JOINT COMMITTEE ON HEALTH AND CHILDREN debate -
Tuesday, 9 Sep 2008

Central Mental Hospital: Motions.

Chairman

We have two motions before us. Deputy Reilly's motion reads, "That this committee ask the Minister for Health and Children to review the decision to relocate the Central Mental Hospital from Dundrum to the proposed new site at Thornton Hall." Deputy Conlon's motion reads:

That this committee ask the Minister for Health and Children to examine the decision to relocate the Central Mental Hospital (CMH) from Dundrum to the proposed new site at Thornton Hall, with a view to confirming that (a) the value of the Dundrum site will be maximised in order to fund a new CMH and to further improve psychiatric services and (b) that the new CMH in its location will be a health facility managed and staffed solely by appropriate health professionals and entirely independent of any other state facility.

Are those motions to be moved? We also have a proposal from Deputy O'Hanlon that consideration of the motions might be deferred pending hearing from the Minister. I am entirely in the members' hands in this regard. We will proceed as the majority of members decide.

Deputy Rory O’Hanlon

Given that we have had a long debate lasting two and a half hours, we might well have forgotten everything that was said the next day and would need to have the entire debate again. Therefore I withdraw my proposal.

Deputy Caoimhghín Ó Caoláin

I realise the restrictions that apply. Not being a member of the committee I cannot participate. However, I wish to make an observation on the motion tabled by Deputy Reilly and seconded by many Deputies and Senators, which I would support. I would flag up one word in the motion. The motion asks the Minister to review. My sense is that the word "reverse" would reflect more accurately the opinions of those whose names are appended to the motion and certainly my own. I believe the decision should be reversed.

Chairman

Would Deputy Reilly like to move the motion?

Deputy James Reilly

I would like first to respond to the previous speaker. The motion was tabled in a spirit of co-operation with a view to trying to achieve unanimity in the committee. Clearly the intent is that the Minister would review the decision in light of all the issues raised by so many experts and expert groups and, subsequently, reverse her decision. I did not want to put the gun to the head of many of those on the Government side who are very unhappy with this decision as some stated clearly and others stated not so clearly. They realise this decision will come back to haunt us for years to come. It is a flagship development. We are all agreed we need a new service for people with mental illness who are in the Central Mental Hospital. We all agree that building is well past its sell-by date. However, we cannot be rushed into a decision that will stigmatise our mental health patients for many years into the future.

I have a very strong objection to the decision. I object to it as an Irish citizen. I object to it particularly as a doctor. I know of no other doctor to whom I have spoken on the matter who agrees with this move and sees a benefit in it.

Deputy Rory O’Hanlon

I have no objection to it.

Deputy James Reilly

Fair enough.

Deputy Noel Treacy

The Deputy is cancelled already.

Deputy James Reilly

I disagree utterly with Deputy O'Hanlon, as do most of his colleagues.

Deputy Rory O’Hanlon

And I respect Deputy Reilly's right to disagree.

Deputy James Reilly

I also respect the Deputy's right to say what he says. I do not believe the decision is in the best interests of patients or of the future development of psychiatric services. I vehemently oppose it, as do most independent people who are not in this room. The Mental Health Commission opposes it. For God's sake, what is the point of having people appointed by the State to regulate bodies? What is the point of having experts? What is the point of having representations from families and patients? No one is in favour of this apart from certain parties on the other side of the House. It beggars belief that we are even proceeding with this. This motion needs to be taken and passed on to the Minister. It will give the Minister some room in which to manoeuvre away from the catastrophic decision she is about to make. We hear platitudes, but what we see is a willingness to prioritise saving money above saving patients. The Government is more concerned about its coffers — its bottom line — than about the people who need services. I hope those who agree with me will have the courage of their convictions. They should walk the walk, as well as talking the talk, by voting against this proposal. My motion will give the Minister an opportunity to review her decision. She needs to be given time to appreciate the error of her ways, with the benefit of hindsight. As Ms Nic Aongusa said, Professor Kennedy came to understand that the decision which was made was wrong when he reflected on the matter. I ask the Government members of the committee to support my reasonable motion, which calls on the Minister to review her decision. If they do not vote this proposal down, the people will judge them harshly for a generation to come.

Deputy Jan O’Sullivan

I assume that Deputy Reilly will move his motion later. He is responding to Deputy Ó Caoláin's comments at this stage.

Deputy James Reilly

Yes.

