2025-12-09

I want to raise the issue of Erkina House, Rathdowney, which is a long established and excellent HSE facility that comes under the mental health services. By definition, the residents are vulnerable people and are entitled to peace of mind and not to be upset by the HSE in their works. Three years ago, we raised this in the House, and the Minister of State, Deputy Butler, was with us and was personally involved in the situation where the HSE announced it was going to close Erkina House three years ago. The Minister of State, Deputy Butler, was directly involved and that did not proceed. There were 12 residents in Erkina House at that stage and the HSE, after that, announced the closure of this facility but subsequently publicly apologised to residents and their families for the unnecessary upset caused to them. All I can say is here we go again with the HSE. Now it says there will be no new admissions to Erkina House. This is closure by stealth. Three years ago, the HSE guaranteed that no residents would be moved out without their and their families' consent. Very recently, I have had a family in contact with me, saying they were against their family member being moved out. If it is now happening, it can only be because the HSE has bullied them to accept the HSE's proposal. I understand there are two or three residents in Erkina House at this stage. This fits into the HSE agenda of closing Erkina House by stealth, which it has been working to do. The care provided by staff in Erkina House is superb. The care and attention and, if I am allowed to say it, the affection they have shown for the residents is exemplary. I sincerely hope the staff will be fully respected by the HSE and whatever arrangements it comes to will be outlined in detail to them. A key priority is also that the staff will be dealt with fairly. I fully understand that Erkina House is an old building and does not meet the current health and safety standards which the residents and staff are entitled to. This is because the HSE has failed to invest and bring this facility up to a standard over the years. There also is an acute shortage of respite beds in County Laois and many Laois people who have had surgery in hospitals locally and require short-term respite are regularly told to go to another county as the HSE does not have adequate respite facilities in County Laois. The HSE should invest in its own respite facility rather than paying a fortune of taxpayers' hard-earned money to private nursing homes. As everyone is aware, two private nursing homes in Laois are already under investigation and monitoring in relation to various matters and as a result, we are short on respite beds in County Laois. Erkina House would be an excellent respite facility for the area, as well as continuing the services it currently provides. I also suggested it as a suitable location for the health centre in the town, as the existing facility is recognised by all and the HSE as not being fit to meet the modern-day standards for facilities. The HSE is turning its back on Rathdowney and south County Laois. Its two facilities in Rathdowney, Erkina House and the health centre, have been starved of funds and investment, and this is resulting in a poorer health service at the expense of the people in Rathdowney and surrounding areas. This must stop now. We need investment in these facilities, not closures.

I thank Deputy Fleming for raising the issue of Erkina House. We have been here before. The Deputy has been a long-time advocate for and supporter of Erkina House. It is a key priority for me and for the Government that people experiencing mental health difficulties receive the appropriate level of care they require in the most suitable location in the community which best meets their needs. Achieving this involves reform of mental health services and developing fit-for-purpose community services that will meet people's needs into the future. I have just spent the past two and a half hours in the Seanad dealing with Committee Stage of the Mental Health Bill, and I will be back in there again tomorrow. It is important that we have services that are fit for purpose. Erkina House is operated by the HSE as a fully staffed community mental health residence. The HSE has advised the Department that there are three remaining residents supported at the residence. Erkina House has provided much-needed mental health support to many people over two decades. I acknowledge the care and affection and immense mental health supports provided by the staff there. However, it is not the type of mental health facility we would build today. In that regard, there are documented issues with the configuration of the building as a mental health service. In 2018, a report by the Mental Health Commission inspectorate outlined the need for a significant response to multi-occupancy rooms. This was further recommended by the HSE for the purpose of infection prevention and risk control during the Covid-19 pandemic. The HSE has advised the Department and me that Erkina House would be significantly non-compliant with forthcoming Mental Health Commission community residence standards and that a significant level of investment would be required to develop the facility in order to achieve the additional regulatory standards required. An independent review was commissioned by the chief officer of the HSE midlands-Louth-Meath community healthcare organisation in 2022. The review was completed on the basis of a potential move of services to another location in County Offaly. This is no longer an option being considered by the HSE. The review strongly recommended that the views of residents on their future service provision be the focus of decision-making. A person-centred management model has been implemented by the HSE, which has indicated that the remaining residents wish to move to other long-term care facilities elsewhere in the community. The HSE has advised the Department that this property is not suitable for upgrade and adaptation, and, accordingly, no new admissions to Erkina House will be undertaken. The HSE has provided assurances to the Department as to the service provision being made for the existing residents to properly meet their needs. I will not go over these details on the floor of the Dáil because the number of people involved is so small that the individuals involved would be identifiable. I would be happy to engage with the Deputy offline on that matter. It is important to address the situation with the staff. At present, there are 12 staff based in Erkina House, five nurses and seven multitask attendants. Consultation with staff and their union representatives is planned for later this month to collaboratively negotiate and agree transition plans. This will be informed by the expressed will and preference of the remaining residents on their plans to leave Erkina House to go into further long-term residential care. In my concluding remarks, I will discuss the Deputy's concerns about Rathdowney and south County Laois and how we can work with him on investment in the area.

