Declan Breathnach (Louth, Fianna Fail)
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Deputy Eugene Murphy will be sharing time with Deputy Mary Butler. Is that agreed? Agreed.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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Yes, a minute of the opening statement and a minute of the reply.

The Minister of State is welcome to the House and I thank him for his attendance. However, I wish to put on public record that the Taoiseach failed to answer a question on this matter yesterday and instead again sent in the Minister of State, Deputy Daly, to bat, while the Minister for Health, Deputy Harris, has failed to come to the House to deal with this crucial issue.

Last Friday myself and fellow Oireachtas representatives of the Roscommon-Galway constituency met Mr. Tony Canavan of the HSE in Roscommon town. At that meeting, it was indicated to us that the Rosalie centre in Castlerea is soon to close, in spite of the Minister of State, Deputy Daly, previously indicating that no such decision would be made until clinical assessments had been reviewed. My Oireachtas colleague and Minister for Communications, Climate Action and Environment, Deputy Naughten, issued a statement in June which indicated that the HSE had confirmed that the Rosalie facility will continue to form part of the service delivery of healthcare in the Roscommon area and that any potential change of its use would take place in consultation with public representatives and relevant stakeholders in the area. Where is the consultation? Have the clinical assessments been reviewed? We have been repeatedly stonewalled by the HSE and the Minister, Deputy Harris, in regard to this unit in Castlerea.

I ask the Minister of State, Deputy Daly, to pass on to the Minister, Deputy Harris, and the Taoiseach the message that this issue is not going to go away. Major plans are currently being put in place for a public meeting in Casltlerea next Monday night which will probably attract 500 people who will send a clear message about the Rosalie unit. Neither the people of Castlerea nor I, as one of their public representatives, will let this issue rest.

County Roscommon has one of the highest percentages of older people in the country and one of the highest rates of Alzheimer’s disease per head of population. As such, the Rosalie unit should be a vital part of our mental health services in the county. Most of the residents of the Rosalie unit suffer from Alzheimer’s disease or dementia and they are unsettled about their future. They have told me that they are upset and worried. It is totally unfair and unacceptable. This matter is not going away. Deputy Penrose knows Castlerea well but I wish to explain to Deputy Ferris and other Deputies who may not be familiar with the Rosalie unit that it is not a broken down centre but rather a fantastic unit which provides excellent care and has very good staff. Its residents are happy there but that happiness is being taken away.

Mary Butler (Waterford, Fianna Fail)
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I also was very disappointed to hear that the closure of the Rosalie unit in County Roscommon had been announced. The unit cares for psychiatric patients, including those with Alzheimer's disease and dementia. As the Minister of State is aware, a recent mapping exercise by the Department of Health and the Alzheimer Society of Ireland, ASI, examined the level of dementia care available to our citizens. The results made for very disappointing reading throughout the country. I accept that the Minister of State inherited these services and I acknowledge his work to date on dementia.

I submitted a parliamentary question to see how many people in Roscommon have dementia and why these beds would be taken from the system. The reply stated that 614 people in Roscommon with dementia live at home and there are 1,842 carers. The Rosalie centre has had no new admissions since September 2016, which indicates that a decision to wind it down was made two years ago.

Jim Daly (Cork South West, Fine Gael)
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I thank Deputies Eugene Murphy and Mary Butler for the opportunity to provide some clarity, background and context on this issue. I wish to highlight that this Topical Issue refers to the announced closure by the Government and the HSE of the Rosalie unit. I can state with complete authority on behalf of the Government that no closure of Roasalie has been announced by the Government or the HSE. The Rosalie unit, part of Áras Naomh Chaolain, is located in Castlerea, County Roscommon. As Deputy Murphy knows, I am very familiar with it. I have visited it and met each of the residents, their families and the management of the facility. I have met the relevant public representatives on numerous occasions on the issue.

Currently, there are 12 residents in the unit. I place on the record that the HSE has not announced the closure of the Rosalie unit and I hope that point will sink in. The unit has been closed to new admissions since 27 September 2016. The issues of continuing to best meet the needs of the residents in an appropriate and safe environment and the future use of the unit have been the subject of recent meetings by me with Oireachtas Members, local representatives and the HSE.

To ensure the best interests of the residents are accommodated the HSE recently completed a clinical assessment of each resident, including engagement with families. Following completion of the clinical assessment process, the HSE asked the College of Psychiatrists of Ireland to independently review the process and outcome. This should be completed within a short time. The HSE will then inform me of the outcome of the clinical assessment process regarding best care options for residents and furnish a report on the Rosalie unit.

