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 Header Item Ambulance Service (Continued)
 Header Item Mental Health Services Funding

Thursday, 2 June 2016

Dáil Éireann Debate
Vol. 911 No. 3

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(Speaker Continuing)

[Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly] The Minister and I may not agree on everything but we do agree there is a lot to be done with our ambulance services. Is there a plan and ring-fenced funding? Intending to do something is not the same as saying money has been put aside and that the Government fully intends to resource the service.

The Minister will be aware that the media are reporting that a woman who made a 999 call waited for 84 minutes for an ambulance to come to her in Cavan, which resulted in very serious outcomes. I am not for a moment making an assumption pending the investigation but I am suggesting 84 minutes is not acceptable. People cannot wait. They need to have confidence in the National Ambulance Service. Regrettably, they do not at present. We need to hear from the Minister that there is a specific, detailed plan and money to ensure that it can be implemented.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris The Deputy makes a number of very fair points. She is correct that it is more than a question of generalities and is about what specifically we will do. I can tell the Deputy very clearly today that the programme for Government, which outlines my mandate and what I need to implement along with my colleagues in the Department of Health, commits the Government to increasing the number of staff working in the National Ambulance Service and the number of vehicles available to that service. I am happy to be judged on that in regard to the implementation of the programme for Government. Obviously, when the Deputy starts to see concrete details on the delivery in this regard, it will be in the run-up to the Estimates process and budget, at which time I will have to show the commitment we need to make regarding the National Ambulance Service. It will be a multi-annual process and it will take a number of years. The report is very clear about the challenges that face the service. The report is also very clear about the fact that even if we put all the resources together and could deal with all the recruitment issues, based on the difficulty at times in finding the appropriate staff, worldwide and not only in Ireland, there would still be a number of issues in rural areas in respect of which new solutions would have to be found.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly To be honest with the Minister, I was looking for something a little more specific than the answer he was prepared to give me. I understand a significant increase in the number of personnel will be involved and that the trade unions representing the workers in Dublin Fire Brigade and the National Ambulance Service have sought a meeting with the Minister. Will he accede to the request for a meeting and advise the House on the result?

No one has a lack of confidence in the personnel in the National Ambulance Service. Everybody knows they do a fantastic job but we will need to see specific targets and figures. Unless and until we see them, people will not be confident that the capacity review's recommendations will be implemented in any meaningful way.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris Let me be very specific. I have four specific points to make. First, there is €7.2 million for the ambulance service this year, as I have outlined. It will enable the creation of new developments within the service.

Second, within a week of my appointment as Minister for Health, I went to the Cabinet and got this report published. It was long overdue and needed to be published.

Third, with regard to the request for a meeting, I would be delighted to have one. I have already had an initial engagement with SIPTU on this. However, I would be very happy to have a specific meeting. If the Deputy wants to contact my office, we can certainly arrange that. I will update the House on that.

Fourth, I do not want anybody to believe these are all vague aspirations. The action plan available on the HSE's website is very specific. For example, on foot of the Lightfoot review, the external capacity review of the ambulance service, 60 actions were identified. Of those actions, 28% are deemed complete, 45% are ongoing and 27% have yet to start. With regard to the HIQA action plan, there were 54 actions, 35% of which are complete, 52% of which are ongoing and 13% of which have yet to start. The document is very detailed in respect of the timeline for commencement and delivery. It is the document with the roadmap for a national ambulance service.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly It will cost money. We need to know.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris Absolutely, it will cost money. The Government is absolutely committed to continuing to increase investment in the National Ambulance Service. We began this process with the last budget under the last Government, and we will continue under this Government.

