Dáil Éireann Debate, Wednesday - 15 January 2014
805. Deputy Simon Harris asked the Minister for Health if he will provide an update on the implementation of A Vision for Change; if he will provide in tabular form the current status of each recommendation or action in the policy document in terms of whether it is completed, in progress or not commenced; and if he will make a statement on the matter. [1017/14]
View answer806. Deputy Simon Harris asked the Minister for Health when he expects A Vision for Change to be fully implemented; and if he will make a statement on the matter. [1018/14]
View answerI propose to take Questions Nos. 805 and 806 together.
A Vision for Change (AVFC), which was launched in 2006,provides a framework for action to develop a modern high quality mental health service over the following 7 to 10 year period. Implementation has been delayed by a number of factors including the changed economic context, constraints in public spending and the moratorium on recruitment. It is disappointing that the pace of change towards a modern, patient-centred, recovery orientated mental health service has been somewhat slower than expected but it is the Government's intention that over time access to modern mental health services in the community will be significantly improved. Since 2012, this Government has prioritised the reform of our mental health services with the provision of an additional €90 million and some 1,100 posts primarily to strengthen Community Mental Health Teams for both adults and children and to enhance specialist community mental health services for older people with a mental illness, those with an intellectual disability and mental illness and forensic mental health services in line with A Vision for Change.
A detailed progress report on implementation on each of the recommendations is not available. However, a great deal of progress has been made with the accelerated closure of old psychiatric hospitals and their replacement with bespoke new facilities, better suited to modern mental health care. Progress also includes the development of child and adolescent services, shorter episodes of in-patient care, the adoption of a recovery approach in the delivery of services and the involvement of service users in all aspects of mental health policy, service planning and delivery.
The establishment last year of the HSE Mental Health Services Division and the appointment of the National Director for Mental Health, delivers on a key recommendation of A Vision for Change. This new Division carries operational and financial authority and accountability for all mental services. I expect that this new structure within the HSE will accelerate the pace of change in the development of our mental health services.
The Health Service Executive's National Service Plan for 2014, setting out the type and volume of health and social services the HSE will provide during the course of this year, commits to a number of key deliverables in 2014 continuing to progress the key multi-annual priorities from previous years including implementing the Access Protocol for 16 and 17 year olds to Child and Adolescent Mental Health Services (CAMHS) and reconfiguring General Adult Community Mental Health Teams (CMHT) to serve populations of 50,000 as recommended in A Vision for Change.
During 2014, the HSE will develop an implementation plan for the last 3 years of A Vision for Change and develop a Standard Model of Care. It will focus on developing a major work stream within the mental health clinical programme which will seek to address a variety of issues that have existed for some time and have been raised during the initial engagement process with internal and external stakeholders.
These include:
- Reduce variation and over time provide a relatively standard level of basic service regardless of location.
- Access to, from and flow through the services, general care pathways and out of hours access.
- How mental health can best support and integrate with primary care, acute hospitals and other services.
- A Change Management plan to get to the desired level of acute and non-acute beds, day hospitals versus day centre, etc.
- Involving service users, carers and family members – moving from consultation to co-production, and greater recovery focus.
In addition, the HSE will begin to address foundational issues within mental health services including
- Develop an initial workforce plan for 2014 to bring greater certainty around essential replacements
- Streamline recruitment to allow for more local control and specialisation where appropriate
- Develop an initial training and development strategy for Mental Health
- Build national capacity to respond in a standardised way to serious adverse incidents
- Commence key projects to address ICT gaps.
The National Mental Health Division is currently preparing a National Mental Health Divisional Plan which will detail further its objectives in 2014 and will include prioritised actions for each Mental Health Catchment Area. It is expected that the Divisional Plans will be considered by the HSE Directorate next week with a planned publication shortly thereafter.
