Derek Keating (Dublin Mid West, Fine Gael)
Link to this: Individually | In context

I thank the Ceann Comhairle for giving me the opportunity of raising this matter of national importance and great urgency. The news has broken that Ms Louise Bayliss has been reinstated to her position by The Irish Advocacy Network Limited. I welcome this news and congratulate Ms Bayliss as the hard-working and caring person of great integrity we now know her to be. However, I am still concerned about the circumstances that led to her removal from her position when she showed herself to be a caring person advocating for vulnerable persons. I ask the Minister of State, for whom I have tremendous regard because of her passion for the mental health sector, to consider the circumstances of the case. Will she or her Department speak to The Irish Advocacy Network Limited, the management of St. Brendan's Hospital and senior management in the HSE about the possibility that this is happening, without notice, time again? Is the Minister of State satisfied that this issue has been resolved? What steps can she take to ensure it does not happen again? I know the Government is committed to introducing important new legislation in this area.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

I, too, welcome the reinstatement of Ms Louise Bayliss by The Irish Advocacy Network Limited. This is a good outcome. However, it does not remove the necessity for us to raise the issues surrounding her case.

The treatment of women patients in St. Brendan's Hospital is a very serious matter. After Ms Louise Bayliss blew the whistle, the matter was raised in the Dáil by a number of Deputies, including me, and the Minister of State subsequently visited St. Brendan's Hospital to see what had been described as temporary arrangements brought about by staff shortages. That happened on 15 December. I trust the Minister of State will take the opportunity to provide an update on the situation in St. Brendan's Hospital for the women concerned and generally, given the ongoing staff shortages.

The issue that must be addressed is why did it take a patient advocate to go to the national broadcast media to highlight the situation and seek a remedy. We would not have know about this were it not for the actions of Ms Louise Bayliss who deserves great credit for her courage. Where are the safeguards for patients falling short? Where are the reporting mechanisms in the system breaking down? These are the issues that must be addressed.

We have to see this issue in the context of the narrowly averted industrial action by members of the Psychiatric Nurses Association in St. Ita's Hospital, Portrane. All of this is related. Again, the issue is the pressure exerted on reduced staff numbers and the reduction in bed numbers. I trust the Minister of State will address these issues.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context

I was delighted to receive a message on my phone this morning from Ms Louise Bayliss telling me of her reinstatement, just as I was utterly shocked and dismayed to receive a call from her last week saying she had been sacked for doing her job and advocating on behalf of patients. Her reinstatement is a victory for her courage and commitment to the cause of mental health patients in ensuring they are properly treated. However, major questions still need to be answered. Why was she removed from the wards after blowing the whistle on behalf of patients? We need to find out who made that decision and they need to be held to account. We need to end the situation where retaliation is possible or punishment is meted out in any State agency or sector of society to people who are doing their job and acting in the interests of society and the persons they are supposed to be looking after. We must urgently bring forward the promised whistleblower legislation. We must address the lack of resources in mental health facilities and the health service generally which can lead to the mistreatment of patients and bodies trying to cover up that mistreatment by acting in the way Ms Louise Bayliss was treated.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

We need to clarify one matter. No one was mistreated. Deputy Richard Boyd Barrett needs to be careful about the language he uses.

I would like to outline some of the background to this issue. When the issue of the transfer of patients from Unit 3B to a low secure ward in St. Brendan's Hospital first arose back in December, I visited the hospital to satisfy myself that the temporary arrangements made for the five vulnerable patients in question were appropriate and would provide a good standard of care. During my visit I was satisfied that they were very well cared for and were comfortable in their new accommodation. I was not alone. Other Deputies accompanied me on that visit.

I spoke with the patients and staff and, while accepting that the move had been somewhat unsettling for them, believed every effort had genuinely been made to keep the disruption for the patients to a minimum. I do not want to overstate this. Clearly, people did not want to be in that position. They would have preferred to remain in their own unit to which they were more used. Because of staff holidays and the Christmas period the move had to be made from a safety point of view.

The decision to keep the patients in another ward in St. Brendan's Hospital was made after careful clinical assessments had been carried out when their individual needs were taken into account. It must be remembered that these women were familiar with the staff in the hospital, some of whom transferred with them. They were also comfortable with their general surroundings. I am delighted that the HSE, with the co-operation of management and staff, managed to reopen unit 3B in early January, a fortnight earlier than originally planned. A degree of organisation was needed for that to happen.

It is important to recognise that A Vision for Change places the service user at the centre of our mental health services, care and treatment. They have a role in how services are offered, including the design, delivery and evaluation of services. The HSE funds and supports a number of voluntary organisations that are working to develop the capacity of service users to fulfil this important role. The trainee advocate involved in this case is under contract with the Irish Advocacy Network, a voluntary organisation that is supported and funded by the HSE to provide peer advocacy services nationally. Peer advocates are people with personal experience of recovery from mental illness who have completed an accredited programme at FETAC level 4.

