Deputy Seán Ryan gave notice of this intention to raise a matter with reference to the designation of certain units at St. Ita's Hospital, Portrane, County Dublin.
Adjournment Debate. - Portrane (Dublin) Hospital.
Thank you for the opportunity to raise this serious matter. The following motion will be discussed at a full meeting of the Eastern Health Board tomorrow:
That the de-designation of areas of St. Ita's Hospital, as appropriate, be proceeded with as early as possible.
The staff of the hospital and the parents and friends of the mentally handicapped are totally opposed to this very vague motion which is being rushed through without proper consultation and agreement with the parties involved. In the reply to a question which I received earlier today, the Minister stated that negotiations are ongoing with the staff. That may be so, but prior to this week the last discussions took place on 24 July 1989. It is proposed to push through this motion tomorrow night.
The staff have concerns. They are talking about promotion opportunities, the status of temporary staff, further employees and whether they will be officers of the Eastern Health Board. These are valid concerns.
The patients of St. Ita's are at present covered by the 1945 Mental Treatment Act. If the current proposals go through the authorities will have no power to detain a patient should they feel it is in that patient's interest. This is a matter which concerns me. Under the same Act the health boards are obliged to provide professional care. What assurance can the relatives be given that this will be the case when the changes come into operation? The Minister should guarantee that professional service will be provided.
There is also a problem in relation to superannuation. Under the current proposals nurses who are redeployed arising from reorganisation of the psychiatric services will be permitted to retain superannuation rights on a personal basis. This is totally unsatisfactory for staff who will be expected to operate under the new arrangement.
De-designation requires amended legislation which would incorporate a Bill of rights for patients and staff. These proposals should be shelved pending such legislation.
There is an urgent need for a school of nursing. Given the major developments proposed, I recommend that this be located at St. Ita's. I would urge the Minister to provide the necessary finance. There has been a lack of maintenance at St. Ita's and certain parts of it are run down. The Minister must ensure that the necessary facilities are provided to enable An Bord Altranais to locate the school at St. Ita's.
This is a very sensitive proposal which will have far-reaching implications for staff and patients alike and should this motion be passed tomorrow by the Eastern Health Board I would ask the Minister not to sign the order until full and detailed negotiations are concluded with all the relevant parties to the satisfaction of all concerned. It is a most urgent development and we must get a proper solution.
I assure Deputy Ryan that he need have no fears. There is a proposal before the Eastern Health Board to de-designate part of St. Ita's Hospital so that in future patients suffering from mental handicap will not be in the area controlled under the Mental Treatment Act, 1945. Deputy Ryan seems to think that is not in their interest, but all the expert advice I get in my Department and outside it and from parents and friends of patients with a mental handicap is that they do not want them in psychiatric hospitals or hospitals controlled by the Mental Treatment Act, 1945. The proposal is in keeping with the best expert advice and the wishes of the parents and friends of the mentally handicapped.
There is a number of elderly people in St. Ita's and the same thing will apply to them. They will have their own unit and special programmes will be organised for them in that unit.
I can assure the Deputy that a very high quality service is available to all patients in Portrane. Of course that will continue. He need have no fears that because they are not in areas of the hospital controlled by the Mental Treatment Act the level of service will be diminished. The whole point of the exercise is to ensure that they get the very best service and that the services develop in accordance with the most modern thinking in each area. I want to assure the Deputy that any changes implemented will come about in an organised and planned way.
Discussions have taken place already with staff representatives; I think they have met twice to date. Of course discussions will continue with the staff involved. Also, guidelines have been laid down by my Department which are available to the hospital. The approval of my Department must be sought for the changes taking place. Of course, I support any change the prime objective of which is the interest of the patient. I believe that what is proposed, or that these particular changes will be in the interests of the patient.
I should say that the inspector of mental hospitals will have a role to play. His advice will be sought and will be available. The Deputy has my assurance that the high quality of service will be maintained and that there will be the normal discussions with the staff involved about the proposed changes. At this stage it is purely a proposal that is going before the health board.