Dáil Éireann debate -
Thursday, 7 Dec 2006

Vol. 629 No. 2

Adjournment Debate.

Mental Health Services.

Mr. Neville

I thank the Leas-Cheann Comhairle for allowing me to raise the report into the death by suicide of Ms Anne Carroll on 17 October 2004 at Cork University Hospital. I wish to express my sympathy to the Carroll family in respect of this tragedy and the suffering it caused. Our objective is to ensure similar tragedies do not take place and that the recommendations contained in the report are introduced as a matter of urgency.

A report into the death of Anne Carroll was submitted to the Inspector of Mental Health Services on 18 November 2004 by Dr. Eamon Moloney, clinical director, south Lee mental health services. Ms Carroll had a history of mental health problems since the late 1970s and had been admitted on a number of occasions to inpatient psychiatric care. She was diagnosed as having bipolar defective disorder and, following an overdose of 200 tablets one week previously at home, was transferred to the GF unit from the intensive care unit at Cork University Hospital on 6 September 2004. However, on 17 October 2004 she returned early from her weekend leave to the GF unit and complained of feeling depressed. She had cut herself with a razor at home and it was reported by her family that she also tried to stab herself. However, there was no record of this on the hospital's clinical file.

When she returned to the GF unit, it emerged her bed had been given to another patient and there was some delay in finding a bed for her. During this delay in obtaining a bed she was noted to be anxious and stressed. Her family feel that Ms Carroll was extremely distressed by the delay and that this contributed to her suicide. They also stated they had expressed their concern to staff about her and requested that her clothes be taken from her. The family feels that insufficient support was offered by the staff of the GF unit to the family in the immediate aftermath of Anne's death and stated there was no suitable place to spend time with her remains.

The report into Ms Carroll's death outlines that the layout of the GF unit is unsuitable for the observation of patients. There is no high-observation or special care unit within the GF unit. A high-observation unit is an area within a psychiatric unit which provides a high level of observation while a patient is in an actually distressed state. There are no specified intermediate levels of observation apart from general observation and special observation within the GF unit. This means that in the absence of a high-observation area, the clinical staff is able to prescribe only special observation for patients requiring any observation level higher than that relating to general observation.

The alarm system was stated to be unsatisfactory and does not always work. It was stated the alarm system was not working on the day of Ms Carroll's death. It is a practice in the GF unit to admit patients to beds of other patients who have gone on leave for one or more nights and who have previously been on leave. The system does not allow for patients returning unexpectedly from leave because they become unwell. Ms Carroll returned early from leave as she had cut her wrist. Her bed had been taken by another person and there was considerable delay in obtaining a bed for her. Eventually another patient was discharged by the consultant on call and this provided Ms Carroll with a bed. The delay and uncertainty regarding whether she would obtain a bed appeared to have added to Ms Carroll's distress and agitation. The use of leave beds for newly appointed patients results in an unsafe situation if patients return early from leave due to deterioration in their mental status. There is no policy on leave beds and no audit had been carried out on the usage of beds.

There was no documentation in the clinical file on the death of Ms Carroll, apart from the entry on the pronouncement of death by the cardiac arrest team. There was no documentation of the interaction between Ms Carroll's family. which attended the GF unit following her death. The last nursing entry outlines Ms Carroll's return from leave to the GF unit. There was no documentation in the nursing file relating to her death. The final entry states that she returned from leave and settled for the remainder of the night. Due to this lack of documentation regarding the death of Miss Carroll and the immediate aftermath, the report found it difficult to draw a conclusion in respect of the support that her family received following the immediate aftermath of Ms Carroll's death.

I ask the Minister of State to implore the Health Service Executive and the Minister for Health and Children to respond to the concerns expressed in the report to which I refer and to ensure the necessary investment is put in place to correct the situation I have outlined. We must also ensure that further deaths do not take place in circumstances such as those to which I refer. Again, I offer my sincere sympathy to the members of Anne Carroll's family, who are extremely distressed about her death.

Minister of State at the Department of Enterprise, Trade and Employment (Mr. Killeen)

I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. The case referred to by Deputy Neville is tragic and I wish to extend my sincere condolences to the family concerned.

In March 2005, the Minister of State at the Department of Health and Children with special responsibility for mental health, Deputy Tim O'Malley, requested the Mental Health Commission to prepare a report on the circumstances of the death of the named person. In November this year, the report was received in the Department.

