Vol. 382 No. 1
asked the Minister for Health if he will make public any and all reports available to his Department into the physical conditions in our psychiatric hospitals; and in particular if he will provide increased funding for essential improvements in emergency cases, including the case of Our Lady's Hospital in Cork; and if he will make a statement on the matter.
15.
asked the Minister for Health the steps which are being taken by management to ensure that present standards of hygiene and patient motivation are improved at Our Lady's Hospital, Cork.
25.
asked the Minister for Health if his attention has been drawn to the public concern at the seriously substandard conditions at Our Lady's Psychiatric Hospital, Cork disclosed in the report of the Inspector of Psychiatric Hospitals; the measures, if any, he intends to take as a result of this report and to ensure that conditions are brought up to an acceptable level; and if he will make a statement on the matter.
28.
asked the Minister for Health if he will make funds avialable to finance the implementation of the Planning for the Future document on the psychiatric services submitted to his Department in 1986 by the Southern Health Board.
30.
asked the Minister for Health if he has satisfied himself that the standard of patient care will be enhanced by the implementation of the rationalisation plans for Our Lady's Hospital, Cork.
54.
asked the Minister for Health if he will outline his proposals following the report of the Inspector of Psychiatric Hospitals on Our Lady's Hospital in Cork; and if he will make a statement on the matter.
I propose to take Questions Nos. 10, 15, 25, 28, 30 and priority Question No. 54 together. A major part of the statutory duties of the inspector of mental hospitals is the formal annual inspection of each district mental hospital following which he is required to submit a report to me. The present inspector, who was appointed last autumn, has submitted a number of reports. I will arrange for a report in respect of 1988, his first full year in office, to be published as soon as possible after the end of the year.
Earlier this year the inspector formally inspected Our Lady's Psychiatric Hospital in Cork and submitted a report on his findings to me. I had detailed discussions on that report with senior officers of my Department, including the inspector.
The management of psychiatric services, including Our Lady's Psychiatric Hospital, Cork, is a statutory function of the Southern Health Board. A copy of the inspector's report was sent to the board. Subsequently copies were circulated to the members of the psychiatric services committee of the board. Copies of the relevent extracts were sent to the clinical directors.
I received a response from the chief executive officer of the board. Subsequently, on 2 June, I met the chairman and the chief executive officer of the board. In the course of this discussion the CEO outlined the actions he proposed to take to deal with the problems raised in the inspector's report. These included the closure of the main block of Our Lady's Hospital, known as the Grey Building, and the transfer of patients at present accommodated there to better and more suitable accommodation. In addition, he proposed to improve standards of hygiene and to promote patient activation throughout the hospital. I was satisfied that the action proposed by the chief executive officer would result in greatly improved patient care at Our Lady's Psychiatric Hospital and help towards the development of a better psychiatric service in the Cork area generally.
The chief executive officer put his proposals to the board at their meeting on 7 June. I am glad to record that they were supported by the board. I look forward now to the speedy implementation of these proposals. My Department will maintain regular contact with the chief executive officer during the implementation process. I have already assured him of my support in the task he has now undertaken.
I am sure the Minister is aware of the appalling conditions obtaining at Our Lady's Psychiatric Hospital in Cork in relation to which steps are now being taken by the Southern Health Board to improve matters. Will any additional funds be provided by the Department of Health — it is unfortunate that the Southern Health Board are selling property in order to provide funds — to lead to the implementation of the Planning for the Future policy in relation to the psychiatric services which is very necessary? Would the Minister agree that the recently published detailed discussions and contacts with the Southern Health board would appear to have been inadequate? I would contend that additional funds are necessary at this stage. Will the Minister say whether such additional funds will be provided in the current year?
I do not accept that additional funds are necessary at this stage. The budget for the psychiatric hospital in Cork is £10 million. Within that budget of £10 million it is possible to effect a number of improvements recommended by the inspector of mental hospitals.
