Tommy Broughan (Dublin North East, Labour)
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Deputies Joe Costello, Derek Keating, Maureen O'Sullivan and Alex White, have four minutes between them.

Joe Costello (Dublin Central, Labour)
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I hope the Acting Chairman will be flexible as regards the time.

The concerns of relatives and staff in Grangegorman are now public as a result of media attention such as on "Liveline". Five women are being transferred from an open unit in Grangegorman to a closed, secure unit. Voluntary patients are moving to a ward for involuntary patients. This is contrary to all best medical practice. These are low risk patients who are being moved into what would have been regarded as a medium to high risk unit. A number of these patients have been in the unit for a considerable period of time. They are familiar with their surroundings and have formed friendships and have decorated the unit for Christmas.

The reason for this significant change in their situation is because of a shortage of staff. This is a peak holiday time and there is an embargo on recruitment in the public sector. The staff are very committed and are to be commended, and a new, state-of-the-art unit will be built next year. However, a current significant bottleneck needs to be addressed. The solution is to provide the staff cover through the use of overtime or agency staff. Another seven patients in the unit were transferred to hostel accommodation on the North Circular Road and in Fairview or to other units. This could be an alternative for the remaining five patients or else the embargo on staff should be lifted to allow for the provision of ten extra staff required over that period. I ask the Minister of State to address the situation.

Derek Keating (Dublin Mid West, Fine Gael)
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I am absolutely furious at the way this matter is being handled by the HSE and its treatment of these patients. I am of the view that this is possibly illegal and it is certainly immoral. It is completely unprofessional to lump five women into a unit which already caters for six patients. During the period of their incarceration they will have the use of a single toilet. Part of the difficulty is that Unit O, where these patients are being incarcerated, is a locked unit and the Mental Health Commission previously deemed this unit to be unsuitable and not fit for purpose. These five patients are being told they cannot use their mobile telephones during the Christmas period. I wonder who made this decision. Are these women five patients or five prisoners? From my voluntary work over the years I know how important matters such as a routine, consistency and familiarity are for patients undergoing treatment and in particular for those undergoing mental health treatment.

The Mental Health Act 2001 has two main features, the promotion and maintenance of quality standards of care and treatment which are regularly inspected and properly regulated. The primary function of the Mental Health Tribunals established under the Act is to ensure the protection of the rights of patients detained involuntarily. These five patients, in my view, are being detained involuntarily. If a person is detained and treated in a hospital against his or her will, this is not complying with human rights. If this is the case, the Mental Health Act must be urgently updated and amended. The information that patients are being moved from their home, Unit 3B, to a locked unit is completely unacceptable. I ask whether this action contravenes the Mental Health Act.

In advance of any Dáil question I will table, I ask who made the decision and on what basis. Was a consultant involved in the decision? Could this action result in a complaint to the Medical Council if this decision was endorsed by a consultant? For the sake of a paltry few bob, I ask the Minister of State to direct the HSE to provide staff for the welfare and comfort of these patients in their own unit during the Christmas festivities. I am very conscious that we have a caring a Minister of State with responsibility for mental health and disability who has inherited the restricted circumstances from a previous Administration. I ask her in the few days leading up to Christmas to ask the HSE to exercise some flexibility.

Maureen O'Sullivan (Dublin Central, Independent)
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I too am appalled at the situation in Grangegorman for very vulnerable people and their loved ones. Eleven long-term patients from Unit 3B have been moved. The most focus has been on those who have been moved into Unit O but others have been moved to hostels and other accommodation. The bottom line is the moving of these patients. They are used to their familiar environment and the move is very distressing and disturbing for them. They have mental health issues and I am aware of the Minister of State's interest in that area.

There are issues for those already in Unit O whose space is being taken over by the new residents and also issues for the residents of Unit 3B. A health and safety issue arises in both areas for both patients and staff and it is also a human rights issue.

Alex White (Dublin South, Labour)
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This is a very disquieting situation. As well as having been contacted by concerned family members, I have also had an opportunity to speak to some of the professional staff involved. Deputy Keating has raised this issue briefly but from my knowledge of their views they are just as appalled and dissatisfied at this decision and its implications. As Deputy Maureen O'Sullivan has said, it runs the risk of seriously compounding the anxiety suffered by these five women at the best of times.

