Professor Jim Lucey:

It is a great pleasure and privilege to be here with the committee today. Members will be conscious of the fact that I have just been appointed to this role as inspector at the Mental Health Commission. I am very proud of that appointment and of the commission I have been privileged to join.

As the Joint Committee on Health, members will be very well aware of the complexity of mental health services. The modern health industry is probably the largest industry in the world. It is the most complex. No longer can we talk about psychiatry, psychology or any other particular modality in isolation. That complexity makes the healthcare industry the most powerful it has ever been in history. It is also the most capacious and potentially beneficial it has ever been. However, it also makes it the most potentially dangerous and harmful. If these resources are misused, underprovided, misdirected or undirected, great harms can occur, an issue I know the committee is alive to.

This report, which I commend to the committee and which our chairman has outlined so carefully, is about the children of Ireland. It is about our children, our families' children and our neighbours' children. It is essentially about difficulties which, as we know from Professor Mary Cannon's reports and the research going on Ireland, are evidenced to affect at least one third of our adolescents. We also know that three quarters of adults who have a mental health difficulty had that difficulty when they were children. What do we do with the healthcare industry to try to meet these resources? We can have reports and recriminations after individual disasters and setbacks, we can celebrate after individual investments and we can pride ourselves on islands of excellence that emerge when we do invest but none of this will be sufficient. As legislators, the members will know this from constituents coming to them with their children's difficulties.

What is lacking is set standards that apply from Dundalk to Donegal and from Kilkenny to Killarney, standards that are about a uniform experience for our children across the country. In a sense, we need a model for the healthcare industry. The best model I can come up with is a musical one, the orchestra. There is no point in saying we have invested in the band section or that the strings are doing well now while the percussion is not so good. We need an independent set of standards. It needs to be independent of the band section and the strings. We need to be able to understand the standards that are set. Psychiatry has a dark history but we are now talking about mental health services in all their broadness, diversity and potential, which is different from psychiatry. However, we need to understand the urgent need for standards to be set.

At the moment, the only location to set standards and see they are met is within the approved centres, which are the successors of the old asylums. We have made great progress in bringing those to a standard. When I was looking at this post and the success of the commission, I was impressed, as someone who has been in clinical practice for 40 years, with the progress that has been made in this 1%. Nine out of ten of those centres achieve 90% of standards. The progress in respect of human rights has been substantial. However, as the inspector, I cannot say that with regard to the vast experience of mental distress for our children. My predecessor put it starkly. I will not reiterate her words because time is pressing but I know that committee members understand we cannot have a healthcare industry without independent regulation. We would not do it in any other walk of life, let alone the one that obtains the largest tranche of our wealth. All of our income tax is going to healthcare services and they regulate themselves. Professional accreditations are all very fine but service regulation encompasses the whole of the orchestra. The concept of service regulation that is independent and verifiable, and conducted according to international standards, exists in only one area, which is 1% of the service.

I want the committee to see the great value of this report. It is the most substantial piece of work ever done by the commission. It was invested in with resources that I do not have to continue. Powers do not exist for me, as the inspector, to enforce this or for the commission to seek that enforcement. We must come to the ears of the committee members. The international standard model that is validated, can be recorded, tested and put to the public is only obtainable if we have an independent regulator to set that standard and to call people to attention when standards fall. The intention is about our children and their rights to recovery. Believe me, I know that mental healthcare works. I know that our children need that mental healthcare. I also know that Dr. Finnerty was right when she said she could not tell the parents of Ireland that their children were getting that standard at present.

I commend this report to the committee and hope that its members will be advocates for it. I welcome the opportunity to advocate for mental health of which we are all a part. When the committee members see the authenticity, openness and clarity of this report, they will be urgent in ensuring that its fate is not to sit on a shelf but rather that its fate will be to become manifest fully in all its recommendations. I thank committee members for listening.