Deputy Jan O’Sullivan

I will second the motion when it is moved. I strongly appeal to the other members of the committee to support it at that stage. As Deputy Reilly has said, the word "review" was chosen carefully to make it possible for the entire committee to support his motion. We could easily have used the word "reverse", which would have been much stronger. We are merely asking the Minister to review the decision. It does not appear, from what I have heard today, that the decision has been re-examined since it was first announced in 2005. That announcement was made by the Department of Justice, Equality and Law Reform, rather than the Department of Health and Children.

While I accept that Ms Nic Aongusa spoke eloquently, I am disappointed that she could not confirm whether a written record was kept of the professional advice that was received by the Department or the various team meetings which were apparently held. It is disturbing that there does not appear to be any written record of the basis on which a significant decision was made. This proposal, which involves a substantial amount of public money, will affect the health of a sector of the community. It is strange that there is no written record of how the decision was made.

It is worth noting that those who will be most affected by this decision — the Central Mental Hospital's patients, their families and the professionals who are directly involved in their care — are those who are most vehemently against it. As public representatives, we have a duty to represent the views of such people. We need to ensure that their opinions are considered when any decision that directly affects their lives is made. It does not affect our lives, but it directly affects the lives of the people I have mentioned. As my colleague, Deputy Kathleen Lynch, rightly said, it will be extremely difficult for people who walk out of the Central Mental Hospital in Thornton Hall to engage with the outside community in any way. That is the most damning element of all of this. The green fields they will see when they walk out may be nice, calm and peaceful, but the same can be said of the Dundrum site. There will be no community on the doorstep for the patients to interact with.

The Minister of State, Deputy Moloney, who chaired this committee for some time, is a reasonable man. My personal experience of him is that he is a caring man. I put it to him that this decision needs to be reviewed. This is a reasonable motion. I urge all members of the committee to support it.

Chairman

I ask Deputy Conlon to move her motion.

Deputy Margaret Conlon

I move motion No. 1:

That this committee ask the Minister for Health and Children to examine the decision to relocate the Central Mental Hospital (CMH) from Dundrum to the proposed new site at Thornton Hall, with a view to confirming that (a) the value of the Dundrum site will be maximised in order to fund a new CMH and to further improve psychiatric services and (b) that the new CMH in its location will be a health facility managed and staffed solely by appropriate health professionals and entirely independent of any other state facility.

Deputy Rory O’Hanlon

I second the motion. We have had a number of discussions on the matter. We have heard evidence that the decision was made by a project team, who referred the matter to the then Minister. As he was not absolutely satisfied, the Minister spent more time considering the issue and the decision was made in 2006. We owe it to the patients who need this facility to move on. For that reason, I second the motion.

Senator Frances Fitzgerald

Deputy Conlon's motion appears to accept the decision to move the Central Mental Hospital from the Dundrum site to Thornton Hall. That is a shame given what we have heard from many groups which are concerned about the decision and many experts on mental heath. I regret the members who are proposing this motion cannot support Deputy Reilly's motion which proposes, at minimum, to review the decision. I also regret the apparent acceptance by other members of the decision to relocate the Central Mental Hospital to Thornton Hall.

It became clear today that relocation was a political decision taken somewhat hastily in 2005 when the Thornton Hall site was purchased and without much consultation with the Department of Health and Children. From the information we have received today, it appears that one year after, the project team took its decision in the knowledge of what was the political decision. It was asked to examine a political decision which was a fait accompli. I am not saying the project team did not examine the issue or consider various alternatives. However, it appears to have been working to a political decision taken in February 2005. That is the context.

It is regrettable that in taking a key decision on an important mental health facility, no international consultation or consultation with expert groups took place and submissions were not invited from key actors involved in this area. If, as was stated today, Dr. Kennedy's work is so valued — for good reason when one considers the improvements he has made in the Central Mental Hospital — his change of mind, irrespective of what he stated in the week after the decision was made, and the detailed submission he made today deserve to be listened to and taken on board by the key implementers of mental health policy.

I ask all members to support the motion proposing a review of the decision to relocate the Central Mental Hospital from Dundrum to the proposed new site. This is the least we owe to the carers and the expert group, the Mental Health Commission, established by the Government to advise on mental health issues. Before the project proceeds any further, we owe it to them to review the decision.

Senator Phil Prendergast

Supporting the motion proposed by Deputy Reilly and seconded by Deputy Jan O'Sullivan would not invalidate the views expressed by any member. I have not heard a better contribution on the issue than that of Senator Mary White. I commend her on her comments, apart from her statement that she would have to vote as she saw fit. A vote in support of the motion will allow the breathing space required by patients, families and professionals and take account of international best practice and Dr. Kennedy's revision of his original decision. It would not be an admission of wrongdoing or flawed decision-making processes.

