Thursday, 16 February 2006
Seanad Eireann Debate
Mr. Feighan: I welcome the Minister of State, Deputy Tim O’Malley, and look forward to a favourable reply to this matter. Will he explain why Roscommon psychiatric foster care service is not receiving the necessary funding and support to continue the valued community-based facility? I am sure the Minister of State has become aware of many of these facilities over the years.
Those who provide this service in the old Western Health Board area in County Roscommon are not getting the recognition they deserve. Over the years, people in psychiatric care have been sent out to the foster care service and at a time when there was less money in the country, those who provided the service, effectively, bailed out the health service. This was not a simple job and they cared for and fed and clothed people in their own home. They became part of the family.
Those who provided the service put so much effort into extending their homes to ensure they reached a certain high standard. These people are now being cast aside despite the investment they made in terms of time, energy and finance over the years and the wonderful service they provided. I believe there is nearly a turf war in the health service and these people are being forgotten.
It is unfortunate that I must raise this awkward and critical situation. However, this service was the way forward even though I know there is a new vision for psychiatric care. We cannot forget about these people who, during tough times, bailed out various Governments, health boards and, more importantly, the psychiatric services. We, and this Government, should not forget the sacrifice made and the work done by these people. Again, I thank the Minister of State for coming to the House and look forward to his reply. I want to ensure these people are not forgotten.
Minister of State at the Department of Health and Children (Mr. T. O’Malley): I thank Senator Feighan for raising this matter. The Roscommon mental health services have undergone significant changes over the past two decades. The move away from institutional care to community care has brought the mental health services in Roscommon closer to the service user. The move from hospital-based care to individualised care has empowered the user to take a more proactive role in their care and treatment. This has been further complemented by care and treatment being provided by multidisciplinary teams in partnership with other health care professionals and the voluntary agencies.
The boarding out-foster care service to which the Senator referred provides accommodation and a normalised system of care for 21 people with mental health problems in the Roscommon mental health services catchment area. The programme, which commenced in 1980, has contributed to the provision of an independent life for those people living in the community.
Some years ago, the Department of Health and Children agreed with the management of the former Western Health Board that the boarding out-foster care service in Roscommon would be phased out over the coming years, to be replaced by more appropriate arrangements. I understand the HSE is currently considering alternative options in respect of those persons receiving services under this scheme.
The acute admission unit at Roscommon General Hospital opened in 1992. This was in response to Government policy on mental health as outlined in the 1984 document, Planning for the Future. I am informed that this was a major turning point for the Roscommon mental health services. As a result, St. Patrick’s Hospital, Castlerea, was closed, community-based mental health services have expanded and a large range of treatment options for service users has been provided in the community.
These changes have been in line with the model of service provision now recommended by the recently published report of the expert group on mental health policy, A Vision for Change. This report is the first comprehensive review of mental health policy since the publication of the document, Planning for the Future, in 1984. This report has been accepted by the Government as the basis for the future development of mental health policy.
The report recommends that a programme of capital and non-capital investment in mental health services adjusted in line with inflation should be implemented in a phased way over the next seven to ten years. The proposed new workforce will comprise more than 11,000 staff throughout the service. Allowing for the assimilation of all existing posts, the expert group has estimated that a total of 1,803 new posts across the services, together with a total non-capital investment of €151 million per annum, in addition to existing funding, will be required.
This programme of investment has already begun with an additional €25 million allocated to the Health Service Executive in the Estimates for 2006 for mental health services. Significant capital investment will also be required to implement A Vision for Change in respect of the provision of new and replacement facilities for mental health services. This has been estimated by the expert group to be of the order of €796 million and much of it could be realised from the value of existing hospitals and lands. The proposals in A Vision for Change will allow for further significant expansion in community services and in specialised services for groups such as children, older people and those with particular needs.
The implementation of this policy will be a matter for the Health Service Executive in accordance with the provisions of the Health Act 2004. The national mental health directorate within the Health Service Executive is in the process of establishing an implementation group to ensure that the recommendations are realised in a timely and co-ordinated manner. As Minister of State at the Department of Health and Children with special responsibility for mental health, I will seek the active support of all involved in the mental health services so that together, we can bring about the far-reaching improvements contained in A Vision for Change. I will shortly appoint a group to monitor the implementation of the recommendations, as suggested in the report.
In conclusion, I stress that A Vision for Change details a comprehensive model of mental health service provision for Ireland. It describes a framework for building and fostering positive mental health across the entire community and for providing accessible community-based specialist services for people with mental illness. On that basis, the Senator can be assured that in line with this policy, the level of mental health service provision will be improved and enhanced in the coming years.
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