Mental health funding ‘grossly inadequate’ given pandemic impact – IHCA

Mental health funding for 2021 is “grossly inadequate” in light of the psychological toll of the pandemic on the population, and increasing presentations, according to the IHCA.  

As part of the IHCA’s analysis of the HSE Service Plan for 2021, President Prof Alan Irvine said: “Of the almost €1.7 billion extra funding due to the pandemic, less than 1 per cent has been earmarked for mental health. Healthcare professionals are seeing more and more mental health presentations. People themselves are seeing and experiencing the unfolding effects of Covid on mental health. Given this, the funding response is grossly inadequate. This is a problem set to dominate all of us in healthcare for some time.”

In its overall analysis, the IHCA estimate that the HSE plan, published last week, will mean over 200,000 fewer patients hospital appointments this year in public hospitals. This figure includes 153,000 outpatient appointments and 50,000 inpatient and day cases.

It is now anticipated that 2021 will be the second successive year of reductions in public hospital appointments as the impact of the pandemic continues to impact hospital care.

According to HSE data, in 2020 there were 248,000 fewer inpatient/day cases than in 2019, with almost 475,000 fewer outpatient appointments. 2020 and 2021 figures combined mean there will likely be more than 900,000 fewer patient appointments in public hospitals compared with pre-Covid activity, stated the IHCA.

With a record 860,000 people on waiting lists and hospital bed occupancy rates due to be reduced for to infection control measures, the IHCA continues to be concerned about bed capacity deficits.

The IHCA has also signalled concerns with a continued lack of targets to hire hospital consultants, including the 728 permanent hospital posts that are unfilled. The Association further pointed to the budgetary approach to other key areas, including mental health, eHealth, recruitment, ICU capacity and equipment.

Prof Irvine commented: “HSE frontline and management staff deserve huge credit in the management of the pandemic to date. Collaborative working during the worst of the pandemic has been a key success factor. Similar approaches are now needed to tackle the massive backlog of scheduled care.

“Compiling a Service Plan amid a pandemic which is causing immediate and knock-on impacts is a huge challenge. The government has stepped-up in terms of additional investment but how we channel this investment is key. We are in effect attempting to service a moving vehicle. Striking a balance between short and medium-term objectives is key and central to this is collaborative planning.

“Reducing levels of community infection with Covid-19 certainly helps but the stubborn nature of Covid and knock-on suspension and cancellation of patient care means backlogged cases build-up. Our ability to respond involves many factors, with beds and recruitment the principle two.  Without addressing these twin deficits, the structural mismatch between capacity and demand will continue to increase rather than decrease waiting times.

“We are heading for a waiting list of almost one million people. We continue to tinker around the edges on recruitment despite knowing that over 700 permanent consultant posts remain unfilled. Unless and until we tackle root causes, no amount of good intentions will be enough.”