The Department of Health and its agencies have been conducting detailed analysis on the impacts of Brexit in the area of health. Contingency planning for a range of eventualities is also underway. A priority will be to ensure that there is minimum disruption to health services and that essential services are maintained on a cross-Border, all-island and Ireland-UK basis.
In relation to mental health, patients only go to the UK for treatment for mental health disorders when all options in Ireland have been exhausted.
The HSE's Mental Health Operations are endeavouring to increase the availability of specialist supports for children in Ireland. For example, there will be 10 beds in the new CAMHS Forensic Service and an additional 20 beds in the National Children's Hospital of which 8 are specialist eating disorder beds. This will increase the range of mental health services available to children in Ireland.
When children travel to the UK for treatment for mental health disorders, an application is made to the High Court to place the child in a UK facility for the purpose of receiving treatment. If the High Court is in agreement, an Order of the Irish High Court is then made under Wardship jurisdiction.
Recent cases involving the placement of Irish citizens with UK healthcare providers for the purpose of receiving mental health treatment have involved an application on behalf of the HSE to the Court of Protection in London for recognition and enforcement of Orders of the Irish High Court which permit the proposed placements.
The legal mechanism which facilitates recognition and enforcement of Irish Court Orders by the UK Court of Protection is under the UK's Mental Health Capacity Act 2005. The mechanism gives effect to the Convention on the International Protection of Adults and is a convention of the Hague Conference on Private International Law being the World Organisation for Cross Border Co-operation in Civil and Commercial matters (HCCH). HCCH currently has over 80 state members including Ireland and the UK. The European Union is also a member. As such, HCCH is not part of the EU.
My Department and the HSE have been meeting regularly to ensure that all relevant units are prepared for Brexit and to consider what, if any, steps need to be taken to ensure that the Irish health service can continue to refer patients to the UK for specialised care as deemed appropriate once the UK leaves the EU.
I am not aware of anything that would indicate that the UK intends to exit HCCH as part of Brexit, and so it would seem that the current mechanism for legal recognition and enforcement of Irish Court Orders by the UK Court of Protection under the Mental Capacity Act 2005 should not be impacted by Brexit.