Maura Hopkins (Fine Gael)
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I thank the Minister of State for taking this Commencement matter.

I am extremely angry with the HSE because it has not been truthful and honest with the people of Roscommon. I say that because information was given to me and to other public representatives, both verbally and in writing, regarding the potential closure of mental health day centres and hostels in County Roscommon. The people who use mental health services within the county deserve to have facts and honesty but we do not have either at the moment.

I have listened to a wide range of individuals over the past number of weeks who are involved in mental health services in County Roscommon. All of these people are very clear and definite in their view that the HSE is publicly stating a message that is very different to what is being implemented on the ground. The statements are not matching up and I am very concerned. It is very important that we get facts and honesty.

To put this in context, I have spoken at length with the Minister of State at the Department of Health, Deputy Helen McEntee, and the chief health officer of community services covering County Roscommon. I was advised that the HSE has no active plans to close the various day centres and hostels referenced, namely, those at Ballaghaderreen, Boyle, Strokestown, Castlerea and Athleague. I was also informed that the HSE has no plans to close the community nursing unit in Aras Naomh Chaolain or to relocate residents to private nursing homes. I was advised that the HSE is currently consulting with residents, families and staff on the transfer of a small number of residents from Knockroe House in Castlerea to more appropriate settings.

This information was provided by the HSE to me and to other public representatives in writing. However, the minutes of recent HSE meetings suggest something very different. They suggest that Strokestown, Ballaghaderreen and Boyle day care centres could close over the next 12 to 18 months and be amalgamated with other centres. These minutes indicate that as part of its proposals, the HSE is to reduce the number of day centres from five to one or two, to be located in north and mid-Roscommon. The minutes also indicate that the HSE has established a group of senior staff to oversee the transition plan for day and training centres in the county.

The HSE confirmed on Monday morning last that it is currently exploring the reconfiguration of existing day centres. It added that if it is identified that day centres are no longer required, staff will be redeployed to strengthen other day centres. I emphasise again that I have been in contact with the chief health officer of community services, including mental health services, in County Roscommon several times over the past number of weeks and never once during those conversations was I told that plans were in train regarding potential closures and the amalgamation of mental health services. Quite frankly, it is absolutely appalling that the HSE would mislead us so blatantly. I am not willing to accept this type of conduct from this organisation, or any other organisation for that matter. People using mental health services and their families deserve the truth and the facts.

Finally, we know that an external review of mental health services in County Roscommon is currently under way. That review was commissioned last year and is really important that it is made available as quickly as possible. The review should assist in terms of identifying the challenges throughout the county. It should also serve to assist us in making improvements. Any improvements, however, must be made in consultation with the people using the mental health services and their families. I ask that the truth and the facts are given to us.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Senator Hopkins for raising this matter, which I am taking on behalf of the Minister of State at the Department of Health, Deputy Helen McEntee, who sends her apologies as she is unable to be here today. The Senator has asked when the external review of mental health services in Roscommon will be completed and made available.

The development of all aspects of mental health services remains a priority for the Government and the HSE. The latter, as the Senator knows, is responsible for the delivery of health services in this country and it secured a budget of €14.6 billion for 2017.This applies particularly in terms of promoting quality and safety and enhancing a recovery focus via local services for individuals and their families. This approach reflects the continued need to implement the key principles and objectives of A Vision for Change by modernising our mental health services and maximising resources to best meet various increasing demands.

In the context of concerns raised some time ago regarding mental health services in Roscommon, I have been advised that the HSE's national director of mental health commissioned an external independent review of the quality, safety and governance of these local services. The review commenced on 28 August 2015 and is being conducted by a team external to the executive. The terms of reference of the review, which is being undertaken in a manner that is respectful of the rights of all to privacy, confidentiality and procedural due process, includes assessing the systems and processes in place to ensure the quality, safety and appropriateness of care for mental health service users in Roscommon; reviewing governance arrangements for high-quality, safe and reliable services, covering issues such as multidisciplinary working, staffing levels and management; compliance with relevant national and HSE regulations, standards or protocols; and examining risk management processes and protocols within the Roscommon service and adherence to them in practice, including arrangements to ensure that incidents are appropriately reported and acted upon.

I understand also that, if it becomes apparent that there are reasonable grounds to believe that there are serious risks to the health or welfare of any person receiving services or that further investigation is necessary, the HSE may, in the interests of obtaining a complete report, extend the review's scope or recommend that a separate investigation be commenced as appropriate.

The HSE has told me that the report will be published in a format deemed appropriate to promote the safety and quality of mental health services in Roscommon for the ultimate benefit of the health and welfare of the public. It was initially envisaged that the review would be completed by March 2016. However, given its scale, the complexities involved and the need for the review team to meet as many people as possible, the team sought extensions to the timeframe. A public consultation exercise was also undertaken as part of the review process. At this juncture, the review is still ongoing and is expected to be completed in the coming weeks.

The HSE will not have sight of the final report until it has been signed off by the review team and submitted to the HSE's national director for mental health in accordance with agreed and due processes. All of the review team's recommendations will be examined in detail by the executive and considered in the context of any potential to improve high-quality and safe care within the resources available to the Roscommon mental health service. The Minister and all of the Ministers of State in the Department of Health will continue to monitor developments on this important service issue closely.

The Senator raised specific queries regarding local issues and the manner in which they had been handled. As I do not speak for the HSE and am merely conveying information, I am not in a position to give the Senator information on the local issues. However, I will undertake to ensure that the HSE provides an explanation as to what has happened with communication. Communication is crucial if we are to have a good, healthy and functional service. Our local representatives are always the touchstone when things go wrong and they need to be given proper and accurate information so that they are in a position to disseminate it to those who may contact them. I would have thought this to be a key priority for the people involved in the HSE.

Maura Hopkins (Fine Gael)
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The Minister of State is right, in that the HSE needs to provide us with accurate and honest information, which we are not getting at the moment. It is difficult to have confidence and trust in County Roscommon's mental health services when there is a complete disconnect between what we are hearing on the ground and what we are being told publicly by higher levels within the HSE. It is not acceptable. I have spoken at length with the Minister of State, Deputy McEntee, in recent weeks. I understand that it is an operational matter for the HSE, but we are discussing people and their families having confidence, trust, certainty and support within the county's mental health services. We do not have those currently. As a public representative in County Roscommon, I do not have confidence or trust in the HSE.

It is important that the external review, which was anticipated to conclude earlier than it will, is done properly and forms the basis for improvements. Mental health services continue to evolve and need to be improved. Changes may be necessary, but they need to be made in light of the review and in consultation with service users and their families.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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The Senator's question on the review was comprehensively answered. As to the specific issues raised, I will ensure that they are conveyed and that someone from the HSE informs her of what is happening with communications on these issues, which are of such concern to people who avail of them, their families and us as public representatives.