The matters raised by Deputies Clune and O'Sullivan are similar and will be taken together. The Deputies have five minutes each.
Adjournment Debate. - Mental Health Services.
I am grateful for the opportunity to raise this matter. Like many who read recent reports in the Irish Examiner, I am concerned by the state to which a young man, Paul O'Sullivan, has been allowed to deteriorate while in the care of the Southern Health Board. Paul is 34 years old and has been institutionalised since the age of seven. He developed slowly until the age of four when he began to lose his speech. Two years later he was diagnosed with autistic tendencies. When he was seven years of age the family could no longer cope and the authorities recommended that he be placed in an institution. Since then he has been in the care of the Southern Health Board. The emphasis of that care has been on containment with no treatment provided to ensure the patient's well-being and development. The sad and alarming fact is that Paul has visibly deteriorated in recent months. He weighs just four and a half stones, yet he is 34 years of age. He has become more agitated and engages in self-mutilation.
I met Paul's sister a month ago and she described the open wounds on his face where he had torn at his flesh. These wounds were not being treated and no effort was being made to control his self-mutilation. There was also concern that he was not receiving the appropriate medical treatment, but thankfully this has been rectified. This is a tribute to his sister and the manner in which she challenged those in charge of his care. Paul's wounds are now being treated and he is wearing appropriate helmets.
Paul's agitated behaviour and distress come from years of inappropriate detention and the lack of appropriate care, treatment and intervention. The sad fact for Paul is that his family believe it may be too late for him. He should have been provided with a multifaceted behaviour support plan to deal with his challenging and self-injurious behaviour. Systems and structures should be put in place to ensure his basic right to the least restrictive environment possible and to a quality of life.
If Paul has an individual care plan, as is usual for those with an intellectual disability or disorder, his family are not aware of it. He is not alone as many others are inappropriately placed in institutions where their clinical and accommodation needs are not being adequately met. This year's report from the Inspector of Mental Hospitals was critical of the fact that those with intellectual disabilities were being accommodated in psychiatric hospitals and noted that there had been no improvement since last year's report. Every year this issue is highlighted with no resulting progress.
Reports of the appalling state in which Paul O'Sullivan exists are the story of one individual. However, up to 500 people are inappropriately placed in mental hospitals without the necessary intervention to ensure they can reach their potential and have the quality of life which all citizens deserve.
I thank the Minister of State for coming into the House to reply to this matter. I look forward to his account of how Paul O'Sullivan's condition has deteriorated to such a state. When will people with a mental handicap or disorder receive appropriate intervention in appropriate surroundings?
I welcome the opportunity to speak on this subject although it is sad that the matter must be raised in the House. It is a sad reflection on our priorities as a wealthy nation that the family of this young man felt they had to resort to exposing the harrowing and intimate details of his life on the front page of a daily newspaper in order to secure the appropriate care to which he is entitled as a citizen.
It is time to focus on our most needy citizens. Disability organisations which have lobbied and struggled for years on behalf of individuals and families are at one in their conclusion that this focus must establish clear rights, underpinned by law, that will provide appropriate care and services in accordance with need. If each individual is not given this basic right there will always be stories like Paul O'Sullivan's or stories of people who have been put in some slot in the system and left there. If these people are lucky the slot may respond to their needs. If they are not, they and their families must go into battle with the system, as Kathy Sinnott did on behalf of her son, Jamie, to get what they need.
We have been promised that the disabilities Bill will go to Cabinet next Tuesday and will be published before Christmas. This Bill should address the needs of people like Paul O'Sullivan so they will not have to resort to publicity to get what they need. The Bill does not come before time and it has slipped down the timetable on a number of occasions already. If it is published as promised, we will be cutting it fine to have it enacted before the end of the Government's term of office.
I have no doubt the many organisations which have awaited this legislation for so long will have much to say about the detail of it. I attended an excellent conference last week called, Get Your Act Together, which aired the views of many interested groups. They are determined this legislation will be effective in guaranteeing them the right, like their fellow citizens, to lead fulfilling lives. We must grasp the opportunity that economic well being gives us to leave the shameful past behind us. We must provide appropriate care settings as soon as is physically possible.
I do not believe it will take until 2006 to transfer all the nearly 600 people with intellectual disabilities who are inappropriately placed in psychiatric hospitals to appropriate centres of care. Up to now, health boards have been moving at the pace they were allowed to by their financial allocations, and it was interesting to hear the Minister of State, in answering the previous matter, referring to the allocation to the Mid-Western Health Board. However, they can only do what they can do within those financial allocations. As a member of a health board, I believe they could respond more quickly if they were given the resources.
