Liam Twomey (Fine Gael)

It is fitting that, as we speak, Deputy Dan Neville and Miriam O'Callaghan are launching two books related to the issues surrounding suicide and mental illness. I wish them well.

I am disturbed at the way we link any success in A Vision for Change to the remnants of a collapsed property market. Any money from the sale of properties in the mental health service in the last four years went back to general Exchequer funds and if the money was given to the HSE it could have spent it on anything. If some of the properties that are now being put up for sale had been sold in the last four years, they would be moved into NAMA in the coming weeks. In some respects, therefore, the mental health services are lucky some of this property is still in their ownership because at least the madness of the property bubble has dissipated.

The property associated with mental health institutions, however, should not be seen as the only reason to improve the mental health service. Those services are disastrous, to put it mildly. In County Wexford, St. Senan's Hospital should have been closed years ago but when I called for it to be closed, there was no great support from other public representatives. They did not understand how backward facilities are in some of these institutions.

At the same time, I am not keen on the plan envisaged at the moment. Under that plan, patients from County Wexford must now go to either Carlow or Waterford to receive treatment and the Government has no plans to build an acute unit on the grounds of Wexford General Hospital. That is another backward step because while many patients can be treated in the community, there is a need for an acute admissions unit for those who suffer an acute psychiatric crisis. They need immediate help and proper inpatient care when such a thing happens. A large unit would not be necessary, things have moved on, and patient stays in acute units can be considerably shortened. There should, however, be an acute unit on the grounds of Wexford General Hospital because we have a population of 100,000, with a huge transient population. In the past I have dealt with acute psychiatric crises among those passing through the county. That can be more difficult because they have no family support or company when the episode occurs and there is a need for immediate transfer.

The Minister of State must also look at the way patient transfers are currently being carried out. There were massive problems with the old system, where a family member and I could sign a pink form and a patient would be bundled into the back of a squad car and taken to St. Senan's. That is no way to do things. There can, however, be significant delays. We take a certain risk, often waiting overnight, before the HSE team arrives to make an involuntary admission to a psychiatric hospital. I would be concerned that if St. Senan's closed completely and the delays that can happen with the HSE team at present continue, we could find ourselves in a worse situation with those patients who most need the highest level of care during a crisis. The Minister of State should ensure the rules are changed to protect those patients.

I have not had the opportunity to go through the Minister of State's speech in detail but the child and adolescent mental health teams are often under-resourced. There may be a doctor and a nurse but they do not have the full team required to look after patients with mental health problems in the community. If those people are not properly looked after, we are only wasting our time, putting their lives at risk while not giving them the care they need, leading to them being placed once more in inpatient institutions. The whole community project then fails. These must not become "ghost" teams, like the Minister for Health and Children's primary care teams, that only exist on paper. The Minister of State must do this properly.

If the Minister of State wants care for mental health patients in the community, it must be done properly. If he wants to provide proper inpatient care for those undergoing an acute crisis, we can settle for less but it must be funded from general Exchequer funds. we cannot rely on selling properties that no one wants these days.

I hope we do not end up with a situation like one I am dealing with at present, where a 16 year old boy who broke his hip on St. Patrick's Day is lying in a hospital bed in Waterford waiting for a transfer to a Dublin hospital for an operation. To be dealing with a such a situation in this day and age is madness. That is happening in the general medical service, an area people understand, but there are worse situations in the mental health services that are being provided across the country. People, however, do not understand that unless they are caring for an individual who has these problems.