Brian Hayes (Dublin South West, Fine Gael)
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Question 13: To ask the Minister for Health and Children when urgent admissions to hospitals (details supplied) will cease due to inhumane conditions identified by the Mental Health Commission; if she will provide details on the locations at which more than 1,000 urgent psychiatric admissions will be accommodated; and if she will make a statement on the matter. [34744/10]

John Moloney (Laois-Offaly, Fianna Fail)
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In June 2010, the Mental Health Commission attached conditions to the registration of St. Brendan's, St. Ita's and St. Senan's Hospitals which, inter alia, require that new acute admissions to St. Brendan's cease in September 2010 and those to St. Ita's and St. Senan's cease in February 2011. I am glad to be able to report progress on this.

The HSE opened a second unit in the department of psychiatry at Connolly Hospital on 6 September last and all acute psychiatric admissions from the Cabra and Finglas areas were transferred to the new unit from that date. Acute admissions to St. Brendan's have now ceased - for the first time, it is worth noting, since 1815. The building of replacement long-stay mental health facilities, which was recently announced as part of the Grangegorman redevelopment project, is due to begin this year; the new 54-bed unit will be completed by mid-2012.

Three old-age psychiatric wards in St. Ita's Hospital are scheduled to close by the end of the year; these will be relocated to a newly refurbished purpose-built unit elsewhere on St. Ita's campus. It is also planned to discharge approximately ten patients to suitable nursing home or continuing care facilities. Plans for the transfer of acute inpatient admissions from St. Ita's to a new purpose-built unit on Beaumont Hospital campus are proceeding. Construction work is expected to begin in February 2011 and will take approximately 18 months. The HSE is considering alternatives to acute admission to St. Ita's that can be established pending full commissioning of the Beaumont facility.

With regard to St. Senan's, the HSE is committed to the closure of all old psychiatric facilities in the HSE south area. Significant steps have already been taken in Wexford, including a reduction in the number of beds from 170 in 2005 to 85 at present. Four capital development projects are under way which will enable the complete closure of all non-acute wards in the hospital by early 2012. There is sufficient capacity in Waterford Regional Hospital to serve the acute admission needs of the extended Waterford-Wexford catchment area, in line with the recommendations of A Vision for Change. However, before acute admissions can be transferred from St. Senan's, community-based services will need to be further developed in both Wexford and Waterford to provide alternative treatment options and reduce dependence on acute beds. Such developments include the provision of a day hospital service and crisis houses. The HSE expects to finalise an integrated development plan for the expanded catchment area shortly.

James Reilly (Dublin North, Fine Gael)
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I thank the Minister of State for his reply, and acknowledge the fact that he was not in charge of this portfolio for much of the duration of the pain and suffering that people have had to endure in these institutions and acute psychiatric admission units. The Minister to his right, however, has persisted with the policy of co-located hospitals, particularly at Beaumont, which impinges on the site which had the original planning permission for a new unit to replace the one at St. Ita's. This unit, I remind the House, has an open ward with 23 men on one side and another open ward with 23 women on the other, with a bank of three toilets, one shower and a bath on each ward. This is no way to treat people in 2010.

Would the Minister of State not consider, given the abject failure of the co-located hospital policy, using the original site at Beaumont Hospital - for which planning permission was obtained at some considerable cost - and proceed without any further delay to build the unit as provided for under that planning permission?

John Moloney (Laois-Offaly, Fianna Fail)
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I fully support everything the Minister has talked about in terms of co-location and, indeed, I support all our policies within the Department of Health and Children.

Mary Harney (Dublin Mid West, Independent)
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So do some of Deputy Reilly's colleagues, actually.

John Moloney (Laois-Offaly, Fianna Fail)
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Commitments made last year for capital programmes are being adhered to - it is not as if we are talking about a project at some future date. The unit at Beaumont will begin construction this year, and the site in Clonmel is under construction. The acute psychiatric unit in Letterkenny is also under construction. Thankfully, there will be no further referrals to Letterkenny hospital. With regard to St. Ita's, in the Deputy's own constituency, I was out there yesterday morning giving a commitment that the unit in Knockamann would be fully open next month. All the commitments we have made on mental health are being adhered to, thanks to the €50 million capital commitment. I will announce details of further openings. By the way, I forgot to mention St. Loman's in Mullingar, where I turned the sod not long ago for a 100-bed unit. I consider this a work in progress.

Jan O'Sullivan (Limerick East, Labour)
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I put it to the Minister of State that the percentage of the health budget dedicated to mental health services has gone down to 5.4%, which is an all-time low. Does he intend to increase the amount of money spent in this area, in the context of commitments in A Vision for Change?

Has a clinical lead been appointed for mental health? We received a list of clinical leads in all the different specialties and the only lead that had not yet been appointed was that of mental health. That may since have been rectified, but I would like clarity on it.

The original plan, when times were good in the building industry, was to sell off properties in order to raise capital funds for the provision of mental health facilities. Is the Minister of State satisfied that funding will be available for the various projects he outlined in his reply and for others that are needed in order to remove people from these Dickensian conditions?

