Mental health funding 'diverted' by HSE

Elaine Edwards

Some €24 million of €51.2 million in funding allocated to the Health Service Executive (HSE) to implement a national plan for mental health services was not used as planned, a report said today.

The funding was used by the HSE to cover its obligations to live within its budget allocation from the Government, it emerged.

An independent group established to examine the implementation of the Government’s A Vision for Change plan on mental health policy also criticises “the absence of clear identifiable leadership within the HSE” to implement the programme.

In its own submission to the monitoring group, published with the report, the Department of Health said €24 million of the additional €51.2 million in mental health resources provided to the HSE in 2006 and 2007 was “used to meet the overriding obligation of the HSE to live within its approved allocation”.

It said the implementation of the mental health policy was dependent “to a much greater extent on the remodelling of existing resources than on new funding”.

Among the criticisms in today’s report, the group says it believes the HSE was “mistaken” in its decision not to implement the recommendation to set up a national mental health service directorate. The monitoring group said it is concerned at the “slow rate of progress” in developing services for children and adolescents with mental health problems.

Today’s report said reform of the mental health service required a “similar approach” to the reform of the national cancer services, and noted the appointment of a Director of Cancer Services to lead reform in that area.

In addition, the report criticises the failure of the HSE to put in place a number of mental health catchment areas, as recommended in the Vision for Change policy.

Chair of the Irish Mental Health Coalition John Saunders said: “Unfortunately, A Vision for Change has not marked a turning point in decades of Government neglect of mental health services.

“Two and a half years on we see negligible improvement for those individuals and families who access mental health services.”

He said that if the human rights of people with mental health problems mattered to the Government, today’s report must be “the turning point”.

He called on the HSE to produce “a meaningful plan” at the earliest opportunity.

Fine Gael spokesman on mental health Dan Neville criticised the “hiving off” by the HSE of funding for mental health policy to other areas.

“Whatever small progress the Minister and the HSE may claim has taken place, there is little doubt that a leaderless, budgetless strategy is just another failure from a Government that promises much but delivers little,” he said.

The HSE issued a lengthy statement outlining areas where progress had been made and said it was “fully committed” to implementing theA Vision for Change plan. It said “significant progress” had been made in certain areas, such as the establishment of multidisciplinary care teams.

On inadequate placing of people with mental health problems, the HSE said many psychiatric hospitals had already been closed with patients transferring to alternative community services over the last number of years.

The HSE was continuing to progress the closure of such hospitals in line with the recommendations in A Vision for Change .

Assistant national director of the HSE Seamus McNulty said A Vision for Change will be implemented “in tandem with the HSE’s overall transformation programme”.

“This approach will ensure that everyone will have access to health services in their local community through appropriate primary care services,” he said.

“We have put in place clear leadership for the implementation of Vision for Change and are committed to taking the necessary next steps. We acknowledge that there is much work still to be done but we are committed to progressing this work within the set time-frame for implementing Vision for Change .”

The monitoring group’s second report published today covers the period from February 2007 to January 2008. It is chaired by Dr Ruth Barrington, chief executive of Molecular Medicine Ireland and its members also include Dr Susan Finnerty, the acting Inspector of Mental Health Services.

© 2008 ireland.com