Mark Daly (Fianna Fail)
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I welcome the Minister of State at the Department of Health, Deputy Butler, to the House.

Tim Lombard (Fine Gael)
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I thank the Minister of State for coming to the House to discuss this matter. I ask for an update on a significant issue in Bantry at present relating to the mental health centre there, which is a very important part of the campus of Bantry General Hospital. A reduction of nearly 40% in beds in the acute wards is proposed. We are looking at a reduction from 18 to 11 beds. This is a very significant issue for the entire region. As the Minister of State is very much aware, given her west Cork roots, Bantry hospital is in the centre of the three peninsulas there. It covers a massive geographical area. The need for this acute unit to be fully operational is very much required. The proposal by the Mental Health Commission to reduce capacity from 18 to 11 beds, which is a 40% reduction, would have a major impact on the ability to have an appropriate mental health centre based in this part of west Cork. In many ways, it is a bizarre situation that there is a possibility that two arms of the State will go to court over this matter in the next few weeks. It is very unusual that the HSE could take the Mental Health Commission to the District Court to look for a stay of execution, if I can use that terminology, regarding this unit.

We need to see clarity on this issue. Will we have a scenario where, unfortunately, the HSE will go down the route of going to the District Court and engaging in a legal process with another arm of the State regarding the availability of acute mental beds in Bantry General Hospital? The long-term plan is also very important. What will be the long-term plan to deal with issues of personal space and the new model of care that is required? That is a major issue. Bantry General Hospital has seen significant developments over the past few years. The Taoiseach was there only a few weeks ago to open another unit. Significant sums, amounting to millions, have been spent there in capital investment. We now need to see a plan urgently put in place to cover this part of the campus.

I ask for clarity from the Minister of State regarding this part of the campus. What are the long-term plans for Bantry General Hospital in respect of the centre? We need to have 18 beds and appropriate personal space there. It is not appropriate that two arms of the State would go to court to fight over what should happen. There are a lot of questions. I hope I will get some answers from the Minister of State.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for raising this important matter. As some Members will be aware, the Mental Health Commission has made the decision to put a restriction on the registration of the mental health care and recovery approved centre in Bantry General Hospital, given its concerns over the size of residents' bedrooms in the centre. I will touch on Bantry General Hospital. I visited it three or four months ago. It is the most fantastic facility. It is the most remote level 2 hospital in the whole country, serving a huge area of west Cork. I know west Cork very well; my father came from Drimoleague. I am very familiar with the area. On the day I visited the hospital, I was very impressed with the fact that it was an old-style hospital doing everything, including looking after older people and those with mental health issues across the whole sector. It is a very important facility in west Cork. I acknowledge the support that all Oireachtas Members have given to that facility over many years.

I have been aware since August that the Mental Health Commission was in consultation with the HSE regarding this particular situation. As the Senator said, this decision would mean the centre's total number of registered beds would reduce from 18 to 11. That is a massive reduction in bed capacity. The centre, which is located on the grounds of Bantry General Hospital, provides residents with acute care - it is important to note that it is acute care - rehabilitation and recovery supports for their mental health difficulties. It serves the local west Cork area, including areas around Skibbereen, Clonakilty, Bantry and beyond.

The HSE advised me last Friday afternoon of its intention to appeal the Mental Health Commission decision to put a restriction on the registration of the mental health care and recovery approved centre in Bantry General Hospital. As this is now a matter before the District Court, it would not be appropriate for me, as Minister of State, to discuss the specifics of this particular case, but I can speak to the issue more generally. I will continue to liaise with the HSE to ensure all decisions and actions taken in respect of the centre are made with the best interests of the residents in mind, both from a health and safety viewpoint and in the context of the provision of appropriate treatments.

Mental health remains a key priority for me and the Government, and we are fully committed to the delivery of high-quality, person-centred, recovery-oriented mental health services. Our long-term strategic aim for our mental health services is to provide a consistent, high-quality service for anyone in need of support for their mental health. It is our responsibility to ensure the provision of high-quality mental health services that are fit for purpose. The Government acknowledges that mental health services must constantly evolve and develop to ensure they are in line with international best practice and regulatory requirements.

The national community mental health operation office is working closely with community healthcare organisation, CHO, 4 regarding compliance issues, most of which, I must emphasise, are premises related. The issues relate not to care but to the premises. CHO 4 has a comprehensive capital plan to accelerate the development of new inpatient units, and the national office is working with it to secure funding in this respect.

My understanding is that the only avenue for the HSE was to appeal the Mental Health Commission's decision to the District Court. The HSE maintains that it cannot afford to reduce the number of beds and notes that, in the context of regulation 22, there are no specifics with regard to the size of bedrooms. The HSE believes the imposition of the condition could have broader implications for many other approved centres in that particular CHO area and within CHO areas nationally.

That is the current situation. At present, there is capacity for 18 residents in the centre. As I have said, many of the patients have acute and enduring mental illnesses. The centre is their home from home. Therefore, it is very important that we, and I, as Minister of State, make sure that there is capacity in specific areas for mental illness.

Tim Lombard (Fine Gael)
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The Minister of State makes a very interesting point about the knock-on implications of this judgment. The judgment could be the catalyst for a complete change in capacity across the entire sector and the country. It is a massive issue for us. It is a real worry now that, because of the decision of the Mental Health Commission, there could be a reduction in acute care across the country.

On the issue of going to court, it is bizarre that two agencies of the State are taking the legal route. I would still hope that communications can continue between the HSE and the commission, so that they do not actually have to go to court to resolve the issue. There must be a meeting of minds in order that we might come up with a solution, if possible. The long-term issue of what is to be done with the unit in Bantry is still a worry for me. We have seen significant investment in Bantry. As the Minister of State said, it is a wonderful unit. We need to put a capital plan in place. Perhaps the Minister of State could elaborate, either today or at a later date, on how we can get money to invest in the campus.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for the way he has addressed this issue. I am conscious that the centre is home for many of the residents in Bantry. As I have said, in CHO 4 the chief officer and the area lead for mental health have put in place a comprehensive plan, which I have seen, in relation to capital projects across counties Cork and Kerry. That is the first point. The plan is being given consideration by the health business services estates.

The second point is that this relates to the national implementation and monitoring committee, which I put in place after Sharing the Vision was launched two years ago by my predecessor, the former Minister of State and Deputy, Jim Daly. One of the conditions of Sharing the Vision was that there would be a national implementation and monitoring committee to ensure that we are all doing our jobs. One of the first things I asked the committee to do was conduct a bed capacity review of mental health beds across the country, because it is really important to know what challenges we are facing in specific areas. That work is under way. I look forward to having that report.

I guarantee that this issue is very high on my agenda. It is extremely important that there is communication between the HSE and the Mental Health Commission. That communication will continue. The last thing I want so see is a court case, but at the same time I have to be very conscious that to lose seven beds in that particular hospital would have a detrimental impact on residents in the area, and also could have a knock-on effect elsewhere. I, as Minister of State, must ensure that we have capacity for these people who have mental illnesses and enduring mental health difficulties. They need the support of the State.