I call on the Minister to revise his target to a date much earlier than 2006 and to ask each health board to indicate the resources, including staff, it would need to expedite the transfer of those who are inappropriately placed in its region. We cannot leave people lingering in twilight lives in emotional pain any longer. We must also immediately put in place a full independent inspection system for all institutions of care, whether run by the State or privately and whether their clients are disabled, elderly, children in care or people with chronic illnesses. The light must be shone inside the locked doors and inadequacies honestly faced up to and addressed. The family of Paul O'Sullivan complained that they could only get as far as the front hall of Grove House and could not go into where he was living on a daily basis. This is the case in many institutions, whether State or privately run.
I hope the exposure of the pain of Paul O'Sullivan will bring about real change for the better for him and for many other people in similar situations.
I thank Deputies Clune and O'Sullivan for raising this matter and for giving me the opportunity, on behalf of my colleague, the Minister for Health and Children, to outline the position concerning these issues.
While I cannot discuss the case of the individual in question in detail, the Minister has been informed by the Southern Health Board that the needs of every resident in Grove House are met by medical and nursing teams. This is done in consultation and agreement with their families. In fact, the medical and behavioural needs of all the residents of Grove House are assessed on a weekly basis. This assessment is carried out by the medical and nursing team at Grove House in the context of each resident's individual care plan which addresses their specific needs. Family members are welcome to contribute to this process.
Why can the Minister of State not discuss the case of this individual in the House? It should be discussed.
That may be the Deputy's interpretation of the matter but it is not the Minister's.
A range of therapies and activities is also available to the residents, including a fully equipped multi-sensory room, a soft play area, music, art and sonas therapy and aromatherapy, literacy classes provided by the VEC, shiatsu massage, bowling, horse riding and swimming, horticulture and social skills, self-care training and cookery.
The residents also go on daily bus outings, attend football matches and shows and go shopping, and there is an extensive Special Olympics programme. Residents also go on holidays to the regional respite centre in Garrettstown and this year a group went to Doolin.
There has been some disruption to the services provided in Grove House in recent months because of a water leak which necessitated the evacuation of a large area of the ground floor to find the source of the leak. This affected a large proportion of the services, including the multi-sensory room, some living quarters and day rooms. The leak has now been found and repaired and the refurbishment programme, which had commenced before the leak was discovered, will be completed by the end of this week. The refurbishment programme included new windows, flooring and painting.
The board has also assured the Minister that family members are welcome to visit and to discuss any concerns they might have about their family members with the staff who care for them. The Minister has asked the board to keep him informed of this individual's progress.
I wish to deal with other issues related to services for persons with an intellectual disability or autism which have been raised. An integral part of the overall development programme for the services is the work which the Department and the health boards are engaged in to provide more appropriate care settings for the following groups: people with an intellectual disability or autism accommodated in psychiatric hospitals; those accommodated in dedesignated units which were formerly designated as psychiatric hospitals; and others who were moved some years ago from psychiatric hospitals to alternative accommodation which is now unsuitable for their needs.
Additional revenue funding of £7.25 million – 9.206 million – and capital funding of £21.58 million – 27.4 million – was allocated to this programme between 1999 and 2001. In 1996 the number of persons with an intellectual disability or autism in psychiatric hospitals was 970. In December 2001 it is 503.
In addition to the various developments to provide new accommodation for those in psychiatric hospitals, Áras Attracta in Swinford, St. Raphael's in Youghal, the Seán O'Hare unit in Stranorlar and Cloonamahon in Sligo are some of the services which have also been allocated funding to provide either new or refurbished accommodation and to enhance the overall level of service available to the service users.
In the Midland Health Board region, a project team has been established to plan and implement a programme to provide alternative placements and enhanced services for persons accommodated in the Alvernia Centre in Portlaoise, Lough Sheever in Mullingar and St. Peter's in Castlepollard. To date, a project manager has been appointed and 11 houses have been purchased or are in the process of being purchased. A twelfth is being refurbished. Work is already under way within these services to prepare both staff and service users for these initial moves which will commence in 2002.
These are concrete examples of the progress in providing alternative facilities and enhanced lev els of services for these groups which the Government has facilitated over the last number of years.
With reference to the disabilities Bill, it is the Government's intention, as already stated, to publish this Bill before Christmas and we will be looking to having it enacted at the earliest possible date next year.
While the Government is proud of the very significant progress which has been made in relation to the overall development of services for persons with an intellectual disability and those with autism, we recognise that more needs to be done. This commitment was reflected in the further investment of 51.525 million, which is being made in these services in 2002.
Deputy Tom Enright has five minutes.
Can I ask the Minister of State if he will allow matters to deteriorate—
There is no facility in Standing Orders to ask anything. Deputy Enright is in possession and must commence.