Mary Butler (Waterford, Fianna Fail) | Oireachtas source

As the Minister is well aware, the department of psychiatry at University Hospital Waterford, UHW, has been in the news for all the wrong reasons in the past month. As a result, confidence in the unit by patients, staff and the general public is at a low ebb. The catchment area for UHW covers Waterford and Wexford.

I was appalled when I read the report from the Mental Health Commission which found that the department of psychiatry at UHW had a mere 57% compliance rate this year. The report's findings are extremely worrying and serve to highlight the serious issues within our mental health services. Over the past three years, compliance levels have fallen from 64% in 2017 to a record low of 57% this year. It is obvious that no structures were put in place in 2017 to halt the decline, which is worrying.

The report raised issues with regard to the fact that children were being admitted to adult settings despite the fact that not all staff had received training in the context of the Children First guidelines. Children did not have access to age-appropriate advocacy services and facilities. The conditions at the unit also raised red flags. The report described two toilets as malodorous with overflowing bins, discarded cigarette butts and thick cobwebs. Also of great concern was the fact that residents' general health was not monitored and assessed by their specific needs. This is very worrying. Physical examinations were inadequate and did not consistently include an assessment of residents' body mass index, weight, blood pressure, smoking status or dental health. For anyone who is long-term in the unit, that is particular a concern. Anyone with a loved one in the unit would be rightly concerned. I have no doubt that the staff in the wards are doing all they can to give the best care and attention to the residents. However, severe staff shortages are undoubtedly having an impact. The Psychiatric Nurses Association of Ireland, PNA, has highlighted concerns with senior management, the HSE and the Mental Health Commission and felt compelled to hold a two-hour stoppage recently to raise awareness of the conditions.

In 2010, St. Senan's in Wexford was closed and the department of psychiatry at UHW was deemed suitable for Waterford and Wexford inpatients. No extra capacity was provided and hence the issues arose. The question is why standards are slipping so drastically. The issues highlighted are simply not acceptable and must be addressed as a matter of urgency. Recently, images of overcrowding with patients sleeping on chairs and floors were circulated on social media. These are deeply distressing and completely unacceptable. However, they came as absolutely no surprise to anyone working within this unit. I have met and spoken with three residents who were in the unit this year and they all confirmed that overcrowding with patients sleeping on the floor is an ongoing issue and was not unique to the bank holiday weekend as was stated. One very brave young woman, Shauna is her name, spoke with me today on WLR radio outlining the many challenges she faced, the conditions in the unit and the severe overcrowding. At one stage over the October bank holiday weekend, an additional ten residents were facilitated. This meant that there were 54 people in a 44-bed unit. Health and safety rules and regulations were obviously ignored as capacity was well exceeded. The reports from UHW are absolutely damning. Not only is the treatment of patients there unsafe, it is inhumane.

I thank the Minister of State for meeting Deputy Browne and me the week before last and for agreeing to visit the unit in the near future. I have been informed by the hospital management that a deep clean has taken place and that the aspects in the report in respect of malodorous smells, overflowing bins and cobwebs have all been dealt with. However, I am appalled that the conditions were allowed get to that state and I know the Minister of State is, too. It is well recognised that additional capacity is required with a figure of 20 beds being the general consensus for the Waterford-Wexford region. The fact that these beds will not be achieved in the short term is further evidence of a hands-up approach to mental health issues in Waterford and Wexford. Kate Killeen-White, chief officer with South East Community Healthcare, said she could not defend the situation in Waterford. John Farrelly, the chief executive of the Mental Health Commission, has admitted that the conditions are unacceptable. Next March, registration is due again for this unit and a meeting will be held in the coming weeks. The Mental Health Commission has warned that significant improvements and changes need to be made for the centre to be permitted to re-register. Unless a clear, agreed, corrective plan is put in place, implemented and adhered to, I would be extremely concerned. We cannot afford to lose this unit from Waterford.

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