Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Senator Máire Devine for raising this very important issue. I am well aware of her track record on mental health and with the Pyschiatric Nurses Association, PNA. I thank and commend her for her work in the past on those particular issues. I know the concerns she raises today are totally genuine. Our objective is to ensure that all patients and the staff who work with them are given priority.

Mental health remains a key programme priority for this Government, underscored by the fact that the HSE's mental health budget increased from €836 million in 2016 to approximately €851 million this year, and will further increase to approximately €910 million next year. This new investment will help to expand and modernise all aspects of the particular services.

Nationally, and in Dublin South-Central in particular, the HSE has encountered significant issues in the past few years in recruiting and retaining registered psychiatric nurses. This is a recognised issue for all nursing disciplines in the Dublin area, and was a factor in the previous industrial action by the PNA in 2016. The HSE has been attempting to maintain a full level of inpatient and community services in the face of this staffing challenge. This has contributed to a significant level of both agency use and nursing overtime. However, in trying to alleviate such pressures, the HSE has an ongoing recruitment campaign for psychiatric nurses in Dublin South-Central, alongside panels already in existence at the HSE national recruitment service in Manorhamilton. The acute mental health admission unit at Tallaght Hospital is endeavouring to provide a safe and secure environment to treat patients for the acute phase of their illnesses. The management of the service has become increasingly concerned about the high dependency on the use of agency staff and the inability to adhere to provisions of the working time directive.

The lack of staff continuity in shifts, together with the over-reliance on agency staff, are significant risks to patient safety. We accept that. The HSE is considering several options, and while no decision has yet been made, consideration has been given to closing the six-bed ward known as the Aspen ward. This ward was originally opened as a high-observation ward in 2003. Due to the limitations in design, it has not operated as a high-observation ward for some years. It now serves generally as a low-stimulus environment for selected patients. The closure of Aspen, if it proceeds, may reduce the bed capacity of the acute admission unit from 52 to 48 beds. A concerted effort is under way to reduce the cohort of patients on the unit whose acute phase of treatment has now been completed in order to ensure that bed availability for acute admissions is optimised. The management of the service continues to engage with staff representatives to explore all options to reduce the impact of nursing vacancies in the service. This service is currently running a nursing vacancy rate of 20%, against a complement of approximately 200 qualified nursing staff. That is a very difficult position.

Any measure taken to relieve this problem by the HSE is taken with a view to minimal impact on front-line services, and will be reviewed regularly for the impact on patient care. Subject to the availability of appropriate additional staffing, it is intended that any bed reduction will be temporary in nature.