Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the Deputies for raising this issue and for giving me an opportunity to update the House. I am taking this debate on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who is on Government business elsewhere.

Galway-Roscommon mental health services are committed to full implementation of A Vision for Change. The guiding principles involved under this widely agreed policy include patient centeredness, equality, access to quality care that is focused on recovery and integration with other mental health and mainstream health services.

The HSE in Galway-Roscommon provides an inpatient and community mental health service for a population of 314,000 and is at an advanced stage in the implementation of A Vision for Change. It has already moved in to local service provision with catchment areas of 50,000, as recommended in A Vision for Change, and appointed team co-ordinators and developed an overarching clinical governance model.

Staff working in the health service cope with significant service pressures and that this is also the case in mental health. However, the focus and priority must always be on provision of care for the patient.

Patients in this service can often display challenging behaviour and HSE staff are provided with a wide range of training and supports. Where a patient has assaulted a staff member, it is recorded and the rarer instances of serious assaults are investigated as part of health and safety management.

In line with revised safety incident management policy, staff are encouraged to report all incidents. The HSE in Galway reviews recorded assaults. According to the records, up to the end of March there were 29 recorded incidents in the acute unit in Galway. All such incidents are risk-rated. Of the 29 incidents of assault, 25 were classified as physical, two as attempted and two as verbal. Of the 25 physical assaults, one was rated high, ten were rated moderate and 14 as low-level. All incidents are discussed and reviewed locally, and any suggested actions are implemented. Trends are reviewed and analysed at clinical governance meetings in Galway. I understand several of the incidents were physical in nature, with staff being struck in the jaw and in the stomach. Clearly, none of us can condone this. However, it is not necessarily the case that additional staff would have prevented any of the assaults on staff members since they were predominately one-on-one assaults.

The whole-time equivalent number of staff working in the acute unit in Galway has risen from 47 in 2013 to approximately 60 in 2015 - a total increase of 13 staff on two years ago - as part of the ongoing reconfiguring of services in the area.

It is important to contextualise the situation in the acute unit. Some of the patient's clinical needs require that they be nursed by a male member of staff. HSE west management have indicated that the executive is finding it increasingly difficult to recruit male nurses. It has put a number of proposals to the Psychiatric Nurses' Association of Ireland to address the gender imbalance. However, I am informed that to date the PNA has rejected all options such as skills mix and a rotation of psychiatric nurses from a community setting into hospitals. The HSE is also progressing the high-dependency unit, which will help to alleviate the pressure on the acute unit. This proposal has gone to the PNA for a response and a response is still awaited.

I am most concerned at this morning's unannounced industrial action. Disruptions to the delivery of care cause unnecessary worry and anxiety. This is clearly not in the interests of patient safety and puts additional pressure on other staff, compromising their health and safety. I call on all concerned to work co-operatively to solve the current situation facing mental health services in Galway. I welcome the Labour Relations Commission intervention earlier today. This would have been possible without the events of this morning. Of course, the LRC is independent, and it is in a position to examine staffing levels and make appropriate recommendations, as it has done in other areas.

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