Commencement Matters

Schools Building Projects

I welcome the Minister, Deputy Richard Bruton.

I thank the Minister for coming to the House to take this issue which is very important for parents and pupils in the constituency of Limerick City.

I want to clarify a number of points with the Minister. The two schools in question are in the Dooradoyle, Raheen and Mungret area, to be based in Mungret, and the greater Castletroy area. They are known as Limerick city environs south west for Dooradoyle, Raheen and Mungret and Limerick city environs east for the greater Castletroy area. The need for these schools was highlighted in a report on the configuration and development of post-primary school provision for Limerick city and parts of its environs from 2014 to 2024 which was completed for the Department in 2014. The report identified a need for two new schools in the Dooradoyle, Raheen and Mungret area, to be based in Mungret, and the greater Castletroy area. In the Dooradoyle, Raheen and Mungret area it showed an expected increase in population of 5,400 up to 2022 and in Castletroy an extra 3,600. Specifically, it stated there was a need in the next ten years for an extra 1,700 post-primary places in Limerick city and its environs and these two areas were identified. The Department's document, Arrangement for Patronage in the Establishment of New Post Primary Schools, refers to demographics. The two areas which required new secondary schools were Dooradoyle, Raheen and Mungret and the greater Castletroy area.

The closing date for applications from patrons was Wednesday, 8 June. How many potential patrons applied and who were they? What is the timeframe for their consideration? When will the announcement be made? What are the criteria to be met in the selection of the patrons? It is extremely important that the needs of children and their parents, living in the areas identified in the report completed for the Department in 2014, are catered for. They were the areas that showed huge growth in the population of schoolgoing children, giving rise to the need for schools to be located in them.

Will the Minister confirm the proposed sites of the two new schools in Mungret and Castletroy?

What sites have been identified and where does the Minister expect them to be located? When are the schools expected to be opened? We understand the two schools will each cater for 600 pupils and it is extremely important that parents be given certainty about the building programme. We understand the school in Mungret will be opening in September 2017 and that the school to be located in the greater Castletroy area will open in September 2018. Living in Castletroy, I am aware that we have a fine school in Castletroy College, but there is a clear need for another school to cater for the increasing number of schoolgoing children coming up. Preference forms were provided whereby parents had to indicate to the Department which patron they preferred. It made no reference to the school that the particular student or pupil was attending. I hope there will be such a reference as it would give a clear indication of the need within the schools in the areas of Dooradoyle, Raheen, Mungret and Castletroy.

Who will be making the recommendation? It is something on which parents and pupils are entitled to certainty. The wishes of parents living in the areas to which I refer must be given weight and taken on board in the criteria being considered as to who will be appointed patron and the type of school it will be. The Minister might provide clarity in that regard.

I thank the Senator for raising the matter of these two schools. He has outlined a great deal of the relevant information. A demographic assessment was published in 2015 and at that stage nine new schools were announced to be opened in 2017 and 2018, including two in Limerick. One was announced for 2017 for Limerick city and its south-west area at Mungret and the other for 2018 serving the Limerick city environs to the east, including Castletroy. Each school will provide approximately 600 post-primary places to add to the provision.

As the Senator said, we invited applications for patronage in April with a closing date of 8 June. Parental preferences for each patron together with the extent of diversity currently available in the area will be the key to decisions made in the process. We seek to ensure diversity in the offer looking at what is already available in the area and then parental preferences. In this regard, prospective patrons were requested to submit with their applications a parental preference template in which parents had been requested to indicate a preference for their children to be educated through that patron's school model and also whether the preference was for instruction through the medium of Irish or English. The closing date was 8 June. I do not have the full list of patrons that have submitted their applications, although I am sure I could provide it for the Senator. The system is that applications from the prospective patrons are being assessed and an assessment report will be prepared for the consideration of the new schools establishment group. The group which is independent adjudicates on applications. It will submit a report with recommendations to me for consideration and final decision. I will announce the patronage of the school following the completion of this process. The patronage assessment report will be published on my Department's website.

The Senator raised an issue as to the catchment within which the assessment of parental preference occurred. My understanding is it is the planning area as defined by the Department. These are broad areas of which are 310 throughout the country. Any parent within that catchment is generally assessed. I note the Senator's concern that the views of people in the immediate area must be taken into account. Obviously, they will be. However, my understanding is no greater weighting is afforded to someone in the immediate parish as opposed to someone in the next parish as long as he or she is within the planning area. Those who live outside the planning area do not have their views taken into account. I have seen cases where patrons in their enthusiasm have gone way beyond the planning area and collected parental preferences which are not taken into account. It is strictly based on the preference of those living in the area specified when the call for patronage was made. It is done in accordance with the invitation.

