Maire Devine (Sinn Fein) | Oireachtas source

On the matter I have raised today, I am speaking for my mental health nurse colleagues and their patients, as well as being a member of the Joint Committee on the Future of Mental Health Care and a member of the Psychiatric Nurses Association, PNA. The high-dependency psychiatric unit at Tallaght Hospital has six beds. It has been rumoured that it will close due to staff shortages. It is my understanding that there are 43 nursing vacancies in this service, which is posing serious difficulties for any recruitment or retention of nursing staff. This has been going on for a considerable number of years.

In an overwhelming ballot last week of PNA members, 85% voted for industrial action should this unit close. In 1999, the admission unit in Tallaght was opened with two beds and no high-dependency observation unit. It involved a prescribed method of taking care of patients who are extremely volatile, vulnerable and unwell. It could be a one-to-one, where one nurse would sit with the patient on a 24-7 basis, or a two-to-one, dependent on the level of risk.They demanded at the time, as did University Hospital Galway, that a high dependency observation unit be opened, in the interests of the patients' dignity and for the safety of staff and patients. It took industrial action to do this. When it was opened, there was a significant decrease in one-to-one, two-to-one or sometimes three-to-one nursing specials was glaringly obvious. The high dependency unit did not need one-to-one, two-to-one or in some cases three-to-one nursing specials for patients, which would deprive them of their liberty.

There is also the matter of seclusion. Seclusion is something we all think of as being like "One Flew Over the Cuckoo's Nest". Seclusion is down and it is used very rarely now. It is also an issue of human rights and personal freedom. However, seclusion in the so-called padded cell, or whatever one wants to call it, is significantly down because of high dependency units.

I am aghast that the Minister of State with responsibility for mental health has proposed closing this high dependency unit leaving patients, staff and visitors to the unit very vulnerable. It is a retrograde step. It is going back to the Victorian practice of taking away people's liberty to move around without somebody following them, even into the toilet or shower, so that they can continue the prescribed one-to-one observation. Could the Minister of State please respond and put nurses' and patients' minds at ease? Go raibh maith agat.