Deputy Proinsias De Rossa gave me notice of his intention to raise on the Adjournment the circumstances of the death of a person in the Hospital of the Assumption, Thurles, County Tipperary.
Adjournment Debate. - Thurles Hospital Death.
I want to thank you, Sir, for the opportunity to raise this matter today on the Adjournment. I consider it an important issue which needs to be raised and dealt with at the earliest possible opportunity. I had Question No. 248 for written reply down to the Minister for Health yesterday in which I sought information about the investigations which had been carried out into the circumstances of the death of a Mr. John Broderick who died, apparently, in the casual ward of the Hospital of the Assumption, Thurles, County Tipperary on 3 June 1988. I asked what the findings were of any investigation that had taken place. I asked whether the casual unit was a locked ward and, if so, the period for which it was locked, if there was any system which allowed residents to attract outside attention in the event of anyone becoming ill or the outbreak of fire, and if the Minister's attention had been drawn to reports that other residents attempted to attract medical attention for the person when he became ill but were unable to do so.
I have asked for a debate on the Adjournment on this issue because I regard the Minister's reply as totally inadequate. The Minister replied that the matter had been fully investigated by the Mid-Western Health Board in conjunction with the staff of the Hospital of the Assumption, that the patient in question was treated in the hospital itself on a number of occasions and had discharged himself against medical advice some 24 hours before his death, that medical opinion indicated that because of the seriousness of his illness he could have died at any time that the casual unit in the hospital was not a medical facility, and the unit was inspected regularly by a night attendant during the night of Mr. Broderick's death. Its purpose was to provide overnight accommodation for homeless men and the board officials were satisfied that the conditions in the casual unit were not a factor in the patient's death. Nevertheless they felt that in the light of this sad incident it was necessary to carry out a full review of the arrangements for homeless people in the area. Accordingly, they have asked the Simon Community in Galway and local voluntary organisations to forward proposals concerning the provision of appropriate alternative accommodation for the homeless in Thurles.
Clearly, that does not deal with the very pertinent question I asked with regard to the circumstances surrounding the death of Mr. Broderick. Mr. Broderick was 63 years of age. He had spent most of his life in England working as a coalminer. In 1962 he contracted TB and spent two years in hospital in Cambridge and had a lung removed. He was known quite well to the Simon Community in Galway as a homeless person.
Rumours reached the Simon Community about his death some time after June to the effect that the ward he had died in had been locked and no one had been able to get medical care for him. The fact is this unit, as the Minister says, is not a medical unit; nevertheless it is in the grounds of the hospital. Access to the unit or permission to go into the unit and stay in it overnight is got by approaching the porter in the porter's gate lodge. My information is that it is locked from the outside at night. It is checked — I should say was checked because the unit is now closed — at 2 a.m. and 7 p.m. and there are no facilities at all for summoning help if a person were to become ill or if a fire occurred, and on the night Mr. Broderick died the other inmates — that is the title which best describes the unfortunate people who had to stay in this unit because they were locked up — made efforts to attract attention by banging on the windows and shouting they could not get out of the building.
The Minister says the conditions under which Mr. Broderick was kept did not contribute to his death. The Minister may well be right, I do not know, but if the man was a relative of mine I would be demanding to know why homeless men were kept in those conditions. The Mid-Western Health Board indicate that they do not have the resources to provide supervision for that unit, they do not have the resources to provide the kind of fire precautions, protection or other facilities necessary to enable people staying in the unit overnight to contact anybody in the main building. It seems there is a serious dereliction of duty somewhere along the line in relation to how homeless men were being treated in this unit.
Senator Brendan Ryan attempted to get information on this matter over a period of months. Quite rightly, he avoided bringing the matter to public attention in so far as he could in order to allow investigations to take their normal course. According to my record, on 16 July the Simon Community called to the hospital to make preliminary inquiries. On 28 September Senator Brendan Ryan wrote to the Minister about the matter. On 11 October the Simon Community wrote to the Mid-Western Health Board regarding the safety aspects of the unit. On 12 October 1988 Senator Brendan Ryan got an acknowledgement from the Minister. On 14 November 1988 the health board replied to the Simon Community asking whether they had any suggestions about how facilities could be provided for homeless people in the area. On 17 November 1988 Senator Brendan Ryan again wrote to the Minister as he had received no reply from him other than an acknowledgement. On 25 November 1988 the Simon Community wrote back to the health board pointing out that they were prepared to help in whatever way they could in relation to homeless people but primarily responsibility for homeless persons was a matter for statutory bodies in the area. On 24 November 1988 Senator Brendan Ryan again received an acknowledgement of his inquiry. This was five months after the death of Mr. John Broderick, but still no information as to what was going on. On 2 December 1988 Senator Brendan Ryan wrote to me and a number of other Deputies seeking to have the matter raised in this House.
