asked the Minister for Health what steps have been taken to establish a National Advisory Council on mental health as recommended by the Commission on Mental Illness, 1966.
Ceisteanna—Questions. Oral Answers. - Mental Health.
3.
I have not yet decided whether to establish a National Advisory Council as recommended by the commission. I am not satisfied that in the present transitional and active stage of implementation of various recommendations of the commission the setting up of a further advisory body would be beneficial. However, I am keeping an open mind in the matter.
4.
asked the Minister for Health in what way the recommendations that a medical staff structure more closely resembling that in general hospitals should be developed within the public authority psychiatric service, will be implemented.
Posts as house officer and psychiatric registrar have been created in a number of district mental hospitals and the designation of higher medical staff posts has been altered as recommended by the commission. Other matters relating to the higher staff are at present being examined and discussions which have taken place between the Department and the staff associations and the managers are continuing.
Would the Minister favour the designation "consultant" in the higher level of psychiatric services as it is in the voluntary service at present?
I agree that this proposal should be implemented. We had a discussion with the managers on 5th February, 1970. There will be tripartite discussions on 19th February, 1970, between the IMA, the Medical Union and the managers and the Department in order to forward this very desirable proposal.
5.
asked the Minister for Health in what way the recommendations of the Commission of Inquiry on Mental Illness, 1966, that the medical and nursing staff should be free to concentrate on those duties for which they have been trained and should be relieved of administrative work which can be entrusted to lay staff, have been implemented.
Attention was drawn to this matter at a conference of managers and resident medical superintendents which was held in my Department in April last. The need for lay assistance was also specially adverted to in a letter which I had issued to mental hospital authorities on the 29th August. From reports received I feel that the mental hospital authorities on the whole are alive to the need for relieving medical and nursing staff of work which can more appropriately be dealt with by non-medical and non-nursing staffs.
6.
asked the Minister for Health the total number of hospitals in the public psychiatric services and the number in which a medical committee in accordance with recommendations of the Commission of Inquiry on Mental Illness, 1966, have been established.
There are 23 hospitals in the public psychiatric service. I have asked mental hospital authorities to furnish information on the second part of the Deputy's question and if he would care to repeat it in, say, two weeks time I would hope to have material for a reply. I intend to meet the heads of all mental hospitals at an early date to discuss with them this and other aspects of the commission's report.
7.
asked the Minister for Health what steps have been taken to create a whole-time chair in psychiatry at University College, Galway, and to provide a separate psychiatric unit to be used by him for clinical work.
Consultations with the appropriate bodies have taken place regarding the creation of a Chair in Psychiatry, and agreement in principle has been reached. It is hoped to finalise arrangements in the near future. I have approved the provision of a new psychiatric unit at Galway Regional Hospital and plans for its construction are at an advanced stage.
8.
asked the Minister for Health how many of the 51 psychiatrists employed in the service are on a fixed salary scale; and what is the longest period for which such an employee has been in such employment on fixed scale.
The information in the precise form requested is not immediately available. If the Deputy will repeat his question in a fortnight I hope to be able to furnish the required particulars.
9.
asked the Minister for Health the total number of mental hospitals in which full-time psychologists are employed in the Republic.
10.
asked the Minister for Health the estimated total number of full-time psychologists needed to provide an efficient psychological service for the Dublin Health Authority psychiatric institutions.
With your permission, A Cheann Comhairle, I propose to take Questions Nos. 9 and 10 together.
The number of district mental hospitals in which full-time psychologists are employed is three.
It is a matter for Dublin Health Authority, in the first instance, to decide what number of full-time psychologists are required to provide an efficient service for their psychiatric instiutions.
Any proposals received for the appointment of psychologists will be carefully considered.
Is it only the Dublin Health Authority which has full-time psychologists employed?
Full-time psychologists are employed by Cork, Dublin and Monaghan mental hospitals. Part-time psychologists are employed in Ardee, Dublin, Carlow, Letterkenny, Enniscorthy, Ballinasloe and Mullingar.
What is the total number of mental hospitals in the country?
I have said that there are 23 public mental hospitals in the country.
11.
asked the Minister for Health what domiciliary care is provided for the 1,100 mentally subnormal children at present on waiting lists for admission to institutions.
