Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

Good afternoon. Many of the areas have been already covered so I do not propose to rehash them. The Assisted Decision-Making (Capacity) Act 2015 was mentioned. We appear to be tripping over ourselves in terms of that legislation and this Bill. Head 7 of the Bill deals with the capacity issues in regard to people making decisions. Head 87 deals with the nursing home supports scheme. I have listened to what the witnesses had to say about how people are being treated in the system. We know that the system is poorly staffed and under-funded. Many of our nursing homes are pre-1970, pre-1960 or even pre-1950. Today, we are discussing how we can bring about change on paper. In my experience, over the years the system has not moved quickly or progressed in a positive manner.

The term "person-centred" was mentioned. In 2018, the Committee on the Future of Mental Health Care was told that the State was spending roughly €10 million on cognitive therapy and various other therapies, but it was spending more than €400 million on medicines. There is a massive gap when it comes to person-centred assistance. This legislation is welcome and we are going in the right direction. My biggest fear is that it will be 2023 before all of this is ironed out and the Bill is enacted, as it should be. There are a couple of sections in the Bill dealing with law and the inability to provide this care as provided for in the UNCRPD. I do not think there is one centre in the Thirty-two Counties that deals persons with a specific mental health issue and, say, autism. I do not like to use the word "disability". It labels people. For many years, people with a disability were labelled as people who were not sick but nevertheless they were tagged and this caused them to be excluded. We have not legislated on a rights basis for these people.

The following is an open question to anybody who might want to answer it. If this Bill, as currently drafted, were to be enacted in late 2022 or early 2023, what would be the biggest worry in terms of its enforcement? The Bill provides that a person with a disability needs a special, individual care plan.

Let us be honest. We know the system is not capable of providing that. In terms of the assisted-decision making capacity element, reference was made to coercion and I see there is a piece in the Bill that indicates you do not automatically become a guarantor for somebody because you are related to them. I welcome that, but it is about the ability to provide all these services. We know the system is creaking at the moment, yet I feel we are going backwards with mental health.

I will finish on this point. We are probably in the worst pandemic that we have ever seen in our lives. People are losing their jobs. You could write a book on marriages. We are not planning for what is going to happen next year in March, April or May. In terms of where we are, what would be the witnesses' biggest fear about the capacity to provide what is outlined in the Bill? Perhaps they could break it down into percentages. Implementation of the Bill in its entirety would be 100% but, for example, it might only be possible to implement 10% of it. Do the witnesses understand where I am coming from?