Political pressure must be put on the HSE West to review its decision that all new mental health patients from Ballinasloe must now attend the psychiatric unit at University Hospital Galway, a former vice chairperson of the HSE West’s regional health forum insists.
City councillor Catherine Connolly claims the health authority is intent on admitting patients to a unit that is “cracking at the seams” while a new 22-bed facility in Ballinasloe has been closed down. She claims this “defies logic”.
Cllr Connolly and fellow forum member Councillor Tim Broderick, together with Arthur Carr of the voluntary organisation Galway East Life Support, met Minister Kathleen Lynch, the Labour Minister of State at the Department of Health (yesterday) Wednesday in Dublin to discuss their concerns.
Cllr Connolly said she fully supports the Galway east psychiatrists, the Ballinasloe Action Group and the GP Association in east Galway in their call for an independent review of the HSE’s decision to close down the Ballinasloe mental health unit. She joined a bed push protest recently from Galway Cathedral to UHG to highlight the issue.
“The HSE West have made a decision to close down an existing 22 bedded mental health unit in Ballinasloe and not allow the patients transfer across the corridor into a new 22 bedded unit, recently refurbished at a cost of €3.2 million, a unit which is empty and will remain empty.
“Moreover they are insisting that all new patients from the Ballinalsoe area must attend the psychiatric unit in Galway city through the accident and emergency department.”
The former mayor claims this has been made against the wishes of the psychiatrists and the nurses in the service, the GP Association in east Galway, the councillors on the Regional Health Forum, local people and service users.
“Quite clearly it is a decision based on short term financial gain with disastrous consequences for the mental health services in both west and east Galway,” she says. “The site at the regional hospital as it stands is utterly congested and the A&E department is continuously at crisis point. Furthermore the psychiatric unit is seriously struggling with inadequate staffing to provide a proper service to the patients already there.”
Cllr Connolly is calling on the Mental Health Commission to confirm that the local department of psychiatry has implemented the urgent recommendations made in recent annual reports before admitting new patients to the unit.
“In this regard I took the trouble to look at the Mental Health Commission reports for the last number of years and the result of the various inspections are far from reassuring for patients and/or their families. It is obliged to inspect the psychiatric unit in Galway, as elsewhere, on a regular basis and write up a report which is easily accessible on their website.”
She states that since 2010, the commission has highlighted a number of fundamental deficiencies. “These include the failure to provide an individual care plan for each patient for four consecutive years in a row, the failure to open up a newly built six bedded special observation unit, the physical inadequacies of the building itself with serious issues in relation to privacy, the limited input from psychological and occupational therapies and a recommendation that a review be carried out in relation to the use
of benzodiazepine medication.”
Cllr Connolly says the commission attached a condition in November 2012 that individual care plans be prepared and implemented for each patient.
“That had not been done when the psychiatric unit was inspected in February 2013 when the commission also noted that that the high observation unit had never been opened despite the high costs of both the building and its commission.”
She says the fundamental problem remains a lack of staff and resources at the unit.
“Yet the HSE West are intent on admitting more patients to a unit that is creaking at the seams and closing down a brand new unit in Ballinasloe.”
Cllr Connolly maintains political pressure must be brought to bear on the HSE West to “see sense” and review its decision immediately.
“I am calling on the Mental Health Commission to confirm that they are satisfied to allow the psychiatric unit in Galway to admit extra patients in a situation where HSE West management appear to have already failed to comply with the Mental Health Commission requirements/recommendations to date. This includes that management source extra staff to open the high observation unit and to prepare individual care plans for all patients currently in the unit.”
In a statement the HSE West says the decision to reconfigure the beds was made last summer by an expert group of four executive clinical directors from mental health services. An implementation team was established in autumn 2013 to plan the reconfiguration, and phase one of the plan began on January 20. Phase 2 will commence on February 17 and the team are finalising Phase 3 currently. The decision is being implemented and is not up for review, the health authority insists.
“This reconfiguration is a major investment in mental health services in Galway and Roscommon; with an additional 44 permanent staff posts at a cost of €2.6m. This is a major investment and there is absolutely no substance in any of the rumours and allegations that the reconfiguration is a cost saving initiative. The reconfiguration is purely based on improving outcomes for patients.”
The spokesperson outlined that the majority of patients who are admitted to the acute inpatient facilities do not come through the emergency department; they are referred directly from their community mental health team.
“The mental health service is very aware that EDs are busy and stressful areas for mental health patients, which is why there are systems in place to directly refer mental health patients to the ward when they require admission to the acute unit.”
Referring to the Mental Health Commission (MHC) reports it said it acknowledges the concerns regarding care planning raised by the commission.
“This has been addressed with the local service in conjunction with the MHC. Care plans are now reviewed on a daily basis by a staff member and on a weekly basis by multidisciplinary senior staff. Monthly audits of completion and quality of care plans have issued to the MHC and new documentation has been developed by the service. An unannounced visit was undertaken by the MHC in late 2013 and preliminary indications show that care planning deficiencies have been addressed and we await publication of their report.”