The HSE has made it clear to me that at no time did it seek to interfere with the internal workings of the Irish Advocacy Network, nor has it ever sought sanction of any kind against the staff member referred to by the Deputies. The HSE has categorically confirmed that at no point - locally, regionally or nationally - was the network advised that this trainee advocate was not welcome in HSE inpatient units. The decision to deal with the issues the network had with certain trainee advocates was taken solely by it.

I understand the Irish Advocacy Network issued a statement today indicating that, following indepth and intensive consultation within the organisation, it has offered to reinstate two trainee peer advocates who had their training posts terminated last week. One of the trainees has agreed to accept this offer. The network is meeting the other trainee tomorrow. The network has made it clear that the HSE had no role in its decision to let the two trainees go, or in its decision to offer to reinstate them to their six-month training posts. I understand a meeting between the HSE and the Irish Advocacy Network is scheduled for this Friday. I will seek a report from the HSE on the outcome of that meeting.

One of the key principles that should underpin our mental health services at all times is that of autonomy for the patient. The services are required to consult service users on service planning and delivery issues. Such autonomy and consultation are critical to our strategic direction in the way in which we intend to continue to develop mental health services in this country. Despite the consequences and the outcome of what happened in this case, it is important for us all to keep in mind that the Irish Advocacy Network is completely independent. I would have it no other way. I do not intend to interfere in any of the decisions it makes, regardless of how we might feel about them. Whistleblowers legislation is an entirely different aspect of all of this. The Irish Advocacy Network needs to be independent. If we start to interfere in its operations, it will not be able to do its job. We need to be very careful about that.

Derek Keating (Dublin Mid West, Fine Gael)
Link to this: Individually | In context

I thank the Minister of State for her detailed response. I have asked the Joint Committee on Health and Children, of which I am a member, to invite Ms Louise Bayliss to address the committee so we can hear her story. I have also proposed that representatives of the Irish Advocacy Network should be also invited to that forum. Some outstanding questions about the function, funding and supervision of the network need to be answered. The Chairman of the committee has indicated that my request will be considered on Thursday morning. I remind the House of the importance of the legislation I mentioned in my initial contribution. I ask Deputies to imagine the society we would have if Deputy Rabbitte had been successful when he sought to introduce whistleblowers legislation in 1999. They can reflect on how free and comfortable some staff in Anglo Irish Bank might have felt in recent years if the legislation had been passed, and on how that might have changed Irish society. The same thing applies to the staff of Our Lady of Lourdes Hospital in Drogheda and some of our nursing homes. The introduction of such legislation is of crucial importance.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

I thank the Minister of State for her reply. Does she know how many staff in the mental health services will take up the retirement option before the end of February? Are contingency plans in place to address the additional staff shortages that are expected across the mental health services? It is clear that such shortages contributed to the issues at St. Brendan's Hospital that we have already discussed this afternoon. Can the Minister of State give us any assurances in relation to a serious matter that will present within a short number of weeks?

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context

I do not want to bandy around terms in a sensitive area like mental health. It seems to me that moving patients from an open unit where they are happy in a community to a closed secure unit - at Christmas, of all times - essentially because of staffing shortages is not the best treatment possible for patients. The question of who is responsible for that is a separate one. Ms Louise Bayliss was right to blow the whistle on it. Although I do not know the truth of the matter, I am absolutely convinced that Ms Bayliss is telling the truth in every single detail of her account. Therefore, questions have to be asked about why she was removed from the wards the day after she blew the whistle on what was happening at St. Brendan's Hospital. I absolutely accept what the Minister of State said about the independence of the advocacy network. I suggest it needs to have an independent source of funding. We can argue about the difference between direct pressure and indirect or implicit pressure, but I suggest that if one's funding comes from the HSE, one will feel compromised in one's ability to advocate on behalf of patients if one thinks it might annoy the HSE. That has to be addressed.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

I will deal with Deputy Boyd Barrett's question first. From where would the independent funding to which he refers come? Is he suggesting that the current funding be withdrawn?

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context

It could be shifted to another Department.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

It is still Government money. It is still the taxpayers' money.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context

It would not be the same management.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

It is imperative that the Irish Advocacy Network stays independent. There may be questions to be answered. We need to ensure we do not apply the pressure that Deputy Boyd Barrett says should not be applied in this instance. I am convinced that everyone is telling the truth. It probably could have been handled much better. I am convinced everyone is telling the truth. I do not think one person is telling the truth and another person is not telling the truth. That might be Deputy Boyd Barrett's view of the world, but it is not mine.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context

I would not be sure.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

I know the people in the Irish Advocacy Network. They are service users. They are there for the good of the people they represent. They do not have another agenda.

I would like to respond to Deputy Ó Caoláin by saying we are not yet certain about what the exit rate will be. The serious difficulty we have is that we are not certain. We managed to secure 400 additional places in the health service plan. The moratorium or pause is a big issue. We need to start dealing with that. I am sure the Deputy, like me, was gratified to hear the Minister, Deputy Howlin, say in the media recently that certain front line services will have to be the subject of an indepth examination. We will have to look at who we employ, where we employ them and the gaps that exist in that regard. That work will have to be done as a matter of urgency. It is clear that more people have always left the psychiatric services than any other part of the health service. That has been the case not just this year but for a number of years.