The Mental Health Commission, which was established in April 2002, is an independent statutory body, the primary function of which is to promote and foster high standards and good practice in the delivery of mental health services and to ensure the interests of detained persons are protected. The report of the mental health services inspectorate of the commission examined the service provided in the acute psychiatric unit — the GF unit — at Cork University Hospital and the physical layout thereof. The report also examined the observation policies and procedures as well as bed usage and related matters. In preparing its report, the commission sought information from the Health Service Executive southern area on the actions undertaken by the health service since the death of the named person. The inspectorate also carried out a review of the circumstances surrounding the death. The inspection took place on 19 and 20 January 2006.

The GF unit at Cork University Hospital is the admission unit for the south Lee mental health services. It is a 46-bed acute psychiatric unit. There are 23 beds for male patients and 23 for female patients. I am informed by the HSE that it is engaged in a process to redesign the unit, which will include a high-observation area. A clinical audit committee has been established and staff have been provided with clinical risk management training.

Under the Health Act 2004, operational responsibility for the management and delivery of health and personal social services was assigned to the Health Service Executive. Accordingly, the Department of Health and Children has written to the HSE requesting that all shortcomings identified in the report be addressed as a matter of urgency. The Government adopted the report of the expert group on mental health policy in January 2006 and €26.2 million was made available this year to commence implementation. The latter amount includes €1.2 million made available to the HSE for suicide prevention initiatives. A further €25 million will be made available in 2007. The Government is committed to ensuring that the highest standard of patient care is provided within our mental health service in line with A Vision for Change.

As Deputies are aware, the report proposes a holistic view of mental illness and recommends an integrated multidisciplinary approach to addressing the biological, psychological and social factors that contribute to mental health problems. It recommends a person-centred treatment approach which addresses each of these elements through an integrated care plan, reflecting best practice and, most importantly, evolved and agreed with both service users and their carers.

Sports Funding.

Mr. Hayes

I thank the Leas-Cheann Comhairle for the opportunity to raise the provision of a sports grant from the Department of Arts, Sport and Tourism in respect of the village of Golden, County Tipperary, where I reside.

I was reluctant to raise this matter by way of the Adjournment. I will, however, outline the background to it for the Minister of State. I wish to express my disappointment with regard to the lack of funding for a project that has the support of the entire community. More than two years ago, the local hall in which meetings and various sporting activities were held, was demolished because the local authority stated it was unfit for use and that insurance could not be obtained in respect of it. At that time, the parish had run a lottery which yielded €1,000 per week. In the interim, approximately €380,000 has been accumulated by way of lottery and other fund-raising activities.

Proposals in respect of the project were put to the Department on four different occasions. An application is currently with the Department in which it is proposed to build a new hall and sports centre that will accommodate the GAA and camogie clubs, the parish council and every other organisation within the parish. Those in the parish were devastated last year when they discovered the project was not being funded by the Department. They lobbied various Ministers and deputations met the Minister for Arts, Sport and Tourism on three occasions. They were promised on each occasion that the money would be provided. On their behalf, I wish to state that they were not merely disappointed but devastated that national lottery funding in respect of their proposal has not been forthcoming. The most recent proposal was altered to bring it into line with the guidelines.

I accept the Minister of State, Deputy Killeen, does not have direct responsibility in this area. However, I want him to relay what I am saying in respect of this project to the Minister for Arts, Sport and Tourism. It is of great importance to the community in this growing rural area. Members observe week after week in this House that rural Ireland is thriving. This project is an integral aspect of community life in the parish of Golden, County Tipperary, but the Government has let the community down. I ask the Minister of State, Deputy Killeen, to relate my views to the Minister for Arts, Sport and Tourism. I was reluctant to raise the issue by this means but there does not seem to be any other way of putting pressure on the Minister to ensure the entitlements of this community.

Mr. Killeen

I am taking this Adjournment matter on behalf of the Minister for Arts, Sport and Tourism, Deputy O'Donoghue, on whose behalf I thank the Deputy for raising it. The Department's sports capital programme is an important element in ensuring the adequate provision of high-quality sports facilities to cater for the various requirements of governing bodies, clubs and local community sports organisations. Under the programme, grants are allocated to sporting, voluntary and community organisations for the provision of sports and recreational facilities and equipment. Through sports capital funding, the Government has provided unprecedented levels of funding for sport and its infrastructure. Since 1998, a total of 5,755 such projects have benefited from more than €472 million in grant allocations.

On applying for a grant, all applicants are issued with the guidelines, terms and conditions applying to the programme to ensure they are fully aware of all the requirements. All applications are assessed on an individual basis by the Department in accordance with a detailed set of assessment criteria, as specified in the guidelines, terms and conditions. The assessment process takes into account factors such as the existing level of facilities in an area, the number and quality of the applications received, the amount of funding being sought by each applicant, the strategic positioning of major facilities that may be required and the most recent census figures. Every effort is made to achieve a balanced geographical spread of funds throughout the country, while also affording priority to projects in areas of social and economic disadvantage.