I have never been so touched or moved by a contribution to a debate in the House or at any point in my 15-year career in politics as I was by the contributions of parents of some of the inmates of the facility. Their words about their loved ones and the facility which serves their needs were eloquent. I agree with what has been said about upgrading treatment facilities for people with mental illnesses. I understand there are difficulties in this area as I have a great deal of experience in it. Supporting the motion, however, will not diminish the standing of any committee member of any party. It simply allows the Minister time to re-examine the decision.

Deputy Margaret Conlon

The suggestion has been made that Fianna Fáil committee members have accepted a fait accompli. We have not. We have asked the Minister to examine the decision because we have listened to the issues raised today and on previous occasions, both inside and outside the House.

We have also gone one step further in asking that if the site at Dundrum is sold and money is realised, it should be ring-fenced to fund a new central mental hospital. The remaining moneys should be used to improve psychiatric services and not be subsumed into some other black hole. The new central mental hospital must be a health facility, managed and staffed by appropriate health professionals and independent of any other State facility. These were the concerns of the friends and parents of the patients when they attended the committee.

Deputy Joe Behan

The public will note that Deputy James Reilly and his colleagues opposite have rejected the opportunity to allow the Minister to attend the committee to discuss this matter. They want to get the motion through today without even talking to the Minister, who ultimately makes the decision. Deputy James Reilly talks about platitudes. He is the king of platitudes. He is a political tub-thumper who, unfortunately, goes one step worse than platitudes. He uses the pain of vulnerable people across the health sector as a political football. He has no regard for the feelings of people in vulnerable situations. All that matters to him today is to get a motion through and——

Senator Frances Fitzgerald

That is an outrageous statement.

Deputy Joe Behan

The Senator should allow me finish. Deputy James Reilly attempts to apply some kind of political punishment and embarrassment to Members of the Government parties because they have the courage to speak out and admit there may be difficulties with the issue. The Deputy just wants the motion put through in order that he can then go out to the public and claim he has achieved again in embarrassing the Government. In fact, he has done nothing, as always, to improve the lot of the people we all want to serve.

As Deputy Margaret Conlon stated, this motion is not the end of the matter. I support the amendment to the motion. I know other Fianna Fáil Members will continue this debate within our party to ensure the best possible result for patients. The time has come to stop the political play-acting and for us to work together for the benefit of all the people.

Deputy Dan Neville

We are asking the Minister to review the decision on the basis of what the committee has been informed. We want to exchange our views with the Minister after he has reviewed the decision. That is the objective of the motion. The Fianna Fáil amendment asks for a review of the decision on two points. The amended motion proposes that the value of the Dundrum site should be maximised in order to fund a new central mental hospital and improve psychiatric services and that the new facility should be managed and staffed by appropriate health professionals. These are the two criteria proposed by Fianna Fáil members. In other words, if these two conditions are met, they will be satisfied for the scheme to go ahead as planned.

It does not surprise me that the Minister and Minister of State who were deeply involved in this decision, neither of whom is currently a Member of the Dáil, had no understanding of the nature of the psychiatric services and the neglect of these services for decades. The need to invest in the service has been ignored and this decision is indicative of the lack of sensitivity towards persons with a psychiatric illness and their families. The stigma surrounding mental illness ensures those affected do not demand access to services and do not expose their pain and suffering. Coming from this milieu, it is not surprising that all the expertise presented to us was apparently given no consideration before the decision was made. We must request that the Minister review it. We will discuss the issues with the Minister as part of that review and take it from there.

Deputy Kathleen Lynch

I will support the motion. I put my name to it, even though, from the outset, I considered it a weak, milk and water proposal merely to seek a review. However, I was persuaded that in order for everybody to be able to support it, this was the motion we had to have.

I am long enough in politics to know that when somebody is losing the moral argument, the response is often to begin personalising the attack in order to throw opponents off the scent. The people in the Visitors Gallery whose loved ones are resident in various mental health facilities are not foolish enough to buy the argument that because one proclaims oneself to be on the side of the angels, that it is acceptable to attack those with a different view on a personal basis. I am glad that is not how we usually do business. It is a pity to see that type of behaviour creeping in.

