Those who have repeatedly raised the shambles that is the health service in this House over the years have been treated by contempt by this Government, which has come up with excuse after excuse for why nothing seems to change. The situation in the mental health services has gone largely unmentioned. This is particularly true of mental health services for older people. Last Friday, the people of County Donegal learned that mental health services for older people in the county have been closed since 7 September last. We heard nothing about this from the HSE or the Government for three months. It was only when I was contacted by concerned family members who were having difficulty accessing services and clinics that we discovered what has happened. We learned that the clinical director of the service sent a letter to all GPs and senior HSE staff in the county in which he stated:

All referrals received by the Mental Health Service for Older People will be returned to sender. A liaison service to Letterkenny General Hospital can no longer be provided... Care of the Elderly Services in Donegal are [now] the sole providers for all needs of the elderly population.

This letter was sent because, in the words of the clinical director, "without urgent contingency planning, the Donegal Mental Health Service can no longer provide a consultant-led, safe service for the elderly population of Donegal".

I remind the Taoiseach that 78% of over 50s with depression are undiagnosed. A further 85% of people over the age of 50 who suffer from anxiety are also undiagnosed. Signs of depression in elderly people can also be symptoms of the early onset of dementia. If no service is available for older people, many cases could go undiagnosed, which might impose extra costs on the health services. As he comes from rural Ireland, the Taoiseach will be aware that many elderly people are suffering from isolation and loneliness, which can lead to increased anxiety and depression. How can they get help when services have been shut down? Mental health services have lost over 1,000 staff since 2008. In January of this year, staffing levels were just 77% of those recommended in A Vision for Change. What does the Taoiseach intend to do to restore mental health services for older people in County Donegal? When can we expect to see a consultant-led mental health service, which the Government has said is a priority? Does the Taoiseach think it is acceptable that GPs should be left to deal on their own with patients who present with mental health problems?

I thank the Deputy for his question. If proper services are to be provided to people right across the board, an economic engine is needed to drive that. For that reason, the Government has deliberately focused on sorting out the public finances and creating jobs that pay well.

The Government is at it a long time now.

Stay quiet, will you? It is not your question.

The more people we have working, the less tax people have to pay and the greater the opportunity to invest in services like those mentioned by Deputy Pringle. The 2016 Vote for the Department of Health is €13.165 billion, which represents an increase of €880 million on the 2015 allocation. Deputy Pringle will be aware that the HSE is required to prepare a service plan setting out how it expects to provide health services to people. It is then required to send that plan to the Minister for Health, who has 21 days to respond to the HSE's proposals. Obviously, there are challenges in the health system. That has always been the case. The service plan was submitted to the Minister for Health on 4 December last. The Minister and the Department will assess the HSE plan. The Minister has 21 days to return it with his recommendations for what should happen. The total level of funding available to the HSE for 2016 is just over €13 billion. The priorities within that will be identified by the HSE and confirmed by the Minister, before being sent back to the HSE for implementation. The scope for vast improvements in 2016 is not there. There is scope for modest improvement. A number of service improvements are planned, including the implementation of the national maternity service.

The Deputy asked about mental health. Where are the answers?

Additional funding for mental health is being handled by the Minister of State, Deputy Kathleen Lynch, who is doing a wonderful job in this area. Further developments in primary care include enhanced therapeutic services for young people. I take Deputy Pringle's point about older people with dementia problems in County Donegal. It is the same thing all over the country. They all deserve a better service. If we are to provide the best service we can give them, we need an economic engine to create the necessary investment. For that reason, the Government intends to continue to focus on well-paid jobs. The more people we have working, the less tax they will pay and the better these services can be. The Minister will return the programme, with his proposals, to the HSE for implementation. One of his priorities is the enhancement of services in the mental health area.

We have been hearing about the so-called "engine" in the economy for the past couple of years, as the Taoiseach has spoken about the so-called recovery, but that engine has not spluttered into life for anybody outside the Pale.

Hear, hear.

Not in Kerry anyway.

Deputy Pringle does not need your help, thanks very much. He is well capable of handling himself.

The Taoiseach has suggested that extra funding is being provided for the health service, but I remind the House that the budget for the health service is still €1.5 billion less than it was before the economic crash. The services are not being provided. The Government has focused on improving the lot of the wealthy, for example, by giving them tax breaks, rather than looking after citizens who are crying out in need of services. The Taoiseach's answer is not good enough for the people of Donegal, particularly the elderly, who do not have a service to go to. When they attend GPs to look for help, the letters and referrals sent by those GPs are being "returned to sender", in the words of the director of mental health services in the county. This issue needs to be addressed as a matter of urgency. Staff need to be provided to allow this service to be restored and helped to get up and running again. It is not enough to say the service plans have to reviewed and sent back again by the Minister for Health. The Government has to act to ensure services are there for the people who need them.

Hear, hear.

Deputy Pringle comes in here on a regular basis with a clear philosophy of "pay for nothing and provide everything".

No. It is obvious that the Taoiseach has not listened to anything I have said.

I am sure the Deputy realises that there is nothing for nothing in this life. The situation that applied when this Government took over was a catastrophic mess.

It had the figures.

Things have improved because the people have rallied to that challenge. Deputy Pringle seems to think the property and water charges can be abolished.

What would happen if the mental health services in Mayo closed?

He thinks all of these services can be provided without people having to pay for anything.

What would the Taoiseach say?

Some €90 million was provided for consultants.

I assume he appreciates that the economy is about people and not about statistics.

I am talking about people.

I want services to be available to the people of Donegal and every other county.

Deputy Pringle is talking about some of the most vulnerable people in the country.

I am not just talking about the provision of services for older people with dementia. I am talking about the provision of services to every person.

It is a blunderbuss, scattergun approach.

Stay quiet.

That is why we want to move towards the abolition of the double-tier system, which has been inequitable.

The Government has abandoned that move.

I know that the community and voluntary services that deal with people with dementia around the country do a wonderful job and provide great comfort and consolation to families afflicted by dementia. The law states that when the HSE submits its report to the Minister, the Minister has 21 days to return it to the HSE. An increase of €880 million has been allocated to the Department of Health Vote and I confirm that one of the areas in which we expect a modest improvement in the level of services is mental health. The Minister will examine the HSE proposals, make his recommendations and return them to the HSE for implementation. I hope the modest improvement to which I referred will have an impact in the homes of Donegal and every other location where it is required around the country.