Tom Hayes (Tipperary South, Fine Gael)
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I thank the Ceann Comhairle for allowing us to raise the important matter of the planned closure of the psychiatric unit at St. Michael's psychiatric unit, Clonmel. This matter, the subject of much debate over the past several years, is a great concern to the people of Clonmel and south Tipperary, the facility's patients, their families, staff and everyone else associated with it. The Minister of State is aware of these concerns and has dealt with them head on.

The reality, however, is that admissions to the facility will stop on 1 March 2012. The Minister of State, and her predecessor, gave the commitment that no closure would take place until new alternative community-based facilities were on the ground. The concern is these facilities are still not in place. From the note I have been supplied, there are also staff shortages of clinical psychologists, social workers and occupational therapists in the area, another grave concern. Only some weeks ago, I, along with Deputy Mattie McGrath, travelled with the Minister of State to Wexford to visit a community-based mental health facility with which people there were very satisfied. People in south Tipperary do not understand similar facilities will be in place in the area because they have not seen them rolled out yet.

I implore the Minister of State to defer the decision to close the St. Michael's unit until all replacement facilities are in place. Then people will be in a better position to make a judgment on these changes.

Mattie McGrath (Tipperary South, Independent)
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I thank the Ceann Comhairle for allowing us to raise this matter this evening. The Minister of State, Deputy Kathleen Lynch, already knows my views on this matter. She has visited the St. Michael's unit at our request and we have had painless discussions on it.

I am not going to repeat what Deputy Tom Hayes has just said. However, I appeal to the Minister of State to honour her commitment that all community-based facilities are in place before the unit is closed. So far, it has not happened. In a recent article, a consultant in Clonmel described the closure of this unit as medical apartheid.

The Minister of State knows better than I do the number of public servants in the health services who applied for retirement today. Even before these retirements came into play, south Tipperary did not have the staff for community-based mental health services it requires. I recently visited the replacement facility for St. Senan's in Wexford which was so new the paint was still wet. While I thank the staff for facilitating our visit, the unit has not been up and running for several weeks and we have no experience of how it works. Communities in south Tipperary have no reassurance as to how such a community-based approach will work for them. We are in favour of A Vision for Change but not in the selective manner the Minister of State has introduced it.

In the last Topical Issue matter, the Minister of State accused Deputy Kirk of scaremongering. Will she rebut the claim she told the deputation of users and family carers from south Tipperary that the decision to close the unit was not set in stone but set in blood? I hope these remarks were taken out of context. To say it, however, to mental health service users and their carers would be inappropriate. I note the Minister of State's official did not deny she might have said it.

A new development now is that no patient will be admitted to St. Michael's after the end of February. Instead, they will be sent on to facilities in Kilkenny. This will diminish further the standing and staff of South Tipperary General Hospital. This is a significant issue which already has seen 14,000 people on the streets protesting. They will be on them again. Two taoisigh, Brian Cowen, and Deputy Kenny have met deputations on this matter. All we want is a reasonable amount of fair play and a full assurance that replacement facilities will be put in place.

Kathleen Lynch (Cork North Central, Labour)
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On the last Topical Issue, I did not accuse Deputy Kirk of scaremongering.

Mattie McGrath (Tipperary South, Independent)
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Yes, the Minister of State did.

Kathleen Lynch (Cork North Central, Labour)
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I said he should not scaremonger and that he also was not the type to do that.

I thank the Deputies for raising this issue which gives me the opportunity to restate the Government's policy on mental health services. The closure of the old psychiatric hospitals and the transfer of patients to more appropriate community-based settings are central to this policy and is a priority for this Government. The evidence is overwhelming that a modern mental health service is best delivered in the community. Hospitalisation should only be used in exceptional cases, and even then, only as a last resort. The Government is, therefore, committed to developing community-based services. Despite financial constraints, I was pleased we were able to announce a special new allocation of €35 million in last December's budget to be used primarily to develop community mental health teams and services to ensure early access to more appropriate services along with improved integration with primary care.

The implementation of A Vision for Change requires the amalgamation of south Tipperary and Carlow-Kilkenny into one catchment area for mental health services. The inpatient bed requirement for the combined population of approximately 205,000 is 34 beds which will be provided in St. Luke's General Hospital, Kilkenny. Accordingly, there will no longer be a need for inpatient beds in St. Michael's in South Tipperary General Hospital and the unit will close.

The psychiatric unit at St. Luke's is modern and purpose built. Service users will be able to avail of a much higher standard of physical inpatient environment there. The unit has the capacity to support the wider extended catchment area and fully meets the requirements outlined in A Vision for Change. The provision of the acute service for the extended catchment area from a single site will release resources to fund more modern community focused services for south Tipperary.