Regarding the accommodation of the schools, my Department works closely with local authorities under the memorandum of understanding on school site acquisitions to identify suitable sites for school development. Work on the acquisition of permanent sites for the schools is under way. Subject to the necessary statutory approvals, it is my Department's intention to acquire land at Mungret which is currently in the ownership of Limerick City and County Council for the purpose of providing permanent accommodation for the new post-primary school to serve the Limerick city and environs south west area. My officials are liaising with officials in the local authority to progress this site acquisition. With respect to the new post-primary school to serve Limerick City and environs east area, my Department has requested Limerick City and County Council to assist under the memorandum of understanding with the identification and procurement of a suitable property to serve as the permanent location for the school. Officials from the local authority have identified a number of potential site options and these are now being assessed technically to establish their suitability. Once the assessment phase is completed, it is anticipated that negotiations with the relevant landowner will commence.

Major construction projects to provide the buildings for the two post-primary sites in Limerick are included in my Department's six-year construction programme scheduled to proceed to tender and construction in 2018 and 2019 to 2021, respectively. We are proceeding with due haste.

I have two quick questions. The demographics report to which the Minister referred and which was published in 2015 specifically recommended that one school should be provided in the Mungret-Dooradoyle-Raheen area and that a second school should be provided in the greater Castletroy area. That was based on the demographics in these locations. It is very important that extra priority be given to the parents and pupils living in the immediate areas of these schools. That was the basis under which the building of the schools was recommended. We cannot have a situation where schools are built and pupils living in the immediate area are not given preference and priority in terms of being able to be educated in their own localities. It is very important for the Minister to look at that matter. Will he indicate when he expects the announcements to be made and when he expects both schools to open for enrolment?

Whatever was placed in the patronage advertisement, including as regards the planning area, will have to be complied with. Patrons will have used that area in good faith to identify parents who would support them. I do not have the exact geographic areas, but they are centred on Mungret and Castletroy. There is no way a parent living closer to the school is given a greater priority than a parent further from the school if they are both within the area. My understanding is all parents within the area advertised will be given equal priority. One cannot assess the wishes of parents who live outside the area. At this stage, it cannot be changed. Perhaps I might get the Senator the exact geographical area.

This is critical because the schools were recommended on the basis of the increase in the number of schoolgoing children in these locations. It is extremely important to factor this into the assessment.

The Senator has made a very good point. Normally, ten minutes are allowed for a matter, but 13 have elapsed. The Minister has given a comprehensive reply.

I appreciate that.

If he has more to add, I am sure he can communicate with the Senator.

I will provide the Senator with the exact map of the area within which the patronage is assessed. The issue of when the schools will open is not one on which I can give an exact date as it depends on site acquisition, design and snags in site specification. That work will proceed. There is a staged approval process whereby the Department satisfies itself at each stage that its requirements are being met. There will be no unnecessary delay in executing the process.

If progress has not been made early in the new year, the Senator can revisit the issue again.

Disablement Benefit

I wish to establish how many Arigna miners who suffered work-related illness have received compensation to date and how many of those who have applied have yet to receive compensation. In 2010 the National Coal Miners Group secured agreement that the Department of Health would extend disablement benefit to former miners suffering from the prescribed occupational disease pneumoconiosis, commonly known as black lung disease. Since this review was established in 2010, when I strongly lobbied on behalf of the coal miners, hundreds of miners have applied for disability arrears under the scheme. This does not just apply to Arigna but also to those who worked in the Castlecomer, Ballingarry and Rossmore mines. The Arigna mine is adjacent to the three areas of north Roscommon, Leitrim and south Sligo.

I pay tribute to the former Minister, Deputy Eamon Ó Cuív, for his work with the cross-party committee. He was very helpful in ensuring these miners were included and we have worked very hard together. Many of the men were formerly Arigna miners and, unfortunately, they have suffered severe health-related illnesses due to working long hours in the mines. As one can imagine, they had to work in very difficult conditions underground, with resultant health consequences. Legislation such as that in place in the United Kingdom was not in place here to protect these miners.

