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 Header Item Health Services Funding (Continued)
 Header Item Mental Health Services Report
 Header Item Adjournment Debate
 Header Item Medicinal Products Availability

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] In terms of what the money is spent on, exactly how many episodes of care did this cover for the year?

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris I also fully support the public health service and want to see investment in it, and I want to see the committee we set up yesterday devise a vision, a plan and funding costs for how to get the service to the place we all want it to be over the next decade.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly Not privatisation.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris I also recognise the NTPF as a useful vehicle at a time when there are people at home who could be watching our questions session today and who are in need of an operation, where perhaps the capacity does not currently exist within the public health service.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly There needs to be investment in front-line services.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris While we will disagree on the extent of that, it is very much my position and that of the Government.

With regard to the €50 million, €51 million was provided in 2015 and the Deputy is correct in regard to the ministerial briefing. Some of that funding has spilled over into 2016 in terms of pay. The €50 million referred to in the programme for Government is not something that would have been available in my ministerial briefing. It is a political commitment by me and in the programme for Government to allocate €50 million in the budget.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly That is the question I was asking.

Deputy Simon Harris: Information on Simon Harris Zoom on Simon Harris I expect that €50 million of the health budget next year will be allocated to waiting list initiatives. As I said, I will be looking at how best to outline that. I will provide the Deputy with some of the figures later.

Mental Health Services Report

 12. Deputy Brian Stanley Information on Brian Stanley Zoom on Brian Stanley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the status of the review of A Vision for Change being undertaken, including the terms of reference, the membership of the panel, the progress to date and when it will completed; and if he will make a statement on the matter. [13717/16]

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee I thank the Deputy for his question, which relates to the review of A Vision for Change which is currently being undertaken. In January 2006, the Government adopted the report of the expert group on mental health policy, A Vision for Change, as the basis for the future development of mental health services in Ireland. It advocated, first, a holistic view of mental illness and an integrated multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems; second, a move away from traditional institutional-based care to a patient-centred, flexible and community based mental health service; third, a person-centred treatment approach which addresses each of these elements through an integrated care plan, reflecting best practice, evolved and agreed with both service users and their carers; and fourth, the aiming of interventions at maximising recovery from mental illness, building on the resources within service users and within their immediate social networks, to allow them to achieve meaningful integration and participation in community life. This is something all of us want, namely, to be part of our community and be able to contribute to our community. Fifth, it advocated the organisation nationally of mental health services in catchment areas for populations of between 250,000 and 400,000, with specialist expertise provided by community mental health teams, which are expanded multidisciplinary teams of clinicians who work together to service the needs of service users.

A Vision for Change has guided national mental health policy for the past ten years and, as we all know, that term has come to an end. While that vision has not changed, the Department is currently finalising a request for tender for a review and analysis of international evidence and best practice in the development of mental health services, including a review of current delivery of services in Ireland. This review will provide evidence to determine the policy direction for a revision of A Vision for Change. The review will also have regard to both human rights and health and well-being objectives. At that stage, the exact timeframe for completion of the revised policy direction will be determined by the planned analysis outlined above.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly The vision of A Vision for Change was never realised, although it was Government policy for five years under Fianna Fáil and further five years under Fine Gael. If the Minister of State talks to any person working in our mental health services, they will tell her the goals that were set out within A Vision for Change were not only not reached, they were not even nearly reached. All that happened is that the big psychiatric hospitals were closed but the community services that were promised were never put in place. I represented people working in the mental health services for years and we watched closure after closure and repeated failures by successive Governments, which did not put in the community care that is so essential.

We do not need another report, we need to have concrete action in terms of how mental health services are going to be protected into the future. In particular, we need to refer to the fact staffing levels are at 23% below what is needed. The Minister of State will be aware targets were set in A Vision for Change but none of those targets were reached in any discernible way. With regard to the review and everything else that will take place, will there be ring-fenced funding and if so, will that be raided like the Government raided it the last time? Can we have confidence that we will see a priority and focus on mental health?

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee To agree with the Deputy, when this document was published in 2006 we possibly did not foresee the financial circumstances in which we would find ourselves in the following years. However, in the last number of years the implementation of A Vision for Change has been given greater priority, with the Government providing an additional €160 million in ring-fenced funding for mental health in the period 2012-16. In view of that additional funding, we have had 1,550 additional posts in that field. However, I am very much aware there is a difficulty in obtaining and maintaining staff. Only this week, the HSE is reintroducing a one-year post-registration programme in psychiatric nursing for nurses who are already in the general field, in intellectual disability or in the children division. While I understand it is not enough, 30 posts are being made available from August onwards. A lot of work needs to be done in that regard.

As the Deputy said, there is no point conducting a review and having it sitting on a shelf, doing nothing. There needs to be a continuous assessment and continuous review, given times have changed since A Vision for Change was published in 2006. We know that the manner in which we implement our policies and our framework must change dramatically. While it will eventually be published, this review will be continuously reviewed and the implementation will be reviewed.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly Is it intended that mental health service users, their advocates, workers in the service and people with a material interest in the findings of this will have an opportunity to have an input into it? Does A Vision for Change, and the priorities set out therein, remain a priority for the Government? If so, will the Minister of State confirm that the workings of the task force will not hinder or impede the implementation of A Vision for Change any further?

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee It would be my intention that the report will be brought before the committee so it could be discussed not just by ourselves and by Deputies but also, as Deputy O'Reilly said, by those who have an interest in it, such as the service users, the providers and the professionals themselves.

Deputy Louise O'Reilly: Information on Louise O'Reilly Zoom on Louise O'Reilly Perhaps the Minister of State misunderstood my question. I asked if these people would have an opportunity to have an input into it, not simply to read the report when it is completed.

Deputy Helen McEntee: Information on Helen McEntee Zoom on Helen McEntee The review of A Vision for Change will allow the different individuals to have an input to this. We will need to look at best practice and at international norms, which will include asking those who are in the field and within the service. The Deputy asked if this is a priority, and it most certainly is. The fact is we have committed to increase spending on mental health year upon year, although I cannot give the Deputy a figure for that increase. We have committed to implement the review and implement A Vision for Change, and also to implement Connecting for Life and the priorities set out in that.

Written Answers are published on the Oireachtas website.

Adjournment Debate

Medicinal Products Availability

Deputy Richard Boyd Barrett: Information on Richard Boyd Barrett Zoom on Richard Boyd Barrett This is an issue the Government and the new politics urgently has to do something about. The Minister is aware that in the past few weeks, we have had two instances where people who are ill, often with life-threatening illnesses or seriously disabling illnesses, are not able to access certain drugs because of price, rather than the question of their medical efficacy or how they could help people who are sick, suffering or, in some cases, in life-threatening situations.


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