As community mental health services are developed in south Tipperary, the service user will be offered alternative services more appropriate to their needs such as home treatment and community day services. In this regard, south Tipperary mental health services are implementing a comprehensive change programme which is transforming the existing service into a modern, fit-for-purpose service providing a service of excellence to the local population. The development of community mental health services in south Tipperary is underpinned by a comprehensive €20 million capital infrastructure programme. This will provide a 40-bed community nursing unit, an acute day hospital and community mental health team base; a 12-bed high support hostel, and an eight-bed respite house.

A Vision for Change represents the Government's mental health policy. The developments and plans for the mental health services in south Tipperary are fully in line with that policy and enjoy mine and the Government's full support. Service users in the region will reap the benefits from the significant improvement in quality and access to mental health services in south Tipperary. I have conveyed again my commitment to the HSE that St. Michael's should not close until the appropriate community-based services are in place for the area concerned. I trust this has clarified the issues for the Deputies.

Tom Hayes (Tipperary South, Fine Gael)
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While the Minister stated she conveyed her commitment on this issue to the HSE, she must convey it to those HSE people who are driving ahead with the closure of the unit.

Kathleen Lynch (Cork North Central, Labour)
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I have.

Tom Hayes (Tipperary South, Fine Gael)
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The problem is we have correspondence from service users and people working in the services which states there will be no admissions to the unit after 1 March.

Kathleen Lynch (Cork North Central, Labour)
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Is this from the people responsible for admissions?

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Minister of State can reply when the Deputies have finished their supplementary questions.

Tom Hayes (Tipperary South, Fine Gael)
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These are the views of retired psychiatrists from the health service. The reality is that they are telling us the case on the ground and that was a week ago. That is where the breakdown of communications is occurring. I thank the Minister of State for giving her commitment but it needs to be brought to the people in south Tipperary who are extremely concerned about the matter. I ask her to do so.

Mattie McGrath (Tipperary South, Independent)
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The Minister of State spoke about a 40 bed community unit, an acute day hospital, a community mental health team, a 12 bed high support hostel and an eight bed respite centre. Where are these facilities? Construction of the acute hospital is under way but the other facilities are not in place. Today is the first day of spring but it will be next winter before we see them. People are worried because admissions will cease from the first of next month.

I cannot get over the change in the Minister of State since she was in Opposition. She has swallowed her Department's mantra hook, line and sinker. I ask her to deny she told the unfortunate users that the date was set in blood. I am disgusted to think she might have said that.

Kathleen Lynch (Cork North Central, Labour)
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It is amazing how easily people are offended. At Deputy Mattie McGrath's request I met service users, all but two of whom happened not to be service users.

Mattie McGrath (Tipperary South, Independent)
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They were service users.

Séamus Healy (Tipperary South, Workers and Unemployed Action Group)
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They were service users and carers. That was the request which the Minister of State accepted.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I ask the Deputy to resume his seat.

Kathleen Lynch (Cork North Central, Labour)
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They were decent and honourable people. Our conversation lasted approximately an hour and a half. We had a free ranging conversation because we should not have to be automatons or robots watching every word that comes out of our mouths. The people I met were courteous and I sympathised with their position because I have been in that position myself and I understand their concern about losing a service with which they are familiar. I tried to persuade them that the service we are going to provide, which Deputy Mattie McGrath saw in Wexford, will be as good if not better.

Mattie McGrath (Tipperary South, Independent)
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They have not seen it.

Kathleen Lynch (Cork North Central, Labour)
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When I was asked at the end of the free flowing, conversational meeting whether it is set in stone, I jokingly said, "No, it is set in blood".

Mattie McGrath (Tipperary South, Independent)
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It was a queer joke in very bad taste.

Kathleen Lynch (Cork North Central, Labour)
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Perhaps, and if it offended the people at the meeting - I strictly refer to the people at the meeting - I withdraw it and I apologise for saying it. I do not think it caused offence because nobody mentioned it at the time, which amazes me.

I have not changed my mind on A Vision for Change.

Mattie McGrath (Tipperary South, Independent)
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Nor have we.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Please allow the Minister of State to continue without interruption.

Kathleen Lynch (Cork North Central, Labour)
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Nobody, whether in Opposition or Government, objected to A Vision of Change when it was introduced in this House in 2006 because we knew it is what we should do with mental health services. I told the facilitator who I appointed to bring this process forward that while 31 March is the preferred date, it is not set in stone. It will not be 31 March 2013 but there is flexibility and that message has been conveyed clearly. In case people are under any illusion, St. Michael's unit in Clonmel is going to close and we are going to implement A Vision for Change in south Tipperary, Kilkenny and Carlow. We will provide a similarly excellent service to that provided elsewhere in the country.

If I said something in a free-flowing conversation, I will be more careful in future to avoid that kind of conversation.