Dáil debates

Wednesday, 30 June 2021

Saincheisteanna Tráthúla - Topical Issue Debate

Mental Health Services

9:32 am

Photo of Pat BuckleyPat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State, Deputy Rabbitte, for being here. I welcome the opportunity to raise this issue.

I will provide a brief background. It was the wording in the previous Mental Health Commission report in 2018 that got me. It said the Owenacurra centre "was" a 24-bed unit situated in the middle of the town. It "was" a single-storey prefab building centred around an internal courtyard. There were 16 single bedrooms and four twin bedrooms. We learned as recently as last Monday that the centre would be closed on the basis of a number of reports. I thank the Minister of State for letting me know that it was coming, but it was still a shock.

The centre had 19 long-term residents, but it also has a day-care centre, long-stay facilities and respite care. It served a lot of the east Cork area as people travelled from Youghal, Cobh and other places to use the centre. I spoke to a number of staff in the centre. We know the patients are the priority at the moment and getting suitable accommodation or services for them.

The location of the centre in Midleton is a very valuable site and having spoken to people they are fearful about what will happen given that the building has been condemned as not being fit for purpose. In this day and age, it is strange to have prefab units. I know from previous reports of the Mental Health Commission that the same phrases came up all the time: "not fit for purpose" and "falling apart", and there were references to ceilings coming down. I got so angry when I heard they were just going to shut it between now and the end of October, which is very soon. Why did the HSE not put resources into the building to maintain it in the way people maintain their house or garden?

We in Midleton and in east Cork do not want this centre to be a big white elephant after October and then listen to bickering from all sides saying it is a valuable site and we do not know what we are going to do with it. We need all those services in Midleton. We need them in that centre on that site. The staff there want some kind of commitment from either the Minister or the HSE, preferably both, that we will not have a derelict building in October, which will draw anti-social behaviour and in the worst-case scenario end up going on fire. What we need is a commitment that something will be replaced on the site to guarantee the same or even better services than we had before.

Most of the staff there seem happy enough to be redeployed and there is good engagement with them. I always give credit where it is due, but I do not trust the HSE. It stated that a plan for the future of the site would be considered in due course. Basically, it does not have a plan for the site yet and that makes me fearful. We should have something similar back on the site as soon as possible because it is a necessity. The Minister of State is aware of the situation given her current and recent portfolios that people are not getting any younger. Mental health issues are increasing, and they will probably increase further. I seek a commitment that a fit-for-purpose building will be put back on the site that can benefit east Cork.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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The Minister of State with responsibility for mental health and older people, Deputy Butler, sends her sincere apologies for not being here to address this very important issue herself. She is before the Select Committee on Health this morning, to bring forward legislation, and so it could not be avoided.

From the outset, I reassure the Deputy that the current and future care needs of the residents of the Owenacurra Centre have been paramount in all decisions and actions taken by the HSE. Owenacurra is a continuing care unit located in Midleton, Cork and currently has 19 residents. It is a single-storey building constructed in the early 1970s and is very much a building of its time. Following its most recent inspection in February this year, the Mental Health Commission raised concerns about persistent non-compliance with regulations on the premises. I note for context that the commission inspects all approved centres at least once a year and plays a vital role in assisting us in improving our mental health services for all. The premises at Owenacurra were highlighted and risk rated as critical. I note here for context that the report noted overall compliance at 83%, up from 80% in 2020.

On foot of this latest inspection, HSE mental health services commissioned the HSE estates department to review the current condition of the premises. I understand that following a number of detailed assessments, it formed the opinion that the building is in an unacceptably poor condition with major defects and that the layout is unsuitable for adequate infection prevention and control. Following this, Cork-Kerry Mental Health Services determined that a refurbishment could not bring the building to the standards required. Therefore, on 23 June, they notified the Mental Health Commission that the Owenacurra Centre would close on a phased basis between now and 31 October.

The immediate priority of the HSE is to consult with residents and their families individually and to agree an appropriate alternative placement based on their assessed needs. Cork-Kerry Mental Health Services have a plan for this, and management will also engage with staff and their representative bodies.

A mental health day service is also located within the building. Work is under way to identify an alternative location for this service, as close as possible to the current location. The future of the entire site will be considered at a later stage.

I note that the HSE is committed to improving its infrastructure, including new or improved community-based facilities and services for people with more severe and enduring mental health difficulties. Of the additional €50 million Exchequer funding provided in 2021, €7 million will fund reconfiguration of mental health facilities, in line with Mental Health Commission Covid risk assessment recommendations. This, plus the recurring €6 million in new development funding, means there is €13 million for minor works and refurbishments in 2021.

In 2020, the HSE drew down almost €4 million in once-off new development funding to improve the physical infrastructure of 16 mental health community and inpatient units, in line with Sharing the Vision recommendations and commission regulations. The Government is committed to the improvement and development of all aspects of mental health services through implementation of Sharing the Vision. The policy aims to enhance the provision of mental health services and supports across a broad continuum from mental health promotion, prevention and early intervention to acute and specialist mental health service delivery during the period 2020-30.

In terms of premises, I also highlight that the new 170-bed National Forensic Mental Health Service Hospital complex in Portrane will replace the Central Mental Hospital in Dundrum this year. This new state-of-the-art facility will include a 130-bed adult unit, a ten-bed forensic child and adolescent unit and a 30-bed intensive care rehabilitation unit.

Photo of Pat BuckleyPat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State for the reply, but while it is welcome, the Central Mental Hospital is in Dundrum not Midleton. We are talking about getting local services.

Local knowledge is local expertise. When any service is run in the community, people get to know each other and more trust is built up. I would not say there is a more laid-back working relationship but there is more understanding and there is harmony and more empathy and respect. As I said at the start, however, our biggest fear concerns what will happen once the service is gone. Surprisingly, what has happened has taken only a couple of months. There has been a very fast step-down and shut-down of the unit, which is worrying, bearing in mind the state in which the building has been. Despite that, I need somebody to commit that once the building is decommissioned and closed, something will replace it in the area. Reference was made in the reply to which I referred to moving the day-care services but the authorities have not identified anything yet. I acknowledge the new 55-bed extension being done across the road, in a very old hospital. It is community led and run, which is fabulous. There should be more of this but the biggest fear concerns the fact that we cannot afford to lose the service in Midleton. We cannot let the building rot or be sold for something else. It was put there for a reason and we need to keep it there. Many use it. Irrespective of the position on long-term care, it is imperative that the day-care and respite services be retained in east Cork. Could the Minister of State commit to finding out as soon as possible what will happen to the building and site?

9:42 am

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Buckley again. I will relay everything he has brought up to the Minister of State, Deputy Butler. I am aware they had a conversation earlier in the week. Based on the original response the Minister of State gave me this morning, the priority concerned the need for infection control and management going into the winter period. I hear what the Deputy is saying about day services and respite care and also about not having an idle building or, more important, a vacant site with nothing planned for it. I will take on board what he has asked about and I will ask the Minister of State, Deputy Butler, to liaise with him and all his Oireachtas colleagues on the plans for the location and take on board their input.

Photo of Catherine ConnollyCatherine Connolly (Galway West, Independent)
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That concludes the Topical Issue Debate. We are in the unusual position of having a little time to spare so beidh sos againn go dtí 10 a.m.

Sitting suspended at 9.43 a.m. and resumed at 10 a.m.