It's too long a way from Farmleigh to Portrane

Bertie Ahern and his ministerial colleagues are due to assemble in Farmleigh House next Tuesday for their last Cabinet meeting of the summer. This is the place which went on auction earlier this year at between £10 million and £14-million and which the State purchased for £23 million. The State's opening bid apparently was £25 million but the vendors beat them down to £23 million.

Once they can tear their attentions away from the fine cornices, cascading chandeliers, intricate woodwork and period furniture, they may be applying their minds to the December budget and to those expenditures the State might engage in "as resources permit", to use the ministerial jargon. If it would not seem vulgar to them in such elevated surroundings, they might give a thought or two to conditions in St Ita's Hospital, Portrane, and other such institutions throughout the State.

The latest available report of Dermot Walsh, the Inspector of Mental Hospitals, is that for 1998. It makes the following observations about conditions in St Ita's: "Not all of the patients had personal clothing or toilet requisites and greater efforts should be made to introduce a personal clothing policy in all areas, especially in the long-stay areas. Individual curtain screens should be provided to ensure adequate privacy for patients. The condition of the corridors and stairways at St Ita's Hospital needed to be improved.

"Sanitary facilities in some of the wards were poor. Some areas were cold and bleak, and greater effort should be made to ensure that sanitary facilities were maintained at an acceptable standard.

"The corridors in St Ita's in general, and in St Joseph's (the mental handicap section) in particular, were in a very poor state of repair. The walls were damp in certain locations, paint was peeling off the walls along the walkways and there were broken windows, some of them boarded up in places. The lighting was inadequate . . .

"The overall standard of hygiene, decor, furniture and fittings was unacceptable. There was not enough furniture or fittings in the day-room. The dining-room was institutional in appearance and had no curtains.

"The dormitory area had no screens around the beds and was in a very poor state of repair. There were no curtains on the windows and very little privacy for patients. The plasterwork was coming away from the walls in certain locations, and the standard of hygiene in the toilet area at the end of the dormitory was unsatisfactory. It was noted that this unit was due to be closed within a week of the inspection."

Through the Freedom of Information Act, I have been able to glean acknowledgements on the part of the Eastern Health Board that conditions in St Ita's are truly appalling. I had known that anyway from a visit I made there in November 1997, but it is nice to get official confirmation of what one sees with one's own eyes, even if the confirmation is oblique.

On May 20th, 1998, Pat McLoughlin, the programme manager of the Eastern Health Board, forwarded to Brian Howard, assistant principal in the Department of Health and Children, what he described as "amendments and comments" to the recommendations of the inspector's draft report.

Here are some of the amendments and comments.

"It is hospital policy that all patients' clothing be personalised and a programme for the marking of all clothes with individual patients' names is in place. It is hoped to complete this programme in psychiatric wards in the course of 1998. Arrangements are being made to improve storage facilities for clothing. Toilet seats and towel rails have been replaced in (a particular) unit . . .

" Unit 10 is a very large unit and arrangements have been made to provide curtains as necessary. The provision of bed screens, as in all other units, is a priority, subject to available resources . . . Upgrading of (the Unit 1 Male) toilet unit has been included in our priority list . . . Missing toilet seats have been replaced . . .

"It is acknowledged that screens and curtains are necessary in relation to providing privacy for patients and these will be provided as resources permit . . .

"It is acknowledged that our maintenance resources do not enable us to upgrade to a major extent the extensive corridors throughout the hospital complex . . . However, over the last number of years we have been able to carry out some upgrading works in the corridors as resources permit."

Just consider the implications of these acknowledgements. The most vulnerable citizens in our society are kept in conditions where they did not have the dignity of their own individualised clothing, at least up to the end of last year, by which time it had been "hoped" to do something about it.

The Eastern Health Board had not bothered over the years to institute the elementary procedure of tagging clothing for people, many of whom live 20, 30 and up to 40 years of their lives in St Ita's. In many instances these people did not have elementary storage facilities for their clothes and possessions.

They were denied the elementary dignity of basic privacy by the absence of curtains or partitions. Toilet seats and towel rails had gone un-replaced for months on end. In one toilet area that I saw, where there were two cubicles in a ward for 18 men, one of the cubicles had been out of order for a year. In another ward, the handles on taps in the bathroom had been missing for several months.

Corridors which were acknowledged to be in an awful condition were simply left in that state. I saw windows boarded up, paint peeling off the walls, ceilings leaking, dampness rising up several of the walls.

But conditions will improve "as resources permit". When "resources permit", maybe it will be possible to ensure that all patients get individual clothing with name tags. When "resources permit", it might be possible to ensure that these citizens are given elementary privacy by having screens around their beds - forget about separate rooms. When "resources permit", perhaps even toilets will be repaired, towel rails replaced and handles put back on wash-hand basins. Maybe the bleak corridors will get a lick of paint and a few of the boarded up windows will be fixed.

Dermot Walsh had made similar observations about conditions in St Ita's over several years, and clearly nothing was done, in part because "resources did not permit".

There are about 600 citizens in St Ita's. Perhaps, while admiring their lavish purchase in Farmleigh House next Tuesday and enjoying the sumptuous conditions there, our leaders might ponder for a second or two on the very different conditions about 20 miles away.

And all because the resources that permitted an expenditure of £23 million on Farmleigh do not permit toilet seats, curtains and individualised clothing in Portrane.