John Moloney (Laois-Offaly, Fianna Fail)
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I have never argued publicly against the fact that the mental health budget has fallen from 8% to 5.4% of the overall health budget. Nor do I give the standard answer that there is hidden investment in mental health through the primary care facilities and community supports. Given that €600 million less will go into health services in this year's budget, the onus is on me to prioritise funding for mental health within this, particularly in the area of early intervention. To allow us to deliver the recommendations in A Vision for Change over the next four years, I will be making the case for a reorganisation of funding within the health budget to prioritise mental health. I am saying this in public and I said it recently at a conference. It ties in with the commitments of A Vision for Change.

A Vision for Change sets out a ten-year programme, of which four years have been completed. We can meet the commitments we have made in regard to the scheduled closure of mental hospitals in the six years remaining. I will be honest with the Deputies. We had hoped to raise €50 million this year but due to the downturn in the economy, we have raised €10 million thus far. Much of the anticipated windfall was dependent on local authorities being in funds. We are negotiating with local authorities on funding our developments over a two to three-year period.

In a nutshell, the commitment I have made on closing the old hospitals within three years remains. In addition to the commitments I gave last year on this year's spending, I gave a commitment that on 1 March each year we would outline what we can do to work towards our goals. Regarding the clinical lead, no appointment has yet been made.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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This is my first opportunity to follow up correspondence I sent to the Minister of State on 14 July regarding the outworking of the Government's policy on mental health inpatient units in the north east. I acknowledge the reply he issued to me on 19 August. Specific questions which I asked in my letter did not receive a response in the Minister of State's letter. Is it the Government's intention to close the admissions unit at St. Davnet's Hospital by the end of November and to discontinue new admissions to the unit from 1 November? I understand all new admissions are to be redirected to the inpatients unit at Cavan General Hospital. It is important that people know the precise situation. This has been suggested and we are weeks away from the prospective outworking of the matter. People within the service and across the community have not been advised of the factual position.

The Minister of State's reply of 19 August referred to an inpatient service planning group established in 2007 to plan for inpatient services not only for Cavan-Monaghan but also for the entire north east. The letter stated that the group recommended that a purpose built acute admissions unit be provided and that a site on the campus of Cavan General Hospital had been identified. It went on to indicate that an interim measure would be put in place in terms of utilising the existing admissions unit at the hospital and that the numbers which heretofore passed through St. Davnet's would be directed there. I object strongly to the closure of the admissions unit at St. Davnet's Hospital which is in an ideal, long-established and beautiful location. People are now being directed to the basement area of a general hospital. I have visited this unit and felt discomfort upon entering it.

Brendan Howlin (Wexford, Labour)
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Allow the Minister of State to reply.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It is unsuitable for people with severe mental health issues.

Brendan Howlin (Wexford, Labour)
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The Deputy's point is well made.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Will the Minister of State clarify the matter and revisit the proposal in light of what I have said?

John Moloney (Laois-Offaly, Fianna Fail)
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It is a pity that the defects rather the progress are always pointed out in regard to Cavan-Monaghan. Within one month of my appointment I had the privilege of visiting St. Davnet's where I met the consultant, Dr. Russell. Long before A Vision for Change was even considered, Dr. Russell was one of the first people in the area to promote the concept of community mental health services and support. What is happening is exactly in line with his vision of eight community mental health nurses for the region.

Unfortunately, interim measures are often required where resources are not immediately available. While the basement services are clearly not adequate or proper, I am considering interim measures for the hospital. It is not just a matter of ministerial diktat. All our discussions take place with the full support of the hospital management group. Whenever I have visited any of these hospitals, I have met consultants, doctors, users and providers to work out the best way of developing services in the region. That is what we are doing in Cavan-Monaghan.

Brendan Howlin (Wexford, Labour)
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We must move on. We have used more than double our allotted time for this question.

John Moloney (Laois-Offaly, Fianna Fail)
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I am not at present in a position to say anything more to the Deputy but I will try to revert to him in the next week or two regarding the November date.

James Reilly (Dublin North, Fine Gael)
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May I ask a supplementary question?

Brendan Howlin (Wexford, Labour)
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We are over time. I do not want to cut the Deputy short on his next question.

James Reilly (Dublin North, Fine Gael)
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I will take the cut on my next question because this is terribly important.

Brendan Howlin (Wexford, Labour)
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It is extremely important. That is why we spent double our allotted time on it.

James Reilly (Dublin North, Fine Gael)
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The Minister of State said we are not discussing plans for the future and that he has done X, Y and Z. The reality is that the patients of St. Ita's still do not know when they will be accommodated by a psychiatric admissions unit in Dublin north. We have not been told when the unit will be built. Will it be done sometime in the future when planning permission is received? In the meantime, we have been told by the Mental Health Commission that the unit should close by February 2011. Where will the patients who are being admitted or who will need admission next year be accommodated?

John Moloney (Laois-Offaly, Fianna Fail)
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The position is clear. Last year we did not have the money but now we are committing the money. We are working with the commission to develop interim measures. I have four specific ideas in mind. I do not intend sharing them with the House at present because it is clear that by doing so I would give rise to concerns about the transfer of patients. I am not looking at the easy option of extending the time period but investigating how adequate and proper facilities can be provided.