Mr. Peter Hughes:

The reduction in bed numbers resulted from the closing of the large institutions. We had almost 12,500 beds in 1984. As I said, the Government policies in 1984 and 2006 were both intended to close beds and introduce comprehensive community services. Our research shows that in the ten years since A Vision for Change was published, over 70% of beds were closed and only 30% of the community resource was put in. With the closure of the large institutions, the money raised from the sale of lands and the staff resources of the institutions were supposed to move to the community to provide comprehensive 24-7 crisis services, outreach services and intensive care rehabilitation units. Those never materialised. As we see, in the same timeframe, the percentage of the health budget allocated to mental health services decreased. Had the budget even stayed at 13%, as it was in 1984, we would probably have an excellent mental health service.

I started my career in the early 1980s in St. Brendan's Hospital when there were 12,000 beds in the system. There is no longer a hospital on the St. Brendan's site, although a new unit with 52 beds has been built on it, and development of community services in the area has been minimal. At that time, we were told nothing could be done with the old hospital because it was an old Victorian building. It is now a state-of-the-art Dublin Institute of Technology complex. I live near the area, and when I walk through the site, I cannot believe the transformation that has taken place. When people lived in the building, it was an absolute disgrace. It is now a beautiful place as a result of investment. While a brand new unit has been built on the site, there has been, as I stated, very little development of community mental health services.

Psychiatric nurses initially embraced A Vision for Change. The result, however, was the removal of beds from the system without an alternative being provided to the hospital mission. That is the sad part of it. We are now being told there is no budget available, yet there are still opportunities. For example, there are lands available in places such as St. Senan's hospital in Wexford, and Portlaoise. Why can the revenue raised from the sale of these lands not be reinvested in mental health services? This was done on a smaller scale in the St. Loman's-Tallaght service where I also worked. When part of the land of the old St. Loman's hospital campus was sold, a sum of, I believe, €28 million was ring-fenced for mental health services. As a result, the primary care centre in Ballyfermot now also provides mental health services and two new 17 bed hostels have been built. Resources were provided when money from sales was reinvested. The problem, however, is that the cost of living in Dublin, among other factors, makes it difficult to attract staff to work in the service.