We are all obliged to obey the party rules but it is unacceptable to justify one's stance by attacking another person on a personal basis. We should each have the courage of our convictions, make our decision publicly and state the reason for that decision. Senator White did so eloquently and explained that she would vote according to her party line because those are the rules by which we are governed. There is no doubt other members will vote against the motion for the same reason. As I said, it is a weak proposal but I was persuaded to put my name to it because it was supposed to be about consensus. All we are seeking is a review. I would prefer a motion that asked for the decision to be rescinded but this is about allowing people the opportunity to vote for something and to go back to the Minister. That is what we seek.

There is no place for play-acting. The Deputy who attacked Deputy Reilly put in a fine performance. It is time now to vote; to put up or shut up. I will support the motion and Fianna Fáil members will most likely support the amended motion. It should not be about personalities but about taking the right action.

Chairman

Any final contributions?

Deputy James Reilly

I believe what Deputy Neville has said is the case. The motion states: "That this committee ask the Minister for Health and Children to examine the decision to relocate the Central Mental Hospital (CMH) from Dundrum to the proposed new site at Thornton Hall with a view to confirming that (a) the value of the Dundrum site will be maximised in order to fund a new CMH and to further improve psychiatric services". We have done the cost-benefit analysis. We are told that this is the situation, that the maximum will be got by selling the site, so it is just being confirmed that Dundrum will be sold and "the new CMH in its location will be a health facility managed and staffed solely by appropriate health professionals and entirely independent of any other state facility". This does not address the issues raised by all the families, patients, staff, Amnesty International and the health commission.

Without engaging with Deputy Behan I can only surmise that his extraordinary outburst, directed at me personally, is borne out of total frustration because he does not agree with this decision but he cannot do anything about it because his party will vote it down.

Question put.

The joint committee divided: Tá, 9; Níl, 8.

Tá

• Blaney, Niall.
• Conlon, Margaret.
• Feeney, Geraldine.
• O’Connor, Charlie.
• Ó Fearghaíl, Sean.
• O’Hanlon, Rory.
• O’Keeffe, Edward.
• Treacy, Noel.
• White, Mary M.

Níl

• Doyle, Andrew.
• Fitzgerald, Frances.
• Kehoe, Paul.
• Lynch, Kathleen.
• Neville, Dan.
• O’Sullivan, Jan.
• Prendergast, Phil.
• Reilly, James.

Question declared carried.

Chairman

I propose that the agreed amended motion be reported to the Houses of the Oireachtas and that Dáil Éireann take note of the motion. The motion will also be sent by letter to the Minister for Health and Children. Is that agreed? Agreed. The committee will now adjourn——

Deputy James Reilly

Chairman, before we adjourn, can our motion be taken?

Chairman

Yes.

Deputy James Reilly

I move motion No. 2:

That this committee ask the Minister for Health and Children to review the decision to relocate the Central Mental Hospital from Dundrum to the proposed new site at Thornton Hall.

Deputy Jan O’Sullivan

I second the motion.

Chairman

Can we proceed? The clerk will call the vote.

Deputy Rory O’Hanlon

Chairman, with regard to the procedure, the last vote was on an amendment to the motion.

Deputy Noel Treacy

Once the amendment is passed the motion dies. The original motion cannot be put to a vote. No parliament in the world would allow that.

Deputy Rory O’Hanlon

The motion, as amended, can be put to a vote.

Deputy James Reilly

I dispute the fact that it is an amendment. It is a different motion.

Deputy Noel Treacy

The Deputy did not dispute it before the result. He cannot dispute it now.

Deputy James Reilly

We are asking for a vote on the motion.

Senator Frances Fitzgerald

The Chairman has taken a decision to put it to a vote.

Deputy Charlie O’Connor

There is a problem with procedure.

Chairman

We will proceed.

Question put.

The joint committee divided: Tá, 8; Níl, 9.

Tá

• Doyle, Andrew.
• Fitzgerald, Frances.
• Kehoe, Paul.
• Lynch, Kathleen.
• Neville, Dan.
• O’Sullivan, Jan.
• Prendergast, Phil.
• Reilly, James.

Níl

• Blaney, Niall.
• Conlon, Margaret.
• Feeney, Geraldine.
• O’Connor, Charlie.
• Ó Fearghaíl, Seán.
• O’Hanlon, Rory.
• O’Keeffe, Edward.
• Treacy, Noel.
• White, Mary.

Question declared lost.

Chairman

We will adjourn until 23 September when we will meet in private session to discuss the work programme and the format of meetings.

The joint committee adjourned at 6.10 p.m. until Tuesday, 23 September 2008.