Liam Quaide (Cork East, Social Democrats) | Oireachtas source

Last week, I appealed to the CEO of the HSE, Bernard Gloster, to reconsider a significant project in Cork that will be a clear breach of the UNCRPD if it goes ahead. The HSE is proposing to invest €64 million in developing a 50-bed, centralised residential mental health facility on the grounds of St. Stephen's Hospital in Glanmire. St. Stephen's Hospital is the site of a new elective hospital, which is appropriate. However, the new residential facility would be for adults with severe and enduring mental health difficulties who require 24-hour staffed rehabilitation and support. Some of those service users may live in such a facility for a relatively short period of rehabilitation, over several months maybe, but I know from working in adult mental health services that many will remain there for years or much of their lives and it will essentially be their home. The HSE has emphasised that the buildings it proposes to build - five bungalows on the hospital campus - will not be institutional in design. As we know, a home is about much more than a building; it is about the broader community in which the person lives. The UNCRPD enshrines the right to community integration for people with disabilities. St. Stephen's Hospital, which I know very well, could not be more removed from that reality.

As I said here last week, the land around St. Stephen's Hospital is zoned for agricultural use. The land directly across from the hospital is zoned for light industry - an online warehouse. The nearest shop of any description to St. Stephen's Hospital is a 1.7 km walk from the entrance of the hospital and that is a service station. The first kilometre of this route has no footpath and there are no plans by Cork City Council to develop one. The nearest grocery shop, which is a SuperValu, is in Riverstown which is a 3 km or 40-minute walk away. Again, the first kilometre has no footpath. There are no community amenities within walking distance of St. Stephen's Hospital and no plans to develop any. The residents typically do not drive. Some will have mobility issues. The distances I have just cited may actually be longer depending on the location of the proposed residences within the large hospital campus.

This proposal is entirely at odds with the progressive trend of supporting people with severe mental health difficulties to integrate in their communities, something that has been core to every mental health policy since Planning for the Future in 1984. It was further emphasised in A Vision for Change in 2006, in the HSE's own model of care for people with severe and enduring mental illness and complex needs in 2019, and in Sharing the Vision also in 2019. It is also in clear breach of the UNCRPD.

Centralising these residential placements in St. Stephen's Hospital will necessarily cut people off from their communities because a facility of that size will serve a broad catchment area. It will not just serve people from Glanmire; it will take in people from parts of east Cork, north Cork and north-west Cork. Despite all of the arguments based on evidence and on mental health policy since the 1980s, despite all of the arguments based on the UNCRPD, and despite the fact that the HSE's claims about what is known as the city of neighbourhoods strategy in Cork City Council, which includes transforming the area around St. Stephen's Hospital, would not in any way survive a reality test because St. Stephen's Hospital is in the hinterland of Glanmire, there is no doubt in my mind the HSE will plough ahead with this.

Mr. Gloster said last week that he will put the plans up for consultation for all agencies to have a say on them. I know that if this project goes to planning stage, it will be considered by the local authority on those terms exclusively and the planning application will very likely be approved. Given that the HSE has an authoritarian attitude that involves riding roughshod over its own mental health policy and the UNCRPD, what recourse do we have to challenge this development? Without sounding hyperbolic, it will condemn large numbers of people in Cork with severe and enduring mental health difficulties to a relatively isolated and detached existence on the grounds of a hospital. A planning submission will not work because it will not be considered under the terms of mental health policy. Can the National Disability Authority, as a body, assist in ensuring the upholding of the UNCRPD in a service provision decision that is of such significance as this? Are there other agencies that can bring their influence to bear on a project like this?