Vol. 357 No. 7
asked the Minister for Health whether he is satisfied that there is a sufficient and independent system of review of practices within psychiatric hospitals to ensure that proper standards of hygiene, personal cleanliness of patients and morale of hospital staff and patients are maintained.
14.
asked the Minister for Health whether he is aware of a report in a newspaper (details supplied) alleging that an adviser to his own Department, commissioned by the Eastern Health Board, had reported on a named County Dublin psychiatric hospital and that this report had been kept secret for over two years; and if he will make a statement on the matter.
15.
asked the Minister for Health if he will make a statement on a report in the media (details supplied) on St. Ita's Hospital, Portrane, County Dublin.
16.
asked the Minister for Health whether he is aware of allegations in a report in a newspaper (details supplied) that in a named County Dublin psychiatric hospital: (a) psychological violence towards patients occurred through use of excessive language, (b) some patients had been punched and deliberately locked in a room for so-called misbehaviour and (c) a small minority of staff were involved in degrading practices; whether there is any truth to these allegations; and if he will make a statement on the matter.
I propose to take Questions Nos. 13 to 16, inclusive, together.
I wonder if there is some mistake here. No. 13 bears no relevance to No. 14.
I understand that it is being taken with No. 14. The Chair has no control in this matter.
There are 22 district psychiatric hospitals and they are monitored in a number of ways: (a) Each hospital has a visiting committee comprised of members of the health board. They visit on a monthly basis and usually so organise their visits that they cover the whole hospital in a number of months; (b) The inspector of mental hospitals carries out statutory visits once a year to each hospital and in addition he visits the hospitals from time to time to deal with specific problems; (c) Administrative and technical officers of the Department in recent years have inspected and continue to inspect hospitals in great detail in connection with the programme of up-grading conditions at the hospitals.
In recent months I have visited a number of psychiatric hospitals and have seen for myself the improvements which have been brought about. These improvements have been very significant and in many instances quite remarkable. I am satisfied, therefore, that the present arrangements for monitoring standards and practices in the psychiatric hospitals are adequate.
I have read the newspaper report referred to and also the document on which that report is based.
A report on St. Ita's Hospital, Portrane, was sought by the Eastern Health Board in July 1980. The request for the report related mainly to a need for guidance on such general questions as nursing staff requirements and nurse training.
The document which was produced contained a number of allegations relating to certain actions by staff in the treatment of patients. It did not deal with the main purpose for which it was commissioned and in view of the unsubstantiated allegations which it contained it was not released to the health board. No evidence was produced to support the allegations contained in the document and the available evidence did not support them.
The document did, in fact, contain criticism of the condition of certain parts of the hospital. However, the action which was being taken before the document was produced, and has since continued, has led to considerable improvement in conditions in the hospital, particularly in relation to areas occupied by patients. Almost £1.2 million was spent on up-grading the male and female long stay blocks since 1977. In addition, £1.3 million has been spent on other improvements in the hospital and in the current year about £0.5 million will be spent on up-grading wards and corridors.
I am surprised to hear what the Minister has to say about this report. Whatever about some complaints which he says were not substantiated, can he confirm that the report contained recommendations and that while its author acknowledged that improvements had taken place he considered himself obliged to report on certain matters he observed in the hospital? In respect of one ward he said,"Ward 4, female, is in our opinion a national scandal——"
It is not in order to quote at Question Time and neither is it in order to endeavour to debate a report.
Can the Minister confirm that the author of the report pointed out that the dirty appearance of some of the patients and the smell from their clothing was such as to constitute a major scandal and that apart from renovations that had taken place in recent times at the hospital, the condition in some wards, particularly female wards, were appalling and that these wards were unfit for human habitation? In these circumstances would the Minister not accept that the author of the report was very concerned in regard to his findings at the hospital and concluded his report by making certain recommendations and by making the appeal that some of the complaints he had made be dealt with immediately? He pointed out that the ward referred to remained open.
I stress that there was never a report as such. A certain document was produced in 1980.
The nursing profession report.
In 1980 a document was completed by a former staff member of the Department of Health which contained very serious allegations of physical and psychological violence towards patients and the absence of hygiene to which the Deputy referred. There were seven pages devoted to these alleged incidents and they were regarded so seriously by the Department that the officer in the Department was questioned at great length by members of the division in the Department. However, the more the officer was asked about the allegations, the more he withdrew his remarks and his alleged double checked assertions turned out to be unsubstantiated. There was not even one allegation on which action could be taken. I have examined the document in question and, to say the least of it, it was badly prepared, badly presented and did not address itself to the terms of reference. Its calibre was such that neither my predecessors nor I considered that we could release it as a document of consequence to the health board in question.
Could the Minister list the improvements carried out since 1982?
When history is written as to the priorities of different Ministers for Health it will be seen that St. Ita's suffered from a general lack of maintenance which affected nearly all psychiatric institutions. However, since 1977 a sum of £2½ million has been spent in upgrading patient accommodation in St. Ita's. Since I came to office, a very substantial amount of money has been spent — a sum of £500,000 has been spent this year — and the dormitories, day rooms and sanitary facilities are greatly improved, some to a very good standard. I know the hospital well as I have been connected with it as a trade union official since 1957. The long corridors badly need to be upgarded and work on these has begun. There has been a considerable improvement in the general physical standards of the hospital and any Deputy is welcome to visit it. I am very concerned that a former officer of the Department of Health with professional competence should have made allegations of this nature and seen fit to release them to a national newspaper. I can only speculate on the reasons for doing so.
In view of what the Minister said about the author of the report, would he indicate if he considers that the report was based on malicious intentions or whether, as the Minister suggested, it was misguided for some other reason? I should also like the Minister to let us know if the Eastern Health Board were informed at any stage over the three years when the report was a secret why the Department of Health refused to publish the report? Would he also indicate if he is aware that there is concern regarding the fact that the report was not published and that reasons were not given?
It is clear that documents of this nature can have a profound effect on the morale of hospital staff. I will never tolerate neglect or failure on the part of any officer in the Department, in health boards or staff in any hospital and I am ruthless in that regard. However, the staff of St. Ita's deserve the best from us in terms of maintaining their morale and protecting their fundamental rights as staff officers. In relation to the 1980 report, the staff were questioned in considerable detail regarding the allegations contained in it and they categorically denied those allegations. They recently met officers of the Department and again refuted the allegations made. Indeed, this document does not deserve the status of a report; it was a series of strung together observations. It was an internal document of so little consequence that, departmentally, it did not have the status of a report. Normally, a report is kept on file having been processed rigorously by officers in the Department. Unfortunately, that kind of press publicity discourages potentially outstanding staff from applying for posts in hospitals and has a disastrous impact on the morale of staff. Reporters, members of RTE and Deputies are welcome to visit any part of any hospital and I will facilitate them in that regard on condition that the privacy of patients is protected. Their rights as residents in the hospitals must also be protected and given due respect. I never cease to be amazed at the number of people who make allegations and write reports although they have never been in a psychiatric ward in their life.