Specific criteria used in assessing applications include a consideration of whether the project aims to increase active participation in sport or improve standards of sports performance in line with clearly stated targets. Applicants should show how the funding will measure these increases or improvements. In particular, facilities that help promote and enhance female participation in sport will be prioritised. Priority will also be given to projects which meet a need for sporting facilities in disadvantaged areas.

The availability of evidence of title to the project site, planning permission applied for or in place, drawings or specifications for the project and accurate costings for each element will also be of benefit to the applicants. In addition, consideration will be given to whether the project is realistic in terms of scale, costs and grant assistance sought. The club or organisation in question should be able to demonstrate a capacity to raise its contribution towards the cost so as to allow the project to be finished within a realistic timeframe. Another factor to be considered is whether the project promoters can demonstrate the availability of an income stream to maintain the building when completed.

The Department will assess whether the project has a high priority in regard to the applicant's existing facilities and whether there are similar sporting facilities already available in the area. The application should include details and evidence of consultation with other clubs, community groups, schools and the local authority, especially those who will use the facility. In addition, the application should clearly explain how the applicant will attract socially excluded people to use the facility. In respect of projects at regional and national level, the Department will also consider whether the project fits in with the priorities for the relevant sport as identified by its national governing body.

Highest priority is afforded to projects in disadvantaged areas aimed at increasing participation. High-priority projects include those which are essential or integral to sports participation or performance, including pitch development, floodlighting, changing rooms and showers. At the end of the assessment process, each application is given its order of priority within its own county. Every effort is made to achieve a balanced geographical spread of funds throughout the country.

In the case of unsuccessful applications, the Department writes to the applicants concerned, enclosing a copy of their assessment and explaining why they were unsuccessful on that particular occasion. This information can act as guidance to organisations in the submission of future applications for support under the programme. It is open to the groups in Golden to reapply for funding under the programme once they meet certain minimum qualifying conditions as set out in the published terms and conditions of the programme.

The 2007 round of the sports capital programme was advertised on 16 and 17 October last, with a closing date of 24 November 2006 for receipt of applications. The Minister is satisfied that all applications received, including those from Golden, have been treated fairly and in accordance with the published requirements and assessment criteria. The Deputy can be assured that any further applications received from those groups will be considered in the same fashion.

Finally, it will be of interest to the Deputy that Golden-Kilfeacle GAA club received a grant in 2000. Kilfeacle and District Rugby Club received grants in 2004 and 2005, as did Kilfeacle Community Association in 2000 and in 2002. County Tipperary has been allocated more than €15.3 million since 1998, with 229 clubs and groups benefiting from the funding provided under the sports capital programme. I will ensure the Minister is aware of the points raised by Deputy Hayes.

Housing Management Companies.

Mr. Curran

I thank the Leas-Cheann Comhairle for the opportunity to raise the issue of housing management companies on the Adjournment. I propose to share time with Deputy Andrews.

An Leas-Cheann Comhairle

The Deputy may share time.

Mr. Curran

Will the Minister of State outline the Government's proposals to ensure housing management companies operate in a fair and transparent manner and that residents are aware of their rights in regard to such companies? We are all aware that the number of housing management companies has increased at an enormous rate in recent years, and many of them are associated with new apartment complex developments. Situations have arisen in many areas that leave much to be desired. Fees are likely to increase at any time and, in some cases, the level and range of services is poor.

This section of the market is poorly regulated. In light of changes in yesterday's budget on tax relief for first-time buyers, it would be remiss not to review this area. Many first-time buyers are on extremely tight budgets and some are faced with considerable fees from the management company of the apartment or housing complex in which they purchase their home. These fees may be the equivalent of two monthly mortgage instalments. Deputies from Dublin frequently encounter constituents who complain that they are paying management fees but receiving only inadequate service or none at all. Fees generally include such services as refuse collection and maintenance of public areas but residents often complain that there is no standard of service in return for the exceptionally high charges.

My colleague, Deputy Andrews, and I seek specific proposals from the Minister for the Environment, Heritage and Local Government in this regard. We accept the need for management companies in gated and enclosed housing and apartment complexes. There must, however, be a level of supervision, regulation and inspection, whether on the part of local authorities or the Department. Residents must have some means of recourse other than the legal route, which is prohibitively expensive for many.

Mr. Andrews

I thank Deputy Curran for sharing time with me. This is a significant problem for residents in my constituency. Huge numbers of apartments are being built every year and their owners find themselves faced with large bills for management fees. I understand the National Consumer Agency proposed that action be taken to rectify the significant dearth of information in regard to the rights of home owners. First-time buyers, in particular, are often not aware of the rules that apply to the type of ownership that obtains in apartments.

