Wednesday, 10 November 2004
Dáil Eireann Debate
Mr. McCormack: I am glad to have the opportunity to raise on the Adjournment a serious matter that is developing in Clifden in my constituency. The community residence was built in Clifden at the initiative of the Clifden Mental Health Association after a long fundraising campaign over ten years. The group acknowledges the grant aid support from the Department of the Environment, Heritage and Local Government in the building of the facility. This modern facility has lain idle for the past year and a half because the Department of Health and Children has not provided the necessary funds for the Western Health Board to staff the facility and allow it to be opened. Some young people are using it as an area of congregation. A certain amount of vandalism has taken place and some windows have been broken. Clifden Mental Health Association has replaced the windows and is trying to keep the building in its original perfect state.
The facility is fully equipped with a capacity of ten beds, eight residential beds and two respite care beds. Eight people from the Clifden area are waiting to be admitted to the facility. Some of those people are unable to live an independent life and live at home with elderly parents who are no longer able to cater for them in the family home. They are very worried as to what will happen to their children when they die. The situation is deplorable. Some people from the Clifden area are also in the long-stay unit in Merlin Park hospital and if they were transferred to Clifden, it would allow the redistribution of beds in the long-stay unit in Merlin Park hospital.
Apparently the obstacle preventing the Department of Health and Children giving funding and allowing the health board to open this facility is the embargo on the recruitment of staff in the Western Health Board area. The Minister of State might tell me in his reply, as I was recently advised in the reply to a parliamentary question, that there is no embargo on the recruitment of nurses. This is not true because the reply to that parliamentary question continued to say that there is no embargo subject to the employment levels remaining within the authorised ceilings. If a health board is at the authorised ceiling it cannot employ anybody else. As the health board needs 14 people to run this facility, unless 14 people leave the employment of the Western Health Board, as a result of the Government embargo, it cannot recruit the people to run the facility.
While I welcome the Minister of State, Deputy Brian Lenihan, I regret that the Tánaiste and Minister for Health and Children is not here. The Tánaiste is not in any way concerned at the plight of aged parents at their wits end minding a loved one in their own home. This matter is very urgent. A year ago one of the members of the Clifden Mental Health Association, an aged lady in her 80s, met representatives of the Western Health Board and on several occasions in the past year and a half I have written to the former Minister asking him for the funds to open the facility. This elderly lady is so serious about the way the opening of the facility is being delayed that almost a year ago she threatened to go on hunger strike within a year if the building is not opened. That very sad event will take place in December as this lady is determined. Even though she is 80 years of age and has nothing personally to gain for herself, for the good of the community in her area she will go on hunger strike if the facility is not opened. There is no use in the Minister of State fobbing me off with a prepared speech. I want him to address the problem.
This week the Western Health Board applied for the necessary funds and the go-ahead to appoint the staff to the facility in Clifden, as it did in December 2002 and mid-2003. Will the Minister respond to the Western Health Board’s request to provide the finance and go-ahead for the appointment of the 14 staff to open this facility for the good of the people in the area, especially the aged lady in Clifden who will be on hunger strike outside the building if it is not open within a month?
Major changes in the delivery of mental health services have taken place in Ireland over recent years. Enormous strides have been and continue to be made in developing a service that is comprehensive, community-based and integrated with other health services. This shift in the delivery of services from predominantly hospital-based care has been a success and the quality of care for persons with a mental illness has been enhanced as a result.
Significant capital is being provided over the lifetime of the national development plan for mental health services. A significant part of this funding is going towards the development of acute psychiatric units linked to general hospitals as a replacement for services previously provided in psychiatric hospitals. In addition to the 22 acute units already in place, a number of units are at various stages of planning. Funding provided under the national development plan will also provide for more community facilities, such as mental health centres and community residences, which will accelerate the phasing out of the old psychiatric institutions.
There has also been a decline in the number of inpatients from 5,192 in 1997 to 3,701 in 2003, with a corresponding increase in the provision of a range of care facilities based in the community to complement inpatient services. In 2003, there were 418 community psychiatric residences in the country providing 3,210 places compared to 391 residences providing 2,878 places in 1997.
Deputy McCormack raised a specific matter related to the Western Health Board and the community residence in Clifden. This was constructed by the Connemara Sheltered Housing Association with funds provided by the Department of the Environment, Heritage and Local Government and the Western Health Board. The fit-out of the building was completed by December 2003 following expenditure by the health board in the amount of €100,000.
In 2003, my Department allocated €300,000 towards the opening of this service but difficulties subsequently arose with the staffing of the residence. Representatives from the health board and the Psychiatric Nurses Association met the Labour Relations Commission on several occasions. This week, however, the Western Health Board has submitted an agreed proposal to my Department on the staffing of the community residence in Clifden. This submission, which would require additional revenue funding and an increase in staff numbers, will be considered in the context of the Estimates for mental health services in 2005.
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