I understand that, to date, over €1 million in State disablement benefit arrears has been paid out to former miners nationwide, almost half of which has been paid to Arigna miners. The Minister might confirm these figures and also outline to the House how many applicants are still awaiting moneys and how many applications have still to be processed, if any. I hope no applicant is facing avoidable delays. At one stage, the official average waiting time between submission of application and receipt of arrears was six months and longer in many cases. At this stage, sufficient staffing resources should be in place in the disablement benefit section of the Department to ensure outstanding claims are expedited.

Recognition of the plight of the miners would not have come except for the sterling work of many people, including former Roscommon county councillor, Charlie Hopkins, who became a very strong advocate of the National Coal Miners Group. I pay tribute to Mr. Hopkins, the National Coal Miners Group and all who have campaigned on the miners' behalf. Living only a short distance from Arigna in the vicinity of north Roscommon, south Sligo and Leitrim, I know many of the men who worked hard in the mines all their lives to provide for their families. I recognise their vital contribution to the local economy for many years.

I hope all those who still meet the criteria under the scheme will receive payment as soon as possible.

I thank the Senator for raising this important issue. Disablement benefit is one of the payments available from my Department under the occupational injuries scheme and may be payable as a single lump sum or regular pension, depending on the extent of the injury or effect of the disease. Eligibility is not limited to miners or to any particular occupation. It is a social insurance benefit and, therefore, any person may qualify for it if he or she works, or worked, and pays, or paid, PRSI at class A, B, D, J or M, and loses physical or mental ability because of an accident at work, a commuter accident on a direct route between home and their workplace or a prescribed disease contracted as a result of his or her work. The level of payment depends on the assessed degree of loss of physical or mental faculty. A prescribed disease is a disease that has developed because of the type of work a person does and also includes any condition resulting from the disease.

Since 2010, my Department has received a total of 247 claims for disablement benefit from former Arigna miners in respect of a variety of diseases and injuries. Of these, 89 have been awarded, 81 were found to be ineligible and 77 are still under investigation. In regard to the total of 81 cases that were found to be ineligible, some of the common reasons for ineligibility are, for example, claims for occupational asthma which have not been made within the statutory limit of ten years of leaving the relevant employment, and, similarly, in respect of occupational deafness, the claim must be made within five years of leaving the relevant employment. In addition, former miners who ceased mining employment prior to 1 May 1967, when the legislation for occupational injuries came into effect, are not covered under the scheme for injuries or diseases originating before that date. In a majority of the total of 77 outstanding cases, my Department is waiting for additional information or evidence to be supplied by the claimant in support of their claim. A small number are awaiting a medical assessment by the Department's medical assessor. My Department will do all it can to process these claims through to conclusion as quickly as possible.

I appreciate the response. I am concerned that the small number of cases awaiting assessment by the medical assessor be dealt with as quickly as possible and that the Department has enough staff to deal with the applications. These were hardy men who worked in very difficult times and who provided for their communities through the 1950s, 1960s, 1970s and 1980s. This work-related black lung disease has overwhelmed their health. To see men coming to meetings with respiratory diseases is horrific. I believe they are thankful for the work done so far and hopeful it will continue.

I again thank the Senator for raising this important issue. As I said, 77 cases are outstanding. In some cases, we are awaiting additional information and, in others, it is our delay because the medical assessment has yet not happened. A new chief medical officer has been appointed to the Department in recent weeks, Dr. Max Hills, and we have recruited nine additional medical officers. While it is hard to recruit doctors, not only in the health service but also in social protection, nine have come through interview and although they have not all yet accepted the post, we hope they will. These cases will be prioritised.

I had the opportunity to visit Arigna many years ago, accompanied by Councillor John McCartin, and Councillor Charlie Hopkins may have been with us also. It is a fascinating place and a very interesting part of our industrial history and particularly interesting to see how mining was carried out in those days. They really were hardy men. It was old-fashioned mining where the miner would effectively climb into a crevice with a hammer and start to dig into the coal seam. It is also a very important place for our political history because it was one of the few places where the red flag flew in the 1920s, under the Arigna Soviet, which was established for a period at the time - a very controversial thing to do in 1920s Ireland. That is not discussed in great detail in the museum there, although perhaps that has changed since I visited. I thought it would be an interesting addition to the visitor facility. I advise Senators who have not had a chance to visit Arigna that it really is worth a visit.

