HSE staffing shortages - Cutbacks are a recipe for disaster

It MIGHT be flippant to suggest that conditions at the Central Mental Hospital (CMH) are ‘crazy’, but before long we could be wondering if some of those responsible for those conditions are not in need of treatment themselves.

Professor Harry Kennedy, the head of CMH, issued a stark warning to the boss of the HSE last June that solicitors for the criminally insane will mount costly legal challenges because — due to the chronic lack of staff — the treatment being provided for patients is inadequate to meet the standards set down in law.

Problems have been escalating since then. These are not just confined to the CMH. There are also stories in the Irish Examiner today about cruelly insensitive practices at St Brendan’s Hospital, Grangegorman, and St Finan’s Hospital, Killarney.

This week the HSE decided to amalgamate the female open unit with the female high security unit at St Brendan’s Hospital. Five women in an open ward have been transferred to the secure unit, due to staff shortages over the Christmas period. The HSE are effectively imprisoning the most vulnerable people in what could be dangerous circumstances.

The public sector embargo prevents the hiring of the extra staff needed, and these shortages will be further exacerbated with expected staff retirements next February. There is therefore concern that the “open” unit will be closed permanently.

At the urging of her Labour colleague Joe Costello, the Minister with responsibility for Mental Health, Kathleen Lynch, is visiting St Brendan’s today to witness conditions first hand. The staff had contacted management, their union and the Labour Court about the unacceptable situation in which the workers and carers have been placed.

Putting high risk and low risk patients together is an affront to proper medical procedure, particularly when the former are potentially quite violent. In a moving letter to President Michael D Higgins, Cormac Williams of the Psychiatric Nurses Association, argues that the much-vaunted Vision for Change, the 2006 report of the expert group on mental health policy, has become a vision for closure.

In the past three years mental services have lost more than 20% of their nursing staff, and funding for mental health now stands at 4.9% of the health budget, compared with 13% when the country entered recession.

The Government seems to have no problem paying exorbitant sums because of contractual obligations, or exceeding salary caps for its own highly paid advisers, but there is a stunning lack of will and capacity to meet its obligations when it comes to dealing with some of the most vulnerable people in society. There are few more vulnerable than mentally ill people.

Ignoring this problem is not a financial or economic remedy but a recipe for social disaster. The Government needs to get its priorities right, because there have been too many horrifying examples of the kinds of disasters that can happen when these problems are ignored.

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