Positive action is required on the part of the Government in respect of this unregulated area. The Minister for Justice, Equality and Law Reform indicated his intention to establish a regulatory authority which will ensure that management agents have certain qualifications and are members of a professional body. These proposals will be welcomed by the 500,000 people who live in apartments and must pay management fees that are often extortionate and in respect of which there is no transparency. I look forward to hearing what action the Government will take.

Mr. Killeen

I am taking the Adjournment of behalf of the Minister of State at the Department of the Environment, Heritage and Local Government, with special responsibility for housing and urban renewal, Deputy Noel Ahern. I am glad of the opportunity to outline the action being taken to tackle issues of residential property management and to clarify certain matters.

The Government is delivering on its commitment to regulate this sector. The new property services regulatory authority, PSRA, being set up by the Tánaiste and Minister for Justice, Equality and Law Reform, will license, regulate and deal with complaints about managing agents, often a key source of problems. These are commercial entities that carry out the day-to-day work of managing and maintaining the development and collecting charges. When complaints are made about management companies, it is often the case that the issues involved relate to activities of managing agents.

A management company is composed of the homeowners in a development. Some agents provide a good service, but complaints about issues such as poor standard of management and maintenance, high charges and lack of accountability often arise from their role. Legislation to regulate property services, including the establishment and role of the PSRA, is being developed by the Tánaiste and Minister for Justice, Equality and Law Reform. A director of the authority has been appointed and an implementation group is in place to make the arrangements for the early establishment of the authority and its structures.

While the regulation of managing agents will be central to ensuring an effective and user-friendly system of residential property management, there are also certain issues to be addressed with the management companies, or ownership companies, as it might be more accurate to describe them. These companies are constituted under company law and broadly regulated by the Companies Acts. The Law Reform Commission has recommended certain changes to company law to address problems for property management companies in that context. For example, certain company law requirements are considered relatively onerous for the types of entities involved and some companies have been struck off the companies register because of non-compliance. The proposals relating to management companies will be reflected in a Bill to consolidate and reform company law.

As management companies are incorporated under the Companies Acts, the rights of property owners as members of companies are also governed by company law. The company's memorandum and articles of association regulate its activities, setting out its objectives, membership and voting structure, accounts and auditing arrangements, proceedings for meetings and the structure and powers of its board of directors. Members are entitled to attend and vote at the annual general meeting, examine the accounts and memorandum and articles of association and, where necessary, apply to the Director of Corporate Enforcement to have an annual general meeting called.

Directors are appointed from among the members and manage the company in practice on behalf of the members. Their functions include drawing up the annual budget, proposing works and services to be undertaken during the year, the amount to be put into the sinking fund and the level of charges required and informing the members of these and other relevant matters. Where residents have problems with management, they should take these up with the directors in the first instance. Tenants should approach their landlord as they have rights with management companies under the Residential Tenancies Act 2004. In cases where companies are run well, one usually finds the directors are competent people, prepared to put time and effort into the successful running of the company and that the members take an active interest.

The Department of the Environment, Heritage and Local Government has acted to deal with certain planning-related issues that have impinged on management arrangements in some developments. For example, it has been made clear to local authorities that planning conditions requiring management companies should not be attached to planning permissions for traditional housing estates and that the existence of a management company does not relieve developers of their responsibilities for completing and maintaining estates. A working group has been established to delineate local authority responsibility to take in charge public facilities in residential estates and further guidance will issue to planning authorities in early 2007.

The Law Reform Commission is examining legal issues generally regarding management of multi-unit structures. It is due to publish a consultation paper in the coming weeks, to be followed by a conference in late January, open to all interested parties. The commission's paper is expected to address legal issues with a view both to preventing future problems and providing a way to rectify existing problems. In light of the commission report, the Government will consider any necessary further measures.

In the short term, the Department of the Environment, Heritage and Local Government is pursuing with the construction industry measures to address some issues involving developers through a voluntary code of practice. There has been a positive response from the industry.

There is also an information deficit in this area. Better consumer information and awareness will help to avoid some problems and frustration. The National Consumer Agency has published an information booklet on management companies. The Department of the Environment, Heritage and Local Government has also compiled a short general information note, which is provided in response to queries. The PSRA will also have a public information function on property management.

Obligations of management companies are fundamentally matters of private contract. Buyers need to ensure they have proper legal advice and information when signing contracts. The long-standing principle of caveat emptor is very relevant. Buyers, when signing contracts, should be watchful about the obligations into which they are entering. Home owners should take an active interest in the operation of their management company.

The Dáil adjourned at 7.55 p.m. until 2.30 p.m. on Tuesday, 12 December 2006.