Health services - Cut in funds a cause for real concern

THE Health Service Executive has been accused of asset stripping our psychiatric services for some time.

The accusations follow the sale of lands attached to psychiatric facilities, the proceeds of which were to have been ring-fenced to be used to enhance our inadequate psychiatric services.

Along with stroke care our mental health services are an indictment of us all and an area where we must improve performance and commitment dramatically.

It will come as little enough surprise to anyone who takes an interest in the way this country manages itself to be told that, yes, in some cases the lands have been sold; but, no, the psychiatric services did not get the money. The cash has been thrown at another, more pressing, problem. Two years ago sales of land and buildings once used by our psychiatric services netted €€1,331,803, last year that figure was €€776,000.

The HSE have confirmed that while all of the money raised was surrendered to the Department of Finance, “to date none has been reclaimed to fund developments”. That, despite a charge from the Irish Psychiatric Association, that hundreds of psychiatric patients are being housed in “poor, sub-standard conditions.”

Though the overall figure involved would have little enough impact on the great challenges facing our psychiatric services it is an indication of how easily a relatively powerless and silent constituency can be ignored and left to its fate.

In August 2003, Tim O’Malley, then Minister of State at the Department of Health and Children, established the Expert Group on Mental Health Policy. The group was to develop a plan for services over the next 10 years and build on the recommendations of Planning for the Future — published in 1984 — which developed the concept of a comprehensive, community-orientated, psychiatric service. Planning for the Future recognised that institutional hospitals were not appropriate for a modern mental health service.

A Vision for Change was published in 2006. One of its key recommendations was that a plan be drawn up to bring about the closure of all mental hospitals.

“The resources released ... should be protected for reinvestment in the mental health service,” the report said.

So all the ingredients of an Irish policy document were in place and the intentions were honourable, clear and rational but, as so often transpires, the reality is very different to the imagined.

We report elsewhere today on how Our Lady’s Children’s Hospital in Crumlin have had to agree with the HSE to try to save €7 million out of a budget of €144m. This is another indication of the tightening economic situation and, as the hospital admits, the cut will mean that services will be curtailed.

Yesterday morning Professor Brendan Drumm defended the HSE, insisting that it is a work in progress and that eventually it will realise its objectives. He also insisted that our health services are well funded and that more effective management is needed more than cash.

It would be wonderful to be able to accept Prof Drumm’s argument without any niggling doubts but it is much easier to be concerned about our psychiatric patients and the children who will not get the attention they need because of the cuts at Crumlin.