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Mental Health Services Funding

Dáil Éireann Debate, Tuesday - 18 October 2016

Tuesday, 18 October 2016

Ceisteanna (15)

James Browne

Ceist:

15. Deputy James Browne asked the Minister for Health the way in which the additional €35 million for mental health services will be spent in 2017; if, with regard to the commitment in the confidence and supply arrangement and in order to provide clarity, he will commit to a multi-annual plan for the period 2017 to 2021, setting out the way the services and measures required for the full and complete implementation of A Vision for Change will be put in place; and if he will make a statement on the matter. [30969/16]

Amharc ar fhreagra

Freagraí ó Béal (6 píosaí cainte)

I ask the Minister of State the way in which the additional €35 million for mental health services announced in this year's budget will be spent in 2017. Having regard to the commitment in the confidence and supply agreement and in order to provide clarity, will she commit to a multi-annual plan for 2017 to 2021, setting out the way the services and measures required for the full and complete implementation of A Vision for Change will be put in place, and will she make a statement on the matter?

I thank the Deputy for his question. I am pleased to confirm that the allocation for new developments within mental health services will be even greater than the significant resources made available in recent years. This arises as a result of a combination of increased revenue funding and a major capital allocation which has been secured for mental health services.

In line with my commitment to achieve a full-year allocation of €35 million in additional funding for mental health, I am initiating €35 million in new services for 2017. Key mental health priorities to be addressed in the Health Service Executive, HSE, 2017 service plan include youth mental health, including the improvement of child and adolescent mental health services; improvement in adult services and those relating to older people, improvement in services for those with eating disorders, and the enhancement of out of hours response for those in urgent need of services. As has been widely acknowledged, and as I acknowledged last week, recognising the time lag in new staff taking up posts and the completion of other preparations for the introduction of these services it is estimated that the revenue spend in the calendar year 2017 associated with this increased allocation will be some €15 million. However, €35 million in service developments will be initiated in the course of the coming year. I look forward to briefing the Deputy on these developments once the details have been finalised and the national service plan approved. In addition, there will be further increases in mental health current spending associated with increased pay rates, and this will be subject to separate funding of approximately €9.7 million.

A priority for me for 2017 was to secure additional capital spending for mental health. This was urgently required to allow the construction contract for the National Forensic Mental Health Campus at Portrane to be awarded. This project has been subject to a significant increase in costs arising from price inflation in the construction sector, some additions to the project, and the need to spend additional money in meeting planning conditions. Completion of the tender process meant funding of these increasing costs needed to be secured before the contract for the project could be awarded, and I am delighted that I obtained the support of my Government colleagues to proceed with this landmark project. It is estimated that approximately €50 million in capital funding will be spent on the project next year, with further spending in completing the project from 2018 onwards.

Additional information not given on the floor of the House

The Central Mental Hospital was established in 1850. The project to develop a new service to replace the hospital was first initiated in 2000. In 2009, the Portrane site was selected. The award of the construction contract, which my Department has approved, means there will be no further delay in the long overdue replacement of the Central Mental Hospital with a modern, purpose-built facility at Portrane.

With regard to the continuing implementation of A Vision for Change, the Department of Health is currently leading the review of this policy with a view to the development of a successor document which will complete the process of modernising mental health services and effectively promoting mental health. I envisage this successor policy including detailed implementation arrangements, underpinned by a multi-annual investment plan, will inform the allocation of resources in future years.

I thank the Minister of State. I need clarity on this issue. Appendix 1 of the confidence-and-supply arrangement commits to fully implementing A Vision for Change. The confidence-and-supply arrangement votes are dependent on the full implementation of the policies attached to that document. We agreed to facilitate budgets consistent with the agreed policy principles attached to the document, which runs over the full term of Government or five years. In response to a parliamentary question I tabled during the summer, the Minister stated that the required amount needed to fully implement A Vision for Change is €35.4 million per annum. Will the Minister of State confirm that the full €35 million will be spent in 2017 and that there will not be a repeat of what occurred earlier this year when money was withheld?

I will agree with the Deputy on that. In order to implement A Vision for Change, we need to continue to increase our funding. That is a commitment this Government has given and, for me, it is a commitment it has honoured. However, we know that is not possible over one budget but that it will be implemented over the course of the next three to five years. The Deputy will agree that it includes not just spending on revenue but also capital spending. If we are to bring ourselves in line with A Vision for Change, we need to improve our services and facilities, and where we provide those services.

The central mental hospital was built in 1850 as a lunatic asylum but we still house people there. In order to bring ourselves into line with A Vision for Change, we need to begin the construction of the new forensic hospital and the €50 million will allow that to happen next year. We will increase spending next year with €35 million of new developments to be initiated. The focus will be on capital and ensuring that the new forensic hospital is started.

The €50 million in capital expenditure is very welcome but the Government needs to understand that the commitment to increase investment by €35 million annually is just that - a commitment to increase investment by €35 million annually, to meet the requirements under A Vision for Change. In 2016 the Government announced €35 million and then withheld €12 million in a U-turn into which it was forced in June. Fine Gael pledged increased funding of €175 million for mental health on page 135 of its programme so I hope that, having announced €35 million in the budget this year, it is not going to perform another embarrassing climbdown. I emphasise that €35 million means €35 million.

As announced last week, we will be initiating €35 million of new developments. As the Deputy points out we have not spent all of our funding, nor have we been able to spend it. In anticipating that we would not be able to spend it all in one year, we have decided that we will initiate €15 million of the €35 million to begin the development. All €35 million will be in the base next year but the focus this year is on the €50 million to further develop services at Portrane. It will take five years to commit fully to the pledge we gave but there is no sugar-coating here. We are initiating €35 million of developments and, overall, we will be spending €74.7 million more on mental health next year than we are spending this year.

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