In the first case of its kind, the HSE pleaded guilty in Kilkenny District Court to two charges relating to the physical conditions in the department of psychiatry of St. Luke's General Hospital, Kilkenny and to two charges relating to not having a consultant psychiatrist sign patient seclusion orders within 24 hours of the seclusion taking place, as required by law. Judge Brian O'Shea fined the HSE and said:

For too long in this country, mental health issues have been ignored and stigmatised. The testimony of the inspectors and photographs [taken during the inspection] are the physical manifestation of that lack of care. What makes this worse is that the facilities here are those that house the most vulnerable people. Those people matter and the environment in which they are cared for matters.

The chairman of the Mental Health Commission, Mr. John Saunders, stated: "As a regulatory body, it is entirely unacceptable to find conditions that you would have expected to find in a Victorian workhouse in a mental health service in Ireland in 2019."

I will not go into detail on the issues raised in the court case: I would not have enough time to do so. The details are absolutely shocking. It is now quite clear that the unit is not fit for purpose. Most of those who know and have worked in the unit are satisfied that this is the case. Staff have been involved in industrial relations continually to rectify the problem.

The mental health services crisis at St. Luke's in Kilkenny and in south Tipperary has been ongoing since it developed in 2012, when the then Government and former Labour Party Minister of State, Kathleen Lynch, closed the 50-bed inpatient psychiatry unit, St. Michael's, in South Tipperary General Hospital, Clonmel. The closure of that unit was opposed by everybody, including nurses, doctors, patients and the public. All advised against it and warned about the difficulties and dangers that would ensue. Unfortunately, we were not listened to, and now the unit is not fit for purpose and continuously overcrowded. Patients are admitted to sleep on couches and mattresses on the floor. South Tipperary patients admitted to the unit are delayed on an ongoing basis and they suffer from inappropriate early discharge. There are also transport difficulties. I acknowledge the work of the Minister of State, Deputy Jim Daly, on this issue. He has accepted that the decision to close St. Michael's unit was wrong. We are working with him in the hope of having the unit reopened.

This is the straw that breaks the camel's back. We want to know sooner rather than later, and hopefully from the Tánaiste today, that the Government will agree to and support the reopening of inpatient psychiatric beds at St. Michael's, Clonmel.

On the Deputy's comments, it is true that the Mental Health Commission took a case against the HSE because of the poor conditions in St. Luke's Hospital, Kilkenny. I have read the background to this. The Deputy very helpfully agreed to let me know the issue he was going to raise this morning. As he said, it is pretty shocking. The HSE's mental health service accepts the serious concerns expressed by the Mental Health Commission and the findings from the legal proceedings. I am assured, however, that remedial works are already under way. The HSE has prioritised the psychiatry facility in Kilkenny for upgrade works valued at in excess of €1 million to bring it up to standard. The investment will address deficiencies identified during inspection processes and will include a comprehensive maintenance programme across the facility to ensure full compliance with regulations set by the Mental Health Commission in respect of privacy and premises. A household supervisor has been appointed and additional household personnel have been allocated to St. Luke's to address the cleaning deficits identified during the inspection of the premises. A training programme has commenced for staff and rules governing the use of seclusion.

Nobody is doubting that the concerns outlined and aired in a legal case by the Mental Health Commission are not serious and need to be addressed but €1 million has been committed to respond.

With regard to south Tipperary, I recognise the work the Minister of State, Deputy Jim Daly, is doing. There are plans to provide a new respite facility in Clonmel to replace Glenville House. A new modular 40-bed unit is being delivered at Clonmel hospital. The question of including psychiatric beds in a 50-bed unit planned for the hospital is also being raised by local public representatives. The Minister of State met Oireachtas Members and various local representatives to discuss current and future provision of mental health services in Tipperary, including a review of bed capacity. He also visited mental health facilities in South Tipperary. Arising from this discussions, he is expecting the HSE to submit a detailed report in the near future, and he will then consider the options available to improve acute capacity in Tipperary.

Any works to upgrade the unit in Kilkenny are welcome. There is a proposal for a crisis house in Clonmel but that is not the issue here. The issue is the availability of inpatient psychiatric beds in Tipperary and the fact that the current service is simply not fit for purpose. The court case is not the only issue. In fact, it is only the tip of the iceberg. The Mental Health Commission reports for 2015, 2016 and 2017, the most recent available, state that in all 21 areas covered, the Kilkenny unit is non-compliant. In many of the areas, such as staffing, premises, drugs and the transfer and admission of patients, the unit has not been compliant since 2015. The fact of the matter is that it is accepted by the HSE and the Minister of State, Deputy Jim Daly, that there are not enough psychiatric inpatient beds in the south east. It is 20 beds short. We want some of the beds back in Tipperary. We want the Government to reopen beds in Clonmel. This is the tip of the iceberg. We have been waiting for inpatient beds for far too long. They should never have been closed.

As the Deputy knows, the 44-bed department of psychiatry based in St. Luke's General Hospital, Kilkenny, is the designated approved centre for acute inpatient services for south Tipperary. Clearly, my previous answer recognises that there were significant problems in regard to that unit. They are being addressed, I am assured, and not before time. From reading the note on the context, I can see why some people would be very angry about this. It is being addressed now, I am assured.

The issue of capacity in south Tipperary and the potential need for further investment in acute beds for mental health services are being considered by the Minister of State, Deputy Jim Daly. He is expecting a report from the HSE in this regard so he will be in a position to make decisions. I will certainly ask him to respond directly to Deputy Healy as soon as he has a recommendation in that regard.