No decision has been taken yet by the HSE on the future of the Rosalie unit. The HSE chief officer has confirmed in writing to me that it is the intention that it continue as a healthcare facility in the future. The nature of this, whether continued use in its present form or some other use, will be informed by the clinical assessment outcome. The HSE has confirmed that any changes to mental health services in the area will be in line with A Vision for Change.

I understand the chief officer of community healthcare organisation, CHO, 2, which covers the Roscommon area, recently met local representatives and spoke to the local media. He indicated the intention of the HSE to cease services at St. Joseph's mental health day centre in Ballaghaderreen. I further understand that decision has been taken in the context of implementing the recommendations of the report of the mental health services in Roscommon. The decision to close this centre and provide alternative day services to the current attendees was taken only after detailed consideration of the needs of all of the individuals involved.

I reiterate that no decision has yet been taken in respect of the Rosalie unit. I await receipt in due course from the HSE of the outcome of the clinical assessment process for the unit. That will help inform the best care options for the residents and its future use as a healthcare facility.

To make it abundantly clear to the Deputies opposite and to those who are watching this debate who have an interest in this facility, admissions to the unit ceased two years ago, in September 2016. There are 12 residents remaining. As Minister of State with responsibility for the areas of both mental health and older people, I have to ensure the residents' needs are best met. If a qualified clinician tells me that their needs are best met in an alternative setting because this is a psychiatric setting, the patients are older, the needs of many of them are geriatric and they may need to be in a social care nursing home type setting where they will be better served, I have to listen to that. I cannot railroad through a decision. However, my commitment, one on which I have been consistent, is that the unit will continue to play a vital role in the provision of services in the Roscommon area. There is no talk from the Government or the HSE of closure.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I reiterate that the Minister of State's work on this issue has been upfront and he has met us frequently. However, I am not reassured by what he has said. I sat at a meeting with an official who said a decision had been taken in the review to close the unit but, as the Minister of State correctly stated, the HSE has asked a psychiatrist or psychologist to examine the matter independently. The reality is that the unit is finished. The Minister of State stated patients' needs would be better met in a more suitable regime. I totally disagree with that. The residents have been well looked after, they trust the staff and are close to their families. This process is interfering with their happiness and making them unhappy. I have serious issues with the way these assessments are done, and I do not like what is happening.

When the Taoiseach was Minister for Health he gave a commitment that this unit would not be closed, and I have a letter to that effect. I ask the Minister of State to honour that commitment. If some changes have to be made at the centre, so be it, but I beg him not to allow the patients to be taken out of the unit. I ask him to use whatever power and influence he has to ensure that does not happen.

Mary Butler (Waterford, Fianna Fail)
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The HSE chief officer has confirmed in writing to the Minister of State that it is the intention that the unit continue as a healthcare facility in the future. The nub of the question is what kind of facility will remain. The reply to a parliamentary question I received on 24 May clearly stated:

Currently there are no long-term plans for the Rosalie Centre. The Centre has not had any new admissions since September 2016. It is not proposed to reopen the unit to new admissions.

The 18 members of staff working in the unit also have to be considered.

Jim Daly (Cork South West, Fine Gael)
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I thank the Deputies. Deputy Murphy stated he did not trust the clinical review. Unfortunately, it is not in my gift to override a clinician's decision. We have to accept the word of the medical authority who makes the decision on this matter. However, to assuage any fears people may have I requested the HSE to ask the College of Psychiatrists of Ireland to do an independent review of the decision in case anybody believes decisions have been taken behind closed doors. That is not the case. The best needs of the current residents are my foremost priority.

The future use of the unit is also a top priority for me. I have been consistent, as was the Taoiseach when he was Minister for Health and my predecessor, that this unit will continue to provide care for people in the area and play a vital role in that regard. However, if clinicians tell me that the current residents' care is better served elsewhere, we have to deal with that. They are two separate issues that are not tied together. If some of the current residents need to be moved to a better facility, we have to do that. The same would apply to my mum or dad, if either of them was diagnosed with dementia and I was told one or the other would have to leave the home they have both lived in for the past 50 years and go to a care facility to receive better care. Nobody wants to do that but I do not have the authority to override any clinician and tell him or her I know better. With respect, no politician has the authority to do that. We have to respect the clinical judgment appropriate to each individual resident of the unit.

My commitment to the future use of this unit is absolute. We are not in a space where we can afford to close beds when there is great demand for social care and acute beds. As the Deputies are aware, there is a strong demand for services to address later life issues. Given the level of demand for beds in the system, the closure of the beds in the Rosalie unit is not a conversation I am willing to entertain with anybody. However, I have to consider the best needs of the residents, which is a separate issue from the future use of the unit. I want to have that conversation with public representatives and involve them in the future use of this facility to which we are committed. We will ensure that the high regard in which it is held continues and it is put to the most appropriate use possible.