00:00Speaker, I'm acutely aware of the workforce challenges in consultant psychiatry within the
00:03Western Trust and indeed actually across the region. A number of actions are being progressed
00:08in response to action 32 of the mental health strategy. A mental health workforce review
00:14report was published in July of 2023 that set out 18 recommendations to address workforce challenges
00:20and that's across statutory mental health services. Work is currently being progressed
00:25to deliver a number of key recommendations in relation to both costing the proposed future
00:29workforce profile and the development of a future recruitment and training plan.
00:34In parallel, my department has established a psychiatric workforce task and finish group.
00:40This will identify a range of actions to help alleviate the pressures within the psychiatry
00:44workforce in the short to medium term. And as part of a significant package of training
00:49expansions, I announced in May of this year an additional 26 new medical specialty training
00:55post, including six in poor psychiatry.
01:00Mark Dricken.
01:02Thanks Speaker. I thank the Minister for his answer. Earlier the Minister mentioned health
01:07inequalities and while poor mental health does not discriminate, it is obviously much more
01:13prevalent in areas of high deprivation. Does the Minister recognise therefore the dire need
01:19for the Western Trust, whether it is least psychiatrists, to receive the funding that it needs to employ
01:28more psychiatrists to ensure that people there get the service and support that they need?
01:33He referred to some of the recommendations that are being implemented. Could he be specific
01:38in terms of which of those recommendations will boost the workforce in day?
01:43I thank the Member for his supplementary question. Obviously, with a focus that I have had since
01:51being elected in 2011 on mental health and wellbeing and since I take a post as Minister on those health
01:58inequalities, I can try and be a bit more specific about a range of actions that could at low or no
02:06additional cost, potentially help alleviate pressures within the psychiatric workforce.
02:12We are doing an analysis of sick absence rates, an analysis of locum use, an assessment of the
02:18impact of existing and emerging workforce challenges, an assessment of the impact of reinstating mental
02:24health officers and how best to promote Northern Ireland as a region to work. That is in terms of
02:29the workforce. In terms of the issues, I think the issues that people face in his constituency,
02:34particularly in areas of deprivation, are well known. These things overlap. I am very much of the
02:41opinion that tackling health inequalities isn't just for the Department of Health. It is also about
02:48socio-economic issues. The Department of the Economy is involved. It is about the environment. It is about
02:54people's behaviour. Equally, we can look at educational underperformance and not just look to the Minister of
03:02Education to do something about that. We know healthier children do better in schools, so that is down to
03:07me. And if we look at our shocking rates of economic inactivity, with 27 per cent of people of working
03:13age neither in work nor seeking work, once again, once you look at the factors contributing to that,
03:18it is not just about affordable, accessible health care. It is about mental and physical health.
03:24So all these things need a whole system, all-executive approach.
03:29Philip McQuiggan.
03:32Minister, I met with the North Royal College of Psychiatrists here last week and had a very useful
03:38discussion in terms of some of the problems, retention, recruitment, lack of permanent increase
03:43of training places here since 2007 for psychiatry training, all leading to unsafe staffing levels and
03:51workforce problems and obviously service provision and implementation of our mental health strategy.
03:56They detailed the use of locums and you mentioned that yourself. Can you ask, or can I ask you rather,
04:02if you have done any cost analysis of the additional cost of us using locums to fill the workforce gaps?
04:10Thank you very much, Mr Speaker. Yes, absolutely. I am not going to quote figures to you,
04:15but we started with nursing and we have reduced our reliance on agency nurses, actually cutting it out.
04:23And so the focus now is on locums who are very expensive, as the member will be aware. And we have
04:31asked one of the chief executives of the five geographic health and social care trusts to lead
04:38on an investigation and on delivering a plan for doing the same with locums as we did with urgency nurses.
04:46Guy Middleton.
04:47Mr Speaker, can I thank the Minister for his responses this far. Minister, the issue of mental health is one that
04:53must be prioritised. Minister, can you outline the impact in terms of the shortage of psychiatrists in the Western Trust,
05:01the impact that that has on patients and how would that compare with other trusts across Northern Ireland?
05:08Thank you, Mr Speaker. Obviously, if you need psychiatric help and it's not there for you,
05:13that can have a potentially devastating impact on your health. I think in terms of numbers,
05:20rather than go through the numbers of psychiatrists in each trust, because that will be determined by
05:26the population of the trust and an assessment of need. What the member may find very interesting is
05:34the number of vacancies which exist across the five trusts. So, as of the end of June of this year,
05:41there were 33 consultant vacancies in psychiatry across Northern Ireland. The Southern Health and Social
05:48Care Trust had the highest level of psychiatric vacancies with 14, but the Western was right behind
05:55with 13. The Northern had four vacancies, Belfast had two, and the Southeastern Trust currently at that
06:02time, 30th of June, had no vacancies. So, there is another massive postcode lottery.
06:07Dan Armstrong. I thank the Minister for his answers so far. Minister, you have outlined what the
06:15Department steps they are taking, which are commendable. Can you provide an update on what specific steps the
06:22Trust are taking the Western Trust to address the challenges around consultant psychiatry pressures?
06:28I thank the member for her question. Following a formal application from the Western Trust,
06:36the Department approved a 10 per cent RRP as an incentive for consultant psychiatry posts in August
06:42of 2024. Despite ongoing recruitment campaigns, no appointments, I regret, have been made to date.
06:49In response, the Trust submitted a further application seeking an enhanced rate of up to 20 per cent
06:55for mental health liaison team, crisis mental health services including inpatients, psychiatry of
07:01learning disability, and community recovery teams. This application was approved by the Department
07:08on the 22nd of August last. That agreed rate is up to 20 per cent of the consultant's starting salary
07:14as a recruitment incentive and, as I say, that was requested by the Trust. The Department remains
07:22committed to supporting equitable access to mental health services and we continue to assess and respond
07:27to workforce pressures in collaboration with the Trust and our other stakeholders.
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