Culture of blame in Roscommon mental health services - report

Financial cost-cutting put ahead of patient care, experts find on behalf of HSE

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A new report into Roscommon mental health services has found a culture of negativity and blame, where financial cost-cutting was put ahead of patient care.

While cost-cutting was heavily criticised in the report, undertaken by a panel of experts on behalf of the HSE, the experts were “surprised” to find funding provided to the services was returned to the Health Service Executive unspent.

Between 2012 and 2014, €17.5 million in direct funding was returned to the HSE by Roscommon facilities.

The report, published on Tuesday, found examples of “systematic failings in reporting and managing incidents of sexualised behaviour” and an overemphasis on financial prudence ahead of patient safety and care.

The review said there was an atmosphere of “control, negativity and a culture of blame” across the services, where “some senior staff normalised bad behaviour; others perpetrated it”. The review team visited nine mental health facilities in the county.

The review began in August 2015 and concluded in July 2017, and was carried out by three senior experts from the Northern Ireland healthcare sector, Brendan Mullen, Dr Nial Quigley and Don Bradley.

Cost management

It said management in the Roscommon services were excessively focused on financial control and cost management, “to the detriment of its staff’s working conditions, patient care, and patient and staff safety”.

In also said “professional standards underlying patient care were ignored or allowed to slip”. The management culture in the region was typified by a lack of openness to criticism, a culture of secrecy and an acceptance of poor standards of care.

Tensions between staff groupings and management in facilities was widespread across the Roscommon region.

There was “no clear strategic direction” in place to implement the Government’s mental health reform programme outlined in A Vision for Change, launched in 2006.

‘Shocking indictment’

A spokesman for the Psychiatric Nurses Association (PNA) said the review was a “shocking indictment of management of the services” in Roscommon.

The PNA was critical of the “emphasis by management on budgets and cost containment over delivery of properly managed services and safe standards of care” outlined in the report.

The spokesman added it was “alarming that implementation of the review’s recommendations and effecting change in Roscommon mental health services is being left in the hands of those who are so heavily criticised in the review”.

The expert review made 27 recommendations for reform in the Roscommon region.

Independent Roscommon-Galway TD Michael Fitzmaurice said “the report is very worrying for the service users in Roscommon”, and highlights “ a total systems failure on many fronts” in the local mental health service.

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