Bhamjee tells of his fears for mental health services

AHEAD OF his retirement from the Health Service Executive (HSE) after 37 years of service, Dr Moosajee Bhamjee admits that “there will be a feeling of good riddance to me from elements of HSE management”.

The South African-born consultant psychiatrist says he had a “tense” relationship with his HSE bosses after being a vociferous public critic of shortcomings in the mental health service over the past 20 years.

Just a day ahead of his last day working for the HSE last Friday, Bhamjee was not softening in his stance, describing aspects of the mental health service as “grossly inadequate”.

Bhamjee says he is leaving a service “where morale is very, very low. You would expect as society becomes more modernised, our mental health services would be improving, but they are not. The opposite is the case. I am quite pessimistic for the future of the service.”

In the interview at his private consultation rooms in Ennis, he reveals for the first time how his criticism put a halt to his career advancement within the public health system.

“I have not spoken about this before now, but in the late 1990s, I could never be clinical director of Clare, even on a locum basis, for a period of 10 or 12 years because of what I was saying about the health service in the press.

“They told me that I had overstepped the mark. I said, ‘Fine, I was happy to be an ordinary clinician’.”

The father of three, however, admits, “Yeah, I was hurt, it was a case of ‘now you know there is no chance of promotion’ as I didn’t want to leave Clare.

“I have been chastised by management on numerous occasions for speaking out, but I felt I had the support of staff for standing up for patients’ rights.”

Three years ago when he highlighted overcrowding at the acute psychiatric unit in Ennis, he was ordered to go before his bosses in Limerick, unhappy that he had spoken out about the situation.

“I stood over what I had to say. I was correct and even today, there continues to be overcrowding at the acute unit where they are taking in more patients than they should.”

The HSE did not respond to Bhamjee’s assertions when contacted yesterday.

Bhamjee’s difficulties with management is in contrast to the close relationship with his patients – illustrated most publicly by psychiatric patients lighting a bonfire in the grounds of Our Lady’s psychiatric hospital in Ennis to celebrateBhamjee’s general election win for Labour in Clare in 1992.

Patients at the now closed hospital “were in many ways forgotten people”, he says. “Out of 40-50 long-stay patients, only five would receive Christmas cards and 40-50 per cent never received visitors.”

He says he still has a copy of a letter from the health service demanding the names of patients at Our Lady’s he had requested toothbruses for in 1985.

“I wrote seeking 25 toothbrushes because they had nothing to brush their teeth with, but I was bewildered to get that response, because even in poorest Africa, there was a great emphasis on people brushing their teeth.”

Bhamjee admits he will miss his patients. “A number of my patients – who I have been treating for 25 years – have been very sad at me leaving and I am very sad at leaving them as well.

“I have done my time, but I am a bit down in the sense that I feel young and I am retiring and leaving colleagues and patients behind.” He says he will continue in his private practice “for a few hours each week, but I must find time to write my memoir as well”.

Bhamjee is one of the “hardware Bhamjees” from the capital of Natal, Pietermaritzburg, in South Africa. “We were the ‘hardware Bhamjees’ as my father had a hardware shop and we all worked there. There were the ‘shoe-shop Bhamjees’ as well.”

His father emigrated from India to South Africa in 1906. In 1965, Bhamjee himself emigrated to Ireland in 1965 to study medicine at the Royal College of Surgeons of Ireland in Dublin. After he received his degree, he returned to South Africa where he began working as a general practitioner.

During his time in Ireland, he met a Co Clare woman, Claire Kenny, and Bhamjee explains “under apartheid laws, we could not marry, so I returned to Ireland and we married”. They have three grown-up children, with Bhamjee’s youngest, Róisín, opting for a career in medicine.

Bhamjee shot to national prominence in 1992 when he made headlines around the world after causing an electoral shock when he was elected as a Labour TD for Co Clare.

After a five-year stint in the Dáil, he opted not to run again and instead concentrate on his medical career, while using his public profile to highlight failings in the health system.

He says: “The Government has not been paying attention to the psychiatric service and the sector has suffered from underfunding over the years.”

Bhamjee remains a critic of the move to shut down the old large psychiatric institutions without, he says, the necessary resources being put in place for the patients in the community.

“We have now built a minimum number of hostels and minimum number of halfway places. They talk about modern aspects of psychiatry, but we don’t have the staffing for it. For example, I don’t believe that my position is being replaced.”

Bhamjee also takes aim at what he calls the managerial takeover in the mental health services.“Management are making decisions without consulting people on the ground. No one is listening anymore to the clinicians. The service is budget driven where budget planning dictates.”

Bhamjee says that what has given him most satisfaction “is keeping patients out of hospitals and institutions for 25 years”.

However, he says: “People who need long-stay care, I would worry about them. Parents ask me what will happen their children when they die. I can’t answer them and it makes me feel inadequate.

“What have I done over the years? I think to myself, and the service is going to get worse from what I can see.”