Last week, I put several questions to the Taoiseach about ethical standards in Fine Gael, and I have just been sitting here, as we all have, listening to the exchanges between Fine Gael and Sinn Féin over dodgy donations and funny money, we might say. I know we are going to return to the issue later.

I want to raise with the Taoiseach an issue that is very serious because of the enormous real-life harm and consequences that have been inflicted on children and families as a result. I am speaking about the damning report of the Mental Health Commission, which has made unequivocal findings about the failings across the child and adolescent mental health services, CAMHS. They are appalling findings. One hundred and forty children have, apparently, been “lost” in the mid-west CAMHS system. There has been an abject failure to monitor children on anti-psychotic medication, chronic understaffing and long waiting lists. There have been two-year delays, we were told, for follow-up appointments, young people reaching 18 with no transition to adult services, and an appalling and endemic lack of organisation across the service.

The findings are shocking and, behind the staggering figures and statistics, there are real children and families, some of whom will suffer lifelong consequences as a result of the failings detailed in the report. I am thinking about the 46 children in south Kerry CAMHS found to have suffered significant harm, as detailed in a report we saw last year, and of the 13-year-old girl written about by Kitty Holland in yesterday's newspaper, who was told, when she was engaging in self-cutting, that she was too high risk to receive help from the charity Jigsaw but not high risk enough to receive support from CAMHS. This was a child with a suicidal diagnosis, left in limbo. It is unthinkable that this is happening in today's Ireland, that children are being sold short in such a way.

It is not just mental health services for children, because a record-breaking 46 children are reportedly waiting on trolleys in hospitals today. That is not how children should be cared for in a republic, with persistent failures of clinical oversight and delivery of services to children in need of mental and physical health services.

The Taoiseach committed to setting up a unit on child poverty in his Department, as part of his nomination speech in December, but will he commit to ensuring children will receive the necessary health services that are clearly not currently available?

Will the Government outline the parameters of the clinical review being conducted by the HSE into all open cases in each CAMHS team so we can see the true extent of failures for children? Will the Government ensure, as a priority, the immediate regulation of CAMHS under the Mental Health Act 2001? We need to see that legislation progressed. On "Morning Ireland" earlier, the Minister for Health, Deputy Donnelly, was somewhat evasive in his response to the question on legislation, yet we know that gaps in the Mental Health Act have left Ireland significantly out of line with international human rights standards regarding mental health services for children. There was a review ten years ago stating that we need to see all parts of existing legislation relating to children's mental health put into one stand-alone Bill. We need to see proper statutory regulation of this service.

I thank the Deputy. The Mental Health Commission's interim report into CAMHS is of great concern to me and to Government. The Minister for Health gave us a briefing on it at Cabinet this morning. Any of us working in politics who have a constituency service, anybody who has worked as a GP and many parents will understand that we have had problems in our CAMHS service for quite some time. Many children get very good care from CAMHS but it also falls short for a lot of children. It is a matter of resources, although they have been improved a lot in recent years, and an issue of governance, which needs to be resolved. I am particularly concerned to hear of children who have been prescribed antipsychotic medications being lost to follow-up. That falls very far below the basic standard of care that should be expected in any country. Child or adult, if somebody is prescribed antipsychotic medicines, they have to be followed up, not just six months later, probably even more frequently than that. I am very concerned that occurred and I wish to better understand why it occurred. The HSE is now contacting all of those so-called open cases to make sure those children are being looked after and they get the care they need.

Like the Mental Health Commission, I thank the young people and their families who spoke to the commission and shared their experiences of the CAMHS service. I know it will not have been easy for them and it is incumbent on us to listen and ensure action is taken. The Minister of State, Deputy Butler, has been clear on this. I will meet with her and the HSE later this week to follow up on the issue. The Minister of State asked for the Mental Health Commission to expand the remit of its report, which is why these findings are now in the public domain. I am advised there is an ongoing exercise of engagement between the Department, the HSE and the Mental Health Commission regarding the findings. It is essential that a full review of open cases by the HSE now takes place to ensure all children and young people are receiving the appropriate care they need. I am told this is under way. The HSE will arrange further clinical follow-up for any child, where required, and it will make direct contact with parents and guardians as necessary. If parents or guardians have a concern, they are invited to contact their key worker. In terms of other actions that will take place this year, a new youth mental health lead post will be created so that there is better clinical governance and clinical control in this area. A new assistant national director level in the HSE will also be created to make sure there is better management.

Regarding Deputy Bacik's questions on the clinical criteria, I do not know the answer. I will ask the Minister of State to come back to her about that. The Government absolutely commits to improving our paediatric and mental health services. They are good by international standards but below the standard we would wish them to be. We are going to do everything we can to raise them in the period ahead. We are going to give consideration to the Mental Health Commission's proposal that it should be allowed to regulate CAMHS. On the face of it, I think it is a good idea, but we need to do the work and the due diligence before we can definitively commit to that.

I thank the Taoiseach for his response but it does not sound as if he and the Government are bringing the necessary urgency to this. I am conscious, as I think we all are, that Dr. Susan Finnerty found her findings so stark that she published them as an interim report. There is an urgent need for action to address that report. As I said, it is over ten years since an expert group recommended reform of the Mental Health Act to ensure all parts of existing legislation relating to children would be in a separate stand-alone section setting out child-specific guiding principles in line with international human rights standards. That is the sort of overall governance the Government needs to be leading on.

The Taoiseach said the Government would give consideration to it but we need to hear more urgency from him about putting in place the necessary framework in order that the services can be delivered to the children who are being currently failed. I would like to hear from the Taoiseach what the parameters are for the HSE review into the open cases. The Taoiseach stated he does not have that available. I would like to hear about the timeline of the amendment of the Mental Health Act.

Finally, can the Taoiseach accept the calls of organisations like Neurodiversity Ireland, which are seeking an urgent round-table discussion with stakeholders, parents groups and clinicians to address the devastating situation for children's mental health services?

I thank the Deputy and completely agree that urgent action is needed. I will be following up on this personally later on in the week, alongside the Minister of State, Deputy Butler, ensuring that the whole of the Government is behind her, the Department of Health and the HSE in taking the actions that are needed. As I mentioned earlier, a new clinical lead will be appointed in youth mental health to ensure we have the clinical leadership and governance which is required. In addition, a new assistant national director will be appointed for CAMHS to ensure that we have the senior management.

Can the Taoiseach say when?

I do not want to make that commitment here until I have had that meeting but as soon as I can answer that question, I will. I point out that there has been a great deal of investment in CAMHS in recent years. There has been a marked increase in staffing in the community, for example. Fewer than 400 full-time staff worked in CAMHS in 2011 and it is now over 659. Much investment has been made in recent years but clearly, we will need more investment in staff, in management and in clinical governance.