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 Header Item Leaders' Questions (Continued)
 Header Item Business of Dáil
 Header Item Questions on Promised Legislation

Thursday, 13 April 2017

Dáil Éireann Debate
Vol. 947 No. 2

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Deputy Catherine Connolly: Information on Catherine Connolly Zoom on Catherine Connolly Thirty-three years ago, in 1984, such was the concern about the mental health services that the central recommendation of the major new document, Planning for the Future, proposed a new model of mental health care. Between 1984 and 2006, there was concern at the slow implementation of the policy and in 2006 - nuair atá an Tánaiste réidh - A Vision for Change was published. This document detailed a comprehensive model of mental health service provision for Ireland for the ensuing ten years, including providing a framework for building and fostering positive mental health across the entire community and providing accessible community based specialist services for people with mental illness. In other words - má tá an Tánaiste in ann éisteacht - it told the Government exactly what to do. A Vision for Change told the Government what to do and how to do it but because its authors knew it would not happen, they made a strong recommendation that an independent monitoring group be set up because the Government, like all institutions, simply cannot be trusted. The implementation body was set up. It sat for two periods, that is, from 2006 to 2009 and from 2009 to 2012, when it monitored and assessed. It comments that the implementation of A Vision for Change was not up to scratch. The implementation body did such a good job in highlighting the slow and inconsistent implementation of the policy document that the body was disbanded.

Separately, year after year the Mental Health Commission has drawn the Government's attention to the failure to implement properly, fully and comprehensively A Vision for Change. In its 2016 report, the commission confirmed that A Vision for Change remained the national mental health policy. The document is to be praised. It highlighted recovery, person-centred approaches, partnership, user and family involvement and the delivery of services in a multidisciplinary community basis. A Vision for Change ran until January 2016. The Mental Health Commission has pointed out that while the vision of the document is excellent, the implementation was certainly not up to par. More importantly, the commission reiterated the need for an independent monitoring of A Vision for Change. Five years have passed without any independent monitoring mechanism. We are one year and three months after the promised review of the existing A Vision for Change. I have no idea what the difficulties are in this regard. I have raised it with the Tánaiste and I have raised it in the Dáil ten times but we still do not have the promised review or the implementation body, which is absolutely essential.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney I thank the Deputy for raising this very important issue, one that is a priority for the Government. Mental health remains a key care programme priority for the Government. This is reflected in the fact that the mental health budget for the HSE has increased from approximately €826 million in 2016 to approximately €851 million this year. That is important because we know there are unmet needs in the State in respect of mental health services. Importantly, the stigma around mental health issues is decreasing and this is particularly noticeable among young people with the initiatives being taken in schools and by the supports these give to young people with mental health issues. There are some wonderful changes in the country in that regard.

A Vision for Change was the first important seminal document that laid out what we needed to do and that described the kinds of mental health teams needed for children and adults. A Vision for Change is still being implemented. I acknowledge that Deputy Connolly has asked this question in the Dáil previously. I am glad to be able to confirm that the Minister of State, Deputy McEntee, has informed me that the first stages of the review will be published within two to three weeks. Once published, the implementation group will be established immediately. This is currently under way.

The review will identify current gaps and it will publish plans to move towards having services available for 24 hours every day of the week. This is very important as access to emergency help or out-of-hours services is a huge issue in mental health. These issues will be addressed.

As Deputy Connolly knows, there have been a lot of developments. If one looks at what has been happening in the area of child mental health services, one sees that the funding prioritised by the Government has allowed new teams to be established. We now have 67 child and adolescent mental health service, CAMHS, teams nationwide, which is a huge improvement compared with the situation some years ago. We have three paediatric liaison teams. These are a very important part of the service because they provide the link between paediatrics and the mental health teams. There are 66 operational CAMHS beds across the country and we are planning to have further inpatient beds for children and young people with mental health issues.

The direct reply to the Deputy's question is that the review report will be available in two to three weeks.

Deputy Catherine Connolly: Information on Catherine Connolly Zoom on Catherine Connolly I thank the Tánaiste for letting me know when the report is to be available but it is not clear what will be the nature of that report. It seems to be the first stage in a further long process. The seminal document on mental health goes back to 1984 so there are no congratulations here. When we are talking about stigma and what is available, the difficulty is that all of this was recognised back in 1984 and re-recognised in 2006. There was nothing wrong with A Vision for Change. It is a brilliant document. It sets out everything. It sets out the figures in respect of suicide, which were at crisis point in 2006 and are significantly worse now, particularly in Galway city and county. We do not need any more statements in the Dáil. Members have been making statements about mental health but want an implementation of the document and want the independent body to be set up. If the Tánaiste is confirming this, then it is progress and I welcome it. We need absolute clarity on the review process and we need an implementation body similar to the previous body - and independent of the Government - to monitor the implementation of the existing A Vision for Change and any new changes.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney Deputy Connolly is absolutely right in that we do not need to reinvent A Vision for Change completely. It was an excellent document and it provided the basic architecture for the development of mental health services in Ireland. More than 80% of the recommendations have been implemented but as with other areas of the health services, a key issue is the recruitment and retention of staff. I have already shown the Deputy the improvements that have been made in the areas of child mental health, for example. The same is true of the adult mental health services. There is further work to be done.

The first stage of the review, to be published in two to three weeks, will address the issues. The review is an evidence-based report and is based on experience internationally and in Ireland. This will influence the further implementation of A Vision for Change. It is about continuing to implement what was originally outlined in A Vision for Change but bringing it up to date and accelerating some initiatives, especially the provision of a 24-hour service seven days per week.

Business of Dáil

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl Before we proceed to Questions on Promised Legislation, Deputy Aengus Ó Snodaigh has a proposal to put to the House on behalf of the Business Committee.

Deputy Aengus Ó Snodaigh: Information on Aengus Ó Snodaigh Zoom on Aengus Ó Snodaigh It is proposed, notwithstanding anything in Standing Orders, that Second Stage of the Prohibition of Micro-Plastics Bill 2016 shall not be taken today, and the Dáil shall adjourn on the conclusion of Topical Issues.

An Ceann Comhairle: Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl Is that agreed? Agreed.

Questions on Promised Legislation

Deputy Robert Troy: Information on Robert Troy Zoom on Robert Troy Exactly six weeks ago, I raised in a Topical Issue debate the subject of the revaluation process that is under the remit of the Tánaiste and Minister for Justice and Equality. The Tánaiste's colleague, the Minister of State, Deputy Catherine Byrne, took the debate in her absence and the Tánaiste was to revert to me. Six weeks later I am still waiting for an update on the revaluation process that is under way in a number of provincial towns across the State. It is leading to increases in commercial rates of up to 400%. Will the Tánaiste's office finally respond to the questions I raised in the Topical Issue debate? Will the Tánaiste also indicate when Members might expect the consolidation of the commercial rates legislation to come before the Dáil? When that legislation comes before the Dáil, will the revaluation process that is currently under way by the Department of Justice and Equality's Valuation Office cease to exist?

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney I will ensure that Deputy Troy receives that reply today and I apologise for that.


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