Medicinal Products Availability

I appreciate the attendance of the Minister of State, Deputy Helen McEntee, to answer my queries. The issue has been raised previously through a Dáil parliamentary question. The person in question, Charlotte Connolly from Mullingar, has been diagnosed with a rare blood disorder known as Degos.

She is the only person in Ireland who has been diagnosed with the disease. There is a drug available, Soliris, which is produced by Alexion Pharma and which has been used in similar cases in America with a high degree of success. The Connolly family requests that she be given access to this drug. In previous answers to parliamentary questions in the Dáil on this matter it was stated the drug was unlicensed for the treatment of Degos disease and that it was exorbitantly expensive. When Alexion Pharma was approached, it suggested she could gain access to the drug under the compassionate drug access scheme. When this issue was raised in the Dáil by Deputy Robert Troy, the then Minister for Health, Deputy Leo Varadkar, said he was unaware of such a scheme. Has the new Minister updated himself on it? Will he inform me of its availability and how it could be used? The drug is unlicensed for the treatment of Degos disease, but it has been recommended for use by the consultant neurologist at St. James's Hospital. Will the Minister progress the issue in a positive manner?

With this matter on my mind this morning, I was taken aback emotionally when entering Leinster House. Last week I could not get in because there were many people outside protesting and lobbying on behalf of the Irish hare. This morning there was no one outside for Charlotte Connolly. She is a human being and the eventual outcome of her condition is death. We have many discussions about various issues in the House. Yesterday I felt more comfortable in my role as agriculture spokesperson discussing the issue of farm safety and the potential saving of lives by taking action and spending money. Today I can actually identify an individual human being whose life could be saved by taking action. I hope I will not receive the copy-and-paste response received previously. Declan Connolly, Charlotte's husband, has written to the Minister since his appointment. He received an acknowledgement of just one letter and no response to the second. If it is not possible for the Minister to give me the answer that I would so love to hear this morning, could he, at least, meet the Connollys to progress the issue further down the line to come up with some solution?

I thank the Senator for raising this issue. I am taking this matter on behalf of the Minister for Health, Deputy Simon Harris, who sends his apologies for not being able to attend. I understand the type of issue the Senator is dealing with, as I have dealt with a similar one in my constituency. I know how difficult it is for the individual affected and their family. The Senator will appreciate, however, that I am not in a position to comment on the case of any individual patient, even when some personal details are already in the public domain.

The HSE, as the principal provider and budget holder in respect of public health services, is obliged to use the resources available in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public. This requires it to make difficult decisions to ensure the finite resources at its disposal are used to best effect. Soliris is an ultra-orphan medicine manufactured by Alexion Pharma and licensed for the treatment of two rare blood disorders. The drug is not licensed for the treatment of Degos disease by either the European Medicines Agency or the US Food and Drug Administration. The licensing of pharmaceutical medicines is a matter for the Health Products Regulatory Authority in Ireland and the European Medicines Agency in the European Union. It is not in the power of the Minister for Health to licence any pharmaceutical product, regardless of whether it has already been approved for use within the European Union. It is appropriate that such matters are dealt with by expert and impartial authorities established for this purpose.

In early 2015 the HSE decided to fund the provision of Soliris for sufferers of two specific conditions for which it had been licensed. At an individual cost of over €400,000 per patient per year, the drug is expected to cost the HSE approximately €8 million in 2016. Given these substantial costs, the director general of the HSE has put in place formal procedures to ensure each case in which Soliris is used is the subject of clear advance authorisation. These arrangements would not permit the drug to be used for the treatment of a condition beyond the terms of the marketing authorisation and where evidence of clinical benefit has not been demonstrated.

It is open to a drug’s manufacturer at any time to submit an application to the European Medicines Agency to have a product licensed for use for a specific indication. Once the drug is approved by the European Medicines Agency, the manufacturer can, if it wishes, submit an application for pricing and reimbursement to the HSE.

It should be noted that there is no provision in legislation for the approval of compassionate access programmes for specific groups of patients with an unmet medical need. I trust the Senator will appreciate the position in this matter. Perhaps such a programme might be looked at further down the line.

I will raise with the Minister the fact that the Connolly family has written to him twice and ask him to respond.