Mental Health Services Funding

 3. Deputy James Browne Information on James Browne Zoom on James Browne asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his priorities for mental health services under the new programme for Government; why there is no funding commitment on mental health services as there was in the programme for Government for the period 2011 to 2016; and if he will make a statement on the matter.  [14119/16]

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee I thank the Deputy for his question and look forward to working with him in his capacity as spokesperson on mental health. As we all know, there has been a debate ongoing for a number of weeks on the key priorities of the Government in the area of mental health. The Deputy and many others have contributed to it. The Deputy put forward his own priorities and wishes and outlined what he feels needs to happen within this sphere. The Government has set out priorities and I have my own goals that I want to see achieved.

A Programme for a Partnership Government confirms the Government’s commitment to further developing and improving our mental health services in line with existing policy, as set out in A Vision for Change. We recognise the importance of fully implementing this long-standing policy in a manner that recognises both geographic problems and that will allow primary care teams, in particular, to provide or access a much greater range of care services. However, since A Vision for Change is ten years old this year the Government is committed to conducting an evidence-based expert review of progress on its implementation and the improvement of mental health services. The review will take account of international best practice and will inform the next steps in the development of our mental health policy, having regard to both human rights and health and well-being objectives.

There needs to be a constant review and consistent implementation following on from the report. We must consult continually on international and European best practice.

A Programme for a Partnership Government gives a clear commitment to increasing the mental health budget annually — I will stand over that commitment — so that we can build capacity in existing services and develop services that badly need to be developed. For example, we aim to extend counselling services in primary care to people on low incomes and to extend support for organisations that offer free counselling and psychological services. In addition, we will work to ensure every emergency department has a clinical nurse specialist in psychiatry on its team, with greater linkages to primary care. We acknowledge staffing is a problem, and I am committed to working on that. Maintaining the link with our communities and making services more accessible are key priorities.

Deputy James Browne: Information on James Browne Zoom on James Browne I acknowledge that the Minister of State might not have been involved in the writing of the programme for Government, but many interested parties, including mental health groups, were struck by the fact that there was no specific funding committed in the programme, as there was in the programme for 2011 to 2016. Perhaps that commitment was not always honoured but at least it could be specifically pointed to in the programme. In 2014, some €20 million was allocated instead of the €35 million that was then promised. This year, €12 million was siphoned off.

My predecessor, former Deputy Colm Keaveney, highlighted concerns about these cuts when the service plan was published in December. Unfortunately, his predictions at the time were borne out with the mental health budget being seen as a soft target. Although the new programme for Government specifically states the mental health budget will be increased annually, which must be acknowledged, can the Minister of State be more specific? How much will be provided in budget 2017 for mental health services?

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee Some €115 million in additional funding for mental health services was made available at a time when other budgets across the spectrum were cut. That increase was made by the previous Government so there is no reason to fear no commitment to increasing funding on the part of the current Government. We have committed to an increase year upon year. Obviously, we would like to see the funding increased as much as possible. Our programme for partnership Government outlines clearly that we want to tackle this problem adopting a cross-party, cross-departmental approach and take on board the various issues more specifically.

I am committed to developing youth mental health services, as is the Government with its announcement of a youth mental health task force. That will require funding but the commitment has been made. We will increase funding year upon year but I cannot give the Deputy an exact figure.

Deputy James Browne: Information on James Browne Zoom on James Browne The programme for Government outlines that the new Government is committed to meeting the recommendations of A Vision for Change. The confidence and supply agreement between Fianna Fáil and Fine Gael also pledges to implement fully the recommendations of A Vision for Change. That requires funding. The Fine Gael manifesto pledges €35 million annually so it seems strange that this was absent from the programme for Government. I hope it was an oversight.

Will the Minister of State work to ensure a funding increase in the region of €37.5 million per annum, which is required to meet the commitments in A Vision for Change, will be made and assure us that the mental health service staffing level, which is currently 75% of that recommended in A Vision for Change, will be adequate? It will require some €187.5 million to rectify this.

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee The full €35 million that was ring-fenced for this year will go into the base for next year. The budget will have to account for the fact that we are examining cross-departmental options.


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