Call for halt to HSE outsourcing as State spent €93m on private mental healthcare last year

Labour health spokeswoman and Dublin Central TD Marie Sherlock called for an end to the 'bizarre and wasteful cycle' of the HSE outsourcing health services. Picture: Stephen Collins/Collins

The HSE spent almost €93m on private mental healthcare last year prompting calls for public investment to end a “bizarre and wasteful cycle” of outsourcing services.

Children sent for treatment by the High Court and people with severe eating disorders are among the patients. 

New HSE data shows €79.6m was spent last year on private placements for mental health in Ireland. In addition, private providers in the UK received €12.9m for patients who could not be cared for here, including children.

Labour health spokeswoman Marie Sherlock called for urgent investment in public mental health care.  

“In 2018, the HSE spent €46m on private providers. That figure is now €79m for 2024," she said. 

Already, €7.5m has been spent this year. This level of outsourcing is simply unsustainable and reflects deep structural failings in the public system.

She also raised concerns over growing reliance on UK centres, saying the escalation is “completely unacceptable”.

“We spent nothing on care in the UK in 2018 and 2019. That figure has now exploded to almost €13m in 2024 — double what was spent in 2023,” she said.

Ms Sherlock called for urgent investment in Irish mental health services by the Government. This should include efforts to make jobs more attractive for new staff and to help retain existing staff. She said: 

Many are leaving for the private sector where pay and conditions are better — and then the HSE ends up paying those same providers to deliver care. 

“It’s a bizarre and wasteful cycle.”

Meanwhile the Irish Hospital Consultants Association (IHCA) has warned that parts of the draft Mental Health Bill 2024 are “unworkable in practice”.

It called for changes, saying that “several critical amendments and considerations are needed” to deliver effective care. Mental health patients “can be among the most vulnerable people in society,” it added.

Warning from hospital consultants 

IHCA vice president and consultant psychiatrist Anne Doherty said she welcomed the “broad principles” of the bill but has concerns about some parts.

“We are keen to see these elements within the bill addressed as a priority to mitigate against impractical legislation,” she urged.

Prof Doherty said it is important that the legislation is “workable in practice so that patients can access services in a timely and care-focused manner”.

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In a position paper, the IHCA highlighted concerning examples including a vague definition of mental disorder and unclear risk criteria.

The IHCA also welcomed some of their proposals were used in the draft bill. Minister of state for mental health Mary Butler last week pledged to enact the bill.

The bill will be discussed during the IHCA’s symposium on Wednesday.