I note the response which is gut-wrenching. We are talking about a human life, but this is a copy and paste answer. I respectfully request the Minister to commit to meeting the Connolly family in person and explore avenues, be it the introduction of a compassionate drugs access scheme or otherwise. The family needs real, not copy and paste, answers. It is a family life that is on the line. I am emotional in addressing the issue. As a county councillor, I get great satisfaction in driving past a signpost on a road where I know I played a part in having it put there. I cannot even imagine what it would be like to help to save human life. Copy and paste answers do not wash. I respectfully request the Minister to meet the family in question to explore other avenues, if the drug in question is unlicensed and there is no compassionate drugs scheme in place. At least we should explore other avenues and give people some hope.

I take on board what the Senator said. I understand where he is coming from, as I have dealt with a similar matter. I cannot speak on behalf of the Minister, but I will bring it to his attention personally and ask him to come back to the Senator.

Mental Health Services Provision

In the 1950s Ireland held the world record for the number of people detained in psychiatric institutions. Thankfully, the majority of the older style Victorian hospitals are now closed and the focus of mental health services is on treating people in the community as close to their homes as possible. In the 1980s, 24-hour supervised residences were opened to accommodate service users who had resided in the old-style psychiatric hospitals, many for long periods. Accordingly, these residences are their homes. It is recommended that such homes be confined to having no more than four residents. However, 40% of the residences inspected by the Inspector of Mental Health Services in 2015 had more than 13 beds. It is important to note that these service users are particularly vulnerable, as many of them have been living with long-term mental health difficulties within institutional settings for most of their lives. However, rather than benefiting from a move to community care, they have, in essence, been forgotten and abandoned by the modern health system which has simply moved from larger to smaller institutions.

Crucially, we do not know how many people are living in these conditions or how many of these residences there are. In its 2015 annual report the Mental Health Commission stated there was a fundamental issue with identifying precisely the number of residences, as well as the number of people living in them. Despite repeated discussions with the HSE, no agreement has been reached on the issue. Additionally, the commission is concerned that some of these residences are too large, have poor physical infrastructure, are institutional in nature and lack individualised care plans. Under the Mental Health Act 2001, the inspector can visit these facilities and report on his or her findings. A service can be requested to provide a quality improvement plan.

However, under current legislation, these facilities are not subject to regulation by the Mental Health Commission. This means that the commission has no statutory powers over them, unlike inpatient units, which it can close down if they breach certain standards of care. The expert group established to review the Mental Health Act 2001 made the following recommendation:

The new Act should give the Mental Health Commission specific powers to make standards in respect of all mental health services and to inspect against those standards. The standards should be made by way of regulations and the regulations should be underpinned by way of primary legislation.

In 2015 the Mental Health Commission inspected 20 24-hour supervised residences. The 2007 HSE report on accommodation for people with disabilities, Time to Move on from Congregated Settings - A Strategy for Community Inclusion, recommended that home sharing arrangements be confined to no more than four residents in total and that those sharing the accommodation, as far as possible, choose to live with the other three people. Some 55% of HSE mental health service 24-hour supervised residences inspected in 2015 had more than ten beds and 40% had more than 13 beds. According to these inspections, only six out of 20 residences inspected were described as in good decorative order, comfortable and homely. A number of residences were institutional in function and environment. For example, chairs were lined up against the walls in a row, bedrooms were devoid of personal possessions, shower facilities were locked, residents were not allowed to lock their wardrobes or bedroom doors. Only seven, 35% of the residences, had exclusively single bedrooms, while 12 had double bedrooms, ten of which had no provision for individual privacy. One residence had two four-bed rooms. The inability to provide residents with a single room impacts on their privacy and dignity. With reference to one of the residences, the inspector reported that the overall state of the residence was poor.

It is recommended that all residents have a yearly medical assessment. In ten of the 20 residences inspected in 2015, the residents had a six-monthly medical check with their GPs, in six residences there were annual medical checks, while in four the residents did not attend a scheduled medical check and attended a GP only if they became unwell. In 14 residences it did not appear that the residents were means tested for charges and each resident paid the same charge.

In summary, the Mental Health Commission stated many of the residences inspected were too big, in poor condition and institutional. There was limited multidisciplinary input in over 50% of the residences inspected. Some residents had no care plans or any meaningful activity to occupy them during the day. Many 24-hour supervised residences were failing to provide opportunities for the optimal recovery and rehabilitation of their client populations, as outlined for them in A Vision for Change, which has been in operation for ten years. Recovery in this context reflects the belief that it is possible for all services users to achieve control over their lives, recover self-esteem and move towards building a life where they can experience a sense of belonging and participation. The guiding principles relevant to the housing needs of individuals with mental health difficulties should include citizenship, equity of access, community care including specialist mental health support, co-ordination of support and inclusiveness. The provision of community residential care for vulnerable mentally ill people, who may not be in a position to articulate their wishes, must be on an equal basis with other citizens and such provision should be a priority.

