Tom Moffatt
Question:20 Dr. Moffatt asked the Minister for Health the number of mentally handicapped patients in psychiatric hospitals; and the steps, if any, he is taking to remedy the situation. [18206/95]
Ceisteanna—Questions. Oral Answers. - Mentally Handicapped Patient Statistics.
Many persons with a mental handicap were admitted in the past to psychiatric hospitals who would not be admitted to such hospitals today. It has been the policy of my Department for some 15 years that persons with a mental handicap should not be admitted to psychiatric hospitals unless they have an underlying psychiatric disorder which cannot be appropriately treated elsewhere. The report of the Review Group on Mental Handicap Services Needs and Abilities, 1991, endorsed this policy and recommended that an assessment be carried out of the circumstances and needs of each person with a mental handicap in the psychiatric hospitals. If the assessment indicated that the person with a mental handicap no longer needed care in a psychiatric setting, the report recommended that he or she should transfer to a mental handicap service.
The latest statistics available indicate that there were 915 persons with a mental handicap accommodated in public psychiatric hospitals on 31 December 1994. This compares with 2,170 persons in 1981. My Department, in conjunction with the health boards, has been engaged in a programme to transfer persons with a mental handicap from phychiatric hospitals and other unsuitable placements to more appropriate care settings.
In 1994, additional funding of £785,000 revenue and £1.16 million capital was provided to transfer over 150 persons with a mental handicap from unsuitable settings. Over 120 of these had been resident in psychiatric hospitals. Included in this funding was £121,000 to assist with the extra revenue costs associated with the transfer of 30 persons with a mental handicap from St. Finan's Hospital, Killarney, to purpose build residential and day facilities in Killarney. Planning permission has recently been received for this development and building work will commence shortly.
In 1995, additional funding amounting to £600,000 revenue and £1.195 million capital has been provided to facilitate the transfer of 64 persons with a mental handicap from inappropriate care settings of whom 36 persons are currently accommodated in psychiatric hospitals. Included in the capital funding is an initial allocation towards the cost of providing purpose built residential and day facilities for a further 36 persons with a mental handicap from St. Joseph's Hospital, Limerick. Discussions on this project are currently taking place with the Mid-Western Health Board.
Where persons with a mental handicap continue to be cared for in psychiatric hospitals, health boards are encouraged to care for them in separate accommodation and to develop programmes of activity suited to their needs. The reduction in the number of persons with a mental handicap in psychiatric hospitals has enabled hospital management to increase the staff-client ratio and to reduce the numbers accommodated in the various units to the benefit of the remaining clients.
I am committed to continuing the programme of transfers of persons with a mental handicap from psychiatric hospitals to more appropriate settings as resources permit.
There is a perception that not enough is being done for the mentally handicapped, that they are second class citizens in receipt of second class treatment from the health boards and the Department of Health.
Although the numbers have decreased in the past 15 years there are still more than 900 persons with a mental handicap in psychiatric hospitals, some of whom should be transferred to more appropriate settings in the community. This does not augur well for the success of the programme.
If sufficient resources were available, we would like to see all the persons concerned removed immediately, if possible, from their present settings. The policy pursued by the Department for the past 15 years was endorsed by the report Needs and Abilities. Money is not always the first obstacle to be overcome, it depends on the number of persons in a particular setting to be transferred. Other factors, such as capital funding, the appropriate location for the persons concerned and staffing requirements, have to be taken into consideration. Much has been achieved, which is not to minimise the problem confronting us. During the summer I visited a number of settings. This year under the programme of transfers 100 persons in a number of health boards areas will be transferred. I would like to see this problem resolved, but we have to operate within the available resources.
Despite what the Minister of State said problems are still being encountered. If it was any other sector but the mentally handicapped, the matter would have been dealt with more expeditiously. A number of severely handicapped persons are still being accommodated in inappropriate psychiatric units. Little progress has been made in placing these patients in on campus special units where they would receive a high standard of care. Will special funding be made available in the forthcoming budget? I am alluding especially to the position which prevails at St. Ita's, Portrane, where the patients are not getting a fair deal. This is disgraceful.
I disagree with the Deputy's final comment although I agree that St. Ita's is an appropriate setting. When I visited the hospital during the summer I was greatly impressed by the standard of care provided by the staff in difficult circumstances. This year £560,000 has been provided to place 24 persons at present in ward K in more appropriate settings. The numbers are high — this should not deter us — but we have to operate within the available resources. In this context worthwhile progress has been made at St. Ita's this year.
Will special funding be made available in the the forthcoming budget to make an extra effort to help the mentally handicapped?
I am not aware of what funding will be made available for the development of services next year, but special funding has been provided during the past 15 years. This year additional funding amounting to £600,000 revenue and £1.195 million capital has been provided. It is my intention to continue in that vein, subject to the available resources.