Seanad debates
Wednesday, 14 February 2018
Commencement Matters
Long Stay Residential Units
10:30 am
Keith Swanick (Fianna Fail)
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I have asked the Minister of State here today to discuss the planned closure of the Rosalie unit in my home town of Castlerea, County Roscommon. A public meeting about the threatened closure of this health facility took place on 8 February. To say that family members of the residents are upset would be an understatement. The unit was previously threatened with closure in 2015 but, following public protests, this plan was reversed. The protests were organised by angry family members who then numbered more than they do now. The cynic in me would suggest that the embargo placed on new admissions since September 2016 was introduced in an effort to minimise the voice of protests which would come once the closure was announced. In an interview last week, Tony Canavan said that the reason this is arising as an issue is that the numbers in the unit have drifted down to a low level and that is because there has not been any new admissions to the Rosalie unit since September 2016. There could not be any new admissions because there was an embargo on admissions. When pressed on the fact that this was because an embargo had been placed on new residents, Mr. Canavan disagreed with the use of the word "embargo". That is, however, what we must call it. It is an absolute disgrace.
The unit at Áras Naomh Chaolain is currently home to 14 elderly high-dependency residents with mental health conditions including advanced Alzheimer’s. It was developed as a specialised psycho-geriatric unit with capacity for 25 people. It is not the same as a general nursing home. I am very familiar with it. I grew up 300 yd .or 400 yd. down the road from it. I am very familiar with the area and my cousin works in the unit.
Fears that the centre would be closed were allayed in July 2015 when then Minister of State at the Department of Health, Kathleen Lynch, told a deputation from Roscommon there were “no plans to close it and there will be no such plans.” For the families of the residents, this offered some relief. That has now been shattered. These patients and their families have been told by the HSE that there is adequate accommodation available in Ballinasloe, County Galway, and Castlebar, County Mayo. I am not sure if the Minister of State is familiar with the hinterland around there but it is an hour's journey from Castlerea to Castlebar or an hour and a half on the train. There is no main direct route to Ballinasloe from Castlerea. There is a road but it is terrible. There is no direct rail link or bus route. It would take at least an hour and a half for families to visit their loved ones in such units. These sorts of excuses are totally unacceptable. Uprooting these people, changing their routines and putting them in new settings different from those they are used to is an absolute disgrace. This unit is their home. I totally disagree with this move. I fell very passionately about it. We in Ireland pride ourselves on having an innate sense of nature. This is not nature. It is terrible. It would not happen in the Minister of State's own home town. This is a political decision and it can be reversed. I urge the Minister of State to deal with it as a priority.
Jim Daly (Cork South West, Fine Gael)
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I thank the Senator for the opportunity to clarify some of the facts surrounding this story. I heard the interview to which the Senator refers on local radio, I have read lot of the commentary and I have heard the views of many of the Senator's colleagues and public representatives on this issue. The HSE has confirmed that no decision has been taken to close the Rosalie unit. The focus of the executive over recent times has been, and remains, on meeting the needs and best interests of the current residents of the unit. The 2006 document, A Vision for Change, sets out a comprehensive policy framework for the development of mental health services. It broadly recommends a move away from the traditional institution-based model of care to a more patient-centred, flexible and community-based service, where the need for hospital admission is greatly reduced while still providing inpatient care as appropriate. This Government has prioritised the reform and resourcing of our mental health services in line with A Vision for Change.
