Tim O'Malley (Limerick East, Progressive Democrats)

I thank Deputy Moynihan-Cronin for raising this matter on this evening's Adjournment.

Operational responsibility for the management and delivery of health and personal social services is assigned to the Health Service Executive, HSE, under the Health Act 2004. The HSE has informed my Department that St. Finan's Hospital campus, to which the Deputy referred, measures approximately 55 acres in total, with approximately 43 acres sited to the south of the ring road in Killarney and the remainder to its north.

At present, mental health services are provided from accommodation within the St. Finan's Hospital building. It is planned to transfer these services to new purpose-built accommodation over the next two years. The HSE's plans for the campus are to develop a range of health care facilities on the campus to provide modern accommodation to meet the present and future health needs of the population of Killarney and its surrounding areas. The plans include the development of a primary care centre and headquarters for HSE services provided to the population of Killarney and east Kerry.

The St. Finan's building itself, and some curtilage, that is, an area of land to make the building saleable, has been identified as surplus to requirements and will be disposed of when the building has been vacated. The HSE has advised that no actual date has been set for the sale of St Finan's building at this time. The HSE is in discussions with the local authority concerning the possibility of disposing of some of the site to facilitate affordable housing.

The report of the expert group on mental health policy, A Vision for Change, which was launched in January this year, outlines an exciting vision of the future for mental health services in Ireland and sets out a framework for action to achieve it in the next seven to ten years. The expert group found:

Mental hospitals have been the mainstay of mental health services in Ireland for many years. However, the type of person-centred, recovery-oriented care recommended ... cannot be provided in institutions of this size or environment.

On that basis, the group recommended that steps should 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.

As the Deputy may be aware, the closure of the 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 in 1984 of the policy document, Planning for the Future. A number of the large psychiatric hospitals around the country have already been closed, including Our Lady's, Cork, St. Patrick's, Castlerea, St. Columba's, Sligo, St. Mary's, Castlebar, and Our Lady's, Ennis. The reorganisation of services which these closures entailed has resulted in the expansion of community facilities, new acute psychiatric units in some cases 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 in the country cater in the main for long-stay patients, many of whom are over 65 years of age. I understand this is also the case at St. Finan's, Killarney, in which the majority of patients are cared for in elderly care wards.

The HSE has indicated that it anticipates the closure of psychiatric hospitals and the reinvestment of the proceeds in modern, replacement facilities to take place on a phased basis. It has also emphasised that hospitals can only close when the clinical needs of the remaining patients have been addressed in more appropriate settings, such as additional community residences, day hospitals and day centres, together with a substantial increase in the number of well trained, fully staffed, community-based multidisciplinary community mental health teams.

The implementation of the recommendations will be a matter primarily for the HSE, which has established an implementation group to ensure the recommendations are realised in a timely and co-ordinated manner. I have established an independent monitoring group to monitor progress on the implementation of the mental health strategy, A Vision for Change. The Government has commenced implementation of this strategy and provided €26.2 million in funding in 2006 for this purpose. A further €25 million has been made available in 2007.

I am sure the Deputy will agree the Government is fully committed to the implementation of the national mental health strategy, A Vision for Change, as the basis for the future development of our mental health services.

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