Mental health funding and waiting lists
Deputy Buckley challenged the Government on World Mental Health Day, saying budget allocations were spin and that services such as CAMHS and counselling were still underfunded. The Tánaiste replied that mental health funding had increased substantially, including more money for pay and new developments, and said CAMHS waiting lists were falling.
To ensure that all parties and groups get their fair allocation of time this week, there are two additional slots today, as there were yesterday. I invite Sinn Féin to pose a second question.
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I wish to take this opportunity to express the condolences of Members on this side of the House to the family of Ms Frances Devlin from Ballinacurra, Midleton, Cork, as well as to her extended family and friends, at this very sad time. I thank everyone who assisted with the search over the past four days and who worked so hard to bring Frances Devlin home. May she rest in peace.
Today is World Mental Health Day and I ask the Tánaiste to bear that in mind when he responds to my question. Of all days, today is the day to tell the truth about mental health. It is time to be honest with the people who depend on our mental health services, with their loved ones who support them and with campaigners and the people at large who want something to be done. These are the same people the Government is trying to fool and gaslight. Since I was elected to the House in 2016, the Government has talked out of both sides of its mouth with regard to mental health. I feel sorry for the two junior Ministers in the Department of Health who, I believe, are genuine but who have been forced to defend the crumbs off they table afforded to them each year, which they must know by now will never fully materialise. Last Tuesday's Budget Statement contains just three mentions of mental health. These include a reference to the reinstatement of capital funding that was earmarked years ago, a meaningless platitude and, worst of all, for the third year running, just pure bull. The Government claims that it is providing €39 million of new money for new services but this cannot be true. Up to this month, €25 million of the allocation announced in 2018 had not been spent, but not for the lack of need. Every year more money has been promised, withheld, re-announced, withheld again and so on. According to the Budget Statement, mental health spending in 2020 will be €1.03 billion. Last week in the Dáil, reiterating the spin of 2018, the Minister of State at the Department of Health, Deputy Jim Daly, said that more than €1 billion would be spent in 2019. If €39 million is added to more than €1 billion, it comes to a lot more than €1.03 billion, unless the numbers are false or there is a fabrication. Yesterday at a meeting with Mental Health Reform, the Minister said that out of the €39 million, there is absolutely nothing new. There is no new money.
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There is €26 million for pay increases and €13 million for the Portrane unit and nothing else. There is nothing for Rehab, CAMHS, A Vision for Change or counselling - absolutely nothing.
This Government is supported by Fianna Fáil. I do not intend to let its members get away with this either because they are propping up the Government. What is the truth? The only conclusion that can be reached on the basis of all of these inconsistencies is that nothing honest is being said on either side of this House when it comes to mental health.
I ask the Tánaiste, on World Mental Health Day, to tell the people the truth. What does he have to say today?
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I thank the Deputy for raising this issue and acknowledge that he consistently raises mental health in this House. Mental health continues to be a priority area for the Government. In budget 2020, the Government maintained its commitment to mental health by increasing funding by €39 million to €1.026 billion. This increase includes €13 million for new developments and €26 million for pay, which will help to ensure that existing initiatives are maintained and enhanced. Since 2012, the HSE mental health budget has increased by approximately 44% from €711 million to well over €1 billion next year. Budget 2019 made allowance for an additional €55 million for mental health services to build on the existing services.
It comprised €20 million for the continuing cost in 2019 of developments initiated in 2018, combined with €35 million for further new developments. The investment has enabled the HSE mental health service to progress initiatives agreed in the national service plan 2019, such as e-mental health pilot programmes, and clinical programmes in areas such as eating disorders and ADHD continue to be developed and implemented. The relocation of the national forensic mental health service to Portrane is another significant investment undertaken by HSE mental health services.
To date, €33 million of the funding has been drawn down and an application for a further €10 million is being processed. The management of the remaining €12 million funding for 2019 will be agreed with the HSE in the coming weeks. This money will also be available for new developments in 2020, for which a total of €25 million will be available. The extra funding has delivered the recruitment of 114 assistant psychologists and 20 psychologists in primary care since 2018, as well as ten advanced nurse practitioners in child and adolescent mental health services, CAMHS, who are currently in training.
It is important to state that CAMHS waiting lists, which were and are a priority for the Government, have been reduced by 20% this year. The August figure was 2,038, reduced from 2,517 in December 2018. I understand that the Deputy wants the Government to continue to prioritise mental health services through financial provision, increased staffing and better services, particularly in the community. That is happening and it will continue to be a priority.
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I thank the Tánaiste for his reply, but I am very sceptical of his claims. It is more spin. The Minister of State at the Department of Health, Deputy Daly, told the media at a press conference yesterday that CAMHS waiting lists have been impressively reduced by 20%. The latest data we have, which were published in The Irish Times on Monday, 9 September, indicate that more than 2,500 children and teenagers were on mental health service waiting lists. The HSE figures for June 2019 and July 2017 are almost identical, at 2,440. Some 267 children, many of them in County Cork, have been waiting for more than a year, an 11% increase. Who is telling the truth on this matter? How do we get to a point such that the Government will invest sufficiently?
The Tánaiste referred to the recruitment of 114 assistant psychologists. I have been told that some of them have already left their posts. I made that point at a recent meeting of the Committee on Health. The last person to leave cancelled 300 appointments. The Tánaiste is not telling the truth.
Sinn Féin, working with Mental Health Reform, managed to clarify that only €15 million of additional money was spent in 2017. The €20 million that was left over was re-announced in 2017, when an increase of €35 million was again touted. In 2018, funding of €55 million was announced, but we know that the real figure was only €30 million. We have constantly tried to highlight that the Government is sloughing this over. The Mental Health Commission stated that it met the Minister and it was confirmed that €26 million of the €39 million is earmarked for pay increases. The Tánaiste referred to an additional €13 million for services but that will be spent on Portrane. There is nothing new. Is there new money for mental health services or are we just wasting our time?
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I was going to compliment the Deputy for adhering to the time limit, but he did not do so.
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I assure the Deputy that we are not wasting our time. The investment in Portrane is necessary and will improve services. Extra investment in pay is necessary and allows us to take on more staff.
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That is what is required. The CAMHS waiting lists are too long but we are making progress on them. The list has reduced by 20% this year. The figure in August was 2,038, reduced from 2,517 in December 2018. The number waiting more than 12 months reduced to 201 in August, down from 314 in December 2018. The HSE service plan 2019 aims to improve CAMHS out-of-hours and seven-days-a-week cover, as well as provision for eating disorders, specialist services and prevention and early intervention services. The Minister of State, Deputy Daly, has invested heavily in early intervention services to treat mental illness symptoms as early as possible, thus reducing the need to escalate cases to CAMH services. The number of CAMHS teams increased from 49 in 2008 to 70 today, as well as three paediatric liaison teams. In 2008, there were 350 whole-time equivalent clinical posts in CAMHS. That figure is now 645. We are investing in more people and better infrastructure. I accept that we are not where we need to be, but the charge that we are not prioritising this area for increased investment is simply not true.