On the recommendations in the report, staff and service users are represented on the review group that authored it. The HSE has advised that a consultant psychiatrist and the chair of the review group have also been appointed to oversee the implementation of the report's recommendations. The executive has advised me that capacity exists within the Creagh suite in Ballinasloe to accommodate psychiatry of later life patients who have complex continuing care needs. This is an approved centre under the Mental Health Act 2001, which has recently been extensively renovated and modernised to the highest standards. However, the executive has advised that there is no current proposal to move the residents to this facility. I convened a meeting with local public representatives and the HSE on 24 January last in Leinster House. A key outcome of this meeting was a commitment by the HSE to fully engage with residents and their families regarding the Rosalie unit. The chief officer of community health care organisation area 2 met residents and their families on 8 February. In addition, I had discussions yesterday evening in Galway with the HSE about the Rosalie unit and I will be visiting it on 27 February. In conjunction with the executive, I will continue to closely monitor the development of all community-based mental health services in the Galway-Roscommon area, including those provided at the Rosalie unit. The unit, part of Áras Naomh Chaolain, is located in Castlerea, County Roscommon. As the Senator is well aware, it is a continuing care facility for psychiatry of later life patients.
Keith Swanick (Fianna Fail)
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The Minister of State mentioned the 2006 policy document, A Vision for Change. He also mentioned that a move away from the traditional institution-based model of care is in train. This is not an institution. This is the residents' home. I have worked in St. Ita's Hospital and I have worked in psychiatry. I have worked in different units all over the country. This is the patients' home. Their families are used to visiting them there.To call this unit an institution is a misnomer and misleads the public. The Minister of State refers to A Vision for Change. At a public meeting held in Castlerea last week, Dr. Charles Byrne, a retired psychiatrist, said that the plan to close the unit violates A Vision for Change guidelines which stipulate that there should be 30 beds per 300,000 population. The population in Roscommon is aging and there are more than 2,000 patients in the Roscommon region with dementia. This is a callous act that violates people at their most vulnerable, because of their dementia and their cognitive impairment. These people have no voice and they probably have no vote, but I guarantee that their family and their supporters do and they will not be silenced on this issue. Nor will I. It is something about which I feel very passionate and I urge the Minister to ensure that this unit remains open.
Denis O'Donovan (Fianna Fail)
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The Minister of State has said that he will visit it and that there are no plans to close it.
Jim Daly (Cork South West, Fine Gael)
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I thank the Cathaoirleach; there are no plans to close it and I do plan to visit it.
Keith Swanick (Fianna Fail)
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Despite everything else.
Jim Daly (Cork South West, Fine Gael)
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I will clarify some things for the Senator in the interest of being helpful. The decision not to admit any further patients to this unit was a clinical decision taken by those practising in the area. It was not taken by HSE management or by a politician, whether it was myself or my predecessor. The admissions stopped.
Keith Swanick (Fianna Fail)
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It was taken to silence the advocates for the patients. That is why it was taken.
Denis O'Donovan (Fianna Fail)
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The Senator has had his chance. It may be the case that never the twain will meet. Perhaps when the Minister of State visits it, Senator Swanick might meet him there.
Keith Swanick (Fianna Fail)
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I would be delighted to meet the Minister of State that day.
Jim Daly (Cork South West, Fine Gael)
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I want to clarify a point that is important for the record of the House. The admissions were stopped on the basis of clinical best practice and by practising clinicians.
Keith Swanick (Fianna Fail)
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That was convenient at the time.
Jim Daly (Cork South West, Fine Gael)
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I have no problem coming in here to answer questions but the Senator will have to listen to my replies.
Denis O'Donovan (Fianna Fail)
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Allow the Minister of State to answer the question.
Jim Daly (Cork South West, Fine Gael)
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The Senator will have to listen, this is a two-way process. The commitment I want to give to the House, to the Senator and others who are concerned about this, is that my top priority is the residents of the Rosalie unit. It will not be a politician that will dictate the future of that unit or these people, or any HSE management, it will be dictated by clinical best guidance and what is in the best interests of these patients and the residents of the Rosalie unit. That is what I will be guided by, not politics or HSE management. I will take the best clinical advice and ensure their rights are protected and upheld.
Denis O'Donovan (Fianna Fail)
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Senator Swanick feels very passionately about this matter in his home town or village. It might be helpful if he meets the Minister of State when he visits on 27 February.
I know there is a lot of passion involved but the Minister of State has to respond.