Joe Costello (Dublin Central, Labour)

The thorny question is whether we need to go down the road outlined by the Minister. We need some clarification. What happens at the moment? Is there any statutory underpinning of the transfer system between the Central Mental Hospital and Mountjoy for exceptional cases? How often has this happened? What is the best medical advice on this? What are the numbers involved? Do we need a unit at all? Are the security measures in the Central Mental Hospital adequate to deal with the situation? It seems that the Central Mental Hospital is the place to deal with the situation envisaged here, if that situation is of any significance. We are in the dark on these issues to some extent.

The Minister indicated that the type of person to which he refers is beyond the possibility of care or treatment, that is, a person who is a complete psychopath and is not responsive to any treatment. Immediately after the Minister's amendment, the legislation states:

The Minister for Health and Children may by order designate a psychiatric centre or, with the consent of the Minister, a prison or any part thereof as a centre (and any psychiatric centre, prison or any part thereof so designated is in this Act referred to as "a designated centre") for the reception, detention and, where appropriate, care or treatment of persons or classes of persons committed or transferred.

It seems it is not appropriate to treat or care for the person to whom the Minister refers as that person has gone beyond such a stage. How many people are at that stage at the moment? We have not yet legislated for this, so there has not yet been any great outcry about such a situation envisaged by the Minister. We would have known all about characters like Hannibal Lecter for whom the Minister is making provision. Did the medical profession come to him about such people? How many of them are out there and how have they been treated thus far? If there is a major security problem, we should hear about it.

We should take on board the principle of the Henchy commission recommendations, namely, that a special unit be provided for seriously ill people who need treatment and secure detention. The cheapest and most pertinent place to do this is in the Central Mental Hospital, which is already a designated centre. Our past experience is that people have been transferred higgledy-piggledy from Mountjoy to the Central Mental Hospital without any great medical criteria. Once prison exists for these issues, the temptation is that it will be used and abused.

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