Dáil Éireann Debate, Wednesday - 25 June 2014
4. Deputy Colm Keaveney asked the Minister for Health in regard to the ongoing delay in the publication of the expert group’s review of the Mental Health Act 2001, the impact of that delay in addressing the continuing human rights issues within the mental health system; and if he will make a statement on the matter. [27414/14]
View answerThe Mental Health Act 2001 was introduced by the former Minister for Health, Deputy Micheál Martin, and marked a significant improvement in mental health care. I have tabled this question to establish why we are experiencing a delay in publishing the expert group's report on the Act. I am concerned that this is impeding human rights as set out in the philosophy of that legislation. The Minister of State, Deputy Kathleen Lynch, has explained that the report was delayed for a range of reasons, including the fact that the Assisted Decison-Making (Capacity) Bill 2013 had not been published. In January she indicated that the review would be concluded in a number of months. When can we expect to have a realistic timeframe for the conclusion of the process and publication of the expert group's review?
The expert group set up to review the Mental Health Act 2001 first met in September 2012 and was originally due to report in 2013. When it began its work, I made it clear to its members that they should take an open and expansive approach and consider all issues which they might consider were relevant and necessary for a thorough review, having regard to the terms of reference for the review. The interim review of the Act, published in June 2012, was, therefore, a starting point for a much more detailed analysis of the issues involved. In line with this approach, the group requested additional time to consider the implications for mental health legislation of the Assisted Decision Making (Capacity) Bill which was published in July 2013. An extension of its timeframe was, accordingly, agreed to.
The Deputy will also be aware that the review takes account of the fact that the Mental Health Act 2001, despite what he has said, predated publication of the Convention on the Rights of Persons with Disabilities in 2007. The convention provides for a rights-based approach to disability and certain of its articles have implications for our mental health legislation. In this context, the need to achieve a balance between individual human rights and the requirements for public safety have given rise to detailed discussion and analysis by the expert group.
The Mental Health Act 2001 was introduced on a phased basis and fully enacted by 2006. It would not be usual to have a formal comprehensive review of legislation that has only been fully operational for less than a decade. The 2001 Act was fully consistent with prevailing approaches to rights at the time and continues to underpin a modern approach to regulation of mental health services in Ireland. I am satisfied that the extended timeframe which was necessary for the current review is not impacting on human rights issues within the mental health system. I expect to receive the expert group's final report by the third quarter of 2014.
Last week the Minister of State indicated that the review would be ready by the third quarter, yet we are experiencing delays in this process. I do not see urgency being demonstrated by the Minister of State in dealing what continue to be significant human rights issues within the mental health system. Last year 80 children were in adult wards in psychiatric units across the country. This is a significant human rights issue. One must look at what has happened in Carlow and Kilkenny concerning the loss of life and human rights. I am asking the Minister of State to pay special attention to this matter and accelerate publication of the expert group's review of the Mental Health Act 2001. In April the Minister for Finance, Deputy Michael Noonan, said it was only a matter of weeks before the review would be published. Why are we experiencing significant delays? I ask the Minister of State to provide absolute clarity in order to ensure we can protect those who are most vulnerable. I am appealing to her to put in place the best form of legislative base to enshrine a human rights philosophy to protect the most vulnerable.
That is the very reason for the delay, but the Deputy does not seem to understand this, nor does he understand we already have a Mental Health Act in place which, as he keeps telling us, his beloved leader published. It continues to provide the governance process by which mental health services are run. We have delayed publication of the review because we want to get it right. Unlike the 2001 Act, we want to ensure there will be comprehensive and rights-based legislation in place. That Act was appropriate for its time, but it is not appropriate anymore. I do not intend to rush this process because in dealing with very vulnerable people, and the people who care for them for whom we also have to care, we need to get this right rather than do it quickly.
I am delighted to hear that the Minister of State is concerned about the front-line staff who care for vulnerable people. She did not bother at all to respond to the front-line staff in Carlow for a significant reference period when they sent correspondence to her. She did not seem to take much action with respect to dealing or engaging with front-line staff. We have pointed out this issue consistently in this Chamber - the Minister of State fails to engage and fails to listen. She chooses whom she wants to listen to because they tell her what she wants to hear.
In particular administrative areas, including Galway, north County Dublin, and Carlow and Kilkenny, she is listening to the wrong people and it is having devastating consequences. Rather than bat them over the head with A Vision for Change policy when people speak out or demonstrate some dissent about her approach, she should sit down and engage with the front-line staff - she may learn something.
I met the same front-line staff on numerous occasions. When I met them first they told me they did not want the unit in Clonmel to close and they have not changed that position. Front-line staff in this instance, as the Deputy will know, are nine people out of 638. The rest of them are happily working and tell me that they are doing a very good job and that the new approach is the right one. Certain people are opposed and resistant to change, but I keep telling them that at the end of the day there is not an option. We are not stopping. A Vision for Change is the policy of this Government and was the policy of the Deputy's beloved leader and the previous Government. However, Deputy Keaveney may not know that; he is not in Fianna Fáil that long. This is where we are going. People have to get on board and be responsible, and they have to care for the people they are charged with caring for.