Would the Minister agree that, while it is fine for him to say he will support the proposals recommended by the chief executive officer, in not allocating one penny to the alleviation of conditions there that are Dickensian and described as a hell hole in Our Lady's Psychiatric Hospital in Cork, such support amounts to lip service only? As a result of the agreement reached between the chief executive officer, the Southern Health Board and the Minister, will the Minister say whether the implementation of the policy contained in Planning for the Future in relation to the psychiatric services in the Southern Health Board region is being shelved since the new plan agreed appears to be the blueprint for the future? Furthermore, would the Minister say what, if anything, he has been doing by way of committing moneys for this purpose. For example, there was a commitment given of £5 million over a nine-year period in the document entitled Planning for the Future. Has that gone by the board now? Has the Minister washed his hands of that plan?
No; in fact I fully support the plan. I might say that the chairman and chief executive officer of the Southern Health Board intimated to me that they had a plan in course of preparation to improve the conditions of the psychiatric services in Cork. Our Lady's Psychiatric Hospital is one of the largest psychiatric hospitals in the country catering for up to 900 patients. In the short term it is necessary to place these patients in suitable accommodation. In the longer term, and in keeping with Planning for the Future, the idea is to reactivate as many patients as possible and have them placed in the community.
I am very glad to learn that the Minister has taken this situation in hand because there is a long-standing history of neglect at this hospital. I might ask the Minister two brief supplementaries in relation to standards of hygiene and patient activation. What mechanism has been put in place to ensure that progress will be made, and monitored regularly, in relation to the urgent need to improve the standard of hygiene and of patient activation? Would the Minister accept that, in relation to making transfers and changes, perhaps the objectives he has in mind would best be served if such transfers and changes were effected not alone in terms of patients but also in tems of management at that hospital?
The immediate step proposed is the working out of a detailed plan with clearly-defined objectives with a specified time schedule for its implementation. To facilitate these arrangements and in order to proceed with the immediate implementation, a designated officer of the board will be assigned full time responsibility for this project. In the meantime, a number of the issues referred to by Deputy Quill — such as hygiene, nursing arrangements and patient activation — will be pursued immediately by the responsible programme manager. There will be a detailed inspection carried out of every ward by the programme manager, the clinical director and the relevant chief nursing officer and a detailed report prepared on each ward.
In regard to the document entitled Planning for the Future in respect of the existing general psychiatric services within the Southern Health Board area, is the Minister aware that psychiatric community nurses are currently curtailing their activities on account of cutbacks in their allowances that, whereas they used to travel and visit patients three or four days weekly, they now curtail such visits to approximately two days weekly, thus gravely reducing the services available to such patients back in the community in the course of rehabilitation? Would the Minister examine the position and, if possible, arrange to have their allowances increased?
How the Southern Health board utilise the time of their staff is primarily a matter for them. I am concerned that each of the health boards — and there tends to be a different response on the part of each of them — should implement the proposals in the document Planning for the Future on the psychiatric services.
How does the Minister expect the Southern Health Board to renovate Sarsfield's Court unit which will accommodate some patients taken out of what is known as the Grey Building? Furthermore, how does he expect the Southern Health Board to provide residential units, especially in view of the fact that the psychiatric services in the Southern Health Board region at present are already operating above their budget allocation for this year? Also in relation to the lack of hygiene and the dirt prevailing in certain parts of Our Lady's Psychiatric Hospital, will the Minister take any disciplinary action against the management who are responsible and accountable for the maintenance of standards in our hospitals because obviously they have not been doing their job in this case?
I am satisfied that a lot of progress can be made within the existing budget of £10 million. Having spoken to the chairman and chief executive officer of the Southern Health Board I am also satisfied that the management are fully committed to dealing with the position obtaining at Our Lady's Psychiatric Hospital.
Will the Minister make any money at all available, even one penny, towards the funding of the proposals contained in Planning for the Future, which document has been with the Department of Health since 1986 and without whose implementation all our words become meaningless? Will the Minister apply even one penny to the implementation of that policy?
I am satisfied that in each of the health board areas certain progress has been made at different levels within the allocation that has been provided for each of the health boards.
