Fiona O'Loughlin (Kildare South, Fianna Fail)
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This is an area with which the Acting Chairman, Deputy Durkan, is very familiar as it is in his constituency. I thank the Minister of State for being here for the debate. The Minister for Health, Deputy Simon Harris, visited Naas General Hospital recently. I know this through social media and newspapers. It is regrettable that other Deputies in the constituency were not invited, because it has always been a matter of respect and courtesy that all Oireachtas Members in a constituency are invited to meet a Minister to air the issues they have. This is not only with regard to this case, but I am speaking about Naas and it is regrettable it did not happen, particularly because I have raised the issue of Lakeview previously in the House with the Minister.

Having said that, and to get to the topic in question, Lakeview is a 29 bed unit in Naas General Hospital. The staff do an incredible job with people who have acute mental health issues. Not a day goes by in the House that some Member does not speak about the importance of mental health. I know the Minister of State is very conscious of it.

This is a crisis situation in Naas. I have spoken to the HSE and it acknowledges and recognises this is the top priority in the country for funding. To have a 29-bed unit in archaic conditions, and mixed wards which certainly do not help anybody in a crisis situation with their mental health, is appalling in this day and age. Many patients cannot be catered for there and must go to the ten bed unit in Portlaoise, which is putting pressure on that unit. There is a huge need for an investment of €5.5 million to be spent on Lakeview to modernise it, to have a positive environment for people suffering from acute mental health issues and to help restore confidence in the system. There is huge burnout among the staff because it is dark and dreary and no investment has been put into it for more than 100 years.

While community mental health support is vital, as are any actions we can take to place an emphasis on positive mental health, when people present with conditions they need to be in a safe and secure unit and it is imperative they are in the proper place and receive the proper care. The investment in mental health in Kildare is the lowest in the country. We have one of the highest rates of suicide in the country. Over the past ten years, there has been an average of 23 suicides in County Kildare, and most of them were in my town of Newbridge. Over the past two months we have had five suicides. We need a situation whereby people can present in an accident and emergency type unit for mental health issues. At present, people present in the accident and emergency department in Naas General Hospital, which is across from the corridor from Lakeview. We need to put in place emergency measures and have a positive environment for those suffering from acute mental health issues.

Helen McEntee (Meath East, Fine Gael)
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I thank Deputy O'Loughlin for raising this issue. As the Minister of State, and as a Deputy from a county which is the equally lowest funded with regard to mental health, I understand where she is coming from.

As Deputy O'Loughlin said, Lakeview is a 29-bed acute mental health unit on the campus of Naas General Hospital. It was designed and built in the late 1980s to cater for the Kildare and west Wicklow population of 135,000 at that time. It succeeded the previous arrangement of services provided by the Carlow and St. Loman’s Dublin mental health services to the population of Kildare, and at the time was a ground-breaking development based on the then national policy, Planning for the Future. Some 30 years on, the current population of Kildare and west Wicklow has increased dramatically to 228,000, and is expected to rise over the coming years.

As the Deputy pointed out, increasing pressures on bed occupancy and levels of acuity have created a very high-risk environment for patients and staff. The HSE indicates the number of beds in Lakeview is inadequate for the current needs of the area, based on the national policy A Vision for Change. The occupancy rates of 140% provide further evidence of this increase in demand and obvious need. A temporary accommodation was reached three years ago, with ten acute beds being made available in the acute unit in Portlaoise for Kildare patients. However, this is not ideal by any means, the numbers remain inadequate and the demand and pressure on the Naas unit has reached unsafe levels again.

It is generally accepted there is a need to develop bed capacity in Naas. Development of the unit would have the effect of addressing the bed crisis situation and de-escalating acuity levels, by managing challenging patients in a more suitable environment. The Department of Health has provided sanction for €5.5 million funding to address some of the physical infrastructural deficits at the Lakeview unit. This funding will enable a design team to conduct scoping and design work, with a view to construction commencing in 2017 and being completed in 2019. This will deliver an additional eight beds and, most importantly, provide a high observation unit to alleviate existing service pressures at the facility.

The lack of appropriate step-down facilities in the form of high support hostels and community based teams also has an impact on the ability of Lakeview to deliver an appropriate service. A Vision for Change would recommend up to 60 high support hostel placements for a population of this size. There are currently only 27 places. The HSE is looking at possible solutions to maintain hostel support capacity in the area and is exploring the potential to increase it.

As part of the significant investment provided by Government over recent years to enhance all aspects of mental health services nationally, funding has been approved to recruit staff to populate three community-based mental health teams for the Kildare and west Wicklow area. This will mean that more patients, as appropriate, will be seen at a much lower level of complexity and will reduce the requirement for admissions to the Lakeview unit, which is where we want to take matters in future. Challenges are being experienced with the recruitment of psychiatric nurses to staff these teams, and work is ongoing nationally by the HSE to overcome acknowledged staffing difficulties. I assure the Deputy that, in light of the additional mental health funding being made available to the HSE for Lakeview, I will continue to monitor progress closely on the matter. I will update the Deputy and colleagues as it progresses.

Fiona O'Loughlin (Kildare South, Fianna Fail)
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I am absolutely delighted to hear this news. For the Kildare people who use the services and their families, as well as the staff at Lakeview unit, this is really good news. The fact that the physical design will be updated - making it a brighter building and a better place for people to be treated in and to work in - is also very welcome, as is the addition of eight new units. I am really glad that construction will commence next year. Will there be disruption to bed space in the two-year period during which this work will be undertaken? What are the plans for the interim period? I am glad about the commitment to more appropriate step-down facilities because these have to be part of the whole picture of treating mental issues. The funding for staff is really good too. I acknowledge the very good work done by Hope(d) locally and by the Samaritans and many other community groups in the area which are really struggling to support positive mental health, particularly among young people, as best they can. Generally, this is really good news and I welcome it.

Helen McEntee (Meath East, Fine Gael)
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I know that the Deputy's priority is that the additional funding be allocated. It is important that work progresses quickly and in an effective manner. My own view is that there will not be disruption but I will clarify that for the Deputy with the design team and those who are doing the scoping work. At present, the service asks staff to work in archaic settings and if we are encouraging staff to come home, and nurses to go into the profession, we need to invest not just in the staff themselves but in the facilities in which they are going to work and this will form part of the work we are doing to implement A Vision for Change. There is also a need to focus on our community-based services and it is a priority for the Government to make sure the approved posts are filled as quickly as possible.

I thank the Deputy and agree with her that the staff and community organisations and teams do a fantastic job. This will help them and we will support them as much as we can.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The next matter is in the name of Deputy Michael Collins who is not yet with us. Deputy Clare Daly is in the House, though, and she has the third matter. Is Deputy Helen McEntee taking the matter on behalf of the Minister for Transport, Tourism and Sport?

Helen McEntee (Meath East, Fine Gael)
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No.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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For topical issues, people really have to be about their business and be here on time.

Helen McEntee (Meath East, Fine Gael)
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I think Members thought the discussion on climate change would last longer.

Clare Daly (Dublin Fingal, Independent)
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We were contacted by e-mail and told that the schedule had been moved forward. We were told a number of times.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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It is highly unacceptable that the proceedings of the House are held up in this manner. I do not want to suspend but we do not have Deputy Michael Collins and we do not yet have the Minister for the third matter. I think the Whips are not about their business.