Senior hospital clinicians and local politicians today met Taoiseach Brian Cowen to discuss a surprise decision by the HSE to close a 49-bed acute psychiatric unit at South Tipperary General Hospital.
The HSE told hospital management last week it had accepted the findings of the Mental Health Commission that St Michael’s Unit was “not fit for purpose in caring for mental health patients”.
Mr Cowen and Minister of State Martin Mansergh attended a meeting at the hospital with consultants and local Oireachtas members, who asked for a deferral of the decision until submissions can be taken from all those affected by the move.
The HSE says the reform of the service was part of a €20 million development programme for the St Luke's campus at the hospital, of which the acute unit is part. It is says it is moving to close "outdated mental health institutions" and to develop "modern community-based mental health services" for people suffering from mental illness in South Tipperary, in line with the national mental health strategy Vision for Change.
The second phase of the redevelopment of the campus includes closing the acute unit and introducing a 24-hour, seven-day home-based treatment team, which will treat any person in crisis in their own home.
It says evidence shows that when such assistance is available, people in crisis are far less likely to need an in-patient bed. It claims that up to 50 per cent fewer acute psychiatric beds will be needed when the home-based treatment team is in place.
The HSE said it plans to transfer St Michael’s unit on a “phased basis” to the modern, purpose-built Department of Psychiatry at St. Luke’s Hospital in Kilkenny.
While there is some concern locally that the move to close St Michael’s unit is part of a broader plan to downgrade South Tipperary General Hospital, the HSE has insisted the plan is “entirely separate” from its plans to reconfigure acute hospitals in the south east.
Speaking after today's meeting with the Taoiseach, chief medical consultant at South Tipperary General Hospital, Dr Paud O’Regan, said: “Our appeal to the Taoiseach was for the decision to be suspended until the matter can be examined more fully and until submissions can be taken from all the stakeholders.”
He said the Taoiseach had agreed to arrange a meeting in the near future between the consultants and Minister of State with responsibility for mental health John Moloney.
Dr O'Regan said consultants at the hospital had learned of the plan to close St Michael's unit "almost incidentally" at a meeting of the hospital executive committee on Tuesday of last week.
There had been no consultation with any member of the acute hospital executive committee, or the management of the acute hospital. Nor had there been any consultation with the general practitioners in the area, he said.
"We feel Vision for Change can be fully implemented but that at the same time an acute in-patient psychiatric facility can be maintained in South Tipperary," Dr O'Regan said.
“We very strongly hope that the Minister of State will see this point of view and we think it’s extremely likely that he will.”
Dr O’Regan said consultants had learned of the HSE’s decision “almost incidentally” on Tuesday of last week, at a meeting of the hospital’s executive committee.
“There had been no consultation with any member of the acute hospital executive committee, or the management of the acute hospital. Nor had there been any consultation with the general practitioners in the area,” he said.
He said consultants believed that if a reduction in beds was required, that it could be served by having two 25-bed units, one in Kilkenny and one in South Tipperary.
“There are all sorts of promises of development of patient-in-the-home services, hostel-type accommodation, but we know that in the present financial climate, it is extremely unlikely that most of these developments will take place.”
The Psychiatric Nurses Association has also expressed concern about the plans to close the unit.
Senator Phil Prendergast of the Labour Party, who raised the issue in the Seanad earlier this week and who attended the meeting, said it had been “very factual” and “civilised”.
She said the status quo would remain at the hospital until Mr Moloney meets the hospital consultants and management next week.
"There isn't any problem with us accepting that things have to change, but there is a problem with the interpretation of Vision for Change that there is not a requirement for some acute mental health service beds in this area."