Dear
Tánaiste
With
the imminent formation of the Health Service Executive in January
2005 I wish to take the opportunity to remind you, the new Health
Service Executive and CEO, Professor Aidan Halligan of the concerns
of psychiatrists regarding the future organization of Mental
Health Services in this country.
I
previously wrote to Minister Martin, 22nd December
2003 and to Mr K Kelly on 4th August 2004.
I
wish to reiterate the position of the Irish College of Psychiatrists
(the professional body which represents the 590 psychiatrists
in this country); the
College considers that the management of the Mental Health Services
under the Community/Continuing Care Programme is not in the
best interest of the Mental Health Services.
Our position is as follows:
We
wish all mental health services to be included in the National
Hospitals Office and we wish to continue to expand the number
of acute units in major hospitals and establish day hospital
/ day programmes and out-patients at Local Hospitals (Hanly
recommendations).
This
would also mean that all specialties of mental health are included
in the one directorate and are therefore under the one Management
structure, encouraging integration of services across the ages.
This is a recommendation of the Working Party in Child
and Adolescent Psychiatry – 2nd Report.
As psychiatry does not fall neatly into the proposed
management structures, it tends to get relegated into structures
which do not reflect its function. The structures are developed with surgery and
medicine in mind.
In
the future with the introduction of the Health Reforms many
of the other medical specialty services will be delivered in
a similar fashion to that of psychiatric services at present.
An example is the development of community paediatrics
and the services for people with chronic illness such as diabetes.
The development of well resourced Local Hospitals will
speed up this process so that the delivery of these services
will begin to resemble the delivery of mental health services.
We
also consider that one management system for mental health would
hopefully mean a greater share of the health budget for all
patients. Mental Health
has not received an increase this year and we
believe this is totally unacceptable, given that we fell
from 9% to 6.8% of the health budget last year. I can emphatically
say that this level of decrease is having serious implications
for service delivery to our mostly vulnerable patients.
A
reasonable alternative solution to the problem could be to establish
a National Mental Health Services Directorate.
I
would request that we would meet with you to discuss these urgent
issues.
With
kind regards.
Yours
sincerely
Dr
Kate Ganter
Chairman
cc Mr T O’Malley, Minister for State,
Department of Health and Children
Mr M Kelly, Secretary General, Department of Health
and Children
Mr D Devitt, Assistant Secretary, Department of Health
and Children
Ms B NicAongusa, Principal Officer, Department of Health
and Children
Mr
K Kelly, Interim Health
Service Executive
Prof
A Halligan, Interim Health Service Executive
CEOs
of Health Boards.