I appreciate the Minister of State's commitment to this area and I do not doubt it for one minute. This is clearly an issue of resources and if the decision is to be reversed on 16 January 2012, it means a solution will exist on 16 January. It may be naive of me to ask the Minister of State but I ask if it is possible to bring forward what will be done on 16 January to 13 December, considering the status quo will be reversed in the middle of January. Surely there is some possibility of this being addressed in a way that can solve it for this short period of four weeks. I ask the Minister of State, knowing her commitment to this entire area, to consider this option. The decision to use a locked or a semi-locked ward is completely the opposite direction we should go. It is completely unacceptable that we should have to take that step at this stage of our development. We should be going in the opposite direction and I know this is the long-term commitment of the Minister of State. This is a bad and a retrograde step and I hope the Minister of State can do something to have it reversed.

Tommy Broughan (Dublin North East, Labour)
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I have allowed some flexibility on time because of the importance of this matter and I will allow similar flexibility to the Minister of State.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Acting Chairman. The extra time is much appreciated as this is a very difficult issue to deal with in a short timeframe for a reply. To respond to Deputy White's final question on why a solution could not be found immediately if one will be found by 16 January of next year, the difficulty is that the staff needed will not return from annual leave until 16 January. There is little we can do in the circumstances. At present, 37 staff are absent in the units in question as a result of maternity leave and sick leave and because a number of those who will retire in February will avail of the accumulated leave to which they are entitled. We must accept this is the case, especially given the extraordinary job performed by the staff in question. I am not sure any of us would do their job.

I am pleased the House is discussing locked units, an issue that was well ventilated recently when we discussed a Private Members' motion tabled by Technical Group. Locked units are from a bygone era, although in some cases people who have emotional episodes need to be protected from themselves and, in rare cases, members of the public need to be protected from individuals. Specific units are in place to deal with such cases. The use of locked units, especially dormitory style units, flies in the face of our mental health strategy, A Vision for Change, and everything that most Members believe in.

It is highly regrettable that the action being taken has become necessary, particularly at this time of year, and I completely understand the distress the decision has caused patients - if that is the correct term - their families and the general community. The Health Service Executive informs me that the measures are necessary given the shortage of nursing staff in Dublin north west mental health services. Dublin will not be the only area that will experience shortages in future. There was a large number of retirements this year among nursing staff in St. Brendan's Hospital and vacant posts were not filled due to the recruitment pause in place in the HSE. Unfortunately, therefore, the executive has been left with no option but to devise a contingency arrangement to ensure both patient safety and continuity of services over the Christmas period. It is not the case that I have only recently become involved in this matter. I have been making inquiries about since before last weekend and the issue must be dealt with in future.

To address Deputy Keating's concerns, the Mental Health Commission has responsibility under the Mental Act 2001 to take all reasonable steps to protect the interests of detained patients. I understand the Health Service Executive has notified the commission of the measures proposed. The Mental Health Commission has responsibility for ensuring the units in question have sufficient staff to provide a safe environment for those who are detained at St. Brendan's Hospital and its staff. Despite our efforts to have people receive mental health services in the community, an approach that keeps them well and prevents them from being admitted to hospital, some of them are being called into acute units. It is perverse that people in the community are becoming unwell and require readmission to hospital. This issue will form part of the review of the Mental Health Act.

The position is that, following clinical assessment, it has been decided to transfer the 12 long-stay patients from Unit 3B. Five have been transferred to Unit O, four to community hostels and the remaining three to other facilities. However, I have been assured that this is purely a temporary measure and Unit 3B will reopen on 16 January next, if not earlier. Concerns in the media largely centre on the transfer of five women to Unit O, which is a low secure ward that has a locked door policy in place. I have received an assurance from the Health Service Executive that patients from Unit 3B who previously could move in and out freely will still be able to do so. This is fully in line with our national mental health policy which seeks to ensure patients are held in the least restrictive environment possible.

Concerns have also been expressed that patients in Unit O have access to only one shower. Again, I am assured that there are two showers available to patients. While I know this is far from ideal and I am acutely aware of the infrastructural deficits at St. Brendan's Hospital, the closure of the hospital is foreseen in the context of the implementation of A Vision for Change. Those who are familiar with the facility will be aware that the reduction in its patient population is proceeding at a steady pace. Acute admissions have ceased and the hospital now provides only continuing care to long-stay patients who are the women affected by the recent decision.

