Written Answers. - St. Ita's Hospital, Portrane.
Mary Wallace
Question:
75
Miss M. Wallace
asked the
Minister for Health
if his attention has been drawn to the fact that up to 347 people with mental handicap are accommodated in St. Ita's Hospital, Portrane, County Dublin, where certain units are unfit for human habitation, such as Unit K, and that the ratio of staff to residents is so inadequate as to require the use of inappropriate restraints and seclusion rooms or padded cells in order to ensure the safety of staff and residents; if his attention has further been drawn to immediate dangers to both residents and staff from the risk of fire; and the steps, if any, he has taken to implement the recommendations of the Commission on the Status of People with Disabilities in this regard.
[5906/97]
Mary Wallace
Question:
76
Miss M. Wallace
asked the
Minister for Health
if his attention has been drawn to the immediacy of the danger of serious injury befalling residents and staff due to understaffing at St. Ita's, Portrane, County Dublin; if his attention has further been drawn to the fact that the policy of removing those residents deemed capable of moving to community-based residences leads to a concentration of those with difficult behaviour in the parent institution, accompanied by the movement of experienced staff to the community, reducing further the living standards of this group; and if his attention has further been drawn to the fact that the staff of St. Ita's do not have the equipment, materials or physical resources to do a good job.
[5907/97]
Mary Wallace
Question:
77
Miss M. Wallace
asked the
Minister for Health
his views on whether the published plans for St. Ita's, Portrane, County Dublin, and their implementation are too little and too slow and do not represent a realistic approach to remedial action.
[5908/97]
Mary Wallace
Question:
78
Miss M. Wallace
asked the
Minister for Health
his views on the fact that the Commission on the Status of People with Disabilities singled out the neglect at St. Ita's, Portrane, County Dublin, for priority attention due to the scandalous conditions at the institute; the steps, if any, he has taken to give immediate effect to the urgent improvements required and recommended in this regard; and if he will make a statement on the matter.
[5909/97]
Limerick East): I propose taking Questions Nos. 75 to 78, inclusive, together.
The Eastern Health Board is responsible for the delivery of health services, including mental health services and services to persons with a mental handicap, in Dublin. Acute in-patient beds for those with mental illness in Dublin north city and county, for those with a mental handicap, together with services for the elderly, are provided on the campus of St. Ita's Hospital, Portrane. In addition, a range of other services — outpatient clinics, day hospitals, day care centres, group homes and a vocational and sheltered employment facility — are also provided.
Over the past three years substantial upgrading works have been carried out on the hospital campus. Between 1994 and 1995 a total of £500,000 was spent on upgrading which included a special capital allocation of £350,000 made available by my Department. In 1996 my Department provided a further £250,000 while the board provided £60,000 from its own resources which enabled further substantial upgrading to be carried out in all patient care areas throughout the hospital. The bulk of this funding was expended on the upgrading of accommodation for persons with a mental handicap on the hospital campus. Further upgrading is in hand, including the upgrading of fire safety arrangements.
Inappropriate restraints, seclusion or padded cells as suggested by the Deputy, are not employed at the hospital. Restraints on patients are prescribed by medical staff for specific reasons and for specific lengths of time and are used in accordance with legislation and accepted medical practices.
Monitoring of the standards of care provided for patients in psychiatric hospitals is carried out by the Inspector of Mental Hospitals. The inspector carries out annual inspections of all public psychiatric hospitals, including St. Ita's Hospital. In his report for 1995, which I have just published, the inspector notes the enhancement of the overall appearance of clinical areas and also the improvement in staff morale in the hospital but acknowledges that further improvement in standards is necessary. The hospital is also visited by members of the Eastern Health Board and is inspected by the Royal College of Psychiatrists and An Bord Altranais.
My Department recently approved funding for the refurbishment of accommodation at Beaumont Hospital to enable acute in-patient psychiatric services to be provided at the hospital as soon as possible. It is the board's long-term objective to provide all acute psychiatry for the catchment population at Beaumont Hospital. This development, coupled with the development of a localised community-based service, means that admissions to large psychiatric hospitals such as St. Ita's will be curtailed.
The board is a major provider of services to persons with a mental handicap. It provides a wide range of community-based services, including day and residential facilities, in addition to the St. Joseph's Mental Handicap Service at St. Ita's Hospital which provides specialist services for persons with severe and profound mental handicap and those with challenging behaviour.
It is the policy of my Department that inappropriately placed patients with a mental handicap should be transferred to more suitable care settings. The development of community facilities for such persons generally requires the transfer of some staff from the hospital to the community. In the case of persons with a mental handicap in St. Ita's Hospital, the transfer of inappropriately placed patients has taken place at the same time as services for the remaining patients have been augmented. Additional revenue funding of £265,000 was provided in the period 1993 to 1996 to increase staffing levels at the hospital, to provide multi-disciplinary support and to enhance services to persons with a mental handicap who are also behaviourally disturbed. A further £100,000 has been provided this year. This funding is over and above that provided for those transferring from the hospital campus. Those remaining on the campus also benefit from the increased staff/patient ratio resulting from the overall reduction in numbers. I am satisfied, therefore, that the staff at St. Ita's Hospital have the necessary equipment, materials and physical resources to carry out their jobs effectively.
The board's development plan for St. Ita's Hospital is being implemented on a phased basis. Significant progress has been made, including substantial upgrading of the mental handicap facilities, improved staffing levels in the services, rehabilitation training and placement of patients in more appropriate accommodation both in the community and on the hospital campus.
The Commission on the Status of People with Disabilities recommended that a special capital fund be created for the replacement of some of the existing accommodation for persons with a mental handicap currently being cared for in psychiatric hospitals and that this programme should be managed by a special unit to be set up within my Department. The commission was especially anxious that St. Ita's should be among the first to benefit under this programme because of the large number of persons with a mental handicap who are accommodated there.
The Government decided, on publication of the report, to establish at monitoring committee comprising representatives of Government Departments, the social partners, organisations representing people with disabilities, their families, carers and service providers to monitor the implementation of the commission's recommendations, including the health care and employment recommendations which are the responsibility of my Department. This is subject to the submission to Government, in the first instance, of a programme of measures to be implemented, which will be drawn up by an interdepartmental task force on which my Department is represented. This task force is due to submit its detailed action plan by 30 June 1997.
Officials from my Department recently met with the Eastern Health Board to begin discussions on the measures which could be taken this year to continue the programme to transfer persons with a mental handicap from St. Ita's Hospital to more appropriate care settings now that the 1997 allocation for new developments is available.
This would include the transfer of persons with a mental handicap from St. Ita's Hospital to more appropriate care settings in a number of locations, including the former Madonna House complex which was acquired last year by the Eastern Health Board for its mental handicap services. The necessary refurbishment work is well advanced and this accommodation will be coming on stream towards the middle of this year.
