James Reilly (Dublin North, Fine Gael)

I oppose this Bill because of its intention to co-locate the Central Mental Hospital, currently based in Dundrum, with the prison. We had a debate last week when I outlined very clearly and strongly why I disagree with this, and it might seem like I am repeating myself. However, when a group of people cannot speak for themselves it is important that those who can speak do so loudly and strongly. I have already outlined that many working in the area are opposed to this. An article by Dr. Harry Kennedy in Irish Medical News this week again states clearly his discomfiture at this move. It is wrong and will stigmatise people with mental illness. It is bad enough that mental health has been the Cinderella of our health services for so long. It is bad enough that, as I have mentioned before, we have Dickensian conditions in St. Ita's Hospital in Portrane where 23 men in one ward and 23 women in another ward have one bank of three toilets, one shower and one bathroom for each ward. Acutely ill men and women going into hospital face this in 2008. This is what they see as their first contact with our health service. It is a disgrace. We will further damage them by stigmatising them as criminal when this is clearly not the case. It is wrong. There is no need to do it. This is about trying to get better value from a site. We have already discussed in this House the money paid for that site. Let us get value from it some other way, but not at the cost of the mental well-being of those who suffer mental health problems.

It has come to my attention today, and not for the first time, that many who go into prison on soft drugs end up on hard drugs. They seem to be more freely available. There is hard information that indicates that more people come out of prison on drugs than went in. How will the new prison address this issue? Will it have a detox unit? Will it have rehabilitation as part of its mission statement? Will it aim to reduce the number of people who come out of prison on drugs rather than increase the number? I refer specifically to men going into prison who may have smoked cannabis in the past but come out having smoked heroin and other drugs. Drugs seem to be the currency in prison. It is difficult to understand that within a controlled environment we are not able to monitor people more closely. As I mentioned earlier, I know of one case of a young man who went into prison having smoked marijuana in the past now lying in hospital virtually paralysed down one side with his right arm and leg swollen and without the use of either after smoking heroin, or what was supposed to be heroin, in prison. I want to alert people again that what people buy on the street cannot be stood over. This has nothing to do with prisons. People think they are buying an ecstasy tablet, heroin or cocaine but they are buying God knows what, with all sorts of dreadful consequences. I mentioned before an idea suggested by a journalist that the Garda should take samples of drugs available on the streets on a weekly or fortnightly basis and let the public know what they find in them. We must keep in the front of the public mind that taking drugs in a recreational fashion, as some people describe it, is a very dangerous pastime which can have lifelong and disastrous consequences. People need to be made aware of this at every available opportunity. While one could say much action has been taken by drugs task forces and so on, the reality is that this area needs to be revisited time and again. Several people died last year as a consequence of taking drugs containing all sorts of impurities. We need to remind people of this, particularly the young.

To come back to the issue of the hospital move, I believe it is a retrograde step and I have explained my reasons to the Minister on a number of occasions. It will impede rehabilitation, increase stigmatisation and the location is totally unsuitable. It is out in the countryside where there is no natural community to be rehabilitated into. Dundrum grew up around the hospital and there is no issue with community acceptance of it but the situation at Thornton Hall is entirely different. It will also result in terrible inconvenience to patients, families, relatives and friends.

I referred last week to the issue of the skills set being lost. Many staff living on the southside of the city close to Dundrum or further south and perhaps even in Wicklow have their lives planned out. They will now be asked to travel to Thornton Hall. We will suffer the loss of key skills sets if this move goes head.

The main issue, however, is the isolation of patients from their families. This flies in the face of Government policy and contradicts the principles and recommendations of A Vision for Change, the Government's agreed policy on future mental health services. It specifically contradicts the following principle: "Priority should be given to the care of individuals with severe and enduring [mental] illness, in the least restrictive environment possible." How can it be claimed that an institution in the middle of the countryside could possibly meet those requirements? It will be very restrictive and will hugely limit the amount of freedom patients can have and the opportunity to let them out for weekends or half-days.

A further principle states: "Forensic mental health units need to be clearly identified as being intervention and rehabilitation facilities that operate in particular conditions of security rather than facilities offering mainly containment." I cannot see what other message the Government is giving to people other than containment by co-locating this hospital with a prison, which is primarily about containment. It is also stated that forensic mental health services should have a strong community focus but there is only a very small and disparate community in the area. We know this goes against best international practice. The consultation with users and their families has still not been completed. This is probably all very boring for the Minister but it is a matter of grave concern to the families concerned and their loved ones.

The lack of cost-benefit analysis is a further issue. A study was carried out which suggests there is an opportunity to redevelop the hospital on its own grounds. This would meet all the requirements I have outlined and would still yield money for the Government because valuable property would remain to be sold. The group to which I referred, the Central Mental Hospital carers' group, asked that redevelopment of the existing site at Dundrum would be considered. It referred to selling off 14 acres of the current site, reinvesting the capital raised from that sale to redevelop the remaining 20 acres and providing a modern Central Mental Hospital, all of which would be revenue neutral.

This is an opportunity to show leadership. It is bad enough that the co-located hospital in Beaumont is now to be planted on the site for which planning permission was granted for the psychiatric unit for Dublin North, which was supposed to replace the temporary building built in the 1960s. It is bad enough that the Government gives that signal but to also do this gives a powerful signal to those who suffer with mental illness and those who care for them. That signal is simply this — money matters more than patients, nowhere moreso than when it comes to mental health.

I ask that the Minister conduct a cost-benefit analysis on all the options before he takes this decision. We are at a time of economic downturn, as we all realise. We need to get value for money but we need to get it in a way that delivers value to the patient, not just euros to the Exchequer. I ask that the Minister reconsider this matter. I ask him not to co-locate this hospital at this site. I ask him to consider those with mental illness and to try, for once, to give them a signal that this Government does care, will do more than talk and will take action that shows real compassion for real people with real problems.

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