Colm Keaveney
Question:86. Deputy Colm Keaveney asked the Minister for Health the position regarding the underspend of €46.8 million in the mental health budget in 2013; and if he will make a statement on the matter. [42997/14]
View answerTuesday, 11 November 2014
Questions (86)
Oral answers (16 contributions)
The Minister of State recently confirmed in response to a parliamentary question that there had been a underspend of up to €46.8 million in the mental health budget. In light of the severe pressure the service is encountering, will the Minister of State offer the House some rationale for the underspend of €46.8 million in that budget?
I wish to say once again that budgetary and other pressures within the HSE delayed the full utilisation of the €35 million that was allocated in 2012 and 2013. The underspend in planned mental health expenditure and the timing of the recruitment of staff developments can be attributed to the time required to get various programmes up and running. I refer, for example, to the counselling in primary care programme, which is one of the most successful programmes we have put in; the enhanced teamworking programme, which has also been hugely successful; the successful mental health information system programme, which should have been in place many years ago; the clinical programmes; and the opening of additional inpatient beds in the area of child and adolescent mental health services.
The provision of additional funding of €35 million in budget 2015 will bring to €125 million the total investment for mental health services since 2012 for the development and modernisation of services in line with the recommendations of A Vision for Change, mostly through the provision of additional posts to strengthen community mental health teams for adults and children. The additional funding is also being used to enhance specialist community mental health services for older people with mental illness or those with an intellectual disability and mental illness, forensic mental health services and suicide prevention initiatives. I believe these things should have been in place many years ago.
At the end of September, an additional 770 posts of the 990 posts provided for in 2012 and 2013 had been recruited, with the remainder at various stages in the recruitment process. There have been difficulties in identifying some outstanding candidates for geographic and qualification reasons.
Therefore, duty has been taken up in approximately 77% of combined two-year posts.
While €20 million was provided for mental health services in 2014, the HSE national service plan outlined that this expenditure would be phased in to allow the HSE to live within its overall available resources. Accordingly, it was decided that the recruitment of the 2014 posts would be commenced to provide for the posts to come on stream during the last quarter of 2014. To this end and informed by the analysis, 200 posts have been identified from the 2014 allocation and the recruitment process has commenced. It is important to stress, however, that the entire underspent funds have been made available to mental health services for spending in 2014 and subsequent years. They have not vanished.
Treatment delayed is treatment denied. The service plan for the recruitment to critical posts that the Minister of State stands over was denied to ensure staff were not on the books until the fourth quarter of 2014, thereby avoiding that payroll cost. Subsequent to last year's budget, the Minister of State publicly committed to ring-fencing €15 million to address the Government's failure in 2013 to protect that valuable resource for recruitment. I welcome this approach and we support A Vision for Change.
So the Deputy says.
The Minister of State keeps beating over the head everyone who does not support her version of A Vision for Change.
There is only one version.
The Minister of State has not listened to the concerns of front-line staff regarding financial resources, for example, those in Beaumont Hospital who resigned citing overcrowding in that hospital as well as funding for A Vision for Change. The Government has underspent.
I am sure the gentleman to whom the Deputy referred would like us to correct the record. He did not resign. He stepped down as clinical director.
From his post.
That happens because people do not always stay in the same posts. I do not disagree with people who disagree with my view of the world. They are quite entitled to have their view and to put pressure on a Minister to get the best possible outcome. I have a difficulty, however, with people - not just in the Dáil - time and again claiming to be in favour of A Vision for Change, only not the way we are doing it when we start implementing it and not in their back gardens. The Deputy knows this. He was involved in one of the many campaigns throughout the country. People must step up to the plate. We need more resources and to do this a bit more quickly, but we are going in the right direction.
Tell us about the back gardens.
I support A Vision for Change, but I do not support the Government's cherry-picking of certain aspects to meet targets of which I am unaware. The Minister of State underspent the budget last year and failed to protect it under the commitment in the programme for Government to recruit specialists. The Minister of State gave a commitment to the public and the House to restore the budget.
I support the fabric of A Vision for Change and the spirit in which it was designed but, by cherry-picking aspects the Minister of State believed would deliver cost savings in other services where someone had proven incapable of spending a budget properly, she failed to protect her budget. This was the core point.
A question, please.
People with mental health issues are not waiting for time-delayed recruitment. They need help and support now.
And extra resources and care.
What the Deputy fails to understand is that we are changing a service. We do not necessarily want the same people who have been working in the service for a long number of years, even though they have done an incredible job. The bulk are nurses who have since upskilled and are doing a different type of job. They would agree with this. I speak with them regularly. They have told me that the expertise they have gained as a result of being allowed to do different tasks is working.
They also tell me it is a better service, in which they prefer working to what had been there previously. Clearly, there will be people who will disagree and who do not wish to change. I can understand this and am not certain that any of us jumps up and down for joy when change is mentioned. However, the Government is determined to change how mental health services are delivered in Ireland. No matter what pressures may come on me, I am determined that the Government will proceed along these lines and on the lines as laid out for us in A Vision for Change.