Pressure builds on HSE to keep St Michael's unit open
The Irish Hospital Consultants Association has joined with consultant psychiatrists in Clonmel in calling for a review of the proposed closure of St Michael Unit at South Tipperary General Hospital. The call comes in the same week that the junior health minister has agreed to look into the situation in South Tipperary.
In a statement to 'The Nationalist' this week, the IHCA and consultant psychiatrists say that they want a review of the proposal because it is "based on an insufficient and flawed assessment of the needs of patients in South Tipperary."
The call comes in the wake of a meeting between the consultant psychiatrists and Mr Pat Healy, HSE Regional Director of Operations last week.
A meeting also took place last week between the Oireachtas members from both North and South Tipperary and Minister of State at the Department of Health with responsibility for Mental Health, Deputy John Moloney.
Both meetings were held last Wednesday, January 27.
At the meeting between consultants and Mr Healy, the HSE was "strongly advised" by the consultants "not to close St Michael's Unit as there is a need for a full evaluation of the impact on patients."
Consultants pointed out that "a full evaluation, involving the consultant psychiatrists, had not been completed on the options for the delivery of the best patient care or the best structure to deliver the appropriate inpatient acute psychiatry care in South Tipperary."
Taking into account what they described as "the lack of appropriate evaluation involving consultation with the key stakeholders" the IHCA and the psychiatric consultants have called for a review of the closure of St Michael's. This review should include a proper evaluation of the options, assessing the structure and system that would deliver the best mental health service to patients in South Tipperary, including psychiatry beds in Clonmel
Consultants say that the full assessment of the option that would include the provision of a modernised 25 bed acute in-patient psychiatry unit in South Tipperary and should take account of the interdependency between South Tipperary General Hospital and St Michael's Unit as well as the need for continuity in the delivery of care by consultants.
The assessment should consider the Vision for Change statement that "the provision of a high quality in-patient unit, based in a general hospital, is an important element of a community-based mental health service." It should also look at the Vision for Change supporting statement that "the acute beds may be provided in a single unit (50 beds) or divided across two units in the catchment area to facilitate easy access for service users and their carers, while taking into account the location of existing units the beds can be provided in two units of 25 beds each."
The benefits of having an acute in-patient psychiatry unit in Clonmel compared with relocating patients to Kilkenny, which is well removed from the family supports which patients require and would undermine the continuity and integrated care available in a South Tipperary, should also be considered, consultants say.
The IHCA and the consultant psychiatrists have written to Mr Healy highlighting that a proper evaluation of the relevant options should now be carried out before any further attempt is made to implement the proposed changes.
The letter states that the evaluation should scope out the best options to provide the best care to patients in South Tipperary, itemising the components of care required, the timing and sequence of the implementation of those components, together with a full list of the resources required to implement them properly.
Mr Seamus Moore, local area health manager in South Tipperary, again defended the decision to The Nationalist. He said that Vision for Change says 50 acute psychiatric beds would service a population of 300,000. The Carlow, Kilkenny, South Tipperary area has a population of just 210,000, meaning there is a need for only 35 beds. "If Carlow/Kilkenny only had 24 beds we would have to contemplate adding to Kilkenny. The fact there are 45 beds in Kilkenny made the decision for us." To provide a modern unit in Clonmel would cost money the HSE does not have, Mr Moore said.
Kilkenny built its new psychiatric unit before Vision for Change was published. If Kilkenny only had enough beds for its own population then the HSE would have considered putting a 25-bed unit in Clonmel, Mr Moore said.
"The Kilkenny unit is purpose built; Clonmel was to the fore in 1968. Now it is completely past its sell-by date. In my view it would have been a waste of public money to spend more capital.
"No doubt there will be some hardship but there will be far less people going in to acute beds when community services are in place. Overall the benefits outweigh the hardships. we are firmly of the view this is better for patients."
Mr Moore added that the decision has received support from patient advocates.
There were positive reports from Oireachtas members from South Tipperary who met with Minister John Moloney, last week. They say he has asked to meet them again when he has had time to familiarise himself with the situation in South Tipperary.
At the meeting in Dublin last Wednesday were Minister Martin Mansergh, Deputies Mattie McGrath and Tom Hayes and Senator Phil Prendergast. They were joined by North Tipp Deputies Noel Coonan, Maire Hoctor and Michael Lowry as well as Senator Labhras O Murchu.
According to Deputy Hayes, Minster Moloney listened to the case the representatives made to him and decided that he did not fully understand the complexities of the STGH situtaiton, so asked to meet with the representatives again, at a later date.
Senator Phil Prendergast said she wants to know how the decision was arrived at to close St Micahel's Unit and has made a Freedom of Information request seeking relevant documents. She also said that when Minister Moloney makes his planned visit to Clonmel in the coming weeks it will be important he meet with concerned stakeholders and take a tour of the hospital.
The need for retaining all services at STGH was also stressed in the meeting with Minister Moloney.
This was the first time that Oireachtas members from both North and South Tipperary have met in support of the Clonmel hospital. Currently acute psychiatric services are provided to the people of North TIpperary at STGH. Under the proposed HSE plan patients from North Tipperary will be sent to LImerick.
At the February meeting of South Tipperary County Council on Monday, a motion in the names of Cllrs Denis Landy, Darren Ryan and Seanie Lonergan called for a letter to be written from the council to the Minister for Health and CEO of the HSE requesting them to reverse the decision to remove all psychiatric services from South Tipperary.
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Saturday 04 February 2012
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