Dáil debates

Wednesday, 22 September 2021

Saincheisteanna Tráthúla — Topical Issue Debate

Mental Health Services

9:20 am

Photo of James O'ConnorJames O'Connor (Cork East, Fianna Fail)
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I convey my gratitude to the Minister of State, Deputy Butler, for attending in her capacity as the Minister of State at the Department of Health with responsibility for mental health and older people.

An important issue in my constituency and municipal district has been prominent in the national news in recent weeks and days. It concerns the provision of mental health residential accommodation in the Owenacurra centre, which is due to be closed down by the HSE. Discussions are ongoing on the future of the day-care services being provided at the facility. In recent days, I attended a public meeting in my constituency. It was extremely well attended by members of the community, not alone from the Midleton area but from across the constituency of Cork East, particularly its southern side. The majority of the families of service users are from the towns of Cobh, Carrigtwohill, Midleton and Youghal.

I would like to convey some of the points that were made to me from the floor at that meeting, which was also attended by colleagues from Cork County Council and my fellow Deputies in the constituency, Deputies Stanton and Buckley. Many valid points were made by the families. Above all else, they would all like to see the retention, if possible, of some type of residential mental health facility in the Midleton area or at least the east Cork region. We all accept, as the Minister of State is well aware, that the building at the Owenacurra centre is in poor condition. This has been clearly shown in the reports done by the Mental Health Commission. I would like to see some thought to be given to the potential for either a full refurbishment, the demolition of the existing facility and reconstruction of a new one or finding a way to incorporate a new residential facility so that the 19 full-time residents using the Owenacurra centre will have a home in their community. It is worth noting that for the long-term residents, the Owenacurra centre is their home and Midleton is their community. It will be difficult for many of them to adjust to their new environments, some of which will be entirely different as we know. That concerns me.

I know these decisions are being made by the HSE but I am asking the Minister of State for her help and for engagement and dialogue on this issue. I hope she will work with me and my constituency colleagues to find a better solution to what is being proposed. Most important, I ask that the HSE allow us time to reflect on the decision it is making and for a full review of what it has attempted to do in closing down the Owenacurra facility.

It was crystal clear from the people in the room in the Midleton Park Hotel, where the public meeting took place, that the Owenacurra centre has been a wonderful resource to the service users who have made great progress. They are extremely happy where they are and their families are also happy that they are able to use the facility. The staff in the centre have done fantastic work. I have been lucky enough to know some of the people who have used the Owenacurra centre through the years and I know many people who work in it. It is clear to me, as a public representative and Deputy for the constituency of Cork East, that the work they have done has been wonderful and that we should try to keep the centre if we can.

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this important issue. Significant Government funding in 2021 means that the mental health budget is now in excess of €1.1 billion. The HSE is providing approximately €139 million this year for mental health services in community healthcare organisation, CHO, 4, which includes east Cork.

I appreciate that this topic has been raised by the Deputy in the context of the closure of the Owenacurra centre, and I acknowledge that we have discussed this matter on many occasions, even as late as yesterday. I thank him for his ongoing and constructive engagement on the closure and the transfer of residents to other healthcare services. The decision to close the Owenacurra centre has not been taken lightly and has been made on the basis that it is not fit for purpose. Significant concerns have been raised by HSE estates, the Mental Health Commission and independent reports on the condition of the building.

It is important to talk about the timeline. On 30 March 2021, the Mental Health Commission corresponded with the chief fire officer of Cork County Council, referring the matter of fire safety issues for its consideration and sharing the Maurice Johnson & Partners report. The HSE used its own report on the building as well as two independent reports. The chief fire officer and building control officer with Cork County Council wrote to mental health services on 13 April 2021 to raise concerns. On 18 June, HSE estates warned that it had discovered that the building was in poor and unacceptable condition with major defects. It stated that even if refurbishment took place, it could not guarantee that the refurbished building would meet current building requirements or be regarded as fit for purpose. While there was no immediate danger or risk to anyone, it was made clear that no amount of expenditure could bring the building to an acceptable standard.

