Denis Naughten (Roscommon-South Leitrim, Independent)
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11. To ask the Minister for Health if he will seek an independent audit of mental health services in the Roscommon-Galway primary community continuing care, PCCC, area; and if he will make a statement on the matter. [47947/13]

Denis Naughten (Roscommon-South Leitrim, Independent)
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I have tabled this question because €8 million is being spent on mental health facilities that are planned to be decommissioned. In recent months, there have been a number of serious incidents at acute psychiatric units within the region because of poor patient management. Decisions are being made on the reconfiguration of mental health services even though we still do not know what patients' catchment areas will be. We are also closing a modern facility in Ballinasloe valued at €2.8 million while spending €24 million on other facilities within its catchment area.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for raising this issue. Mental health services in HSE west, including Galway and Roscommon, which operate as one administrative unit, have been resourced to implement A Vision for Change. This involves modernising the service in the area to provide better outcomes for patients and staff. However, existing resources in Galway-Roscommon need to be reshaped and the priority for some time has been to achieve this in line with similar reconfigurations undertaken or planned elsewhere nationally.

In this light, a detailed assessment was carried out by HSE west, including taking account of the recommendations of an expert group to reconfigure mental health services in Galway-Roscommon. An open and transparent scoring system was used to assess the merits of all relevant criteria and locations, including the most appropriate skill mix for service delivery in the future. I accept the recommendations of the executive to bring about a much needed and long called for reconfiguration of mental health services in the region.

I wish to stress that community mental health services in this case can only be enhanced on a transitional or phased basis, particularly bearing in mind that at least some staff from St. Brigid's in Ballinasloe must transfer to new community-based provision. There is flexibility within existing overall HSE west mental health resources to deliver this objective.

I and HSE senior officials recently met with a delegation consisting of local public, care professional and union representatives about the re-configuration of services across Galway-Roscommon to outline the position. Bearing in mind all the circumstances, I am satisfied that the approach being taken by the HSE to enhance future mental health services for this area is the best option, taking account of overall service needs and all relevant resource issues.

With regard to the type of audit suggested by the Deputy, I would point out that the decision of the expert group was reached as objectively as possible and the approach used was similar to that adopted for similar initiatives elsewhere. Any such audit would significantly delay the pressing need to continue modernising local services and would not be justified. The Deputy will also be aware that HSE west has recently established an implementation team, including both patient and staff representation, to engage in appropriate consultation to progress this initiative and to address any outstanding local concerns. The team has already held a number of briefings and meetings with, among others, the Mental Health Commission, Ballinasloe Town Council and HSE staff.

I wish to re-iterate my own commitment, and that of the Government, to using the significant funding provided for mental health in recent times to continue implementing A Vision for Change, including delivery of measures that are in the best interest of clients of mental health services in the HSE west area.

Denis Naughten (Roscommon-South Leitrim, Independent)
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I thank the Minister of State for her response but I wish to pose a few supplementary questions. She said that similar audits have been carried out elsewhere. Has a similar audit been carried out in Mullingar where €5 million is currently being spent on a facility in St. Loman's Hospital? It would be of a similar standard or grade to Ballinasloe. I am referring here to an audit of all mental health services in Roscommon-Galway and not just the acute services. Can the Minister of State explain how we are examining the reconfiguration of a system when we do not know the catchment area? It has not been finalised where the integrated service area will be, whether Mayo will be included, or whether it will go across some of the other catchment areas. Is it sensible to make decisions when we do not know what the final reconfiguration will be?

The Minister for Health has put the case well that money should follow the patient, and we would all agree with that principle. Why does it not also apply to mental health services?

Kathleen Lynch (Cork North Central, Labour)
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If we were to carry out the audit now, as the Deputy has suggested, one would find that Galway-Roscomon - which has always been considered as one administrative unit for mental health - would be well above what is recommended in A Vision for Change. We are not doing that now. We know what is there and what we need to deliver the service. Phase 1 provides for the closure of five beds in Ballinasloe and the opening of five beds in Galway University Hospital to be implemented by January 2014, phase 2 involves the closure of a further five beds in Ballinasloe and the opening of five beds in Galway University Hospital, to be completed by April 2014 and phase 3 will see the opening of a further five beds in Galway University Hospital, bringing the total number of beds there to 50, and the closure of Ballinasloe.

I was asked why I was doing this. It is because I believe the people in that area deserve an exceptional service, which exists in other areas of the country. I still do not understand how Deputies can stand up here and tell me that I am implementing A Vision for Change too slowly, yet when it comes to their particular area they do not want it done at all.

Denis Naughten (Roscommon-South Leitrim, Independent)
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There is an issue concerning numbers in Galway-Roscommon. As the Minister of State knows, there is a historic issue there regarding people with an intellectual disability and that needs to be acknowledged. We are opening a high observation unit as an interim measure, which did not exist three months ago when we had a crisis in Roscommon. It is planned to demolish that €3 million facility in two years' time.

As regards the issue of money following the patient, why is it that a woman can have her baby in Portiuncula Hospital but if she has acute post-natal depression she cannot be treated in Ballinasloe because it is not within her catchment area?

Kathleen Lynch (Cork North Central, Labour)
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Even though there is a connection between maternity and post-natal depression, we have to separate maternity services from mental health services. In the new mental health services in Galway, for instance, we will be putting in place facilities for women and their babies to be dealt with in the one unit. That is already happening in Cork with the new unit we are building there and it will have to happen elsewhere also.

As regards crisis management within acute units, we are dealing with vulnerable people. I am always surprised that people are surprised that we have episodes that need to managed more directly. We are dealing with very ill and vulnerable people. Those who work in the service and manage these situations every day know that it is not peculiar to Ballinasloe. This happens in every acute unit around the country. We must start recognising that people in the Galway-Roscommon area deserve the same excellent service that exists in other areas of the country.