Tom Clonan (Independent)

I am also a member of the disability matters committee which, unfortunately, sits at precisely the same time as the health committee and I apologise for leaving earlier. To declare a conflict of interest, I sat on mental health tribunals for more than a decade before I was elected. I have attended hundreds of mental health tribunals. Before I ask questions, I want to say that I cannot speak highly enough of all the people involved, including the legal chairs, barristers and solicitors, who perform the tribunal's role of reviewing a person's involuntary detention, and the independent panel of psychiatrists who work in conjunction with the Mental Health Commission. I have one quick observation to make on the amount of effort that goes into it by everyone involved, and particularly by the legal representatives who advocate for the interests of those who are involuntarily detained.

I have never seen anybody dial it in, as it were. It is a really rigorous framework of oversight and governance, and I know from the narratives of the detentions the role that An Garda Síochána plays. I know this from over a decade of talking to psychiatrists and legal representatives.

I will not mention the station involved, but in the Dublin metropolitan region, there was a particular Garda sergeant who was very skilled at diagnosing a personin extremisand what his or her actual illness might be. He had become something of a legend and somebody people would call if they had a person who wasin extremis.

I have only positive things to say. I do not know that members of the Irish public or even elected representatives necessarily understand what a psychiatrist is, particularly one with higher specialist training. There is much confusion, even among the allied medical professions, in this regard. I do not know that there is necessarily a proper understanding of what psychiatrists do. I refer to the full range of not just their medical but also their psychosocial skills. Many of them are fully qualified in CBT and other forms of medical intervention. That said, I cannot think of another medical specialty that is subject to this level of oversight and governance. I am involved in a charity. One of the board members is a plastic surgeon. When I was explaining to him about how tribunals operate, he was very surprised, frankly, to learn that his practice might be interrogated by another fellow professional and that a third independent professional would write a report based on his treatment. There is already a significant level of governance and oversight in that regard.

From informal feedback from my contacts, I know there is a lot of genuine concern about the legislation. If this Bill is enacted, will it empower psychiatrists to fully meet their professional and ethical obligations to treat some of the most vulnerable people in society? Are there aspects of it that would act as an impediment to that? In the context of the provision around having to apply to the High Court for permission to provide treatment, would that inhibit their professional and ethical obligations to a vulnerable patient? Is it even workable in the clinical environment, such as it is?

Professor Sadlier mentioned recruitment issues. Do he, Professor Kelly or the Mental Health Commission have a view on the appointment of people to consultant posts in psychiatry who do not have higher specialist training? The Mental Health Act is quite vague in that regard. It does not stipulate that a person must have higher specialist training. I shudder to think what would happen in any other medical specialty if people who did not have higher specialist training were able to be appointed.