Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Ceann Comhairle for the opportunity to speak briefly on the Mental Health Commission report on St. Fintan's psychiatric hospital in Portlaoise. I also welcome the Minister of State at the Department of Jobs, Enterprise and Innovation, Deputy John Perry, who will respond on behalf of the Department of Health.

The issue of older person's services is very important in County Laois. Many of the residents of St. Fintan's Hospital in Portlaoise are elderly. Proposals have been made regarding the closure of two such facilities in the county, namely, Abbeyleix and Shaen hospitals. In that context, it is important to consider together the two units designated for closure and St. Fintan's psychiatric hospital.

The Mental Health Commission, which is responsible for St. Fintan's Hospital, paid an unannounced visit to the facility on 28 March 2012 in line with normal practice. The commission's report found the hospital "continued to admit residents which had resulted in an increase in the number of residents in the hospital which contravenes national policy on the closure of 19th century psychiatric hospitals." The previous Government's policy of closing such hospitals has been adopted by the current Government, Health Service Executive and Mental Health Commission. The report also found the following:

All residents did not have a choice of main meal and access to fresh drinking water. A therapeutic activation programme was not available for all residents of the approved centre. Residents were not provided with adequate information about the approved centre and the services offered. The Rehabilitation team and the Psychiatry of Old Age team were not adequately staffed with health and social care professionals.

On the day of the commission's visit 38 people were resident in the hospital, 25 of whom were in ward six, with the remaining 13 in what is known as the "rehabilitation area". In its conclusions, the Mental Health Commission report notes that St. Fintan's Hospital "was the only old psychiatric institution in the country to continue to increase its bed number year on year." Instead of closing, the number of beds in the hospital increased in the past year. The report also notes that the residents were either elderly or under the care of the rehabilitation team. The commission's first recommendation is that "plans to progress the closure of St. Fintan's Hospital should proceed expeditiously."

What should be done with the hospital's residents? In May 2012, the Health Service Executive in the midland region published an information and consultation document on its older persons service in which it invited people to participate in a consultation process on the potential closure of two community nursing units, Abbeyleix and St. Brigid's Hospital, Shaen. The document stated that all institutions for older persons in the midlands will be subject to the future decision process and listed facilities in Mountmellick, Longford, Birr, Mullingar, Athlone, Tullamore, Edenderry, Shaen and Abbeyleix. It does not, however, refer to St. Fintan's Hospital because while the Mental Health Commission is responsible for psychiatric hospitals, the Health Information and Quality Authority is responsible for other residential institutions for the elderly and ne'er the twain will meet. As my time has concluded, I will make some final points when I hear the Minister of State's response.

John Perry (Sligo-North Leitrim, Fine Gael)
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I thank Deputy Sean Fleming for raising this important issue, which I am addressing on behalf of the Minister of State at the Department of Heath, Deputy Kathleen Lynch.

Under the Mental Health Act 2001, the Inspectorate of Mental Health Services is required to visit and inspect every approved centre annually. Such centres are defined under the Act as "a hospital or other in-patient facility for the care and treatment of persons suffering from mental illness or mental disorder". The inspectorate carried out the 2012 inspection on St. Fintan's Hospital, Portlaoise earlier this year and the report is available to the public on the Mental Health Commission website.

St. Fintan's Hospital is an old Victorian Hospital which was licensed by the Mental Health Commission for 42 beds. There were 43 residents on the day of inspection and these were either elderly or under the care of the rehabilitation team. None of the residents was detained under the Mental Health Act 2001. Staff were described as being caring and knowledgeable and the nursing care and practice was high, with each resident having an individual care plan. The inspectorate was also pleased to highlight improvements and initiatives carried out in the hospital over the past year.

The inspectorate was critical of the fact the hospital continued to admit residents during 2012. This practice had resulted in an increase in the number of residents in the hospital. Ideally, both the Minister of State, Deputy Kathleen Lynch, and the Health Service Executive would like greater use to be made of community health services. In this regard, Deputies will be aware that the HSE is in the process of filling some 400 posts from the €35 million special allocation the Minister of State secured to increase staff on community mental health teams. When these additional health care professionals are in place, it will help the HSE provide more appropriate community based services for many of those who are currently in residential care. The main recommendation contained in the report, however, is that plans to progress the closure of St. Fintan's Hospital should proceed expeditiously.

