Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I thank the Minister of State, Deputy Byrne, for staying here to answer this Topical Issue matter. I am often in the Chair and I see her frequently having to deal with some of those questions. That is not easy for her but we do need to get our point of view across.

Unfortunately, when it comes to mental health services, Roscommon has been in the headlines for all the wrong reasons. We were all familiar with the external review into mental health services in County Roscommon, which, as the Minister of State will know, painted a damning indictment of a service in crisis mode, a service I would remind her where it was deemed a culture of blame, secrecy and negativity abounds. It was one of the worst cases in the country. There is no doubt about that. I brought our spokesperson on mental health to a special conference evening in Roscommon and he was shocked and astounded at what was revealed there.

A commitment was made in the programme for Government to improve mental health services in the country. The reason I am raising this matter on the Topical Issue Debate is to seek assurances that those key recommendations will be implemented without any further delay and to seek an update on them, if they have already been implemented.

I remind the Minister of State that the review carried out in Roscommon commenced in August 2015 and it was finally completed in September 2017, two years later. While I accept the three independent people who produced that report needed to get all the facts and figures, that was an extraordinary length of time when we are dealing with mental health issues. What is the point in having such reviews carried out if they are just left on the shelf to gather dust?

We discussed the crisis facing the Rosalie centre in Castlerea in Roscommon with the Minister of State, Deputy Jim Daly, yesterday evening. We discussed the need to save that unit. There are 12 patients in that unit. It has a capacity to accommodate 33 patients, but it has been simply run down by the HSE.

It is time that the HSE took its orders from the Minister. We need that space in the Rosalie unit in Roscommon. We need our hostels. There are a number of hostels being threatened with closure and no matter what the elected members, the HSE fora members, Deputy Browne, myself or any of my colleagues say, the HSE continues to take its decisions and move the way it wants to.

The HSE continuously tells people, such as me, that it knows what is best for the patient. I can tell the Minister of State, Deputy Catherine Byrne, I know many of those families and people, and in some of those situations, I, their families and the local GP know best what those patients need. Sometimes the HSE is totally wrong.

Clinical assessment goes on and on every time. In one case in Roscommon regarding the Rosalie centre, we are being told that the patients no longer need psychiatric nurses and they are moving on now to older care. The reality is a bond has built up between those patients and the staff. What is happening, and I cannot get this through to the HSE, is the service is making people unhappy.

Something we all try to do in mental health care is try and make people happy again. With conversation, one gets them at ease. One should talk to them. The Minister of State, Deputy Catherine Byrne, herself knows that. She put a lot of work into such issues in her own constituency. In my view, the Government needs to have strong words with the HSE and instruct it not to be making these people and their families unhappy.

I thank the Minister of State again for taking the question here this evening.

Catherine Byrne (Dublin South Central, Fine Gael)
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I will be taking this matter on behalf of the Minister of State, Deputy Jim Daly.

Mental health remains a priority for this Government, reflected by the additional €35 million given in the last budget, thus bringing total HSE funding this year to over €910 million. The HSE is committed to ensuring that mental health services are delivered and modernised nationally, including those in the Galway and Roscommon mental health area. This objective is reinforced through the HSE Service Plan 2018.

In 2015, the executive deemed it necessary to conduct an independent review of the quality, safety and governance of Roscommon mental health services to support achieving the goals set out in A Vision for Change and other relevant national policies. Within a short period of being commissioned, it was clear that the initial timeframe proposed to conduct the review was insufficient and the review team received more time to complete its work. The subsequent comprehensive report made 27 recommendations for local service improvement. The report indicates that the review team was impressed by the majority of staff it met or interviewed, and it highlighted their commitment that services improve in Roscommon.

The overriding concern of the majority of those interviewed — staff, service users and carers — was that patients and families in Roscommon were not receiving services in line with best practice to meet required quality and safety of care standards.

Core issues highlighted in the report, for example, related to improving multidisciplinary team working, addressing fractured relationships among some of the local staff, enhancing line management and ensuring allocated funding is spent appropriately.

The steering group to oversee the implementation of the recommendations of the report, which was published on 5 September 2017, has had regular meetings since that time. The initial focus of the steering group was to work through each of the recommendations, and set out clear, positive achievable actions. Following this, the project manager was tasked with drafting an action plan, which was signed off by the steering group in January last.

This is currently being considered by the HSE at national level. Arrangements have also been made to ensure independent oversight of implementation of the action plan.

Some of the recommendations have already been implemented, and more are in the process of being implemented. As highlighted in the report, other recommendations require a targeted approach to change management. In this regard, external change management practitioners have been employed to work through the changes directly with HSE staff. Communication has taken place with all relevant stakeholders including service users, family members, staff unions and public representatives, and the HSE will continue this process of engagement.

The action plan will be communicated to all relevant stakeholders once it has been signed-off at HSE corporate level, which is expected shortly. The Minister of State, Deputy Jim Daly, has had various meetings with the HSE and local political or other representatives about improving mental health services in Roscommon.

The most recent of these was a constructive meeting last night in Leinster House, as has already been stated. The Minister of State also recently visited the area. The Deputy can rest assured that the Minister of State and the Department of Health will continue to closely monitor this issue to ensure that the recommendations of this report are delivered as quickly as possible.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I do not doubt the sincerity on the issue of the Minister of State, Deputy Catherine Byrne.

The Minister of State, Deputy Jim Daly, did a good job in chairing the meeting last night but from a HSE perspective, it was not constructive at all. The continuation of that unit in Castlerea, which is vital for the mental health services in County Roscommon, looks doubtful.

The capacity in that excellent centre, which is in a fine building, is 33. The HSE has deliberately refused to take new people in over a period of two years. It is now down to 12. It looks like they will let people go until there is nobody left and they close it down.

I will go back briefly to the independent report, which, as I stated, was a shocking indictment of the situation in Roscommon, and give the Minister of State, Deputy Catherine Byrne, a few facts from it to remind her of what happened.

In 2012, the HSE returned €4.57 million in funding from Roscommon. In 2013, it sent back €6.91 million. In 2014, it sent back €6.19 million. Therefore, €17 million, which figure Deputy Byrne herself will be shocked with, was sent back by the HSE out of the mental health services in Roscommon when it was under pressure.

Sixty staff, including some excellent front-line staff, were interviewed as part of that review. They were outspoken about some things that were going on. They want the service to improve. They want a proper service for the people.

We must make the HSE realise that it is dealing with very vulnerable people, as Deputy Catherine Byrne herself well knows. As I stated, I am aware Deputy Byrne does a lot of work like this in her own constituency.

These are vulnerable people. I ask Deputy Byrne to bring back the message from me that the HSE should not continue to treat people in my constituency, who have in many cases mild mental health issues and need support and need help, like this.

Catherine Byrne (Dublin South Central, Fine Gael)
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I assure the Deputy I certainly will bring back his message.

I am taken aback at how important it is with mental health services right across all our communities for people to be in a happy environment where there is continuity and where, to be honest, they can feel at home. I have had experience of it in my own family with the mental health service locally. For anybody who is suffering with or who has relatives who have a mental health issue, it is important that such continuity is maintained, not only by the service providers or among staff, but in the family as well. I appreciate the message Deputy Eugene Murphy has given me and the concerns he has raised.

As I stated earlier, I will do my best, as always, to relay the messages back from the Deputies who raised the issues when the main Minister is not here and I would want that they would reply to the Deputies at the required level as well. I will continue to do that until I lose my job.

Declan Breathnach (Louth, Fianna Fail)
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I appreciate that.