I have been in touch with the HSE on a regular basis regarding this matter and I reassure the Deputy that in the context of the closure, the priority of the HSE and my priority is the welfare of the 19 residents. A needs assessment has been carried out for each resident to inform discussions around relocation with residents, their families and the multidisciplinary teams. While some people may require ongoing continuing care, others will be facilitated to live in lower support settings, based on their needs. Information on this was provided at yesterday's meeting of the Sub-Committee on Mental Health, chaired by Senator Black, which the Deputy attended. The multidisciplinary teams have met all residents and their families, with the exception of one family, with whom a meeting is scheduled for this week, to discuss their options, with the will and preferences of each resident being of central importance.

I am also aware that it was acknowledged by the HSE at yesterday's meeting of the Sub-Committee on Mental Health that communication processes with residents and families will be reviewed. I discussed this with the chief officer for mental health last night and he has given me a guarantee that this area will be reviewed. A member from the independent Irish Advocacy Network is part of the project steering group, in addition to a mental health service user family member and carer engagement representative. This is to ensure that residents and families continue to have independent supports available throughout the process.

In terms of mental health services generally in the Cork area, the HSE provides a wide range of community and hospital-based mental health services. I am also aware that a day-care centre operates out of the Owenacurra facility and I made it clear again last night to the area lead for mental health in CHO 4 that a temporary premises must be found immediately while a permanent solution is being put in place.

Photo of James O'ConnorJames O'Connor (Cork East, Fianna Fail)
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I thank the Minister of State for her response. While I am in Dáil Éireann, I stress the point that the loss of the residential service being provided at the Owenacurra centre will have a major impact in east Cork. It will leave the entirety of the southern side of the Cork East constituency without a residential facility. That is worrying to me as a Deputy for the constituency. I ask again if a budget can be found, either now or in the future, to retain some type of residential facility in the Midleton area.

I accept the point the Minister of State made about the serious issues relating to the current facilities of the Owenacurra centre. I do not think those issues are avoidable. I would like to see an effort being made by the Department of Health, the HSE and the Mental Health Commission. The commission was aware of the deterioration of the building's condition. That is made quite clear in the commission's reports from 2017 to 2020. It is crucial that we fight for a new facility in the Midleton region. On the night of the public meeting, many people from the Midleton community made the point that they are worried the site could be used for an alternative purpose and its current capacity as a HSE facility would be lost. People want to be reassured that whatever happens with the grounds of the Owenacurra centre, it will remain a healthcare setting in some form for the future. It is a strategically located facility in the Midleton area. I will allow the Minister of State an opportunity to respond.

9:30 am

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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I thank the Deputy. Improving all aspects of mental health service delivery is a priority for me, the Government as a whole and the HSE, in line with the executive's national service plan 2021. This includes continued collaboration between relevant agencies and service users to ensure that quality and standards in our mental health facilities are further improved in line with best practice and recommendations. With regard to Owenacurra, the most important issue is the safety and welfare of the current residents first and foremost. There is clear consensus that the current building is not fit for purpose and cannot be brought to the standard required. It is a building of its time. However, I take on board the Deputy's point that this was the facility in east Cork where people with mental health illness were able to live and engage within the community.

The HSE has a plan in place to close the centre on a phased basis and ensure clear and open channels of communication are maintained with the individuals residing in the centre and their support networks. I know many concerns were raised in the sub-committee and by the Deputy about the fact that 31 October is approaching quickly and perhaps not everyone will be in the best place, facility, home, hospital or nursing home for his or her care. Last night, the mental health lead in the area informed me that 31 October is the deadline but if there are still residents in the facility on that date, the service will continue to work with families to get the right places for them.

It is imperative that a temporary premises is found immediately so that people who use the day-care centre will be able to receive supports in the community.