Seanad debates
Thursday, 29 May 2003
Adjournment Matters. - Mental Health Services.
10:30 am
Tom Morrissey (Progressive Democrats)
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I thank the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, for coming to the House today to give a report on unit 9 of James Connolly Memorial Hospital which is due to be relocated to a new purpose built hospital. I also raised this matter in February at which time I was informed by the Minister that a snag list was being compiled and due to be discussed the following week. This would have been around 11 February. Since then I have had a meeting with senior management of the Northern Area Health Board and attended a meeting where I expected to meet the assistant chief executive but there were no less than four other managers present to discuss the subject with me. I was quite surprised by this because I had been led to believe there were no problems. At the meeting I was promised I would be given a copy of the snag list. While I was not supplied with the list by the Northern Area Health Board, I did receive it from another source.
The report I have been given states:
It is a story of incompetence and neglect that will cost the Tax-payer hundreds of thousands of Euro, if not millions . The Design Team did not include Psychiatric Nurses and indeed excluded the Director of Nursing who has now been given responsibility for its operation . it is no exaggeration to describe this Unit as a disaster, to say it is the worst ever provided to the Psychiatric Services, to declare that it is unsafe for Staff, compromises Patient care and raises the distinct possibility that Patients will refuse to go there.
The report lists some of the issues of concern. It states the facilities in the new unit are cramped with the television room, recreation area and smoking room inadequate for 22 patients. One patient with three visitors will fill the new visiting room. The dining room can accommodate about six patients. Apparently, the design team did not realise that mentally ill patients were rarely confined to bed except in the very early stages of treatment, if at all. Somebody on the team had concluded that patients would eat their meals from bed tables when in reality the majority use the dining room.
There is no way that any Nurse with common sense, any regard for his/her continued practice or with even a semblance of patient welfare would place a client in any one of the five side rooms where the biggest expanse of space is glass. Or where there are open electric sockets, light fittings, which are accessible, doors, which are unsuitable. These Rooms can never be used to accommodate acutely disturbed Patients, even for "time out" in their current state.
This and the previous Government have poured millions into the health service. The number of staff has been increased by over 30,000 since 1997. It is appalling that at such a time we would have management in a health board area which could be accused of such neglect. If benchmarking, which the Government brought into being, is to mean anything other than divvying up pay increases and adding to our public sector pay bill, it must include accountability. There is no accountability in this situation. I met five managers but our meeting was a whitewash. They told me they were responsible for the management of the hospital while the unions were responsible for staff in the hospital. I asked who was responsible for patient care.
I visited unit 9 last week. One would see better in a Romanian orphanage. The unit would be condemned if it was part of a television series we were watching from Romania. It is hard to believe we can see this in Ireland given the millions spent on the health service. It is appalling to think we have a new hospital built, yet this is happening here in Dublin. It is time for decisions to be made. I want to see patients being removed from what the inspector of mental hospitals considers are not proper facilities in unit 9 and relocated as soon as possible in the new hospital. If it costs hundreds of thousands or €1 million to make this move, it should be made public and those responsible brought to book. It is high time that patient care was placed at the top of the agenda. If we are told what has happened is true, there has been gross neglect.
Tim O'Malley (Limerick East, Progressive Democrats)
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I thank the Senator for raising this matter on the Adjournment. I also take the opportunity to welcome some friends from America to the Visitors Gallery. I hope they have had a good trip to Ireland.
The acute psychiatric in-patient services for area 6 of the Eastern Regional Health Authority are currently being delivered from unit 9 at James Connolly Memorial Hospital, which has 22 beds. In his report for the year ended 31 December 2001 the inspector of mental hospitals noted that the unit was unsuited for its purpose and that its shortcomings had resulted in unsatisfactory conditions for service users and considerable difficulties for staff. The inspector also noted that the unit was structurally and decoratively poor with a temporary add-on structure providing bathroom facilities for female patients. The unit will be replaced by a new psychiatric unit in the new development currently nearing completion. Patients will be relocated to the new unit which will provide improved patient facilities and services. The new unit will be a 56 bed unit comprising 44 acute psychiatric beds, six high observation beds and six psychiatry of old age beds. Patients from a 22 bed unit at St. Brendan's Hospital will also be moving to the new unit.
Discussions are ongoing with unions representing psychiatric nurses moving to the new psychiatric unit at James Connolly Memorial Hospital. The discussions are currently concentrating on a number of issues of concern in relation to the physical layout of the new acute psychiatric unit. Proposals aimed at addressing these concerns were presented to staff unions at a recent meeting with the Northern Area Health Board. Draft operational procedures and protocols were also presented, including admission, discharge and security policies. The unions requested some time to consider the proposals and advised that they would report back by 4 June 2003.
The new acute psychiatric unit will provide bright and spacious accommodation for patients as part of the integrated services available at James Connolly Memorial Hospital. In the interests of patient care, I hope all interested parties will co-operate to progress its opening.