A High Court judge has described mental health services in Co Roscommon as in “a crisis situation”.
An interim report to the court described the services as “dysfunctional” and carrying “unnecessary risk”, Mr Justice Tony O’Connor noted.
He made the remarks when dismissing an action by senior HSE executive Helen Earley aimed at preventing her temporary transfer to an alleged lesser role.
While Ms Earley was never subject of any investigation or disciplinary process, the HSE sought to temporarily re-assign her while a review was being conducted into allegations of sexual abuse and an alleged cover up at HSE mental health facilities in Roscommon.
Ms Earley claimed her reputation would be damaged by such a move and sought to remain in her position as the HSE Area Director of Nursing, Galway/Roscommon Mental Health Service. Last July, she got an injunction preventing the HSE moving her pending the outcome of the hearing.
It was argued, since July 2012, Ms Earley has overseen very significant changes, including implementing “tough cuts” and this resulted in a significant dispute with the Psychiatric Nurses Association (PNA). The reason for the move was to appease the union and the HSE had no contractual entitlement to transfer her to another role, she claimed.
The HSE, represented by Peter Ward SC and Tom Mallon BL, argued it was entitled to reassign her temporarily pending the outcome of several investigations concerning facilities she had responsibility for. These include a system analysis, full national review and a screening process.
The decision to reassign Ms Earley came after the Mental Health Commission (MCH), which regulates the HSE’s provision of mental health services, raised very serious concerns with the HSE about welfare of some service users in Roscommon and local management’s response to certain incidents.
The Nursing and Midwifery Board of Ireland also informed the HSE it had notified gardaí about withholding of information on offences against children and vulnerable persons.
Mr Justice O’Connor said that “begged the question” about the failure of the HSE’s local management to notify gardaí about such allegations. There were concerns about alleged sexualised behaviour of a service user of a facility, allegations concerning a member of medical staff, anonymous complaints and claims of a cover up, he said.
All this resulted in reviews being established to see if procedures and reporting policies of the HSE’s mental health facilities were operating properly, he said.
In his reserved judgment dismissing the action, Mr Justice O’Connor ruled no bad faith conspiracy or failure to recognise Ms Earley’s rights had been established. The decision to move her was not made with a view to investigate Ms Earley’s conduct or to starting disciplinary proceedings against her personally, he said.
The HSE decided to initiate a review and screening of anonymous complaints, and it was considered prudent to reassign Ms Earley while those processes were ongoing, he said. Nor was the purported transfer done to appease the union.
It was never disputed by Ms Earley during the case that mental health services in Roscommon are in a state of crisis, he said. None of the evidence persuaded the court to a conclusion other than the services are “in a crisis situation.”
An interim report to the court, part of an external review, stated there was “poor implementation of governance arrangements and major relationship difficulties at most levels within the organisation”. It also expressed increasing concern mental health services for the people of Roscommon are “dysfunctional and carry unnecessary risk.”
The MHC in its report last September said many of the corrective actions it raised about one mental health facility in Roscommon had not been implemented months after it had first raised concerns. The judge said he did not accept the temporary reassignment was a sleight on Ms Earley’s reputation and said she appeared “rather precious and melodramatic about the effect on her status”. He was “bewildered” by her refusal to engage positively with the HSE when the issue of reassignment arose. She had not been accused of wrongdoing and is not the subject of a disciplinary process, he noted.
No matter how one might sympathise with her perception of what people might say following her reassignment, it was quite apparent she became so consumed with asserting her rights she ignored her own responsibility for good governance and management, he said.
While it is a constitutional right for disputes to be litigated, professionals should recognise the most vulnerable in society, such as those who require mental health services, have rights which professionals and the courts ought not allow to be affected by the litigation process if at all possible, he said.