The treatment of women caught up in the CervicalCheck scandal is just one aspect of a much broader malaise involving health services and the unwillingness of officials to break new ground and face up to their responsibilities.
A cross-party Oireachtas committee was established to consider the development of mental healthcare services two years ago. But it received minimal cooperation from the HSE while a parallel planning group, designed to make its work redundant, was set up within the Department of Health. Venting the committee's frustration at these developments, chair Joan Freeman criticised the HSE's response to financial questions as representing "smokescreens and vagueness".
Prisons are, once again, being used as dumping grounds for people with mental illness
Mental healthcare attracts little publicity, compared to hospital trolley numbers. Inadequate services can be equally life threatening, however, and the committee urged immediate action in response to “a mental health crisis” within the Traveller community. There, suicide rates are six times higher than in general society and services are more difficult to access. The phasing out of Victorian-style mental homes in the 1980s was the correct decision. But their closure was treated as a cost-saving exercise. Over the following three decades, spending on mental care fell from 14 to 6 per cent of the health budget, while the number of beds fell from 12,000 to 1,000. Promised primary care services and community-based facilities did not materialise. Prisons are, once again, being used as dumping grounds for people with mental illness, while rooms at the Central Mental Hospital remain unoccupied because of staff shortages.
Nothing will change without accountability. Faulty and non-existent services are the outcome of deliberate executive decisions or funding shortfalls and should be recognised as such. For years, despite being “ring-fenced”, money voted for mental health was diverted by the HSE to acute hospital and other services.
The report amounts to an indictment of the State’s health bureaucracy. The glaring inadequancies it identifies require urgent action.