Pat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State for her appearance tonight at this ungodly hour. We are back again talking about the Owenacurra centre. I am delighted this Topical Issue was selected. I have been driven to frustration over the past two years between parliamentary questions and committee meetings. I wrote to the European Ombudsman in October 2022. I wrote that I was contacting her office because I had tried as many avenues as possible, without success, to receive answers about the care of the elderly in our communities. These avenues included the Committee of Public Accounts, the then Committee on Public Petitions, the Sub-Committee on Mental Health, and the Joint Committee on Health. The office of the European Ombudsman replied to me in November 2022 to tell me that the matter did not fall under its writ, because it is a matter for the HSE. A number of weeks ago, the European Ombudsman appeared before the then Committee on Public Petitions and I took the opportunity to raise the issue. I explained that I was not talking about the HSE but about the human rights infringements. I asked the European Ombudsman if she would revisit it. The European Ombudsman, Ms Emily O'Reilly, replied to me on 19 June, to tell me again that it unfortunately does not fall under the remit. She wrote that protecting the rights of persons with disabilities is a priority and that she endeavours to use her mandate as widely as possible to that end but notwithstanding that, as European Ombudsman she must operate within the limits of her mandate.

I am raising this because I have gone down every avenue and have been sent from the Ombudsman to HIQA, from HIQA to the Mental Health Commission and from the Mental Health Commission to the HSE. I have raised numerous Topical Issues and have had numerous interactions back and forth. I remember how the representatives from HSE appeared before the Committee on Public Petitions to discuss the closure of Owenacurra. During that meeting, I raised concerns from families of residents there. I mentioned the word "coercion" and the HSE would not accept it. I mentioned the word "misleading" and the HSE would not accept it. This was about respecting the wishes of the residents who were there. According to minutes of a special meeting of the HSE safety and quality committee on 8 February 2023, the committee raised concerns regarding placement at St. Stephen's Hospital in Glanmire and St. Catherine's Ward at St. Finbarr's Hospital. The minutes noted that these centres have received lower inspection compliance ratings from the Mental Health Commission than the Owenacurra centre. The minutes also noted that "concerns were expressed that these environments are congregated settings that are campus-based, isolated, away from the community in contravention of the Convention on the Rights of Persons with Disabilities, Government policy, and HSE policy." It was stated that at the time, Government policy and HSE policy was to move away from congregated settings. This information is in the public domain. The minutes also noted "some members of the Committee expressed dissatisfaction with the need to transfer the residents away from the Midleton area contrary to their expressed wishes".

The HSE has acknowledged it in the last meeting yet I am black and blue from the past two years bringing this up in various committees and parliamentary questions. At the most recent meeting of the HSE, it has now clarified that the members of its safety and quality committee have said what I have been saying all along. Who do I get answers from because I have gone everywhere? I have gone to the European Court of Justice on this and have been waiting for a response for six months. This is how bad it is. If the Minister of State can be of any assistance in getting justice for these people, I would appreciate it.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this matter again and for his constant advocacy for the residents of Owenacurra and the six people who still live in Owenacurra. It is their home from home. I thank him for always being so respectful when he speaks about this. The independent regulator, the Mental Health Commission, in inspection reports found that the premises at Owenacurra was not up to the required standard. Following advice from construction experts and the fire officer, the HSE took the difficult but necessary decision to close the centre in a co-ordinated, resident-centred way. The service continues to mitigate the risks associated with the current building. As the Deputy is aware, the kitchen was closed down and any food was brought in because that was one of the main issues.

The HSE informed residents and their families in June 2021 of the decision to relocate services from the Owenacurra Centre. Here we are in June 2023 and we still have six residents living in their home. Am I satisfied with the pace of this? No, I am not. I cannot believe I am back in here two years later still discussing the same issue. Residents will not be moved until appropriate placements have been found for each person. The expression "will and preference" have been used a lot but they have been respected. It will be based on their individually assessed needs and their will and preference. The HSE priority is to ensure that the most optimal placements are progressed for the six remaining residents. Meetings have taken place with families and residents and engagement continues with all residents to offer support and assurances.

I have, through the Department of Health, provided the HSE with €500,000 capital funding to assist with the reconfiguration of services associated with the Owenacurra premises. This has ensured that the HSE has purchased a property in Midleton that will be a community residence for mental health services. In the longer term, which was announced in the capital plan recently, the HSE will provide a new ten-bed rehabilitative residential unit in Midleton town. Both the Government and the HSE value the regulation of our mental health services as it provides a framework in which to constantly review and improve our services, so they remain person-centred.

