Dáil debates

Thursday, 28 September 2017

Ceisteanna - Questions - Priority Questions

Mental Health Services Provision

4:15 pm

Photo of Bríd SmithBríd Smith (Dublin South Central, People Before Profit Alliance)
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4. To ask the Minister for Health when the closed beds in the Linn Dara facility in Cherry Orchard will be reopened; and if he will make a statement on the matter. [41005/17]

Photo of Bríd SmithBríd Smith (Dublin South Central, People Before Profit Alliance)
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In June, we lost half of the beds in the child and adolescent mental health services unit in Linn Dara in Cherry Orchard. At the time it was promised that they would be reopened in September. Half of the complement of psychiatric nurses was missing. Can the Minister of State enlighten us on what is happening with Linn Dara? Will the facility be fully staffed and opened in full?

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I thank the Deputy for giving me the opportunity to address this issue, which has been a matter of concern for a number of Deputies and Senators for some time. There are currently 60 child and adolescent mental health service, CAMHS, beds operational nationally. This is up from 48 in early summer and will increase further once Linn Dara resumes its full capacity of 22. There are currently 20 operational beds in both Cork and in Galway, eight in Fairview and 12 in Linn Dara.

In June last, due to staffing difficulties, some beds in Linn Dara could not take new admissions. This, unfortunately, left Linn Dara with just half of its 22 bed complement operational. For those discharged for clinical reasons, the HSE provided dedicated follow-on supports from the community-based CAMHS service, where deemed necessary. The executive has also made available the CAMHS day service, as appropriate in individual cases, to enhance supports for young people and their families. The operational difficulties that faced Linn Dara recently arose from problems in recruiting and retaining mental health professionals. Staffing cover had to be augmented in recent times through methods such as staff working additional hours, overtime and engaging agency staff. Funding availability is not the issue in this case.

A phased opening of the closed beds in Linn Dara is planned for the week beginning 30 October, with a graduated increase in bed capacity. The HSE aims to be back at the full capacity of 22 beds by mid-November. This is similar to the approach taken when the unit increased bed capacity originally. The HSE is required to provide advance notification to the Mental Health Commission of its reopening plan.

The HSE has been exploring every option to resume normal operational levels and to maximise the use of Linn Dara in the future. The executive has intensified its efforts on recruitment, and a number of staff have been identified to join the service. The Deputy may rest assured that all efforts will continue to be made to address ongoing service difficulties at Linn Dara, with a view to reopening beds as quickly as possible.

Photo of Bríd SmithBríd Smith (Dublin South Central, People Before Profit Alliance)
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I have no doubt that the Minister of State is doing everything he can within his limits. The problem is that the limits are very tight. As in the earlier discussion about staffing and pay, everybody acknowledges that it is difficult to recruit and retain nurses in this country. It is even more difficult to recruit and retain psychiatric nurses. That is not because they have an aversion to working in institutions, hospitals and clinics in Ireland but because their pay and conditions, stress levels and the pressure on them are wicked. They prefer to emigrate. We are haemorrhaging nurses as a result. Of the 17 nurses needed to staff Linn Dara so the beds can be reopened and be operational how many have been recruited? I accept that the Minister of State is doing his best. He says that every effort is being made and I do not doubt his sincerity, but one arm of the Government is saying it is doing its best to keep the service going while another arm, the Minister for Public Expenditure and Reform, is boasting about the new pay deal, which does not restore pay equality to nurses. That is restricting the ability of the service to recruit in the manner it requires. There are two different forces competing in tandem and that is wrecking fundamental and essential services such as the mental health services.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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There are different stages of recruitment but there should be a new complement of five nurses within the next two to three weeks. I met with the Psychiatric Nurses Association last week and listened to the challenges its members face. I will continue that engagement. I also addressed the conference of the mental health nurses this week. I am familiar with the struggles and challenges facing them and the Minister for Health, Deputy Harris, and I are determined to continue to try to deal with them as best we can. Hopefully, Linn Dara should be back at full capacity by mid-November. I will welcome any efforts by the Deputy to ensure that happens and to hold us to account for that in the meantime.

Photo of Bríd SmithBríd Smith (Dublin South Central, People Before Profit Alliance)
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Today is the 25th anniversary of the UN Convention on the Rights of the Child. On the "Morning Ireland" programme today, the Ombudsman for Children said the Government will be called to the UN to account for the lack of services for children. Linn Dara is a facility for adolescents with mental health issues. Between June and August last, six young people committed suicide in the area between Cherry Orchard and Ballyfermot where Linn Dara is located. Tragically and shockingly, most of them were young women. I am not saying all of them would have gone automatically to Linn Dara. One has to be suicidal to get into that facility. However, there are needs for mental health treatment which become apparent much earlier that are not caught by the system.

The Government is being called to the UN so it can be told that it is failing young people and children. That is happening. Many issues affecting young people are not being caught early enough and the services are not available 24-7 so they can access them. It is a tragic situation, and it will get worse. The next generation is being reared through the austerity years and has seen special needs education at schools cut for eight or ten years. There are also those who are living in homeless accommodation, not to mention those who are coming out of direct provision and from homeless services back into so-called normal living. How will their mental health be dealt with in a system that is creaking and already failing? The consequences are not just tragic, but criminal. The UN will have to point this out to the Government when the Government is called before it. Telling me that there are five nurses out of 11 does not tick the boxes for the reopening of all the beds required in Linn Dara. It requires 11 nurses, not five.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I will not get into the micro-management of the staffing levels there, the individual nurses and so forth. Clearly, it is not an issue with funding. I do not say that defensively because it is a matter of fact.

Photo of Bríd SmithBríd Smith (Dublin South Central, People Before Profit Alliance)
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Then pay the nurses properly.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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That is a separate issue, and there are a number of different matters relating to that. However, I am assuring the Deputy that this is not an issue with funding but with the recruitment and retention of nurses. There are improvements coming in that area.

I share the Deputy's concern for the well-being and mental health of young people and I want to have the best system and a system we can be proud of. Much good work is taking place and a great deal of money is going into it. I want to ensure we are getting value for the money and that the services are being provided where they are needed. Appropriate referrals is another issue, where people are left on inappropriate lists, are inappropriately referred and so forth. There are many challenges within the system that go far beyond the issue of funding. As I have said previously, the job would be very easy if it was just a matter of funding. There are challenges which we are seeking to fix and I hope we can make improvements on them over time.