Dáil debates

Wednesday, 3 March 2010

Priority Questions

Mental Health Services.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 45: To ask the Minister for Health and Children her views on the fact that vulnerable patients with psychiatric or intellectual disabilities continue to be housed in archaic institutions in which they fail to receive adequate care and treatment; and if she will make a statement on the matter. [10865/10]

Photo of Áine BradyÁine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

Our current model of mental health care is largely institution-based, and 15 Victorian and older asylums are still in use. However, A Vision for Change, the report of the expert group on mental health policy, provides a framework for action to develop a modern, high-quality mental health service over a seven to ten year period and recommends that the remaining psychiatric hospitals should close and that patients should be relocated to more appropriate community-based settings.

The mental health capital programme will provide the infrastructure necessary for the patient-centred, flexible community-based service envisioned in A Vision for Change and will facilitate closure of the remaining hospitals. In this regard, Budget 2010 provided for a multi-annual programme of capital investment to be funded from the proceeds of the sale of lands. In 2010, the HSE will dispose of surplus assets and reinvest an initial sum of €50 million in developing the new mental health infrastructure. Projects which will be progressed in 2010 include the development of an acute unit at Beaumont to replace the acute unit at St. Ita's, Portrane; the construction of a community nursing unit in Clonmel which will enable St. Luke's Hospital to close later this year; and the construction of a community nursing unit in Mullingar to facilitate the closure of St. Lomans's Hospital. Approximately 300 patients with an intellectual disability are placed in psychiatric hospitals. Their needs, which relate to their disability rather than a mental health concern, will be addressed by the HSE in the context of the closure of the hospitals.

In addition to those inappropriately placed in psychiatric hospitals, it is estimated that approximately 4,000 people with disabilities reside in institutions or congregated settings. This includes a cohort of approximately 460 patients with an intellectual disability who are accommodated in specialised units which were formerly designated as psychiatric hospitals. Their needs will be addressed in the context of the review of congregated settings which is nearing completion. Congregated settings are defined as living arrangements where ten or more people share a single living unit or where the living arrangements are campus-based. The review will inform policy development on services for people with disabilities and specify a framework to guide the transfer of identified individuals from congregated settings to the community.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

In 2004, planning permission was sought and granted for a new psychiatric unit at Beaumont and, as far as I know, it was put out to tender in 2005. However, nothing happened thereafter, funding having been withdrawn or evaporated. The new collocated private hospital at Beaumont, which has yet to have a sod turned, a brick put in place or a bed delivered, is impinging on that site and the psychiatric unit must move elsewhere. Today, we are told again by the Minister of State that it is in the pipeline. We have been waiting for 20 or 25 years and it is just not good enough.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

A question to the Minister of State.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Will the Minister of State provide a definite timeline for this unit?

Why do children continue to be admitted to adult centres? In 2009, 155 children were admitted to adult centres. Suicide rates have increased and 1,200 seriously ill patients continue to be admitted to inappropriate institutions. Will the Minister of State provide a list of assets sold to date and the revenue raised for same; a list of assets due to be sold and the estimated revenue that will be raised for same; the timescale for investment; and the details of where the 1,200 patients will be placed? With regard to those with intellectual disabilities, our mental health services were described by the inspector as crumbling institutions unfit for human habitation with residents wandering around aimlessly, cramped dormitories, the presence of dirt, the stench of urine, poor sanitation, broken furniture and the absence of constructive daily activities.

Photo of Áine BradyÁine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

In 2010, the HSE will dispose of surplus assets and reinvest the initial sum of €50 million. The HSE has already identified properties and has already received €15 million. It is in the process of selling other lands which will realise €50 million this year. The mental health capital programme will provide a range of facilities throughout the entire spectrum of mental health care facilities, including acute psychiatric units, day hospitals, community nursing units and high-support hostels, which will provide the infrastructure necessary to enable its modernisation into a patient-centred flexible community-based mental health service. The acute unit at Beaumont is prioritised as one of the projects to be funded in 2010. Acute admissions will be moved from St. Ita's to a new unit at Beaumont.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

There are still 23 men and 23 women sharing open wards with a block of three toilets, one shower and one bathroom. This is a disgrace in modern Ireland. Why has the 60-bedded unit at St. Ita's sat idle for the past seven months while intellectually disabled people live with paint peeling off the walls and the dirty conditions I described?

What percentage of child and adult community mental health teams are not fully staffed? The Minister of State should have that information.

Photo of Áine BradyÁine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

The Minister of State, Deputy John Moloney, was quite clear as to where he wants to go with A Vision for Change and he has three main items on his agenda: the appointment of an assistant national director with sole responsibility for mental health; to get the capital ringfenced; and to protect the human resources, which are affected by the moratorium. Deputy Reilly was present when the Minister of State indicated that he is working with the Minister for Finance to develop a mechanism whereby the human resources in certain mental health services can be supported and reconfigured where vacancies arise elsewhere and in the overall employment control framework of the HSE.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

What is the percentage of child and adult community mental health teams that are not fully staffed? The Minister of State should have that information.

Photo of Áine BradyÁine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

That is the same issue.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

How many? Name them.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

Perhaps the Minister of State will revert to the Deputy.

Photo of Áine BradyÁine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

The answer is that I do not know.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

A Vision for Change was published in 2005. It is a disgrace.