Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

Gabhaim buíochas leis an gCeann Comhairle as an deis seo chun ceist fíor-thábhachtach a phlé.

It is a very serious matter that nine clinicians in the area of mental health in the Carlow-Kilkenny, south Tipperary area have withdrawn their confidence in the HSE's management of the service. They cited nine suicides in the area over a period of just 17 months, as revealed in an investigation aired last Sunday on RTE's "This Week" programme. I have raised this as a Topical Issue, while our party leader raised it with the Taoiseach yesterday, because the HSE and the Minister of State with responsibility for mental health services, Deputy Kathleen Lynch, must account publicly for the fact that these clinicians believe their concerns have not been taken seriously, despite being raised repeatedly.

In a letter received by RTE under freedom of information, the nine doctors wrote to the Minister of State, Deputy Lynch, to express "serious concerns" about local services in light of the nine fatalities. The doctors questioned the safety of governance in the service and said they felt devalued and ignored in their attempts to raise their concerns internally in the HSE. That a group of front-line clinicians should feel strongly enough to co-sign such a letter is alarming. The clinicians highlighted nine deaths in the period from August 2011 to January 2013. What makes this most worrying is that they raised their concerns first in November 2012 and by the following June they were writing to the Minister of State to say that those concerns had not been properly addressed. The clinicians said they were not informed of the outcomes of HSE reviews of these tragedies. The fatalities concerned included three suicides of inpatients by the same means, four suicides in home-based settings, and a further suicide in a crisis house.

I have a number of specific questions. Did the Minister of State act on the consultants’ call to intervene with the HSE to ensure proper investigation of incidents and that review findings would be properly communicated and appropriate reforms implemented? Did the Minister of State accept the contention of the HSE briefing document supplied to her, which claimed the fatalities in the service are not out of line with figures for the preceding 11 years, citing Central Statistics Office statistics for Counties Carlow and Kilkenny and south Tipperary? What does the Minister of State say to retired consultant Alan Moore, who said on RTE that CSO figures do not reflect the number of suicides occurring in hospitals, which he believes is unusually high? Can the Minister of State confirm that an investigation is being carried out by the Irish Mental Health Commission into governance structures within the service and that a separate review is under way by Dr. Colm Henry of the national lead clinical directors programme?

It is also serious that the local consultant group has described clinical governance systems in the area as unsafe and that participation in them would be a dereliction of duty. This is serious. These revelations came just three days before today’s publication of the annual report of the Mental Health Commission, including the report of the Inspectorate of Mental Health Services. That report shows that only 44% of psychiatric hospitals and mental health facilities are compliant with staffing level regulations. I ask the Minister of State to address the questions posed.

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