asked the Minister for Health the number of mentally handicapped persons, adults and children, who are on waiting lists for residential care in the administrative area of the North-Western Health Board.
Ceisteanna — Questions. Oral Answers. - Mentally Handicapped Persons.
8.
There are 46 mentally handicapped persons, 30 adults and 16 children on the waiting list for residential care which is maintained by the North-Western Health Board.
What plans has the Minister to deal with that problem? I am sure the Minister is aware that the provision of residential care, particularly for the adult mentally handicapped, is serious. It is a situation existing throughout the health board areas and I should like to know if the Minister has any plans to deal with it.
As the Deputy may be aware, in 1977 the health board put forward a proposal to the Department which involved the decentralisation of the facilities at St. Joseph's Hospital in Stranorlar, following which the building would be used as a residential centre for 100 to 150 adult mentally handicapped persons. Then the proposal to use St. Joseph's for mentally handicapped was accepted in principle by the Department depending on the progress that could be made with proposals for the provision of places for the elderly who were being accommodated elsewhere. Last December I gave approval for 15 posts to enable the first phase of the accommodation of the mentally handicapped to be commissioned. It is envisaged in relation to St. Joseph's that 26 residential places will be provided. It is intended that the initial intake of 11 persons will be from the community, thus reducing the number on the waiting list. A further 15 adults will be admitted from St. Conal's Psychiatric Hospital in Letterkenny, or from residential centres outside the region. I think the health board are making progress in relation to the 46 mentally handicapped persons.
How many new beds are being created?
Twenty-six residential places will be provided. The initial intake will be 11 from the community and a further 15 adults will be transferred from St. Conal's in Letterkenny. That would take up the 26. At the moment there are 30 adults and 16 children on the waiting list for residential care.
Are they in the community?
Yes, they would be in serious need.
Why is it necessary to give so many beds to people already in residential care? The priority must be those who are waiting in the community. Anybody who has seen those people in the community will appreciate the difficulty of looking after some of them and recognise that the problem is in the community and not in regard to those in residential care. Fewer than half of those going to this new unit are from the community.
There has been a very difficult situation in Donegal because up to now there have not been any special residential facilities for the adult mentally handicapped there. Traditionally, the adult mentally handicapped from County Donegal were placed in St. Conal's. One will appreciate the necessity for transfers from St. Conal's to St. Joseph's.
While I appreciate that ideally the patients from St. Conal's should be transferred to a unit specially for the handicapped, would the Minister not consider that priority must be given to those in the community who are not, and never have been, in residential care? Because of this further development it will be possible to transfer patients from St. Conal's. Those in the community who need residential care should be given priority, but the Minister tells us they will not get even 50 per cent of the places.
I agree they should be given priority, but the Deputy will share my view that it is intrinsically undesirable to have mentally handicapped persons in psychiatric hospitals. The advice we have been given says that 15 patients should be transferred to the new facility, although admittedly that will leave a substantial number in the community awaiting care.
A final supplementary. We must go to the next question.
The Minister suggested that I shared his view, but I do not.
That is a debate.
There are approximately 70 patients in need of residential care in a unit for mentally handicapped and 25 are in St. Conal's.
A question please, Deputy.
I ask the Minister to ensure that all the places go to the people in the community because they should be given priority.
I will carefully investigate the situation again and ask the chief executive officer of the health board for his views. At the moment the ground floor space has become available in St. Joseph's for the mentally handicapped. I will communicate with the Deputy.
9.
asked the Minister for Health the number of community care nurses employed by the North Western Health Board who are available to give advice in the homes of persons where mentally handicapped adults or children are resident; if he considers that the number available is adequate or satisfactory; and, if not, the number of nurses that would reasonably be required for this purpose.
The North Western Health Board have appointed two public health nurses to provide a counselling service to parents of mentally handicapped children in the Donegal and Sligo-Leitrim areas.
In addition, as part of their general duties, the board's public health nurses would be expected to be involved to a certain extent in counselling the families of disabled persons, including the mentally handicapped. The board are currently considering further training of community care staffs in the field of mental handicap. Services for mentally handicapped persons provided by the board and local voluntary organisations also give advice to the families of the mentally handicapped.
In general, the services available appear to be adequate, but I will be keeping the matter under review.
The Minister stated there are two nurses covering the whole of the North Western Health Board area.
The North Western Health Board have appointed two public health nurses to provide counselling services.
For such a large area two nurses appear to be inadequate. The Minister might consider giving special training to the existing public health nurses so that they, as residents of the community, would be in a position to counsel parents of handicapped children.
I have been very impressed by the efforts of this health board. They have indicated that they have availed of, and intend to develop, further training courses in the field of mental handicap for their community care staff. If the recruitment embargo was lifted — and it will not — they probably would consider appointing more nurses for counselling work.