Nicky McFadden (Fine Gael)
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I thank the Minister of State for attending. I raise this issue which has become very woolly recently because there has been rumour upon rumour in the Mullingar area. As late as three weeks ago, I spoke to the Minister of State, Deputy Moloney, who informed me he would meet senior management at St. Loman's Hospital, Mullingar, and then, lo and behold, there was a big headline in the local newspaper that the hospital was to close. After further checking and research, I realised the Minister of State had asked for a plan from the hospital management regarding the proposed closure and also for a plan for the patients.

There are 110 patients in St. Loman's Hospital, some of whom have been living there for more than 50 years and do not know anywhere else. It is their home. This is my chief concern. While we all agree these horrible institutions must close, we must also prepare proper facilities and homes for these people. There has been very little consultation with staff, some of whom have worked at the hospital for a very long time. Very good work is done at St. Loman's Hospital in Mullingar which has been a sanctuary for these people, some of whom travel from as far away as Naas. The joined-up thinking in the Health Service Executive is that St. Loman's Hospital will now take people from Naas in an overflow situation. One gentleman from Naas has nowhere to go as he has been there for so long.

What is to become of these people? The hospital is chock-a-block at present. An acute bed unit is needed for people with acute psychiatric illness. The facility that had been promised for the general hospital in Mullingar has gone by the wayside despite promises being made years ago. There must be proper rehabilitation facilities for people who are being discharged into the community as well as psychological support and supportive employment, which is quite haphazard at present. There is far too much dependence on prescribed drugs for patients. We need to figure out ways of helping people to live with dignity in their communities. Some of them might even be able to go home if they were to have a proper outreach plan. I believe the term is an assertive outreach plan which is a patient-centred plan that would meet the needs of the patient and would not be in any way woolly.

Family support is very important. Families are very worried about relatives who have been long-stay patients at St. Loman's. Social support is also needed. For people to live in an austere grey psychiatric hospital or live alone in a community where nobody visits them or where there is perhaps only one community worker is not the solution. I am concerned that people would be put out on the rubbish heap, as it were, with nowhere to go, which is the case at present. I have very little confidence in this regard. A sum of €3.5 million was received from Westmeath County Council for a tranche of land on which it built houses but this money has not gone back into the psychiatric or mental health services in Athlone, Mullingar and the Westmeath area.

The Minister of State will probably refer to A Vision for Change which was launched in 2006 and has been referred to many times in this House. It is a great document and refers to €21.6 million each year for seven years and €151 million in addition to existing funding for an additional 1,803 posts. While we are in a very different climate than we were in 2006, at the same time, €796 million was recommended to be put back into the services. The document also states that when the valuation of each building and the lands in the mental health services is complete, that money would sufficiently counterbalance the capital costs of all of the required mental health services referred to in A Vision For Change. Forgive me for being cynical but I know what will happen — the money will simply be ploughed into the Department of Finance. With regard to adolescent psychiatric services, there was an announcement last year that an additional two beds would be provided. Mental health is the poor relation of the health services.

I ask the Minister of State to reassure the people of the midlands and the entire mid-Leinster area of what is to happen to those in the region who have psychiatric illness or intellectual problems. Services for the intellectually impaired are provided now on a day care basis in a ward in St. Loman's Hospital and 30 people have been able to avail of this. No recommendation has been offered for that service facility, which is called Lough Sheever, nor for the highly trained and experienced staff. Where will they go? I apologise for taking this time.

Mary Wallace (Meath East, Fianna Fail)
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I thank Senator McFadden for raising this issue as it provides me with an opportunity to outline the plans for the closure of the remaining old psychiatric hospitals.

As the Senator mentioned, A Vision for Change is the report of the expert group on mental heath policy. It provides a framework for action to develop modern, high quality mental health services over a seven to ten-year period. The Government has accepted the recommendations of the report which, when implemented, will overhaul the existing mental health services and provide community-based interventions that are accessible and effective in promoting recovery and reintegration.

The report recommended that a plan to bring about the closure of all psychiatric hospitals should be drawn up and implemented and that the funds realised by the closures be reinvested in the new mental health infrastructure. The Health Service Executive has disposed of a small number of psychiatric properties to date and the funds realised have been surrendered to the Exchequer. The Department of Health and Children recently received a submission from the HSE outlining the projects it considers should be funded from these disposals and it will pursue these proposals with the Department of Finance. The Department of Health and Children will seek also to agree an overall approach on the extent and timing of property disposals with the aim of facilitating the modernisation of the mental health infrastructure.

The closure of the old psychiatric hospitals, the realisation of their asset value and the reassignment of staff from the hospital to community settings is key to the implementation of A Vision for Change. Concerns have been expressed that the closure programme has been delayed unnecessarily. However, we must realise and recognise that no hospital can close until the needs of all the remaining patients have been addressed in more appropriate settings, such as additional community residences, day hospitals and day centres, and the necessary community-based, multi-disciplinary community mental health teams have been established.

The Minister of State, Deputy John Moloney, visited St. Loman's Hospital last month to check on progress in respect of the proposed closure. He was assured that the reconfiguration of the St. Loman's campus, which currently accommodates 119 patients, is the single highest priority for the HSE local office. He was informed also that a development control plan for the hospital has been finalised. In the plan there is provision for appropriate accommodation for all those patients still remaining in St. Loman's Hospital. Briefs for the provision of this alternative accommodation have been drawn up in consultation with staff. In line with national policy, the phased relocation of patients to more appropriate community-based facilities has commenced.

Although psychiatric hospitals were the mainstay of mental health services in Ireland for many years, the type of person-centred, recovery-oriented care recommended in A Vision for Change cannot be provided in such large institutions. The focal point of modern mental health services is the community, and developing a community-based service is the way forward. I, therefore, assure the Senator that the Government is fully committed to the closure of the old psychiatric hospitals, which I stress will be completed only when the needs of all remaining patients have been appropriately addressed.

Nicky McFadden (Fine Gael)
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I thank the Minister of State for her reply. Most of it concerned A Vision for Change, which we all accept is a very good document. However, the Minister of State mentioned a development control plan. Is it possible to get a copy of that plan? I am sure it is freely available. Does the Minister of State know what it contains? That was the bones of my Adjournment matter.

The Minister of State mentioned provision for appropriate accommodation and the phased relocation of patients to appropriate community-based facilities. My concern relates to the word "appropriate", which is the operative word. What is to become of the enormous facility at St. Loman's Hospital? It is a massive old building and is a protected structure. Perhaps the Minister of State will return to me in her own time with answers.

Mary Wallace (Meath East, Fianna Fail)
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Although the building is a protected structure, I know the Senator would not say it was necessarily the most appropriate place for modern care for the patients involved.

Nicky McFadden (Fine Gael)
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No.

Mary Wallace (Meath East, Fianna Fail)
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I refer to the plan about which the Minister of State, Deputy Moloney, was advised when he visited Mullingar. He was advised that the development control plan for the hospital had been finalised. The phased relocation of the patients to more community-based facilities has commenced. That is not to say it is being implemented, but there is a plan for it.