HSE accused of mismanagement over €940 daily spend on security for patient

THE HEALTH Service Executive (HSE) was last night accused of gross mismanagement of resources over its daily spend of €940 on security for one patient at a psychiatric unit in Ennis.

Making the charge, Fine Gael health spokesman Dr James Reilly TD said: “This is a classic case of penny wise and pound foolish by the HSE.”

Since July of last year, the HSE has spent €364,308 on providing 24-hour security for the 35-year- old Ennis man, who suffered brain damage after a concrete block was dropped on his head during the course of an assault 10 years ago.

The man was involuntarily admitted to the acute psychiatric unit at Ennis General Hospital after there was no space at the Central Mental Hospital (CMH) and subsequent tests of the man found that he was unsuitable for admission at the CMH.

Yesterday, the secretary of the Psychiatric Nurses Association (PNA), Des Kavanagh, said that the acute unit in Ennis “is an inappropriate place for this man”.

He said: “If the HSE had proceeded with the plans outlined in the 2005 document A Vision for Change and built a secure psychiatric unit for the west of Ireland, this man would have care in a properly structured environment and the HSE would not be spending a small fortune on security at a time when resources are very, very scarce.

“It is not fair to the patient, to the staff or other patients at the acute unit that he is there. It is a frightening experience for other patients to see one patient being accompanied by two security guards at all times,” he added.

“Having the man placed at the acute unit in Ennis – where patients are normally treated over a three- to five-week period – is not ideal and is not allowing him to maximise his potential, ” said Mr Kavanagh.

He also said that the security spend is reflective of the HSE not making the proper investment in infrastructure for patients. Mr Kavanagh said that he hopes the care plan for the man will be the subject of discussion between the HSE and the PNA at the Labour Relations Commission.

The HSE has this year cut the budget for the psychiatric unit by 11.5 per cent to €3.7 million and Mr Kavanagh claimed that the spend on the man’s security is coming from the €3.7 million.

However, HSE spokesman Bernard Gloster said last night: “It is wrong to suggest that the costs incurred in ensuring the safety of this patient, and that of hospital staff and other patients, impacts in any way on services for other mentally ill persons in Co Clare.

“We would be rightly criticised if we did not take steps to do the best we can in a tragic and most difficult case.”

The HSE said it considered care at other locations in Ireland and in the UK for the man, “but these were not advanced because of associated costs and considerations dealing with quality of care”.

The statement went on: “The patient’s case has been reviewed on numerous occasions by independent mental health tribunals which have declared themselves satisfied that, while the acute psychiatric unit at Ennis may not be the ideal setting, it is the best one possible at present given the circumstances of the case.”

It added “there is no conflict between Ennis General Hospital and the CMH on admission and clinicians believe that the optimum treatment is best provided in a secure care setting given the fact that the patient’s condition requires management and not treatment”.

The statement pointed out that the man was referred for assessment at the CMH, but the clinical outcome found that the patient was unsuitable for admission.