I am pleased to inform the House that construction is under way on a 54 bed replacement long-stay facility as part of the Grangegorman redevelopment project. Building is expected to be completed in 2012 and the new facility will provide patients with their own single bedrooms, en suite facilities, therapy and rehabilitation spaces, in other words, the types of facilities we should have been providing years ago. I am confident patients will have moved into the new facility before next Christmas, although I accept this will be cold comfort to patients in Unit O. Again, I express my regret that these measures were necessary.

Budget 2012 provided an additional €35 million for mental health services which will be used to provide additional posts in the community. I hope people will never again be locked up for 20, 30, 40 or 50 years. I visited a locked unit in which one person who clearly did not present a danger to anyone had resided for 60 years. The additional funding will enable the HSE to enhance the multidisciplinary composition of community mental health teams and focus on key priorities in mental health. There is, however, a need to explore more fully how mental health services, owing to the age profile of staff within the service, have been impacted disproportionately by the staff moratorium. This issue is already the subject of discussions between officials of my Department and the HSE and I intend to pursue it further to achieve an appropriate result which ensures the quality and safety of our mental health services in the future. The blunt instrument of the moratorium will not serve us well in mental health. For this reason, we must closely examine the areas in which we most need staff and how they can best be provided. Discussions will have to take place on this issue because staff will be lost in areas in which they are needed and retained in areas where we could do without them. I appreciate that the Acting Chairman, Deputy Broughan, has allowed me considerable latitude.

Tommy Broughan (Dublin North East, Labour)
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I allowed an additional five minutes for discussion of this important topic. However, as other Deputies have been waiting to speak on other topics, I ask Deputies Costello, Keating, O'Sullivan and White to confine their contributions to putting a single question to the Minister of State.

Joe Costello (Dublin Central, Labour)
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While I appreciate the Minister of State's remarks on the additional €35 million in the budget and new proposals regarding the facility in question, we face a real and immediate crisis which is completely unacceptable. We may find, as a result of the recruitment embargo and forthcoming retirements in February, that we still have staffing shortages on 16 January. While this matter is being addressed, will the Minister of State make arrangements to allow the Deputies who have raised this issue to visit the unit in order that we can see where the women in question are being placed? I know such a facility resides with the inspector and ask the Minister of State to make the appropriate arrangements.

Derek Keating (Dublin Mid West, Fine Gael)
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I acknowledge that the Minister of State's heart is in the right place and I have no doubt she will make a significant contribution to mental health services in the lifetime of the Government. Does she not have the power to direct the HSE to resolve this single sensitive and critical issue for five human beings at Christmas time?

Maureen O'Sullivan (Dublin Central, Independent)
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I presume additional staff went into the other unit because additional patients were there. Given that this is Christmas time, and in light of the stressful nature of this issue, can the Minister of State not use some of the €35 million to resolve this difficulty? I understand some of the families are also willing to contribute.

Alex White (Dublin South, Labour)
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I was about to ask the same question. Is it not possible for the HSE to secure the services of temporary staff for this short four-week period? I understand what the Minister of State has said. I would not for a moment wish to trespass on anybody's right to take annual leave. If we accept that the response we have been given - the posts lie vacant and cannot be replaced - is accurate, does the HSE not have some flexibility to hire staff for four weeks?

Tommy Broughan (Dublin North East, Labour)
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I ask the Minister of State to conclude.

Kathleen Lynch (Cork North Central, Labour)
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I appreciate the Chair's patience. I can inform Deputy Costello that I have already made a request to be allowed to visit the unit. I have been told it is not a difficulty. I did not make a similar request on behalf of other Deputies. I will make such a request and revert to all the Deputies in question. I assure Deputies O'Sullivan and Keating that people on overtime and agency staff are already working in the unit. I have been informed by the HSE that the difficulty is that it is better to have staff with whom the residents of the unit are familiar, rather than people who are not known to them. It is very easy to understand that point. The HSE has assured me that it has asked people to do a little extra work over Christmas. It is natural and understandable that people are reluctant to work during the Christmas holidays. I am in regular contact with the HSE. If it agrees to a visit by the Deputies when I contact it again, I will contact them.