Paul Connaughton (Galway East, Fine Gael)
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Thankfully, I came down earlier than I had expected to, otherwise there could have been another mishap. I thank the Ceann Comhairle's office for the opportunity to raise this issue. The situation at Toghermore House, Tuam, County Galway, has been raised as a Topical Issue before. It is a 24-hour mental health facility on the site of other mental health facilities, including a day hospital. An issue arose towards the end of last year, around 21 December, whereby a decision was made by the HSE to close the 24-hour facility due to what the HSE claimed were fire safety reasons.

A good deal of campaigning took place on the issue and, as it turned out, towards the end of January following ministerial pressure the money was set to be allocated for the facility to remain open. It is important to understand that this facility received a grant of almost €1.4 million between 2010 and 2011 for upgrading. When the Minister of State at the Department of Health, Deputy Lynch, visited the facility in 2011 she stated, "The development of this integrated campus at Toghermore brings together a range of mental health services which will undoubtedly have a hugely beneficial effect, not only on the lives of the patients, but also on the lives of their families and friends." Anyone reading that statement would have a clear understanding that Toghermore House, a 24-hour facility, is a cornerstone of mental health services in Galway and Roscommon. One can imagine the anger that many people felt when they learned this facility was going to be closed.

At the end of January the facility was kept open due to ministerial pressure. In the intervening two months money was set to have been allocated to carry out the necessary fire safety works. What money has been allocated for those works? What was the total figure required? When will these works be carried out? When will the premises be up to the required safety standards such that it can start to take in patients once again? In the past two months figures of €250,000, €300,000, €360,000 and €500,000 have been mentioned as necessary to do up Toghermore House. This is a farcical situation and although I understand how important fire safety is, it is ridiculous that this could close the facility.

Some €1.4 million was put into it, but we cannot get an estimate of the amount needed to keep it upgraded.

I understand the decision on Toghermore House will be made in the context of a review of all mental health services and 24 hour facilities in counties Galway and Roscommon. I would like to know who is on the review board and will be supplying the information. There is concern that HSE West has not been completely upfront with patients and their families or the staff of Toghermore House. When is the review due to begin? Who will undertake it? How long will it take and what are its terms of reference? We have not seen openness or transparency in the past three months.

Many of the people who use this service are in vulnerable circumstances and the continued uncertainty about the future of the facility does not help. A report was prepared only two months ago on the people concerned and the problems they were facing owing to rumours about the closure. It described one individual as becoming unstable and distressed on finding out about a potential move. Another patient was described as stable for many years in a low support facility, but the report noted that most of the hostel's residents had poor coping skills and expressed concern about the clinical risks that could arise if they were relocated.

These concerns must be addressed. Toghermore House should be maintained as a cornerstone of A Vision for Change and mental health services in Tuam. The people of Tuam and north Galway will not accept anything less. The State cannot be allowed to close a facility in which it invested €1.4 million only a few years ago. I ask the Minister, Deputy James Reilly, or the Minister of State, Deputy Kathleen Lynch, take a hands-on approach to receiving confirmation that the money was spent properly.

Seán Sherlock (Cork East, Labour)
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I thank the Deputy for raising this issue for discussion. I am taking the matter on behalf of the Minister for Health.

Tuam mental health service caters for the Tuam and Headford catchment areas, with a population of approximately 35,000 and a caseload in excess of 800 people. Traditionally, the service was provided at St. Brigid's Hospital in east Galway but gradually during the years community mental health services in Tuam and Headford have been developed. A report on fire safety in Toghermore House was delivered to the HSE in December 2012. It highlighted a number of shortfalls in fire safety which needed to be addressed as a priority. The assessment focused on relevant issues, including means of escape and associated signage and plans; structural fire precautions and fire equipment; coverage provided by fire alarm and emergency lighting systems; and facilities for the fire service.

A local steering group consisting of a mental health clinical director, a consultant psychiatrist, a director of nursing, an occupational therapy manager, a business manager, a team leader social worker and a patient representative was formed by the HSE and met to address the challenges outlined in the report. The steering group is liaising with residents and their families as part of the process. HSE West has implemented improved fire risk assessment and hazard identification measures. All staff and patients have been informed that appropriate actions have been taken such as a complete ban on smoking in and around the residence structure and improved observations in all areas. To mitigate immediate risks, the HSE is installing a fire alarm system and continues to have hourly fire checks. Preparatory work for the fire alarm system has now been completed and the work is being carried out with minimum disruption to the daily routine of residents.

The executive is commissioning a full review of all 24 hour residential facilities in counties Galway and Roscommon. The outcome of this review will assist in its determination of future requirements for mental health services in these geographic areas. The membership of an expert group to oversee this review is being finalised by the area manager and the executive clinical director. It is expected that the review will be completed within a 12 week period from the date of commission. It should be noted that no other mental health services in the Tuam complex or surrounding areas are affected by the fire safety issue. These facilities include the day hospital, day centre, training centre and workshop, primary care, CAMHS and out-patient and psychiatry of later life services, which continue to operate as normal. The Deputy can rest assured that the responsible Ministers will continue to closely monitor developments on this issue.

Paul Connaughton (Galway East, Fine Gael)
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I mean no disrespect to the Minister of State when I say the Topical Issues debate becomes a farce if one Minister of State arrives into the Chamber and proceeds to read out four scripts. I received the answer he has just read from the HSE one week ago. I asked a series of questions on the cost of the fire safety works, the identities of the individuals being appointed to the review board and the terms of reference of the board. I want the relevant Ministers to take a hands on approach because we cannot spend €1.4 million in upgrading this facility only to review it two years later. This will feed into a review of all services in counties Galway and Roscommon. It has become a bigger issue. The people of these counties deserve to know what the review will entail. If a decision was taken two years ago to invest in this facility, it behoves us to find a long-term solution. I still do not know how much money has been spent on Toghermore House or when it is going to take in new patients.

I acknowledge this issue is not part of the portfolio for the Minister of State, but reading almost word for word a script I have already received from the HSE is not an acceptable way to do our business. If he does nothing else, I implore him to bring the message to the Minister, Deputy James Reilly, and the Minister of State, Deputy Kathleen Lynch, that we will not accept a downgrading of the facility in Toghermore House in the light of the investment made. We must provide the level of care the individuals concerned and their families deserve. It is not sufficient to consult them. They need to be told where their loved ones will be staying for the next few years. It is time for the Minister and the Minister of State to take a hands on approach to securing Toghermore House for the future.

Seán Sherlock (Cork East, Labour)
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I agree with the Deputy that it is farcical for one Minister of State to respond to four issues. However, I know the Minister, Deputy James Reilly, and the Minister of State, Deputy Kathleen Reilly, would engage directly with him on his questions about who is on the steering group and the details of costs and timelines. I note, however, that the patients are represented on the group and, if the process is working properly, it should address the needs of patients and their families. I tend to agree with the Deputy on the issue. I have had similar experiences in my own area and ensured the regional director of operations was answerable to me on any issue arising. I recognise that it is important to raise these issues in the House and apologise to the Deputy for my lack of intimate knowledge of them.