Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister of State for taking the time to take this issue. It concerns the conditions in the department of psychiatry in St. Luke's Hospital in Kilkenny, which serves both Carlow and Kilkenny. It now serves patients from Tipperary since the closure of St. Michael's Unit in Clonmel yet there has been no expansion in that service even though there has been a big increase in the number of patients with which it deals. The conditions were highlighted on a number of occasions by staff. Examples were patients sleeping on makeshift mattresses on the floor and people putting two or three chairs together to provide beds for patients. It has led to significant issues for staff morale. One would question what sort of service is provided or what conditions the patients are in. A makeshift bed on the floor does not really say very much for the service. I imagine the view is probably to get people in and get them out as fast as one can because they are so overstretched.

One of the most significant issues is that we have been looking for a meeting between Members of the Oireachtas from Carlow and Kilkenny and the HSE management responsible for the department of psychiatry at the hospital since 14 February. I requested a meeting but I imagine all Members of the Oireachtas in the constituency have an interest in it. The head of the hospital group for the south east came back to say that this was not her area. There was no further information. It was just a case of her not being accountable for this. We went through the Oireachtas HSE representatives line but heard nothing back. We did so again on 15 February and 29 March and on 10 May we finally tracked down somebody who is supposed to be head of the mental health services for the CHO 5 region into which Carlow and Kilkenny fall but there was still nothing.

I am not one bit surprised about the HSE because it seems to be accountable to nobody; it does whatever it likes. As we have seen recently with the cervical smear test scandal, women are not at the top of its priority list.

I would like the Minister of State to convene a meeting of the management there. I have no faith in them given that they do not have the manners to come back to an elected representative in the area to say "I'm not the person you should be contacting, but this is the person" or "I'll get somebody to contact you with the information." It sums up the HSE and how it acts about everything. I do not have any confidence in it being able to facilitate a meeting or give us any concrete answers. I ask the Minister of State to organise a meeting for the Oireachtas Members in the constituency so that we can find out what the issues are and what we can do to try to address them. I know there is never an overnight solution to these things. At the very least we should be able to sit down with the management there and find out what the issues are.

Many staff are coming to me and other elected representatives informing us how it is nearly impossible for them to deal with these kinds of working conditions. They have obviously trained to try to help and support people at a very difficult time in their lives. They feel that their hands are tied in many cases and it is very frustrating. I would like to see if we can do something positive about this. We can certainly not get any further until somebody is willing to sit down and talk to us about it.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputy for raising this important issue. The provision of appropriate and safe facilities for patients within the mental health service is a priority for me and for the Government. To ensure that services are provided in a safe environment the Mental Health Act 2001 provides the Mental Health Commission with the power to inspect, regulate and enforce standards in all approved centres. Approved centres are hospitals or other inpatient facilities for the care and treatment of people experiencing a mental illness or mental disorder and which are registered with the Mental Health Commission. Such inspections are carried out annually and a report is produced following each visit.

The HSE works closely with the Mental Health Commission and welcomes its inspection reports. The priority for the HSE is patient care and support for service users, as well as to ensure adequate accommodation and staffing in this respect. The commission’s reports help to identify those areas where improvement is required. The HSE also plays a key role in ensuring that any identified issues are remedied.

From 19 to 22 September 2017, the Mental Health Commission visited the department of psychiatry acute mental health facility in St. Luke’s General Hospital, Kilkenny. The 44-bed department of psychiatry serves the Carlow, Kilkenny and south Tipperary catchment area. The department has 45 whole-time equivalent nursing posts in place in addition to other medical, specialist and support staff to serve the needs of all those who require treatment and support.

During its inspection, the Mental Health Commission identified a number of issues relating to staffing requirements, screening, storage of medicines and a number of other areas. To address these issues, the commission has developed a corrective and preventative action plan. This plan outlines the steps to be taken to ensure full compliance. As noted in the inspection report, many of the actions detailed in the plan have subsequently been completed, are ongoing or are in the process of being addressed to the commission’s satisfaction. The HSE has provided funding to south-east community healthcare services to complete a number of environmental works at St. Luke’s.

Actions being taken by St. Luke’s include: provision of additional staff training and review of policy to ensure compliance with their review requirements; risk assessment forms are now being updated and reviewed in line with the approved centre’s risk management policy; and awareness of policies and procedures relating to searches will continue to form part of staff induction process and at staff meetings.

The Mental Health Commission will follow up on this report with a further inspection to ensure that all necessary steps have been taken to ensure that St. Luke’s is fully compliant with mental health legislation.

The Mental Health Commission fulfils a very important role in ensuring our mental health services are of a high standard. Inspection reports, such as this, help to ensure that any deficiencies in the provision of mental health services are identified and addressed.

The Deputy has requested a meeting with HSE management. Of course, she, as a public representative and the other Oireachtas Members in the constituency are entitled to seek and be granted such a meeting. As I do not know the other side of the story, I will not comment on the floor of the Dáil. However, if the Deputy sends me the details of the request, I will ensure she gets her right as a public representative along with the other Oireachtas Members in the constituency to engage with HSE management. Communication is a vital part of the mental health service, as it is with any other service. It is very important that communication is two way.

Kilkenny has a very strong record in the area of service user involvement. It is one of the areas that is working hardest in service user engagement and hearing the voice of the service user. I am very pleased with a number of initiatives in Kilkenny and it is one of the stronger areas in that respect. The voice of the public representative must also be heard. I do not want to go any further because I do not know the other side of the specific issue the Deputy raised. If she sends me details separately, I will liaise with her and her Oireachtas colleagues in the area to ensure she gets full access to management and gets her queries answered.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister of State for the reply. I will send him the details. The first thing is that there is no response. I can send him copies of the emails and letters we have sent, but unfortunately there is very little of the other side of the story, with the exception of one or two people saying it does not fall into their area.

Unfortunately that is a common theme in the HSE. It is a difficulty patients face all the time. We are supposed to have an Oireachtas line that does not even work on which people cannot even come back to us. There is no point in having these systems in place if they do not work. There is a wider lesson to be learnt for the HSE. It has complete lack of accountability and feels it can brush everything under the carpet and eventually people will stop requesting meetings. However, for me in this case that will never happen. Even if it takes six or seven months to have a meeting, we will persevere with it until we get it.

The idea is to be constructive to see what we can all do as a group to try to progress these issues and relay to the HSE management the experiences of the staff and patients. We often come across stories that they will not hear first-hand. Communication is helpful. It is extremely frustrating to deal with an organisation that feels it is okay to ignore; it should not be okay for anyone to do that, particularly when people rely on us and feel we might be able to get some answers or at least organise a meeting or get a little bit more progress on the issue.

I will send the Minister of State the information and I would appreciate if he could organise a meeting for those of us in the constituency.

Jim Daly (Cork South West, Fine Gael)
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I will progress the matter if the Deputy sends me the detail of the issue. The public representative has a key role to play in the delivery of mental health service. As a Minister of State, I very much value the opinion, contribution, input and engagement of my Oireachtas colleagues who represent all the stakeholders in the delivery of mental health care.

By and large there are not many adversarial issues among Oireachtas Members in the mental health area. There is co-operation, goodwill and uniformity for the most part. Most people want to be constructive and that goes across all parties and none. As long as I am a Minister of State I will ensure the Oireachtas Member plays the key role he or she rightly should in the delivery of mental health services.