I propose to take Questions Nos. 17 and 20 together.
Deputies will already be aware of the ongoing efforts made by my Department to fill the vacancy left by the previous in-house military psychiatrist, who retired in May 2018. In this regard, a direct entrant competition for the position of military psychiatrist, which closed on 30th September 2018, yielded no applications. To continue to provide an interim in-house service until such time as the military psychiatrist position could be filled, attempts were made to secure a locum psychiatrist but these also proved unsuccessful.
To explore every option to facilitate an in-house appointment, I gave approval in late-2018 for my Department to conduct a competition for a contracted civilian consultant psychiatrist at pay rates equivalent to those available in the HSE. This approval was subject to sanction by the Department of Public Expenditure and Reform. Sanction has recently been received, and my Department is currently in the process of making the necessary arrangements for a competition to be advertised.
As I have outlined on numerous occasions in the past, there is a nationwide shortage of trained psychiatrists, with recruitment issues in a number of sectors of the health service. The difficulty with recruitment for such a position is not unique to the Defence Forces.
I also wish to stress yet again that there is no delay in referring Defence Forces personnel requiring immediate psychiatric care or assessment. Patients presenting to Defence Forces Primary Carers (Medical Officers or contracted civilian GPs) with a requirement for urgent psychiatric assessment are referred to HSE Accident & Emergency Departments. Those requiring hospitalisation are admitted immediately. Furthermore, in order to provide Defence Forces Primary Carers with the broadest range of options possible in dealing with the spectrum of cases that present to them, they have also been authorised to refer cases to local external private psychiatrists for outpatient treatment where deemed appropriate.