Dáil Éireann Debate, Thursday - 26 May 2022
5. Deputy Mark Ward asked the Minister for Health the status of the national review of the Child and Adolescent Mental Health Service, CAMHS, following the mistreatment of children in south Kerry CAMHS; and if he will make a statement on the matter. [26377/22]
Amharc ar fhreagraThe Maskey report into south Kerry CAMHS found that over 200 children were put at serious risk and that 46 children suffered significant harm. I seek an update on the status of the national review of CAMHS, including the timescale for completion and publication. I also seek an update on any improvements that have been made for children in south Kerry.
I thank Deputy Ward for his question. The Maskey report contains 35 recommendations, the implementation of which will involve a range of actions by the Cork, Kerry Community Health Organisation, CHO, for Kerry south, as well as national actions.
As the Deputy knows, the audit of CAMHS is divided into three separate parts. The procurement process for the national audit of compliance with CAMHS operational guidelines is under way. This had to go out to tender. Proposals were received on 2 May 2022 and following assessment and in line with procurement procedures, a provider will be identified as soon as possible thereafter.
The successful provider will be requested to complete the audit within six months of appointment, but I want to see it completed before the end of the year. I am pushing really hard on that. There is a huge opportunity for us in relation to the 73 CAMHS teams, and to look at the complete area of oversight in relation to compliance.
An expert audit group on prescribing practice has been established. It is independently chaired by Dr. Colette Halpin, who was nominated by the College of Psychiatrists of Ireland. The audit group includes Dr. Imelda Whyte, who is a child psychiatry faculty chair, and Dr. Suzanne McCarthy, who is a senior lecturer in clinical pharmacy practice at University College Cork. We felt it was very important to include pharmacy because pharmacists have raised issues with regard to the prescriptions they receive coming across their counters.
The engagement of an academic partner to conduct qualitative research into CAMHS experiences is at an advanced stage. The research methodology for this audit strand will require ethical approval, and the process for securing same is under way. It is expected that the research into the experiences of children and young people attending CAMHS, their families, referrers and other key stakeholders can be completed within six months of the confirmation of the ethical approval.
I thank the Minister of State. On the procurement processing, I always get worried that this will slow things down and that there is a lack of urgency here. Does it go to tender after this? What happens after the procurement process and will that slow things down any further?
I am aware the Minister of State will come back on this, but it is my understanding that since the Maskey report there is still no full-time consultant in south Kerry and a locum is still filling in. We even heard the bizarre news that the whistleblower, Dr. Sharma, asked to come back - he said he would come back and work for the HSE - but his pleas were ignored. At this stage, that man should be commended and not ignored. Is everything possible being done for those children in south Kerry CAMHS at the moment? Will this review be slowed down by any procurement and tender processes?
As the Deputy is aware, we must do due diligence. These audits will cost quite a lot of money. Obviously that is not the issue but they must be done right. We will get real-time data that we have never had before. We have been talking about the waiting lists in CAMHS for so many years and we have been talking about the challenges. I welcome that we will have these data but I want it completed before the end of the year. The six-month timeline was always there. I meet regularly with the HSE to move this along.
The Mental Health Commission is also doing its own review, as opposed to an audit. I met with Dr. Susan Finnerty again last week. The commission has commenced that review and it is up and running. I welcome that the Mental Health Commission is doing a review at the same time the HSE is doing an audit. There will be great comparisons to be made at that time.
On the Deputy's specific question on the south Kerry CAMHS, that post is still vacant but not for the want of trying and not for the want of funding. Huge improvements have been made and I will come back to the Deputy on those.
I want it on the record that while I may be critical of CAMHS, I am not being critical of the CAMHS staff.
I know that.
I appreciate the pressure they are under at the moment with staffing, as the Minister of State has mentioned. At the moment, CHO 4, which includes south Kerry, is at 64% of what is recommended in A Vision for Change. I can understand the pressure they are working under.
Will the scope of the review include Tusla? The Oireachtas Joint Committee on Children, Equality, Disability, Integration and Youth found out some weeks ago that 20 children who were in the Maskey report were also under the care of Tusla. Will Tusla be included in that report to look at what its role was?
With the closure of the beds in Linn Dara, are acute mental health inpatient facilities to be included in any national review of CAMHS? I received information during the week that 27 children spent 87 days in adult mental health facilities in 2021. I am aware that this number has decreased but there was CAMHS inpatient bed availability at the time. One child spent 13 days in such a unit. Will there be any movement to stop this draconian practice?
On the Deputy's first question, the four acute units are included in the audit. I believed that this was very important.
The Deputy asked about Linn Dara. The Deputy will be aware that everything that we can do is being done. There was a report in the newspapers yesterday when I said there was capacity of 16 beds available in Cork. This is actually correct. There are 13 inpatients there at the moment.
To the end of March this year, thankfully, no child had been placed in a psychiatric ward so far this year. If there is capacity, sometimes the units in Dublin and in Merlin Park in Galway do gastro-tube feeding for young people with eating disorders if it is recommended by a consultant psychiatrist. The procedure is not available in Cork and this might be the reason the person was not sent to Cork even though there is capacity there with beds.
Most of it was in the CHO 9 area.
