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Mental Health Services

Dáil Éireann Debate, Tuesday - 19 October 2021

Tuesday, 19 October 2021

Questions (93)

Pat Buckley

Question:

93. Deputy Pat Buckley asked the Minister for Health the detail of work to improve the responsiveness of the HSE to reports regarding the conditions of mental health facilities and to provide oversight and accountability in this regard. [50595/21]

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Oral answers (6 contributions)

I ask for the detail of work to improve the responsiveness of the HSE to reports regarding the conditions of mental health facilities and to provide oversight and accountability in this regard.

I thank the Deputy for the question. The Government is firmly committed to developing all aspects of mental health services nationally. Both the Government and the Department of Health recognise the need for continued service improvement across the country.  The Mental Health Commission is the regulator for mental health services in Ireland and is entirely independent in its operation. As part of its work, the commission’s Inspector of Mental Health Services regularly inspects mental health facilities, including those operated by the HSE.  As part of the inspection process, the HSE and the inspector may agree on corrective actions to be taken to enable a facility to operate in line with regulations. Where such actions involve the conditions of facilities, the HSE estates department may be engaged to inform appropriate responses, in conjunction with senior community health organisation, CHO, management.  A decision might be made to undertake works to ensure they meet Mental Health Commission standards and regulations and are safe for both residents and staff.  For example, the department of psychiatry in St Luke’s Hospital Kilkenny has benefited from capital funding upgrades, and works to upgrade Galway CAMHS at Merlin Park will be completed in early 2022. On occasion, if a facility might be deemed a safety concern, a decision may be taken to close that facility. At all times, patient safety and dignity is a priority for the HSE.

Sharing the Vision recommends that capital investment should be made available to redesign or build mental health units in acute hospitals which create a therapeutic and recovery supportive environment.  In 2021, €15 million is available to the HSE for major capital works in mental health, including approved centres, and €13 million is available for minor capital works and refurbishments.  A national improvement project to develop and roll out a HSE ligature risk reduction policy and audit is also under way. This will meet Connecting for Life recommendations.

I welcome the Minister of State's reply. This issue has to do with the Mental Health Commission but it also has to do with the HSE. There have been reports about this in 2016, 2018 and 2020, as well as two reports in March 2021 making recommendations that were due to be completed in 2016. The HSE does not seem to have the accountability to stand over its own buildings. This goes back to the Owenacurra centre. The HSE is saying the building is not fit for purpose. I want all the Ministers and Ministers of State to hear this. The Mental Health Commission went there.

It is like the national car test, NCT. If a person fails something in an NCT, he or she goes to the garage, gets it fixed and then the car passes the test. The HSE has shown nothing short of total arrogance and ignorance when it comes to any Mental Health Commission report. It said in all those reports that the proprietor, which is the HSE, had ignored all the recommendations. Why are we now closing a mental health centre in Midleton in the middle of a pandemic?

I knew from the Deputy's question that he was talking about the Owenacurra approved centre in Midleton being closed. We have had many conversations about this issue and I have met the Deputy to discuss it. As he knows, the Owenacurra centre is a long-term residential centre with 19 residents but also accommodates a mental health day service.

As the Deputy will be aware, in March of this year - I do not have the exact date - the Mental Health Commission contacted the fire officer in Cork County Council to say it was concerned about a fire risk in the Owenacurra centre. Obviously, straight away the HSE would have to look at the challenges in that regard.

At the end of June, the HSE notified the Department of its decision to close Owenacurra by the end of October. The current building is not fit for purpose. The HSE carried out a report but the Deputy will be aware that it also commissioned two independent reports, which we have all seen. Many issues were raised with regard to fire safety and asbestos. Even though works commenced, the HSE informed us that no matter how much money was spent on the premises, it could not be brought to the standard needed.

I thank the Minister of State for her reply. I have a copy of the report from 2016. I have been trying to say that the HSE was told back in 2016. In 2016, 2017, 2018, 2019, 2020 and 2021, therefore, it was okay for people to live in the centre but now it is unsafe. The Minister of State is blaming the Mental Health Commission, which is there to improve services. The HSE has ignored all those requests for services and we now have a centre that is threatened with closure. It is causing immense stress.

We have no clarity from any HSE department on what has happened with patient safety. The Minister of State mentioned it but I can tell her that patient safety is not paramount within this. I know the way families have been treated. I spoke to patients there who came out on a rally with us last Saturday to try to garner support to keep the services in east Cork and, particularly, Midleton. I recall one gentleman told me that he thought it was going to be his forever home and that he was going to die there.

We cannot lose the services. I appeal to all the Minister and Ministers of State to come and have a look at it. As one resident said, "Don't move us; improve us". That is what we need in east Cork and in the Owenacurra centre.

I am very conscious as we speak tonight that this is home to 19 residents. I am very conscious of that in case anybody was listening. There is no blame game here, however. One person is not pointing the finger at the other. The situation is very clear. The premises, as all concerned have admitted, is not fit for purpose at the moment. At the moment we are making sure that every single resident has been consulted.

As the Deputy knows, the HSE is currently trying to secure a house in Midleton town to support five of the residents who are embedded in the community. As I told him last week, there were five residents in the nursing home whose physical health has deteriorated to a stage that they were not fit to stay in a mental health facility. Those five residents are, therefore, moving to nursing homes under the fair deal scheme. Two other gentlemen have been relocated to high-level mental health hostels in Cork because that is their will and preference. It is important to recognise that. I spoke only yesterday to the area lead for mental health, who today visited a premises to try to secure a day care centre for mental health in the area.

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