Dáil Éireann Debate, Thursday - 20 April 2023
15. Deputy Violet-Anne Wynne asked the Minister for Health further to Parliamentary Question No. 347 of 9 March last, the reason that all CAMHS appointments in County Clare take place in the same venue; and if he will make a statement on the matter. [18587/23]
View answerI raise the issue of CAMHS in County Clare, specifically further to the reply I received from the HSE regarding a question I submitted. Will the Minister of State please explain why all the CAMHS appointments in County Clare take place in the same venue in Ennis? Will she make a statement on the matter?
I thank the Deputy for raising this matter. The mid-west CAMHS leadership team works in partnership with clinical directors for the national clinical programmes to develop new models of practice to meet the needs of children and families in the mid-west. The HSE has advised my Department that the mid-west community healthcare mental health service has one CAMHS centre in Ennis, which is used by both the Clare west and Clare east CAMHS teams. There are a couple of reasons behind this. As the Deputy knows - I do not have to tell her - Ennis is the largest centre of population in County Clare. Therefore, the CAMHS facility is optimally located for a large proportion of the county’s population. In addition, it also offers parking and is conveniently located to public transport. Notwithstanding that, the HSE has advised my Department that it is also progressing a CAMHS outreach facility at Inisgile, Parteen. This will facilitate appointments in the east Clare area, providing a service close to people's homes in that area of the county. It is intended that this centre will be operational in the first quarter of 2024, which is a little away.
However, I will tell the Deputy another piece of good news,which is that a CAMHS hub has commenced and is being developed in the mid-west. We have several of these CAMHS hubs throughout the country. The hub is a national clinical programme for which the mid-west is a pilot site. It is intended that the hub and associated pathways will provide an alternative to inpatient care providing children and young people with acute treatment at home or in the hub day hospital, which will be located in Limerick city. What happens in these cases is that when a young child or adolescent gets a diagnosis on being seen originally by the multidisciplinary team, he or she can then opt to have some supports provided online. There will always be a person with them for this - for example, a parent - which is very important. To answer the Deputy's question, we are trying to make CAMHS supports easier for people living in various areas of County Clare.
This is my second time, two days in a row, that I have raised the issue of CAMHS in County Clare in the House. Yesterday, I raised the issue of the significant deficit in staff. The Minister for Enterprise, Trade and Employment, Deputy Coveney, was unfortunately unable to give me a direct reply as to what aggressive recruitment strategy was being undertaken by this Government. Today, I am fed up. The Department of Health has under-profile spending of €22 million in the first quarter of 2023. Public underspending translates to underachievement. Meanwhile, we have 168 children and adolescents in the mid-west who are waiting more than a year to be seen by CAMHS. An independent review into CAMHS mid-west cases identified, in January this year, 140 children and young people who experienced delays in receiving follow-up care. That is atrocious.
The Government talks about the recruitment and retention crisis as though it is some external force and not in any way affected or influenced by the Government. Why can the underspend of €22 million in the past three months not go into training allowances or incentives to encourage graduates to work for CAMHS?
What is the plan in that regard?
My budget does not run for only three months of the year. It runs from 1 January to 31 December and much of the spending happens throughout the year as we recruit. For example, last year we recruited 91 new people to mental health services. Some 10,362 people were working in mental health services in December 2021 and in December 2022 the number was 10,453. The budget runs for the whole year. It is important to acknowledge that there were 33% more referrals into CAMHS supports in the past two years. The total number of referrals in the area the Deputy referred to was 1,928 in 2022 and the waiting list is currently approximately 85 children and adolescents. Waiting list initiatives are under way across six CHOs, including in the Deputy's area.
On the issue of the review into open CAMHS cases I mentioned earlier, I would appreciate if the Minister of State would inform me of the steps that have been taken to follow up with the 140 children and young people who fell between the cracks and, crucially, what steps have been taken to ensure that never happens again. I do not think I can underscore enough the fundamental importance of early intervention in the case of a young person who is suffering with mental health difficulties. We need to support young people and their families throughout Clare and the mid-west.
I welcome the news of the hub the Minister of State mentioned. It is positive information. Again though, it is in Limerick city and for people who live in west Clare, which is more than 45 km from Ennis, it is a greater distance for them to travel. My concern is about distress being caused for individuals and their families in trying to make an appointment for supports and services relating to mental health. I highlight that the HSE's response to my parliamentary question mentions, as the Minister of State also mentioned, the outreach accommodation being sought in west Clare and that is welcome. However, I note that there is no mention of west Clare. Why is that? There is a primary care centre in Kilrush which would be ideal. Why has space not been sought there?
The whole purpose of the CAMHS hubs is to prevent people having to travel if they have this option. That is what we are trying to do, to give parents and children more options. With respect to the follow-up of the 140 cases the Deputy referred to that were classed as lost, the team in Limerick informed the Mental Health Commission that it had a significant staffing issue at that time. It was down three consultant psychiatrists. They have now been put in place. We now have a full complement of seven consultant psychiatrists in CHO 3. My understanding is that all of the 140 cases were contacted. In a few cases they had left the area and it has proven more difficult. Some had left the country.
