Vol. 531 No. 4
25 Ms O'Sullivan asked the Minister for Health and Children if his attention has been drawn to concerns expressed in the report of the Inspector of Mental Hospitals that about 300 severely mentally handicapped people were wrongly being cared for in psychiatric hospitals; the steps he will take to address this situation; and if he will make a statement on the matter. [5965/01]
The 1996 annual report from the national intellectual disability database indicated that of the 970 persons with an intellectual disability accommodated in psychiatric hospitals, 310 persons required alternative placements. The 1999 annual report indicated that of the 854 persons resident in psychiatric hospitals in April 1999, 493 needed to transfer to the intellectual disability services. The 1999 figures reflect both the ongoing transfer programme and the assessment of need review process which is part of the work associated with the intellectual disability database.
My Department is working with the health boards and the Eastern Regional Health Authority to provide alternative accommodation and services for this group and a programme of refurbishment in respect of accommodation which will continue to be used in the short to medium term. Twenty-nine persons from St. Finan's hospital, Killarney, recently moved into new purpose built accommodation and a further 87 persons in other health board areas will also move to similar facilities over the coming months. By the end of 2002, purpose built facilities for a further 87 persons, which are at an advanced stage of planning, will also have come on stream. This is over and above the provision which has and continues to be made for smaller groups of between four to six persons in community-based group homes.
My Department has requested an update on the numbers currently in psychiatric hospitals and the plans which the boards have in place to meet the needs which have been identified for this group. While this information has not yet been received from all of the health boards, it is clear that the numbers of persons with an intellectual disability in psychiatric hospitals is steadily declining and it is estimated that the current number will be between 650 and 680. I will inform the Deputy of the up to date position as soon as possible.
Would the Minister accept that a very high number of people accommodated in psychiatric homes should not be there – according to the inspector's report – and that were these people not people with intellectual disability there would be absolute uproar? Would he accept the criticism made by the inspector that those with intellectual disability confined to psychiatric hospitals should be separated from psychiatric patients suffering from psychotic disorders? I am referring to the inspector's most recent report. Will the Minister guarantee that that separation can take place during the inevitable wait for the building of the new unit? Will he ensure these people are given some recognition of their status within hospitals?
As this matter has been raised time and again by the inspector who says he takes a very serious view of it and finds it totally unacceptable, will the Minister provide us with a target for ensuring all these people are relocated? He has been given the message often enough. Does he believe the inspector means what he says when he makes these absolutely damning comments in report after report?
I accept that the situation is unacceptable and has been for a long time. This Government has been the first to make available huge resources to deal with this matter, in terms of dramatic increases in funding. This is an area which required funding in the first instance to provide new appropriate residential and day care facilities for people with intellectual disabilities. Such people should not have been placed in psychiatric hospitals in the first instance. That they were is clearly a failure of society in the past. We have put in place a programme to systematically eliminate that practice.
The intellectual disability database provides us with a very good basis for doing so in a programmed manner. My predecessor, Deputy Cowen, allocated very substantial funding to this area. I have continued with the same level of funding this year.
The Minister's time has concluded.
The Minister has not answered my questions.
I said the situation was unacceptable.
Deputy McManus, I have called Deputy Boylan. The Chair is not responsible for the reply given by the Minister. Deputy Boylan, please.
I would like if Deputy McManus's queries could be answered.
I wish to point out for Deputies' benefit, because the Minister is not the only offender, that one minute only is provided for asking a supplementary question and the Minister then has one minute to reply.
The Minister—
Deputy McManus's question took one and a half minutes. Deputy Boylan, please.
I am sorry I cannot be helpful, Deputy McManus. I was interested in hearing the response to your questions, perhaps we will get them in written form.
Would the Minister accept that his Department, in a time of plenty, is falling down in the area of early diagnosis of mental handicap in young people and in providing adequate treatment and care in this area? I am concerned, in particular, about children suffering from autism for which we have practically no facilities. Children with different types of mental handicap are being treated together which is not beneficial to their development.
Before you reply, Minister, we will take a brief supplementary from Deputy McManus.
What target is the Minister setting to ensure the complete removal of people with intellectual disability from psychiatric hospitals and can he guarantee that while that target is being reached he will ensure these people are not inappropriately placed in hospitals with people suffering from psychotic disorders?
To respond to Deputy Boylan, we have improved significantly the diagnostic process for children with a mental handicap. The pic ture is broader in relation to children with autism. There is a shortage of psychologists and paramedics in many areas. There have, as a result, been delays in making the required assessments. Autism, which has been examined as part of the psychiatric model, needs to be examined in a broader way as part of a multidisciplinary model. I am proceeding to invite proposals on that basis.
To respond to Deputy McManus, I would like to set a target whereby all new placements will be available within a five year timeframe. One would like to be in a position to do this within a tighter timeframe of four years, but it is my advice that it will probably be five years before all the buildings required are in place. I am not in a position, therefore, to give any guarantees today due to the logistical issues involved. The direction we have given is that there should be a separation of treatment for those with an intellectual disability in psychiatric institutions. This is happening in a number of places.
