‘I haven’t got the mental energy to do this any more’ ABANDONED BY THE HSE
On the one hand these families are being promised that their local care home will stay open, on the other HSE managers are publicly stating a decision has already been made to close it. As they simply seek a solid future for their vulnerable loved ones, they are demanding Government intervention
SITTING AT his kitchen table last Tuesday morning, Liam Walsh listened in weary, defeated silence to the podcast of a local radio show that had been broadcast the day before. ‘It’s not about whether the facility has a future or not,’ chief operations manager of HSE West, Tony Canavan explained. ‘I’ve already been very clear... from September 2016 we haven’t made any new admissions and I’ve no plans, and we haven’t veered from this one iota, no plans to change that position...
‘So the long-term future of the unit, that decision has already been taken.’
‘I swear to God, as I listened to him talking I just thought to myself: “I haven’t got the mental energy to do this any more,”’ Liam says, the frustration and distress palpable in his voice. ‘But then I looked up at my eldest son David, who is just seven years old, eating his breakfast beside me.
‘I’m always telling him about how we have to do the right thing, be the best person we can be. And I knew that if I didn’t go on, I wouldn’t be able to look him in the eye. So, here we go again.’
It’s just three years since Liam sat in a room in Leinster House with the then Junior Health Minister, Kathleen Lynch, as she gave her firm commitment that the residential unit where his mother Breda has lived since 2009 would not close.
The Rosalie Unit on the outskirts of Castlerea, Co Roscommon — already a well-known name in political and health service circles — is a HSE-run facility for pensioners with mental health issues. It was first threatened with closure in 2015 but after locals rallied and protested, they were promised that it would remain open and its future was secure.
‘I remember that meeting with Minister Lynch and the then HSE West boss, Bernard Gloster, so well,’ says Liam. ‘Bernard opened it up by apologising to the families of the residents for all the stress and upset we had been caused.
‘While the Minister told us: “I can give you a firm commitment that our policy will be that it is not closing. It won’t close and it will form part of the mental health services for this region going forward. It won’t be allowed to fall below 15 beds.” We then had it confirmed to us in writing in a letter from the office of the then Minister for Health, Leo Varadkar, to our county council.’
It would appear, however, that a decision to shut the unit was taken again just over a year later. Not that the families or staff were ever officially told. Instead, they say, they were left to figure it out for themselves.
They began to notice that things were getting very quiet around the once vibrant centre. It had 34 residents when Breda Walsh, who has dementia, first moved there but now has just 12.
‘They put an embargo on taking in anyone new in September 2016,’ Liam explains. ‘They did it without telling anyone. The only reason we know is because we noticed the place was getting quiet so people started asking questions.
‘That’s how we found out that they were planning on closing the Rosalie again.’
It has been a long, exhausting and deeply frustrating battle for the families connected to the Rosalie Unit who utterly believe the best thing for their loved ones is to stay where they are.
It’s a fight that ended up in the Dáil again this week, as well as being mentioned at the Joint Committee on Health. The families say getting responses and clarity on the situation from the HSE has been extremely difficult. And that the interview earlier this week on Shannonside Radio with Tony Canavan was the first time he has admitted that the unit is definitely closing.
‘It flies in the face of everything in the agreed procedures,’ says Liam. ‘The HSE have done exactly what we said they would do from day one. But I have an email from Jim Daly [Minster of State for Mental Health and Older People] that says no decision will be made until the assessments were carried out and then reviewed.’
Indeed Jim Daly’s email, dated May 24, states: ‘As agreed at the meeting on May 2, the clinical assessment process currently under way by the HSE is expected to be completed shortly. Following this, the HSE will revert to me on the outcome of this process.
‘It was also made clear at the meeting that engagement between the HSE and local stakeholders should be maximised in the meantime, and that no decision has been, or will be taken, in relation to the Rosalie Unit, until these assessments have been completed and reviewed.’
On Monday’s radio show, however, Canavan told listeners that while the assessments have been carried out, they have not yet been reviewed.