I thank the Minister of State for her response. I understand and appreciate what she is saying, but, obviously, I have a number of questions. As already stated, the Minister of State was involved in an issue relating to Erkina House a number of years ago and was very positive and helpful on that occasion. The Minister of State indicated that a significant level of investment would be required to develop Erkina House in order to achieve the additional regulatory standards required. We all agree on that. Everybody in Ireland agrees. Everybody in Rathdowney agrees. The reason that is required is because the place was starved of investment in recent years. Those responsible deliberately made sure that nothing was done in an organised manner when there were up to 12 residents on the premises. They chose to close it by stealth. That is the word I would use. If the facility has been starved of investment, it will not meet the new requirements necessary for the health and safety and the mental health of the people there. We have a great asset in Rathdowney. I have been told that the Minister of State has been looking at getting a new health centre in a different location. Very recently, I have had it in writing from the HSE that the Minister of State will not proceed on that basis because it is too expensive and that she will look at the property owned by the HSE in the town. I ask that there be an extension to the existing health centre at its current location or that it be combined with Erkina House in order that, like many other HSE buildings, it will have a dual use. I ask for that to be considered, if appropriate. We are short of respite places. This facility could be suitable in that regard. There are two nursing homes that have been in the national media and before the courts in recent months. As a result of that, the HSE is currently not using them. People looking for respite have to travel a very long distance outside the county to get that. People should be able to get respite within their own county. We have the property in Rathdowney. Of course it needs investment, but it could be a multi-use facility. I ask the HSE not to turn its back on Rathdowney, as it seems to be doing in the context of both Erkina House and the health centre.

I understand the strength of the Deputy's feelings. As I said, he has been advocating for Erkina House for many years and also for the residents who live there and who called it their forever home. I understand how difficult it is for residents who have lived in a facility that they will have to move away from for several reasons. The Deputy has accepted that the building is no longer fit for purpose in the context of the provision of mental health supports. It no longer aligns with the mental health policy, Sharing the Vision, and HSE policies, including Time to Move on from Congregation Settings and Design for Mental Health Housing 2015 to 2017. However, I hear him loud and clear in relation to the facility. On many occasions, the HSE has moved out of facilities and they have been left unused. I am very much of the view that every option should be explored. I will make contact with the HSE in the region to see that all options are explored on the future use of the premises. I am conscious of the issues the Deputy raised in respect of the health centre. My first priority is to the three residents at the facility in the context of making sure that they are moved on safely and securely and that they get the long-term residential care they need. My next priority is the 12 staff. This is a time of uncertainty for them. I will request that every effort be made to support the staff as they are relocated. Obviously, this can be a disruptive process for many people. I reiterate that I am happy to work with the Deputy to explore all options for the premises.