Kathleen Lynch (Cork North Central, Labour)

I agree with the Deputy on the issue of psychiatric services. To discontinue a service without informing the people who rely on it is not right and should not happen. I hope it will not happen under the new regime we are trying to establish. The days when psychiatric services were part and parcel of the overall Vote and budget for acute hospitals are coming to an end. I hope we will be able to disentangle the funding and establish a far more robust system of psychiatric services. I am aware there is major resistance to the closing of particular units - I am not talking about day centres - but we must move from the bedside to the fireside. People with mental health issues must be treated in the community in a humane and respectful fashion. They should not turn up at centres to find them closed. I agree with the Deputy in that regard.

The Deputy asked about Raheen hospital. The Government is committed to supporting people to live with dignity and independence in their own homes and communities for as long as possible. Where this not feasible, the health service supports access to high quality long-term residential care where this is appropriate. We continue to develop and improve health services in all regions of the country to meet this objective and to ensure quality and patient safety.

The HSE has sole operational responsibility for the delivery of health and social services, including those at facilities such as Raheen Community Nursing Unit in County Clare. The community nursing unit is located in a rural area in south-east Clare. The unit has a total capacity of 28 beds. It can accommodate 14 long-term residents, with 12 places allocated as short-term care or assessment beds and two places dedicated to palliative care.

The HSE in the mid-west had spent €20 million more than its allocated budget at the end of June 2011. One of the measures implemented to deal with this issue is a reduction in the use of agency staff and overtime across all health and hospital facilities and services in the mid-west. This has had an impact on the number of residents that can be safely accommodated. Consequently, the HSE has reduced the number of beds in Limerick, County Clare and north Tipperary by 65. The reductions, mainly in short-stay beds, are as follows: 15 beds at St. Camillus Hospital, Limerick; 17 beds at St. Ita's Hospital, Newcastlewest; 22 beds at the Community Hospital of the Assumption, Thurles; six beds at Dean Maxwell Home, Roscrea; and five beds at Raheen CNU. It must be noted that 23 of these beds are currently vacant. A reduction of nine beds had originally been envisaged in County Clare; however, through a successful redeployment of nursing staff, this figure was reduced to five beds at Raheen. The reduction will be managed with minimum disruption to residents. I accept the Deputy's point about the planning that goes into respite and long-stay beds. Clearly, this is a cause of major disruption.

The Deputies will appreciate that all developments must be addressed in the light of current economic and budgetary pressures. Any decisions taken by the HSE must have regard to this and to the current moratorium on the recruitment of nursing and non-nursing staff.

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