‘That process is complete,’ he said of the assessments. ‘And in order to make a final decision on it, I’ve asked for an independent review, which I expect to be done in the next few weeks... Certainly by the end of July we’ll have a clearer picture.’
As it stands, things are far from clear. Canavan may have claimed on Monday that the long-term future of the unit has been decided, yet two days later at the Joint Oireactas Committee his predecessor Bernard Gloster, now chief officer of HSE Mid West Community Healthcare, said otherwise.
When asked by Sinn Fein’s Louise O’Reilly if the unit was closing down, he replied: ‘I’ve just texted my colleague [Tony Canavan] and he did assure me that no decision has been made yet.’
Deputy O’Reilly asked for confirmation of this in writing and Gloster was quick to agree to the request. ‘Whatever public anxiety there is,’ he said, ‘I’m sure he [Canavan] would want to bring some clarity to that.’
‘You know when we had a public meeting back in early February of this year, Tony Canavan promised there would be full disclosure,’ says Liam Walsh with a sigh. ‘The next thing we heard from him was that radio show on Monday.’
The families are also unhappy at how the assessments were carried out.
‘All of us got letters to tell us to meet with the clinical psychologist, which we did,’ he explains. ‘It was a very casual meeting, just a chat. Every single one of us asked her if this was the clinical assessment. She categorically told us that no, it wasn’t and that it was just a care plan meeting.
‘Last Friday, however, at a meeting with public representatives, Tony Canavan told them the assessments had been carried out and they were now going to be reviewed by an independent third party.
‘But as far as we’re concerned the assessments have not been carried out yet, we were categorically told that the meetings with the clinical psychologist were not assessments. And if they had them in the meantime, surely we would have had some sort of knowledge of them? It shows little regard for us and our family members.’
It would seem the the row over the Rosalie Unit is set to get even bigger. Last week at a meeting between public representatives and the HSE to discuss the unit and the closure of a day centre in nearby Ballaghaderreen, Independent Minister Denis Naughten ended up walking out.
‘I left the meeting in disgust as clearly the HSE is not prepared to even consider the impact this is having on residents or views of next-of-kin,’ he later explained to a newspaper.
‘I’ve written to Jim Daly on foot of the meeting and I’ll be seeking a meeting with him and the Minister for Health this week.’
Another local Independent TD, Michael Fitzmaurice, was also unequivocal in his outrage at the handling of the matter by the HSE. ‘I was at that meeting where we were assured it wouldn’t be closed and where we were promised it would, in fact, be enhanced and brought up to 30 beds,’ he told the Irish Daily Mail. ‘It’s been done by stealth. And it’s going to come down to a political decision because the HSE have already made up their minds about the Rosalie, a long time ago.’
Fitzmaurice pointed out that the current Government is in a vulnerable position, propped up by Fianna Fáil and Independents like Minister Naughten, and that this was something that should be considered when pushing for action.
‘It’s like the HSE can do whatever they feel like,’ he said. ‘And the only way we’ll stop them is by causing problems for the Government.
‘At a meeting a few months back, Minister Naughten said he’d talk to Leo Varadkar, that he was standing with the people of the Rosalie. He was impressive and I told him so... Well the time has come for him to honour what he said.
‘I’ve sent emails to Micheál Martin, Mary Lou MacDonald and Eugene Murphy [local Fianna Fáil TD]. I sent them two months ago looking for a motion to be brought up in the Dáil. But there’s been a lot of ducking and diving.
‘There’s no question that the Rosalie needs to stay open, it’s a good facility. And this claim that it
‘It’s like the HSE can do whatever they feel like’
‘No one knows anything, we get mixed messages’
can be replaced by a community care service vexes me. I have a person coming to me at the moment, who has tried to commit suicide twice. There’s no community care going out to them. It’s just not there. We feel Tony Canavan is trying to ram the closure down people’s throats.’
The Irish Daily Mail did try to contact Tony Canavan this week, but our request for an interview went unanswered.
He has explained before, however, that he believes the residents at the Rosalie would be better served elsewhere.
