Thursday, 10 February 2005
Mental Health Services.
Question 4: To ask the Tánaiste and Minister for Health and Children the details of the consultations between her Department and the Department of Justice, Equality and Law Reform in relation to siting a psychiatric hospital in the grounds of the new prison; her views on whether the decision will further stigmatise patients suffering from psychiatric conditions; the position with regard to the decision to dispose of property surplus to the psychiatric services and invest the proceeds in the development of the services; and if she will make a statement on the matter. [4318/05]
Before I reply, I wish to point out an error in the question. Deputy Neville referred to "siting a psychiatric hospital in the grounds of the new prison". This is incorrect. The proposed new psychiatric hospital will not be in the grounds of the new prison.
This is the first Government to propose building a new central mental hospital. I will provide the history to this in case Members think it was a hasty decision.
I will answer it. In 2003, the then Minister for Health and Children, Deputy Martin, established a project team, chaired by the East Coast Area Health Board, to progress the redevelopment of the Central Mental Hospital. This team included representatives from the Department of Health and Children, the Eastern Regional Health Authority, the East Coast Area Health Board, the clinical director, director of nursing and hospital manager of the Central Mental Hospital, the Irish Prison Service and a representative of the chief executive officers of the other health boards.
The project team's remit was to critically examine all options for the redevelopment of the hospital, to put together a design brief for the redevelopment and to examine various financing options for the project. Six options were considered by the group: to develop a new facility on a greenfield site in the greater Dublin area; to develop a new facility on a greenfield site outside the greater Dublin area; to refurbish and upgrade the existing facility to accommodate the service; to have a partial new build of the hospital with retention and refurbishment of some of the existing building; to transfer the service to another existing facility; or to do nothing.
Several options, including the option of remaining in Dundrum, were examined under the various criteria including clinical quality-strategic fit, the cost, both capital and revenue, timescale, future demands, integrated services, accessibility to the public and safety and security.
The team reported to the Department in May 2004 and recommended that the Central Mental Hospital be relocated to a new purpose-built facility in the greater Dublin area as this was judged to be the most appropriate option for delivery of patient care. The project team made no specific recommendation to locate the Central Mental Hospital adjacent to a prison. However, it must be borne in mind that 97% of admissions to the hospital come from within the prison service.
The new central mental hospital will be a health facility providing a therapeutic forensic psychiatric service to the highest international standards in a state-of-the-art building. I can confirm that the hospital will remain under the aegis of the Department of Health and Children and will be owned and managed by the Health Service Executive. I have asked my officials to examine the option of providing a separate governance structure for the hospital, by way of its own board, reflecting its importance as a national, tertiary psychiatric service. It is intended to develop the central mental hospital, independently of the prison complex to replace Mountjoy Prison, by means of a separate capital development project managed and directed by the Health Service Executive. A new central mental hospital on the 150 acre site will have its own grounds with a separate entrance, access road and a separate address to the prison complex.
The Deputy referred to stigma. Much has been said about the stigma of the mental health service. The present Government is doing more than any other Government to relieve that stigma and to help patients. We are encountering significant opposition from many unlikely quarters. I am doing everything possible, including speaking to many voluntary organisations which appreciate the work that is being done. The Central Mental Hospital has been in Dundrum since 1850. This Government is the first to consider relocating it and building a new central mental hospital. I also understand that the Minister for Enterprise, Trade and Employment, Deputy Martin, the Minister for Justice, Equality and Law Reform, Deputy McDowell, and I were the first Ministers ever to visit Dundrum.
The lands of the Central Mental Hospital are the property of the Office of Public Works. My Department is preparing detailed proposals for Government for the development of a new hospital and the disposal of the property at Dundrum. It is my intention that the proceeds from the sale of the existing site will go towards the provision of the new hospital in the first instance, with the balance of funds to be invested in health facilities, in particular community mental health facilities. A memo will go to Cabinet soon in that regard.
My question relating to what consultations had taken place between the Department of Justice, Equality and Law Reform and the Minister on siting the hospital in grounds of the prison was not answered. In view of the exposé in a recent "Prime Time" programme regarding practices in regard to the movement of prisoners who are suffering from psychiatric conditions and who are rendered as being insane, it is important that we are made aware of the details of any deliberations that take place between the Department of Justice, Equality and Law Reform and the psychiatric services in Dundrum. Given that people are determined insane and removed to the psychiatric hospital, then rendered sane for the purposes of being taken to court, and subsequently rendered insane to return to prison, we are anxious to know what discussions took place with the Department of Justice, Equality and Law Reform in this regard.
Does the Minister of State agree that organisations such as Aware, Schizophrenia Ireland and others have expressed extreme concern about the discrimination taking place against those who are mentally ill? The patron of GROW stated——
I am asking the Minister of State to comment on the fact that 97% of hospital admissions come from the Prison Service. Surely it is an indictment of the whole service and the relationship between those with mental illness and the psychiatric services that people with severe mental illness are being moved from prison, and the whole approach——
The Deputy referred to three organisations, Schizophrenia Ireland, Aware and GROW. I met GROW yesterday to discuss many matters of concern regarding mental health. To my knowledge its representatives did not even mention——
I will not mention Vincent Browne. I had a very useful discussion yesterday with GROW for approximately an hour or an hour and a half and its representatives did not refer to the Central Mental Hospital. I had a very useful discussion this morning with Schizophrenia Ireland. Its representatives had reservations about the site but, following my discussions with them, they understand the progress that is being made.
I have not spoken to the organisation, Aware. The Deputy speaks about stigma, but a constant reiteration and repetition about the problems in the mental health service is becoming a bit tiresome to many organisations. Much good work is being done.
The Chair wants to make a point. In fairness to every Deputy in the House, we try to stay within Standing Orders as best we can. Six minutes is allowed per question. On the last question, my understanding is that the Minister of State had two minutes for a reply but took five minutes. As we have spent more than ten minutes on that question, I ask Members on both sides of the House to try to stay within Standing Orders as best they can so that we can get through as many questions as possible.