In the words of Oscar Wilde, a cynic is a man who knows the price of everything and the value of nothing. Based on what we have learned about mental health funding this week, one can only conclude some within the Department of Health and the Health Service Executive (HSE) are modern disciples of the cynics school of ancient Greek philosophers.
The extraordinary decision of Minister of State for Mental Health Kathleen Lynch to write to her department's Secretary General asking him to resist moves to transfer one-third of the budget for developments in mental health to other parts of the health service for 2016 reveals a shortsighted ploy by senior health service administrators. According to Ms Lynch she felt obliged to act after learning of a decision to divert some €12 million of the €35 million ring-fenced mental health budget to shore up funding shortfalls elsewhere. "Such a decision would have a very serious negative impact on the implementation of mental health policy," she warned.
The HSE and the Department of Health have "form" in this area. In 2015 the HSE failed – not for the first time – to fully spend its mental health budget. Although widely acknowledged as the underfunded Cinderella of the health system, the HSE's inability to put scarce resources to work for the betterment of a vulnerable group in society is hard to fathom. Patient advocates have rightly condemned the attempt to hijack the agreed mental health budget. Dr John Hillery of the College of Psychiatrists of Ireland said it reflected "an ambivalent attitude to mental illness by some decision makers. This must be resisted as scandalous and discriminatory".
It is unacceptable that the actions of senior health service managers repeatedly suggest a fundamental belief that the nation’s mental health does not enjoy parity with its physical equivalent. In the private sector such actions would prompt serious questions. That such an approach appears to be an acceptable part of management culture explains much about the dysfunctional nature of our health service.