‘I have expressed the opinion for many months now, that I think it is possible that we would be able to provide better care for the residents in the Rosalie Unit in a different setting,’ he said. ‘And the reason I’m saying it is because the balance of their care needs has shifted — from mainly of a psychiatric nature when they would have been first admitted to one that is now of a medical nature because people are older.’
Families of people at the unit, however, are adamant that the care they are getting there is excellent. Indeed I visited the unit in April with Liam Walsh. It’s a warm, bright and spacious centre, which I described in my dispatch for this newspaper. A couple of days after my visit the code for the front door was changed and, unlike before, Liam and other family members must now report to the front desk before being allowed in to see their loved ones.
Jean Anderson’s brother Terry has suffered with severe mental health issues since his 20s. She moved back to Roscommon from Dublin after their mother died to take care of him and six years ago he was given a place in the Rosalie. Jean has been delighted and relieved at the care he has got there, a place where he has made friends and adores the staff who take care of him.
‘They’ve been together for so long,’ she says. ‘I really mean this when I say they are like family now. To split them up now, well it’s just a disgusting way to treat them.
‘Terry is very aware of what’s going on. Only yesterday he was asking me when this meeting was taking place and what’s going to happen?’ she says of a public meeting that has been called for this Monday evening in Castlerea. ‘Are they going to send him some place else?
‘But what can I tell him? No one seems to know anything and we keep getting mixed messages. Personally I think Leo Varadkar needs to do something. He was Minister for Health when we were promised it would remain open. He needs to do the honourable thing and stand by what he told us.
‘We’ve been pushed around around so much, it’s just so unfair on the residents.
‘And Tony Canavan’s opinion that they would be better off elsewhere? He’s not a clinical physician, what would he know? It’s also a slight on the staff who work there and do a fantastic job.
‘There’s a real air of disquiet in there at the moment, from the residents and the staff, it’s horrible to see it like that. Someone has to step in and say enough is enough.’
Senator Maura Hopkins, who lives in Castlerea, could see things being wound down at the Rosalie and had her suspicions confirmed when approached by the concerned family members. Despite travelling to Galway on a couple of occasions, to seek answers about what was happening at the unit, she felt she was being brushed off by HSE management.
It took putting forward a parliamentary question through Fine Gael TD Peter Burke before they finally got confirmation last November that there had been an embargo on any new residents being admitted to the unit since September 2016.
‘I believe that if it hadn’t been brought into the public domain there would not have been any engagement at all with the families,’ she told the Irish Daily Mail this week.
‘And even as it is, the engagement that there has been, is not what you would have expected. There seems to have been a lot of miscommunication, the assessments for instance, where families were told they were just there to help with updates on care plans, not to decide on their loved ones’ future.
‘I raised the issue again with Minister Jim Daly yesterday when I met him. And I met Minister Simon Harris on Monday and reiterated my concerns to him. There is a lot of frustration out there that the HSE is just not listening to the concerns of the families or the constituents.’
Indeed Liam Walsh’s frustration and anger appears to have reached tipping point.
‘It’s deeply upsetting for all of us who have family members in the unit but it’s also worrying for everyone in the area,’ he says.
‘What is going to happen in the future? There are just 12 residents left but room for three times that many. As far as I’m concerned the HSE has manipulated the situation — as people died, their places at the Rosalie were not filled. And as numbers dropped, the unit became less and less viable. The HSE made it not viable.
‘But they have yet to provide an properly viable alternative to the unit. I have it straight from people who are working in mental health services in this area, the suggestion of an outreach team taking over is not viable. The team is at best skeletal, this is what I’ve been told by senior staff, it’s just not functional.
‘And take my own mother’s case, when she moved into the unit in 2009 she was still able to walk, talk and feed herself. If the system they are proposing was in place then, they would have insisted that she live with me and one of their outreach team might call out to us once a week to make sure everyone was still alive. That’s the best they can offer.
‘I would probably be dead by now if that had happened, I would certainly be divorced. There is a need for a residential care unit like the Rosalie. The Government’s own policy, Vision for Change, states there should be 30 beds per 300,000 population. It’s there, in black and white, but they’re ignoring it.
‘So that’s why we still have to fight this fight, not just for the residents, but for everyone.’