In 2008 the HSE conducted an evaluation, in accordance with the guidance for value for money and policy reviews, of the efficiency and effectiveness of long-stay residential care for adults within the mental health services. The report found wide variations in resource allocation, a significant minority of clients were deemed to be inappropriately placed, low levels of discharges from long-stay residential services to lower level supports and a lack of consistent understanding of or approach to rehabilitation among the residences. I have more to say, but given that I must conclude, I will send it to the Minister of State.

The Senator will have to write a letter. She seems to have many pages.

The best thing would be to arrange a meeting to discuss it. I thank the Senator for her detailed analysis of many problems. There is widespread acknowledgement that there are many problems that must be addressed. Mental health continues to be a priority for the Government. It is reinforced by the fact that funding is increasing and we have given a commitment to continue to increase it. This will be paramount to how we can progress and address many of the issues the Senator raised.

The Mental Health Commission annual report 2015 reflects the widely accepted need to further develop a community based mental health service, with a prevention and recovery focus, as outlined in A Vision for Change, which, as the Senator said, is ten years old. Given that it was to be reviewed after seven years, we need to get moving on it. The Mental Health Act 2001 provides that the inspector of mental health services visits, inspects and reports on every approved centre at least once every year. The inspector may also inspect any other service where mental health services are being delivered under the direction of a consultant psychiatrist.

The report of the expert group on the review of the Mental Health Act 2001 was published last year. The group recommended the Mental Health Commission develop a risk-based approach to inspection to ensure maximum effectiveness and efficiency in the use of scarce resources. The group was in broad agreement that inspections of approved centres should be proportionate, based on risk and take place at least once every three years. Annual inspections may be required if the risk profile merits such scrutiny. This would allow for community services to be registered and inspected at reasonable intervals using a risk-based system starting with all community mental health teams. Work on the general scheme of a Bill to amend the Mental Health Act 2001 and to include the recommendations I have mentioned is under way in my Department. I will take the Senator's suggestions and would welcome working with her on any of them.

In the context of ongoing development of community mental health teams, the HSE continues to promote prevention and recovery initiatives and enhanced service user engagement across the mental health services. This has been reinforced by my decision to commence a process of policy review for mental health, guided by research into international evidence and best practice in these areas. We should focus not just on mental illness but also on health, well-being and many other factors that contribute to it. Six approved mental health centres achieved full compliance with all regulatory requirements in 2015. While 55 centres were found to be non-compliant to varying degrees, 82% of these findings were small issues rated as having a low to moderate risk of recurrence, which can and, I hope, will be addressed in the very near future. I have urged the maximum effort on the part of all non-compliant centres to meet the necessary requirements in 2016 and in this respect I welcome the introduction of the Mental Health Commission Judgement Support Framework to guide and assist approved centres to comply with the commission’s regulations, rules and codes of practice and to promote improved quality of services through a transparent inspection process. In the light of the fact that it will take time and funding to improve it, we must give as much support as possible to the services to try to ensure they are as compliant as possible.

Funding for the mental health service in 2016 has increased from the 2015 outturn of €785 million to €826 million, an increase of €41 million, which includes the €35 million ring-fenced. This funding is used to develop the priorities for 2016, which includes improved counselling services across both primary and secondary care, continued development of community mental health teams, improved 24/7 response and liaison services, which needs to be a priority, psychiatry of later life, perinatal mental health and two new mental health clinical programmes, namely, ADHD in adults and children and dual diagnosis of those with a mental illness and substance misuse.

The Department of Health sanctioned the HSE to commence expenditure and I have signed off on approximately €22 million of this year’s funding for new developments. It is expected that sanction for the remainder of the funding will be signed off on in the coming weeks.

I thank the Minister of State for her response. It is a large area and the Minister of State has probably already met Mental Health Reform.

Yes, I attended its AGM.

I was going to ask for that to happen.

I would welcome the opportunity to meet the Senator to go through some of the issues she has raised.

I thank the Minister of State.

Sitting suspended at 11.10 a.m. and resumed at 11.30 a.m.