Dáil Éireann Debate, Thursday - 28 October 2004
4 Mr. Neville asked the Tánaiste and Minister for Health and Children the strategy to implement the 33 recommendations of the review completed in June 2004 of the care and treatment of a person (details supplied) in the course of her admission to the acute psychiatric in-patient unit at the Mid-Western Regional Hospital in September 2004; and if she will make a statement on the findings of this review. [26576/04]
View answerThe case referred to by the Deputy is a tragic one and I extend my condolences to the family concerned. Deputy Neville raised the matter on the Adjournment some time ago but it falls today to consider what progress has been made on the implementation of the recommendation.
The Mid-Western Health Board established an independent review committee in October 2003 to examine the circumstances of the tragic death of the patient, which occurred in September 2002. The final report of the committee was presented to the Mid-Western Health Board on 28 June 2004. A copy of the report was also made available to the family of the deceased and to my Department.
Officials of my Department recently met senior management of the Mid-Western Health Board to discuss the measures being taken to implement the report's recommendations. They were informed that the Limerick mental health service welcomed the report and its recommendations, which provide a means to guide continuous improvements within the service. The recommendations have been converted into detailed and specific action plans and a working group has been established within the Mid-Western Health Board to implement the actions identified. The working group has been meeting regularly since early September and implementation is being monitored, reviewed and directly supported by the executive of the Limerick mental health service.
Among the recommendations made by the committee is the need for progress on the development of an inpatient unit for children and adolescents in Limerick. I am pleased to inform the House that approval has been given for the appointment of a design team for the development of a 20-bed child and adolescent in-psychiatric unit on the Mid-Western Regional Hospital campus. Proposals for a high observation unit within the adult acute psychiatric unit in Limerick are also at an advanced stage, and this development is in line with another of the committee's recommendations.
On receipt of the report of the review committee last July, my colleague, the Minister of State, Deputy Tim O'Malley, referred it to the Mental Health Commission. The commission endorsed the recommendations of the committee and indicated that those recommendations, which are applicable to all mental health service providers, would be incorporated in the quality framework currently being developed by the commission. This framework includes the development of standards for mental health care, clinical governance and codes of practice.
Additional information not given on the floor of the House
The annual inspections by the Inspector of Mental Health Services provide for the ongoing monitoring of such policies and standards by the Mental Health Commission. We will continue to monitor developments in the mental health services to ensure that the recommendations of this report are fully implemented.
I thank the Minister of State for his reply and join him in expressing sympathy to the family concerned. Does the Minister of State agree that this report offers a unique and rare window to difficulties arising in our psychiatric services and exposes ten issues that arose regarding this tragic death? Does he agree that the culture of secrecy in our psychiatric services, protected by the stigma surrounding mental illness, does not facilitate open discussion on the difficulties arising in the psychiatric services? I request that he officially publish the report to allow full and detailed discussion of it. If this death occurred following an appendicitis or an accident with ten issues arising which seriously affected the life of the person concerned, there would be a national discussion on it.
Does the Minister of State agree that the fact that this patient was removed from a private hospital in Dublin to a public facility in Limerick exposes that money decided the fate of the patient because of the money-orientated nature of the services? Will he agree to an independent inquiry into the death of another patient which took place one year earlier in October 2003 in the same unit? Will he respond to the call by the trade union representing the staff in this unit for this unit of the Mid-Western Regional Hospital to be closed?
The Deputy has raised a number of issues. He referred to the number of recommendations made. However, 33 distinct recommendations were made.
Yes, but ten issues arose regarding the death of the patient involved.
I am glad implementation of each of those recommendations is under way at the relevant levels in the mental health services. The report is being treated with the utmost seriousness. Those 33 recommendations are being acted upon. I am not aware of the earlier case to which the Deputy referred. If he communicates with me on it, I will raise the matter further.
A parliamentary question has been tabled on it.
The Deputy will appreciate that I am representing the Minister of State, Deputy Tim O'Malley, and I am not apprised of that case, but I will follow it up for the Deputy.
I am prepared to consider the Deputy's request for publication of the report, but as I understand it, the report is available to the public. I do not know in what format the Deputy wants it to be published.
I want it to be laid before the Dáil or in whatever format is the norm. It is not published.
I will give consideration to the Deputy's request for publication of the report.
On the lack of openness on this matter——
I was referring to the psychiatric services.
—there has been no lack of openness in this House on discussion of this matter. Deputy Neville raised it on the Adjournment and today during Question Time.
That was not my question.
I am answering the Deputy's question. There has been no lack of openness or candour in the replies prepared for me on this matter, which has been raised by the Deputy on the Adjournment and today on Question Time.
As regards the openness of matters which fall within the province of the Mid-Western Health Board, that is a matter within the province of that board. When the Oireachtas in 1970 decided to establish the health board machinery, clear accountability structures were laid down within that machinery where the chief executive and the relevant officers reported to a board. I appreciate that at this time that structure is not in operation but we are about to introduce radical legislation that will refashion that system. The period to which the Deputy referred is a period in which there was a health board, the Mid-Western Health Board, in existence in that area. That matter was within the functional area of that health board and it was its responsibility to deal with the issue of accountability.
We would like an investigation into all such deaths. There was openness in regard to this person's death.
We have exceeded the time allowed for this question and must move on to the next question.
On a point of order, is this not another example of how this system is being used by the Minister of State so that he does not give answers?
That is not a point of order.
Deputy Neville has not been able to ask a supplementary question, as happened earlier in the case of my party colleague.
That is not a point of order.
This is a disgrace. The Minister of State was waffling and did not give Deputy Neville an opportunity to ask a supplementary question.
The Deputy is using up time. I call Question No. 5.
May I ask a brief supplementary question?
In fairness to——
We rarely have an opportunity to raise this issue in a general way.
Deputies McManus, Gormley and Twomey did not have an opportunity to exceed the time allocated for their questions. I call Question No. 5.
Every suicide in this State should be investigated in the same manner as this one was. I welcome the openness in which this case was dealt with.