Both the Health Service Executive and Minister of State acknowledge and accept the Mental Health Commission report and its findings. While noting the positive comments in the report, the HSE also notes the specific deficits identified, which it is actively addressing.

The HSE has developed plans for a purpose built, 40 bed unit to be located on the St. Fintan's Hospital campus as a replacement for the hospital. Funding of approximately €6 million for this important project has been secured from the HSE capital plan and the estimated timeframe for this work will be three years. While this unit is being progressed, the HSE is also considering and actively pursuing all options regarding interim solutions for the existing hospital and its current service users given the findings in the report. It will liaise with the Mental Health Commission to ensure relevant standards continue to be met as required.

Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Minister of State and am pleased that, although he has again confirmed that the plan is to close St. Fintan's Hospital, plans are afoot for a new unit to be built on the hospital's grounds. However, we all know that it will take some time. In these straitened times, it may not happen. It is still some way off, as it has not gone through the planning process yet.

We are discussing care of the elderly in three institutions - Abbeyleix, Shaen and St. Fintan's Hospital - in County Laois. The problem is that St. Fintan's Hospital is under the HSE's hospital division whereas the other two institutions are under its community care division, and ne'er the twain shall meet. When the HSE carried out consultations on care of the elderly, zero reference was made to St. Fintan's Hospital because it was handled by a different wing. It is almost as if the divisions were separate organisations. There is only one HSE, only one Department of Health and only one body responsible for dealing with these institutions. The artificial division in the HSE, whereby the Health Information and Quality Authority, HIQA, deals with one group of people while the Mental Health Commission deals with another, is insufficient.

At the beginning of the consultation process, the HSE suggested to me that some of the patients in the hospital in Shaen could move into St. Fintan's Hospital. Given there is a closure order on the latter, some of the staff and residents, who need the level of professional care to which they have been accustomed, could move to the facilities in Shaen while others could move to Abbeyleix. Under the HSE's capital plan, funding is made available for equipping a Respond! community accommodation facility in Abbeyleix so residents could be relocated from St. Fintan's Hospital. There are background plans to transfer patients from the hospital. I ask that it be done. It would have the benefit of securing the issue.

I apologise to the Ceann Comhairle for my outburst 12 months ago on the closure of the facilities at Abbeyleix and Shaen, which was mooted last November. Using the staff of St. Fintan's Hospital to care for their designated patients would provide the ideal solution to retaining those community nursing homes. There would be no need to discuss their future closure.

Before the Minister and his senior departmental officials make a final decision, they should consider St. Fintan's Hospital in conjunction with the Shaen and Abbeyleix situations and not take an isolated decision. The three institutions should be considered collectively.

John Perry (Sligo-North Leitrim, Fine Gael)
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I will be brief.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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There is no need to rush. The Minister of State has two minutes.

John Perry (Sligo-North Leitrim, Fine Gael)
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The Minister of State, Deputy Kathleen Lynch, is conscious of Deputy Sean Fleming's final point. It is accepted that the HSE needs to consider alternative accommodation. This is the Minister of State's top priority. The HSE has a firm plan of action. This work will be done. As the funding is available, it is only a matter of getting on with the job. In the interim, alternative accommodation will be provided.

The HSE recognises that the new unit will not be available for three years. Interim measures are required to ensure compliance with the Mental Health Commission's standards. This is the Minister of State's immediate emphasis. In no way will she neglect this responsibility. The Deputy will see rapid progress in terms of alternative accommodation.

The HSE is actively pursuing all options as interim solutions and will remain in contact with the Mental Health Commission in this regard. Some €35 million has been allocated for the planned expansion of community health teams. In many ways, this will enhance the region's facilities. I assure the Deputy that I will bring the points he has raised to the Minister of State's attention.