Dr John Hillery, who resigned from the HSE because of lack of progress in mental health services and what he sees as an unwillingness for rapid change, was giving a keynote address to the Family Carers Ireland conference ‘Life After Care’.
“The fact that we are still discussing these issues as needs rather than as facts is a disgrace. It is one of the reasons I resigned my clinical post earlier this year after nearly 30 years in the mental health and intellectual disability services as a trainee and consultant.”
Dr Hillery said the inability for rapid change in systems and poor environments was always a frustration. The introduction of regulation of environments with the Health Information and Quality Authority provided great hope, but seemed to him to become somewhat of a box-ticking exercise.
Regulation in the services I mostly worked in was not interactive from my point of view with reports written without a right to correction or other reply.
“It seemed to be what is known in regulatory circles as ‘whack a mole regulation’, after the old fairground game, where a hammer is applied to the figure whose head sticks up.”
Dr Hillery added: “Our health service has major staffing problems. No one seems to have connected the difficulties in recruitment and retention to the culture and environment of the HSE. Reports of snails on the walls of the clinic and no hope of improvement until a successful business case was made for environmental improvements seems to be bureaucracy gone mad.”
He explained to delegates that he continued to spend too much time writing memos and making phone calls advocating for respite and other supports for individuals and carers that should be taken for granted.
One example being the way young people with intellectual disability and challenging behaviour lose their respite and sometimes other services once they leave school. It continues to amaze me that this was an issue when I was first a consultant and is still an issue today.
Pointing out that the HSE has no board and an acting CEO, Dr Hillery said mental health services lack governance and a proper budget.
“The national budget for mental health services remains at six per cent when a Vision for Change recommended a higher figure 10 years ago and when that of equivalent countries is around 12% gives the lie to stated commitments to services for people with mental health problems.
“The minister for mental health has been quoted as saying that the current budget is sufficient despite these comparators and issues such as lack of appropriate teams and environments for mental health service delivery.”