The Deputy will appreciate that, in common with other persons, children on the waiting lists may be eligible for a wide variety of services, including specialist advice, nursing and medical services, medical and surgical appliances, medicines, et cetera. In a number of areas care units, special schools and special classes which these children may attend, have been developed. It would be impossible, however, without a very lengthy and laborious investigation to indicate in detail the extent of the domiciliary services provided for all those on the waiting lists.
Is the Minister quite serious when he says that the laborious exercise involved would not be necessary in view of the fact that we have 1,100 such children and we have not any correct statistics apparently as to how they are being looked after at present? To what extent are services available to these children?
As far as I can ascertain, health authorities have very wide powers for the operation of domiciliary services for eligible classes in their various areas. They can provide a medical nursing service for the aged, the chronic sick, the mentally handicapped and so on. They can also provide such special appliances, clothing and bedding as may be required for such cases. As the Deputy also knows, we have a programme for implementing the recommendations made in the report on mental illness which forms part of the provisions in the Health Bill for providing home help in the various areas and in general for developing the domiciliary services. There is a general advance in the direction of sending psychiatric workers out from mental hospitals to help in the domiciliary care of people who are mentally afflicted, to keep them at home as much as possible or to bring them in for the day in some cases. For instance, in County Cork there are people who work and who come for the weekend to some institution where they can be treated for mental disorders. This is a continuing process and I am trying to expedite it as much as possible. The main point is that we go on expanding this service.
This is a particularly distressing problem because these are people who require institutional care and who are rather seriously disabled. If the Minister is not prepared to isolate this problem, to watch it carefully and specially, how is he to know that the services are being provided?
We are watching this and, as I have said, I am having conferences as quickly as I can having regard to the burden of work on the Department. I shall be having conferences with all those in charge of mental health in the country as soon as possible following on a conference that took place last April. We have a great deal of information about what is going on and I can assure the House that in relation to the number of residential places that have to be found I am constantly in touch with the officers of the Department. I had occasion to visit an institution of one Order and I asked the Brother in charge whether he thought there had been any unreasonable delay on the part of the Department between the point where they were prepared to engage in instruction of new staff to look after severely or moderately handicapped children and the actual provision of the building and consequent extension of the work. The Brother concerned said he thought there was not any excessive delay and that a real effort was being made. It is going to take some time before we can find residential places: it is not because officers of my Department are inactive or the Brothers or religious Orders who are able and willing to do this work are inactive or that there is any real delay or lack of feeling of urgency about this matter.
Is the Minister of the opinion that the number of subnormal children necessitating domiciliary care will increase or decrease with the improved plans?
It is very difficult to say. This is not really a matter to be discussed at Question Time as it is far too big a problem. It should be raised on the Estimates—indeed, many of these questions should be raised on the Estimates—and they are far better discussed then. Since the report on the mentally handicapped has been produced there has been no evidence of a notable increase in the numbers coming forward but I have no doubt there may be an increase as the public become more conscious of what can be done for mentally subnormal children. We have been told by the experts that if we plan 1,300 places we will be releasing adult places for children and we will be making a fair contribution towards a solution of the problem. I could not absolutely promise there will not be an increase in the demand.
I am calling Question No. 12.
It should be possible for the Minister to give this information in answer to Deputy Dr. Browne's question or at least to contact the local authorities by circular and ask them for information on this matter in regard to their respective areas. Then the Minister would be in a position to give us some information.
I think I have shown my interest sufficiently in this matter at this stage. I have had a very short period as Minister for Health to convince the House that we are doing everything we can.
I am calling Question No. 12. May I point out that there are 222 Questions on the Order Paper and Deputies have been deprived of replies for days. I think those Deputies should be considered. I am now calling Question No. 12.
The Minister has not given the information——
These questions should be asked on the Estimate.
12.
Dr. Browne, Dr. O'Connell
andMr. O'Leary asked the Minister for Health what steps have been taken to implement paragraphs 201 and 202 of the Commission of Inquiry on Mental Illness concerning the process of admission to a public psychiatric hospital, particularly in relation to informal admission.
Draft heads of a Bill to amend the Mental Treatment Acts are being prepared in my Department.
Paragraphs 201 and 202 of the commissions's report will be considered in this connection.
Can the Minister say when the Bill is expected?
I cannot say.
This year?
It might be towards the autumn but I have no idea. It is a question of the Department working as hard as possible on all aspects of this matter.