Eugene Murphy (Roscommon-Galway, Fianna Fail)
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I will say what I said before, that the Minister of State, Deputy Byrne, is always pushed into these positions and I feel somewhat sorry for her.

Catherine Byrne (Dublin South Central, Fine Gael)
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That is all right.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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The Minister of State is here and does her best to answer the questions. I expected that the Minister of State, Deputy Jim Daly, would be here. This issue relates to the imminent closure of the Rosalie unit in Castlerea in County Roscommon. It is rather a sad evening for me to have to get to my feet once again to discuss this issue. The Ceann Comhairle has allowed me to raise this on many occasions since I became a Member of this House in 2016. The Rosalie centre had capacity for 33 people. It was a beautiful centre. They were people with mild mental health and disability issues, perhaps with Alzheimer's disease. They are people who very much needed somebody else to look after and care for them and to ensure that they were okay in life. Over recent years, little by little, the numbers were whittled down. It was at 34, it is now down to 12, and yesterday we had the announcement from the HSE's CHO 2 that it was to close.

This has been a bone of contention since 2016, when the HSE attempted to close the centre. The then Minister for Health, now Taoiseach, Deputy Leo Varadkar, and the then Minister of State, Kathleen Lynch, gave commitments at that time that this centre would not be closed. Last year, the director we were dealing with, Tony Canavan, called the elected members to a meeting in Roscommon town and told them that it was the intention of the HSE to close this unit. We fought it on many occasions. This is a beautiful centre, not a run-down building, with amazing staff. One thing that upsets people greatly is that people who have been here for many years, who are happy in their surroundings with their families close to hand to visit them, are having their centre closed. Their home is gone and many of them feel it. The Minister of State can imagine if she moved into a strange room herself, with different colours and of a different size. There is no question of being well looked after, since I know they will be, but the surroundings will completely change for these people. The HSE has told us that two will be moved immediately. Many will be moved locally over the next months to a local centre which is not too far from this one. The message from the families and from me and other political representatives is please to have this decision reversed. It is causing a lot of hurt and anger. It is a fantastic centre.

The experts will tell us that these people do not need any psychiatric care any more and that care to deal with old age or such is needed. I have a problem with that. Are the Minister, the Minister of State and experts saying that the medical staff are wrong? I am not saying that they are wrong but people have been in their home for many years. I have no doubt that when the Minister of State changes that environment, she causes them great distress and pain. I would appreciate the best answer the Minister of State can give me.

Catherine Byrne (Dublin South Central, Fine Gael)
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I am taking this matter on behalf of the Minister of State with responsibility for elder care, Deputy Jim Daly. The Minister of State would like to reassure the Deputy that the current and future care needs of the residents of the Rosalie unit has been paramount in all decisions and actions taken by the Health Service Executive, HSE. The Rosalie unit is located in Castlerea, County Roscommon. It is a continuing care facility for psychiatric and later-life patients. There are currently 12 residents in the Rosalie unit and the stated intention of the HSE is to continue to provide care for these residents in line with the needs identified in their individual care plans.

The Government committed to, and prioritised, the reform of our mental health services in line with A Vision for Change. The strategy set out a comprehensive policy framework for the development of these services. In line with the strategy, it is the HSE's position that there is an urgent need to improve mental health services in Roscommon and this was highlighted in the independent review of the services in 2017. As part of the improvement process and in order to best address the patients' care needs, the residents of the unit had clinical assessments carried out by the HSE consultant-led multidisciplinary team. The clinical assessments of the residents of the Rosalie unit indicated that their care needs had changed since admission, to include physical care needs, and that their individual future care needs would be best met outside the Rosalie unit.

This assessment was reaffirmed by independent clinical assessments. Specialist consultant psychiatrist of later life, Dr. James Anderson, was engaged to carry out the assessments of the Rosalie unit residents in December 2018 to determine their clinical needs, dependency levels, and optimum care setting. As part of the process, next of kin and relatives of the residents were invited to attend at the clinical assessments, so that their views could be taken on board. Independent advocacy was provided to residents and their relatives throughout the clinical assessment process. Dr Anderson's independent report concluded that at the time of assessment, a number of patients required inpatient psychiatric care in a different setting, and that the remaining patients' needs require general nursing care. Individual plans in respect of the future care arrangements for each resident of the Rosalie unit will be discussed thoroughly with the residents and their next of kin, in order that their individual needs can be met in the most comprehensive way, and in the most appropriate setting.

The clinical team and an independent advocate will be available to support them through this process. The Minister of State, Deputy Jim Daly, wants to assure the Deputy that the focus has always been on the well-being of residents throughout this process, and it will remain so. Clinical advice that has been independently verified has stated that the current residents' care needs would be best met in a more appropriate setting, and the HSE has a duty to act on this advice.

Eugene Murphy (Roscommon-Galway, Fianna Fail)
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The Minister of State is right to refer to Dr. Anderson's independent report, as it is called. I should have stated that the report suggested that two of the patients require inpatient psychiatric care and the rest of those patients require general nursing care. To go back two years, I was in that centre and it is possible to have a debate with some of the people there. When one of them stands at a doorway and says "I don't want to move out of here", that causes me fear. It disturbs me. We are forcing those people out to a different environment.

I have no doubt they will get excellent care and be well looked after but why move those people out of a place that has become their home over many years? Irrespective of what psychiatrists or psychologists tell us, common sense would tell me not to take people out of there. It is like taking a person out of their home who is not suffering from Alzheimer's or dementia and telling them they have to go into a nursing home. People do not like being taken out of their own corner in general.

County Roscommon has the highest incidence of Alzheimer's in the country per head of population. We will also have more older people per head than any other county. Rather than close any of those facilities we should be opening them. Rather than getting rid of the ten patients there we should bring that centre up to full capacity. The Minister told me at a meeting this morning that it will be a residential care setting. If it is to remain as a residential care unit, why not leave these, mainly elderly, people there to live out their lives? It is not much to ask. I ask the Minister of State to go back to the Minister of State, Deputy Jim Daly, and the Minister for Health, Deputy Harris, and plead with them to ask the HSE to reverse this decision.

Catherine Byrne (Dublin South Central, Fine Gael)
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I am not familiar with the setting but I take on board the Deputy's concerns and compassion. Change is very difficult for anybody. It is even more difficult for an older person. Moving from an environment where they live can be very stressful.

I was given a response to the Topical Issue matter and had to read it. However, I will take on board some of the issues the Deputy raised, particularly why, if the service is to remain, the patients are not allowed to remain. I cannot answer that because it is a medical decision. Improving all aspects of policy and services in mental health is a priority under the HSE plan for 2019. This relates to all areas nationally, including Roscommon. The Minister of State, Deputy Jim Daly, encourages public representatives and the media to take responsible approaches when commenting on the HSE decision to transfer patients currently residing at the Rosalie unit. Roscommon has more appropriate health facilities to better meet their health needs and care. The Rosalie unit will not close as has been reported. However, it is highly likely that the psychiatric service currently provided at the centre will cease in due course and a new service will be provided to best cater for the health and care needs of the local community based on demographic evidence. The Minister of State, Deputy Jim Daly, will continue to liaise with the HSE to monitor all aspects of the mental health service care, including health services in Roscommon. I assure the Deputy I will bring a very clear message back to the Minister of State and I apologise again that he could not be here.