepressants are not intended to be used as a long-term solution and are damaging when taken in the absence of ongoing counselling or talking therapies. In Ireland, however, there are 250,000 people - medical card holders - on antidepressants and perhaps only one in ten is talking to anyone about the root of his or her problems. It is a recipe for drug dependence and it does not lead to a great deal in terms of recovery.

The people in Wexford desperately want things to be different. Kenneth Rowe's family have spoken about the lack of talk therapy offered to him. He was put on powerful antidepressants. On 2 January 2018 his prescription was doubled and his agitation became extremely intense. He was dead three days later. We will never know if talk therapy would have saved him but we owe it to him and to others to make real change to the way we provide mental healthcare in this State. It is not good enough.

It is important to state that medicines - antidepressants, anxiolytics and anti-psychotics - have a role to play in the treatment of mental illness. I know the Deputy is not disputing that and does not disagree with it. When these medicines are prescribed, it is by general practitioners or psychiatrists. I am sure that in the vast majority of cases when these medicines are prescribed, this is the appropriate course of action. I also acknowledge the Deputy's point to the effect that it is much easier for a doctor to prescribe medicine that a patient can get within hours than it is to get counselling, cognitive behavioural therapy or talk therapy for him or her. The doctor can sign the prescription, give it to the patient and the patient can be in the pharmacy within the hour and have his or her medicine. It takes much longer for patients to get access to other treatments such as behavioural therapies and counselling and all those things that we know also have an effect. The Deputy makes a fair point.

The Minister of State, Deputy Jim Daly, is here and he has informed me that he is going to meet the CAMHS teams' management and clinical leads next Wednesday, as well as senior HSE management. Deputy Wallace is aware there is €55 million available to make meaningful improvements in mental health in the year ahead. The challenge the Government always faces is to ensure that money gets to the patients. If it works, we should see more people getting access to those therapies more quickly and, perhaps as a result of that, a fall in the number of prescriptions and in medication costs.