I will talk about the 13 former residents in a high-level way so as not to identify anyone. The HSE advised me that following assessment of residents' needs and engagement regarding residents' will and preference, 13 residents left Owenacurra and have been accommodated at home with community supports, in nursing homes, in mental health high-support hostels and mental health services residential units.

I also met with the new mental health lead in CHO4 in the past few weeks and the mental health team in the area to discuss Owenacurra and other mental health issues in CHO4. I thought it was really important. I did express my concern that this is taking a long time and Owenacurra is still open with six residents. I am glad to see there is progress regarding one property and my understanding is that a second property is being considered because these people were given a guarantee that they would get to live in Midleton. They are embedded in the community and it was important that this would be respected.

Neither I nor the HSE has received correspondence from the European Ombudsman regarding Owenacurra. The European Ombudsman can investigate complaints about institutions, bodies and agencies of the EU but cannot investigate complaints against national, regional or local administrations, including the HSE. The Office of the Ombudsman can, however, examine complaints about the HSE.

Pat Buckley (Cork East, Sinn Fein)
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I appreciate the response. I am well aware of the three beds and the possible ten beds but we had 22 beds there so we are basically halving the service. It is not what was there before but that is for another day. I was raising the concerns of residents and families. I got information from the residents that people were coerced. The Minister said people were relocated. According to minutes of a special meeting of the HSE safety and quality committee on 8 February 2023, "some members of the Committee expressed dissatisfaction with the need to transfer the residents away from the Midleton area contrary to their expressed wishes" so it was not a smooth transaction for some of the people and I feel we have let them down. They did not have options so this is certainly an infringement of their civil liberties. Taking them from a place that is more compliant and putting them in a place that is less compliant is moving in the opposite direction to the model in Sláintecare, which is an integrated service. Moving them into the middle of nowhere instead of Sarsfield Court is bonkers.

While I welcome aspects of the Minister of State's response, how much would it have cost to keep those services and how much will it cost now to halve the services? We will not even have the additional services that go with it. I do not know what is happening with the day care services there. The dental services have the community hospital service and the doctor's service across the road. To make it worse, this is a precursor because a number of other HIQA reports are coming down the line that mention St. Brigid's in Tipperary, where we will be fighting the same battle; St. Brigid's in Portlaoise; and another one in Clifden. I am raising the flag to say there is no oversight in the HSE, which seems to have free rein. When you have committee members saying at a meeting "yeah lads, we fecked up on this and we probably fecked up on that but are we going to bury it?", how do I get an answer to prove that I told you so? I am getting the runaround again. It is very frustrating.

Mary Butler (Waterford, Fianna Fail)
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I understand the Deputy's frustration but he must think back to two years ago when I was informed by the fire office in County Cork that the building was not fit for purpose and was a danger to the residents. At that time, two or three reports were commissioned. We do not have that type of reduction in beds referred to by the Deputy. It is really good news that we are going to have this new ten-bed unit there. The current outline plan is very ambitious with a goal of commencing building on quarter one of 2024 - so this is not too far away - with a view to the completion of the unit in quarter one of 2025. My plan is that there will be two community homes in Midleton where those six residents will have those supports. They will also have wraparound supports. The Deputy said that the residents' will and preference might not always have been adhered to but the Mental Health Commission had a role to play here.

Pat Buckley (Cork East, Sinn Fein)
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The Mental Health Commission never mentioned the closure of the facility.

Mary Butler (Waterford, Fianna Fail)
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The Mental Health Commission, as an independent statutory body, had a role to play here.

Pat Buckley (Cork East, Sinn Fein)
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I understand that.

Mary Butler (Waterford, Fianna Fail)
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Its role was to be involved. It was kept updated on every occasion when one of the residents was moved.

We must get to the stage where the last six residents will get their forever home. It will be located within Midleton where a new ten-bed unit will be built which will be very important.

I know for a fact that in some instances, residents were moved from Owenacurra who now live in nursing home care and their families are happier because they do not have the stigma-----

Pat Buckley (Cork East, Sinn Fein)
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Absolutely.

Mary Butler (Waterford, Fianna Fail)
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-----about being in a mental health facility. I want to ensure that this transition is smooth for the six residents who remain there. I thank the Deputy again for his interest in this matter.

Pat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State for her time.