Kathleen Funchion presses minister on North Kerry CAMS reviews

Thanks very much. I am taking this question from my colleague, Deputy Pah Daly, to ask the Minister in relation to what steps are being taken to recruit more staff for the out-of-hours GP – sorry, I am reading the wrong one. I am reading your question, Holly. That is what happens when you are taking a question for someone else. What reviews are currently taking place with respect to the North Kerry Cams and how they differ to the announced national audit of cases? Thanks very much. Good morning. I was actually expecting your colleagues sitting beside you to take this question on behalf of Deputy Daly. So following publication of the Maskey report, in order to gain assurance about the quality of the CAMS service being provided in North Kerry, the HSE confirmed a planned sample file audit of 50 files in North Kerry CAMS and that this would take place. This was a random audit of files and represents approximately 10% of the caseload of the North Kerry CAMS teams. So just as there is no confusion, we all understand the situation in relation to South Kerry and the Maskey report that has ensued. And as a result of the Maskey report, at the time, there were concerns raised about North Kerry CAMS and that there might have been a crossover from South Kerry, so that is why we are discussing this today. So this audit was undertaken by a team of 10 consultants from across the country with oversight provided for the national clinical advisor and group lead for mental health. On the 21st January 2023, the local HSE received a final report from the team of CAMS consultants who carried out this audit in North Kerry. The audit team raised potential concerns regarding the standard of care received by a small number of patients. The audit team recommended that a further review be carried out of all cases currently open to the service. Based on these concerns, HSE CH04 took immediate action by beginning the process of setting up a look-back review. And that was a commitment I had given at the time that if any issues were raised in North Kerry, we would move to a look-back. The HSE has advised the Department of Health that in preparation for the first phase of this North Kerry look-back review, the files of current cases are being profiled in order of urgency and risk. Discussions with a proposed senior clinician to lead on the review are ongoing and the draft terms of reference have been developed. The review is separate from the audits arising from the MASCIE report, more specifically the National Prescribing Audit, which focuses on prescription practices and CAMS, and the National Audit of Compliance with the CAMS operational guidelines. Thanks very much, Minister. As I said, I am asking this question on behalf of my colleague. And the results of the reviews that we have had so far, whether it was by the HSE or the Mental Health Commission, are very clear that serious lapses and standards of care took place, but obviously devastating consequences for the children in Kerry, teenagers, young people and their families. And at that time, the Taoiseach, at the time of the publication of the South Kerry look-back review, admitted that it was a very serious matter. And we have seen little progress in terms of the urgent restructuring needed within mental health services in Kerry. And the status of the North Kerry review, I know you have touched on it there, Minister, is also unclear. And in relation to families, like what value is it for families in the context of the wider audit? And I understand that Deputy Daly had also asked separately how many families have come forward. And any information that you might have in relation to that would be appreciated. In the immediate aftermath of the scandal break in families, children and young people were left without any support. And with the local service that they understood, had let them down. And I suppose families feel that progress has been, you know, there's a lot to be desired there. Thanks. Deputy, I know you're asking this question on behalf of your colleague, but I don't agree that the status is unclear. The status is actually crystal clear. On the 21st of January, 2023, the local HSE received a final report from the team of CAMS consultants who carried out the audit. When concerns were raised by the audit team in relation to individual children, immediate contact was made with the families and clinical reviews and open disclosure meetings were facilitated as appropriate. Contact was also made with the families of the remaining 34 young people reviewed by the audit team, advising that their files were part of the North Kerry CAMS clinical audit and that the audit found no evidence of harms in its findings. So the audit looked at 50 files, so 34 families were contacted, thankfully, to say there was no issues. And then there was approximately between 14 and 16 cases that warranted holding a look back. I also have to say that last week, for example, I travelled to Ballincolig in Cork and I met with families of families of children that were affected by the debacle in Kerry CAMS. And I think it's important to keep in touch with the families affected. Thanks very much for that, Minister, and obviously I will relay that information to my colleague as well, and maybe some of that is new information as well, in fairness, particularly any meetings that you would have had last week. And he had made the point as well that latest figures show 4,314 children were awaiting CAMS appointments, and 88% from the start of 2020, and more than 600 of these have been waiting for more than one year, and the majority of those areas are Cork and Kerry. And I suppose just to make the point in general in relation to CAMS that we need a properly staffed CAMS team to address the waiting lists and ensure we do not face the same issues. Again, the crisis was fundamentally an issue of proper supervision and oversight, with a lack of adequate workforce planning at the heart of it. And I suppose that would be true of all CAMS services that we want to see it working really well, and we're talking about children and young people. And just what a plan has been brought forward to resolve the issues and start the process of rebuilding the trust with vulnerable children and service owners. I think you've touched on some of that in fairness in your initial reply. Thank you very much, and thank you for both your questions. That's what I was going to say to Deputy Function. We're all very aware of the challenges we have in CAMS all over the country and the fact that we do have waiting lists that are only going in one direction, and I'm very unhappy about that. As has Minister Donnelly, we did speak about it. We speak about it constantly. One thing you didn't mention, Deputy Ward, that there were 33% more referrals into CAMS in the last two years than ever before, and the teams saw 21% more children than they saw ever before. But the amount of referrals that are coming in is just unprecedented. That's the first point. Now, just let me answer, please. Just let me answer. There was 225,000 appointments given to children in the care of CAMS last year. There are 91 people in mental health service staffing increased from December 21 to December 22. So it's not that we're not acting, but just to let you know, in order to drive CAMS reform, I'm holding a series of roundtable discussions with key CAMS stakeholders. The first meeting is this afternoon with the College of Psychiatry, the HSE and the Department. And in the next two weeks, there will be further ones with the NGOs, psychology and mental health reform, across the board to see how we can address these issues. Because I am very concerned about the waiting lists. Thank you. You