Clearly, a fairly responsible attitude was adopted by the Simon Community and Senator Brendan Ryan in relation to this matter. They attempted to deal with it in a responsible way and to ensure that any investigations about what may or may not have happened would take place without the hype of publicity. Still, it was not until January 1989 that Senator Brendan Ryan received a reply from the Minister which, again, was very poor in regard to the information provided. It was dated 12 January 1989 and it read:
Dear Brendan
You were in touch with me recently requesting information on the circumstances surrounding the death of Mr. John Broderick in the Casual Unit at the Hospital of the Assumption, Thurles, last June. The Mid-Western Health Board were asked to make inquiries into this matter.
Following detailed consultations with the staff at the Hospital of the Assumption, the board are quite satisfied that conditions in the casual unit did not have any bearing on Mr. Broderick's death. The medical report indicated that Mr. Broderick's chest condition was so severe that he could have died at any time.
The current position in relation to the casual unit is that following discussions with the staff of the hospital the health board have decided to close the unit until further notice. The Simon Community in Galway have been invited to submit proposals to the board regarding alternative, more suitable accommodation for the homeless in Thurles.
That letter begs all types of questions but the most important one is, why it has taken so long to carry out an investigation into this matter. Why do the Minister and others, too, appear reluctant to admit that the ward was actually locked and that nobody could get out of it while this man was dying? What steps have been taken to provide alternative accommodation for homeless men in that area? Are there any other casual units or casual wards around the country that are locked at night? Why was this unit locked at night? Why should homeless men be treated in this way? What guidelines do the Department and the health boards apply to the operation of such units around the country? What has happened to the Homeless Persons Bill? Where are the guidelines for health authorities in regard to dealing with homeless persons in their areas? Those questions arise from this unfortunate case. It is unfortunate that the answers will not bring Mr. Broderick back but, nevertheless, arising out of this incident we should ensure that the conditions under which homeless men have to live will be improved. We should not tolerate the locking of places where such people stay so that they do not have any opportunity to make contact with the outside world. These are important issues and I hope the Minister, in the course of his reply, will treat them as such.
I fully appreciate Deputy De Rossa's concern in raising this matter. As he correctly points out we were awaiting a report from the Mid-Western Health Board within whose region the incident occurred. When Senator Ryan wrote to me I did not have that information readily available. Obviously, we had to pursue this matter through the normal channels. Following their investigation into this man's death and following detailed consultation with the staff of the Hospital of the Assumption in Thurles, the board have forwarded their report to me. As Deputy De Rossa pointed out, the person in question was a regular visitor to the hospital over the years. His last admission was on 26 May 1988 under the care of the medical officer. He was anointed on 31 May. On 1 June however, he discharged himself against medical advice and he turned up the following night at the casual unit which is in the hospital grounds. The unit was checked at regular intervals by the night watchman and all seemed to be in order. Unfortunately, when breakfast was being served on the morning of 3 June it was discovered that this man had just died.
I should say that the medical report indicates that his condition was serious and that he could have died at any stage. I understand from the board's report that the homeless people who have attended the casual unit in Thurles in the past have always been treated in a most caring manner. Access has been allowed in some instances up to the early hours of the morning. In the circumstances I am satisfied that conditions in the unit did not have a bearing on this person's death. I should say that this sad incident raised some fundamental questions about the continuation of this service on the hospital site. Moreover, the board's officials consider in the light of their investigation that the location and the structure of the particular building were not satisfactory. As a result of these inquiries the board decided to close the casual unit at Thurles. Since then discussions have been initiated with the Simon Community in Galway, as Deputy De Rossa pointed out, and with local voluntary groups who were invited to submit proposals to the board on this issue so that alternative, and more suitable arrangements, if necessary, can be made for accommodating homeless people in the Thurles area.
The points raised by Deputy De Rossa this evening in regard to other casual units around the country and whether persons are locked into them will be checked out. I am sure Deputy De Rossa will accept that the board's approach to this matter was a sensible one. I am hopeful that their discussions with the Simon Community will help to bring about a solution to what is a difficult problem.
May I ask a question?
Tá an Dáil ar athló go dtí 2.30 p.m. Dé Mairt seo chugainn.
It is not normal practice to allow a Member ask a question?
The Dáil stands adjourned until 2.30 p.m. on Tuesday next.
The Dáil adjourned at 5.15 p.m. until 2.30 p.m. on Tuesday, 31 January 1989.