Kathleen Lynch (Cork North Central, Labour)

I thank the Acting Chairman. The extra time is much appreciated as this is a very difficult issue to deal with in a short timeframe for a reply. To respond to Deputy White's final question on why a solution could not be found immediately if one will be found by 16 January of next year, the difficulty is that the staff needed will not return from annual leave until 16 January. There is little we can do in the circumstances. At present, 37 staff are absent in the units in question as a result of maternity leave and sick leave and because a number of those who will retire in February will avail of the accumulated leave to which they are entitled. We must accept this is the case, especially given the extraordinary job performed by the staff in question. I am not sure any of us would do their job.

I am pleased the House is discussing locked units, an issue that was well ventilated recently when we discussed a Private Members' motion tabled by Technical Group. Locked units are from a bygone era, although in some cases people who have emotional episodes need to be protected from themselves and, in rare cases, members of the public need to be protected from individuals. Specific units are in place to deal with such cases. The use of locked units, especially dormitory style units, flies in the face of our mental health strategy, A Vision for Change, and everything that most Members believe in.

It is highly regrettable that the action being taken has become necessary, particularly at this time of year, and I completely understand the distress the decision has caused patients - if that is the correct term - their families and the general community. The Health Service Executive informs me that the measures are necessary given the shortage of nursing staff in Dublin north west mental health services. Dublin will not be the only area that will experience shortages in future. There was a large number of retirements this year among nursing staff in St. Brendan's Hospital and vacant posts were not filled due to the recruitment pause in place in the HSE. Unfortunately, therefore, the executive has been left with no option but to devise a contingency arrangement to ensure both patient safety and continuity of services over the Christmas period. It is not the case that I have only recently become involved in this matter. I have been making inquiries about since before last weekend and the issue must be dealt with in future.

To address Deputy Keating's concerns, the Mental Health Commission has responsibility under the Mental Act 2001 to take all reasonable steps to protect the interests of detained patients. I understand the Health Service Executive has notified the commission of the measures proposed. The Mental Health Commission has responsibility for ensuring the units in question have sufficient staff to provide a safe environment for those who are detained at St. Brendan's Hospital and its staff. Despite our efforts to have people receive mental health services in the community, an approach that keeps them well and prevents them from being admitted to hospital, some of them are being called into acute units. It is perverse that people in the community are becoming unwell and require readmission to hospital. This issue will form part of the review of the Mental Health Act.

The position is that, following clinical assessment, it has been decided to transfer the 12 long-stay patients from Unit 3B. Five have been transferred to Unit O, four to community hostels and the remaining three to other facilities. However, I have been assured that this is purely a temporary measure and Unit 3B will reopen on 16 January next, if not earlier. Concerns in the media largely centre on the transfer of five women to Unit O, which is a low secure ward that has a locked door policy in place. I have received an assurance from the Health Service Executive that patients from Unit 3B who previously could move in and out freely will still be able to do so. This is fully in line with our national mental health policy which seeks to ensure patients are held in the least restrictive environment possible.

Concerns have also been expressed that patients in Unit O have access to only one shower. Again, I am assured that there are two showers available to patients. While I know this is far from ideal and I am acutely aware of the infrastructural deficits at St. Brendan's Hospital, the closure of the hospital is foreseen in the context of the implementation of A Vision for Change. Those who are familiar with the facility will be aware that the reduction in its patient population is proceeding at a steady pace. Acute admissions have ceased and the hospital now provides only continuing care to long-stay patients who are the women affected by the recent decision.

I am pleased to inform the House that construction is under way on a 54 bed replacement long-stay facility as part of the Grangegorman redevelopment project. Building is expected to be completed in 2012 and the new facility will provide patients with their own single bedrooms, en suite facilities, therapy and rehabilitation spaces, in other words, the types of facilities we should have been providing years ago. I am confident patients will have moved into the new facility before next Christmas, although I accept this will be cold comfort to patients in Unit O. Again, I express my regret that these measures were necessary.

Budget 2012 provided an additional €35 million for mental health services which will be used to provide additional posts in the community. I hope people will never again be locked up for 20, 30, 40 or 50 years. I visited a locked unit in which one person who clearly did not present a danger to anyone had resided for 60 years. The additional funding will enable the HSE to enhance the multidisciplinary composition of community mental health teams and focus on key priorities in mental health. There is, however, a need to explore more fully how mental health services, owing to the age profile of staff within the service, have been impacted disproportionately by the staff moratorium. This issue is already the subject of discussions between officials of my Department and the HSE and I intend to pursue it further to achieve an appropriate result which ensures the quality and safety of our mental health services in the future. The blunt instrument of the moratorium will not serve us well in mental health. For this reason, we must closely examine the areas in which we most need staff and how they can best be provided. Discussions will have to take place on this issue because staff will be lost in areas in which they are needed and retained in areas where we could do without them. I appreciate that the Acting Chairman, Deputy Broughan, has allowed me considerable latitude.

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