Tim O'Malley (Limerick East, Progressive Democrats)

I thank Deputy Mc Guinness for raising this matter and assure him that the widest possible consultation will take place. I do not disagree with the comments he made because I am very clear as regards what we intend to do in this regard.

I have been advised by the HSE that all decisions regarding the disposal of lands attached to psychiatric hospitals will be taken in the context of the recommendations contained in the report of the expert group on mental health policy. This report, A Vision for Change, recommended that a plan to bring about the closure of all mental hospitals should be drawn up and implemented. The resources released by these closures should be protected for reinvestment in the mental health service. It also stated that the full economic value of psychiatric hospital buildings and lands should be professionally assessed and realised.

A Vision for Change envisions an active, flexible and community-based mental health service where the need for hospital admission will be greatly reduced. The expert group stated in the report that mental hospitals had been the mainstay of mental health services in Ireland for many years. It stated, however, that the type of person-centred, recovery-orientated care recommended could not be provided in institutions of this size or environment. On that basis, the group recommended that steps be taken to bring about the closure of all the remaining psychiatric hospitals which are a legacy of a bygone age and to reinvest the resources released by these closures in the mental health services.

The closure of large mental hospitals and the move to modern units attached to general hospitals, together with the expansion of community services, has been Government policy since the publication of Planning for the Future in 1984. A number of large psychiatric hospitals have already been closed — Our Lady's in Cork, St. Patrick's in Castlerea, St. Columba's in Sligo, St. Mary's in Castlebar and Our Lady's in Ennis. The reorganisation of services which these closures entailed has resulted in the expansion of community facilities, new acute psychiatric units attached to general hospitals, including St. Luke's Hospital in Kilkenny, and, most importantly, an overall improvement in the delivery of services for the service users, their families and carers. Most of the remaining stand-alone psychiatric hospitals cater in the main for long-stay patients, many of whom are over 65 years of age. I understand that this is also the case at St. Canice's Hospital, Kilkenny, where the majority of patients are cared for in wards for older people.

The report recommends that a plan be drawn up for the phased closure of each of the hospitals. It is recommended that this plan consist of a four-stage process, as follows: stage 1, identify measures required to enable admissions to cease and put these measures in place; stage 2, cease admissions to the hospital and draw up plans for relocation of existing patients; stage 3, implement plans for the relocation of existing patients; and stage 4, final closure of hospital.

It is emphasised that this process should take place on a phased basis, with wards closing sequentially. It also makes clear that the process will require funding for training and upskilling of staff who will subsequently be redeployed to work within the mental health services provided in the community.

The HSE has welcomed the publication of this report and has stated that its national mental health directorate will immediately establish an implementation group to ensure that the recommendations are realised in a timely and co-ordinated manner. The HSE has also emphasised that hospitals can only close when the clinical needs of the remaining patients have been addressed in more appropriate settings.

I assure Deputy McGuinness that the Government is fully committed to the implementation of this report, which has been accepted as the basis for the future development of mental health services. The programme of investment has begun with an additional €25 million allocated to the HSE in the Estimates for 2006 for mental health services and I am confident that this level of investment will continue in the coming years. Significant capital investment will also be required to implement A Vision for Change, estimated by the expert group to be in the order of €796 million, for the provision of new and replacement facilities for the mental health services, and much of this could be realised from the value of existing hospitals and lands.

I reassure the Deputy that I should be delighted to consult him and others in Kilkenny and the other regions where hospitals will be closed. Our priority, obviously, is to ensure that the patients get suitable accommodation, either in the same location or in others. We are mindful of the fact, however, that the lands we have available are health assets and that they will be converted into mental health and other health assets as needed in the community.

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