Who will bark if watchdogs axed?
A pattern has begun to emerge whereby Minister for Health James Reilly has allowed independent bodies responsible for implementing and evaluating Government policy wither away. Recent examples include the Food Safety Authority of Ireland board, the new national children’s hospital, and a monitoring body on mental care. Whether the failure to fill these vacancies has arisen from pressure of work on Dr Reilly, his desire for greater control, or an anxiety to avoid criticism, is immaterial. What matters is that independent oversight has been compromised and remedial action is urgently required.
Chairman of the Mental Health Commission John Saunders expressed concern during the week that an independent monitoring body for mental health services had been allowed to collapse. The group dissolved last summer when its seven-year remit ran out. Since then there has been no evaluation of progress in the Government’s mental health strategy, A Vision for Change. At the same time, the HSE diverted a portion of the allocation for community mental health to other purposes.
Minister of State with responsibility for mental health Kathleen Lynch has reassured interested groups that community services will receive promised funding and extra staff this year. Yet, even if an estimated 800 positions are filled, a significant shortfall in expert personnel will remain. Despite the importance of early intervention for young people and a recognised need to replace institutional care with community facilities, this area of healthcare has lost ground in financial terms. In the past six years, its share of health spending has declined from 7.2 to 5.3 per cent.
Recent studies have found that the incidence of suicide among young Irish men is among the highest in Europe. A number of factors were identified as contributing to that situation, including abuse of alcohol, the recession, and unemployment. Medical intervention in childhood was identified as a vital component in reducing the incidence of suicide, with GPs being trained to recognise signs of depression. An information campaign is planned. But in the absence of adequate community mental health services, it may have little effect.
Dr Reilly publicly acknowledged that mental health stress is “rampant” before an Oireachtas committee. Recognising the problem is not, however, a sufficient response. Expert help can make the difference between life and death for some people. Finding resources to run the health system has been extremely difficult, even as competition for resources has intensified. Additional funding has been promised for mental health care this year. But in the absence of an independent monitoring body, it will be impossible to know whether progress is being made in meeting the targets set in A Vision for Change.