The Mosney accommodation centre for asylum-seekers in Co Meath is considered by the Government to be the "flagship" of such centres around the country.
However a highly critical report drawn up in recent weeks by the North Eastern Health Board (NEHB), which is responsible for providing health and social services to the 800 people living at Mosney, indicates that all is not well at the former holiday camp.
Over the last four years the number of asylum-seekers accommodated in Mosney, under the Government's controversial "direct provision" scheme, has increased from 200 to around 800 at present. However the report suggests that neither the funding nor the staffing levels were put in place by the Government to meet the needs of this growing population.
"It has been identified that the Mosney centre whilst providing excellent accommodation facilities is not providing healthcare to meet the identified needs of its population," the document states.
The report criticises the administration of childhood immunisations and warns of the potential of infectious diseases spreading through the camp.
The report highlights delays in the administration of immunisation to babies who, according to the health board, can sometimes be nearly four months old before they receive their five-in-one injection which should be given at two months.
"Children of school-going age are not being offered their booster vaccinations which are recommended in the Irish population at 4-5 years of age.
"Apart from good vaccination uptake rates being a cornerstone in a healthy population, the living accommodation in Mosney is rather confined, so if an infectious disease were to break out it could spread fast in a susceptible population," the report states.
Controversially, the report maintains that there is evidence that the direct provision system operated by the Government for most asylum-seekers - under which the State provides full board and lodgings and only a small cash sum per week - can "impact negatively on infant nutrition".
The report states that a recent study showed a reduced rate of breastfeeding among mothers from cultures where breastfeeding rates were traditionally high.
"The free distribution of formula feeds is believed to have promoted bottle feeding among these women. Problems were identified with sterilisation of equipment and continuation of feeds."
The report states that a national committee is currently developing best practice guidelines on infant nutrition for direct provision accommodation providers.
The report also states that the health board has experienced "particular difficulty" in securing GPs to provide medical services at Mosney despite what it maintains was a considerable financial incentive offered. "Experience (since the centre opened) would indicate that on average each resident attends a GP at least once a month."
The report states that the accessibility of the health centre for residents results in constant demand for GP/medical attention even outside of clinic times.
"Afternoon GP cover is provided by a local GP on an on-call basis. Centre nursing staff feel pressurised into a 'triage' role as there is no clear protocol in place for this practice."
The provision of GP services at the centre will cost around €300,000 this year, the report estimates and it recommends that a full GMS medical practice be established. The report also highlights problems with the provision of ante-natal care for asylum-seekers at Mosney.
It says that recent instructions from the State Reception and Integration Agency for women with "complex" pregnancies to continue ante-natal care in Dublin hospitals had "presented the health staff at the Mosney Centre with further ambiguity around ante-natal care with many residents perceiving care as being inequitable".
The report also expresses a warning about the nursing service at Mosney. "As employees of the NEHB and in the absence of clear protocols and guidelines, the nurses themselves may compromise their own scope of practice and potentially have taken on specialist/advanced nursing practice role."
The report maintains that due to limited nursing resources it has been necessary to defer key services including post-natal care of mother and baby after two weeks, home visits to chalets and primary development screening for young children .
The report also highlights problems with the community welfare service - which operates a clinic once per week - due to lack of resources.
It maintains that nursing and administrative staff often face "dilemmas" in dealing with distressed residents and warns that there are "potential crowd control issues" on some occasions.
The document also criticises "current practice and communications" between the health board and the Reception and Integration Agency regarding the arrival of pregnant women and families which it says are not adequate or appropriate given the potentially high risk health needs of this group.
