I propose to take Questions Nos. 216 to 218, inclusive, 256 and 276 together.
The Government will be considering the 2011 Estimates for the health service over the coming weeks in the context of its strategy for economic recovery and its target to reduce the general government deficit to 3% of GDP by 2014. Notwithstanding the difficult financial environment, the Government is determined to do everything possible to protect services, to respond to priority demographic and other needs and to support ongoing reform of the public health services within the resources available for health. To achieve this, staff at all levels will have to work together to deliver services in a more flexible way. It is essential that the impact on frontline services of any cuts is minimised while ensuring that the needs of service users remains the highest priority.
The HSE is working within limited financial resources. The appropriate management of the public finances means that the health sector, which represents over 27% of public expenditure, must operate within the approved budget set out at the start of the year. Under Section 31(1) of the Health Act, 2004, the HSE is required to prepare an annual National Service Plan. The Plan, which must indicate the type and volume of health and personal social services to be provided by the HSE, is submitted to the Minister for Health and Children for approval. The appropriate management of the health services also means that the mental health services must be funded in an equitable and sustainable manner.
The estimated cost of the implementation of ‘A Vision for Change’ is €150m over 7 — 10 years. Development funding totalling €54 million has been allocated to the HSE since the launch of the Report in 2006. In addition, almost €1 million was allocated this year under the Dormant Accounts Fund for a programme of suicide prevention measures to help communities to develop integrated local action plans for suicide prevention. To further the implementation of ‘A Vision for Change’, the 2010 Employment Control Framework for the health service provided an exemption from the moratorium on recruitment and allowed 100 psychiatric posts to be filled by nurses or therapists.
There are substantial resources already invested in mental health. The reconfiguring and remodelling of these resources will be the main focus for the immediate future. While implementation of ‘A Vision for Change’ has been somewhat slower than originally anticipated it is important to say that in many parts of the country, services are pressing ahead with the implementation of the policy. Significant progress has been achieved including: shorter episodes of inpatient care, improved child and adolescent mental health services, fewer involuntary admissions and the involvement of service users in all aspects of mental health policy, service planning and delivery. Acute admissions to St Brendan’s Hospital have ceased. Plans for the transfer of acute inpatient admissions from St Ita’s Hospital to a new purpose built unit on the Beaumont Hospital Campus are proceeding. New Community Nursing Units in Ballinasloe and Mullingar have been developed.
The number of child and adolescent inpatient beds will increase from 30 to 52 before the end of 2010. This together with the Mental Health Commission code of practice relating to the admission of children under the Mental Health Act 2001 will greatly reduce the need to admit children to adult units.