North Tipp patients for Ennis

A NEW proposal to transfer psychiatric patients from North Tipperary to the Mid-Western Regional Hospital Ennis has been described as “ludicrous”.
Fianna Fáil TD, Timmy Dooley made the claim against the background of chronic staff shortages and further proposed cutbacks in the Clare Mental Health Service.

According to Deputy Dooley, a serious question mark hangs over Health Service Executive plans to transfer new non-acute psychiatric patients from North Tipperary to the Clare service at the end of the month and to accommodate up to 15 in-patients in the Acute Psychiatric Unit at Ennis hospital a month later.
The influx of patients is expected if the HSE proceeds with its plan to move all acute psychiatric services from South Tipperary General Hospital in Clonmel, where a specialised unit has been earmarked for closure.
While Deputy Dooley isn’t opposed to the treatment of patients from outside a particular catchment area or county, he said it is hard to understand how the Clare Mental Health Service could treat extra patients with less staff and funding.
“I don’t know how you can remove funding and expect to be able to deliver a better service. Taking patients from outside the area when the Clare service is struggling to cope with its own patients seems ludicrous,” he said.
His concerns are shared by the Psychiatric Nurses’ Association (PNA) general secretary, Des Kavanagh, who said the plan simply does not make sense because of the lack of adequate staffing and resources in the Clare service.
A Mid-West HSE spokesman said, “It is our duty to manage our resources as efficiently as possible in order to provide the best possible care to patients.
“We are continually reviewing the use of resources including staff and we are now assessing staffing and assignments within Clare Mental Health Services to ensure the safe delivery of care in current circumstances.”
There are 39 in-patient beds in the Ennis Acute Psychiatric Unit, which normally runs at 100% occupancy and local PNA representative Denis Meehan claimed three extra beds had to be provided in wards in recent weeks to cope with an increase in patients.
The plan coincides with proposed cutbacks in vital community psychiatric services for Clare patients if the HSE implements cost-saving measures.
Nursing unions have been informed the HSE can no longer afford to pay for overtime or hire agency staff to cover chronic staffing shortages in the Clare services following the non-replacement of up to 65 nurses over the last three years.
As a result, said Mr Meehan, local clinical managers have been left with no option but to move staff from community services and day hospitals to cover staffing shortages in residential psychiatric facilities throughout the county.
He claims the number of nurses employed in residential psychiatric facilities is already below agreed staffing levels.
In the Acute Psychiatric Unit in Ennis, on occasions, there have been seven nurses working a 12-hour day and five per night compared to agreed staffing levels of nine and six respectively.
In the  Cappahard residential facility at Tulla Road, Ennis, there have been five or six per day and three by night compared to agreed staffing levels of eight and four in recent weeks. In Teach na Beatha, Gort Road, Ennis, staffing numbers have been running at one by day and night – 50% less than agreed levels.
In the high support unit at Delganish, Shannon, there should be two working by day and night but actual personnel is half this number.
Mr Meehan said the biggest problem is that the funding attached to all these posts has been withdrawn, which means the HSE hasn’t the finance to fill these vacancies.
He expressed concern that up to 25 PNA nurses, working in the community, may have to be redeployed.
The PNA representative says that reducing community services goes against the main recommendations of Vision for Change, which calls for more services in the community.
It also comes at a time when more services are needed in the community to deal with rising depression, self-harm and suicide levels. He said day hospitals also provide a vital service to out-patients who receive medication and other support services.
There are currently four community nurses in Kilrush Day Hospital, three in Lisdoonvarna, three in Shannon and five in Ennistymon.
Apart from the closure of Orchard Lodge, which resulted in the redeployment of 14 nurses, who were caring for 17 patients, he says no new nurses have been recruited to the service.
Lifting the national recruitment ban to allow the HSE hire more permanent nurses would be the best option as members don’t want to work overtime and believe the hiring of agency staff is a very expensive way to deal with staffing shortages, according to Mr Meehan.
Mr Kavanagh claimed the HSE was spending thousands of euro training mental health nurses who were forced to head to Canada, the United States of America, Malta and the UK for work.
He estimated that graduate nurses could be employed for a starting salary of about €26,000, which was about one-third of the cost of hiring agency staff.
The proposed reduction in community psychiatric facilities for Clare patients was raised with Minister of State Kathleen Lynch on Tuesday. Mr Kavanagh, claimed she seemed visibly shocked with this proposal and asked one of her advisors to take a note of this matter.
National research conducted by the PNA has revealed that mental health has taken a disproportionate amount of staffing cutbacks in recent years. While psychiatric nurses represent only 4% of the total HSE employees, 44% of all staff reductions in 2010 and 35% in 2010 were in the mental-health sector.
“Any plans to cut community services in Clare is ‘inhumane’ and a very backward step. I don’t blame local managers, who are under huge pressure to make cost savings. They are being told by senior HSE officials at national level they can’t recruit, pay overtime or agency staff, Mr Kavanagh said.
Deputy Dooley claimed Taoiseach Enda Kenny engaged in “double-speak” by talking about the Government’s plans to increase funding for mental-health services at the People of the Year Awards function on Saturday night.
“The facts on the ground in Clare in terms of reduced funding for psychiatric services don’t bear out what he is saying. It is bad enough to withdraw funding but to say you are increasing it when this is not the case amounts to double-speak,” he said.