Dáil Éireann Debate, Tuesday - 22 June 2004
5 Mr. Neville asked the Minister for Health and Children his views on the fact that the additional funding of approximately €90 million allocated since 1997 for ongoing development of mental health services is a manifestation of the total neglect of the services resulting in 83% of consultant psychiatrists having no access to a psychotherapist, 76% to a family therapist and 33% to an occupational therapist. [18519/04]
View answerSubstantial progress has been made in recent years in ensuring that those in need of mental health services receive the best possible care and treatment in the most appropriate setting. The Deputy is correct in stating that additional funding of approximately €90 million has been invested in mental health services since 1997. This funding has enabled real progress to be made in providing additional medical and health professional staff for expanding community mental health services, to increase child and adolescent services, to expand the old age services and to provide liaison psychiatry services in general hospitals. For example, in 1997 there were 207 consultant psychiatric posts and by 2004 this had increased by 74 to a total of 281. This includes an extra 19 child and adolescent psychiatrists, eight psychiatrists of learning disability, three forensic psychiatrists, 28 adult psychiatrists and an extra 16 old age psychiatrists.
In addition to the increased revenue funding outlined, substantial capital funding has also been provided to mental health services over the lifetime of the national development plan to fund the development of acute psychiatric units linked to general hospitals as a replacement for services previously provided in psychiatric hospitals. In addition to the 21 acute units now in place, a number of units are currently at various stages of development.
Health boards continue to develop a comprehensive, community-based mental health service. This has resulted in a continuing decline in the number of in-patients from 5,192 in 1997 to 3,966 in 2002 with a corresponding increase in the provision of a wide range of care facilities based in the community to complement in-patient services. There are now 411 community psychiatric residences in the country providing 3,146 places compared to 391 residences providing 2,878 places in 1997.
Additional information not given on the floor of the House
A very significant development within the area of mental health service provision in recent years has been the enactment of the Mental Health Act 2001. The main vehicle for the implementation of the provisions of the Act is the Mental Health Commission which was established in April 2002. The commission's primary function is to promote and foster high standards and good practices in the delivery of mental health services and to ensure that the interests of detained persons are protected.
The Mental Health Commission's strategic plan 2004-05, published earlier this year, indicates that one of its priorities for the commission is to put in place the structures required for the operation of mental health tribunals, as provided for in Part 2 of the Act. This year, additional funding of €3 million is available to the commission for this purpose. The commission is currently in discussion with my Department, the health boards and other relevant agencies to ensure that all elements of the organisational and support systems required are in place prior to the commencement of Part 2 of the Mental Health Act 2001.
Under the provisions of the Mental Health Act 2001 the commission has appointed Dr. Teresa Carey to the position of Inspector of Mental Health Services. A team of assistant inspectors has also been appointed. The inspector had indicated that she expects to commence a programme of inspections of mental health facilities from June 2004.
The Deputy has referred to psychotherapy and family therapy, services generally provided within the health boards by clinical psychologists. I recognise that service providers have experienced particular difficulty in recruiting clinical psychologists. One of the main reasons for this has been the very small number of post-graduate training places available for such professionals. My Department, together with the health boards' directors of human resources, have been examining various issues in relation to human resource planning for clinical psychologists in the health services, including the need to increase the number of postgraduate psychology training places on a planned and sustainable medium-term basis. It is worth noting that since 1999 there has been a threefold increase from 26 to 84 in the number of trainee clinical psychologists employed in the health services.
While substantial improvements have been made in recent years in the delivery of mental health care and in the quality of mental health facilities, I acknowledge that much remains to be done. To ensure that we continue to obtain the best possible return on our investment in this important area of health care, I appointed an expert group on mental health policy in August 2003 to review all areas of mental health policy and service provision. The group consists of 18 widely experienced people who are serving in their personal capacities. The membership encompasses a wide range of knowledge and a balance of views on many issues affecting the performance and delivery of care in our mental health services. The group is expected to complete its work in 2005.
The Minister is attempting to blind us with figures. However, does he not agree that funding of €90 million since 1997 is a national disgrace? It is approximately one and a half times what was spent on electronic voting and, at an average of €11 million per year, is €4 million less than was spent this year on Punchestown. This level of investment, the lowest of any of the medical services, totally ignores the one in four people who will suffer from a mental illness during their lifetime. Why is the national treatment purchase fund not available to those in need of assistance and on a waiting list for more than 12 months? Why is treatment for varicose veins considered more important than for depression when such procedures are available under the national treatment purchase fund?
With regard to figures quoted by the Minister, of the 400 clinical psychology posts funded, 180 are vacant. Why is this the case when the psychiatrists association, in its presentation to the Joint Committee on Health and Children, stated that 73% of all psychiatrists do not have a psychologist available to them? The association further stated that the presence of a multi-disciplinary team was connected to the improvement and cure of those being treated for psychological and psychiatric illnesses.
The Deputy referred to psychotherapy and family therapy services generally provided within the health boards by clinical psychologists. I recognise that service providers have experienced particular difficulty in recruiting clinical psychologists. One of the main reasons for this has been the very small number of postgraduate training places available for such professionals. My Department, together with the health boards' directors of human resources, has been examining various issues in relation to human resource planning for clinical psychologists.
For over seven years.
Much has been done, as the Deputy knows, and 35 clinical psychologists are in training at present. However, I accept that more needs to be done. Since 1999, there has been a threefold increase, from 26 to 84, in the number of trainee clinical psychologists employed in the health services. The Deputy is very well briefed by psychiatrists.
The Minister is also well briefed.
Allow the Minister to speak without interruption.
I attended an informative North-South meeting yesterday organised by the Irish Advocacy Network, a group which does much work with the users of services. Many attended from North and South and they were extremely disappointed that, despite sending invitations to psychiatrists from North and South, not one attended. Nonetheless, it was a fantastic meeting and good to listen to the users of the services, who have much to say about the provision of services. Users need to be listened to more, and I intend to do this.
I wish to ask a further brief question.
The time for this question is concluded.
