James Reilly (Dublin North, Fine Gael)

Likewise, while I accept there is a serious issue that has to be dealt with, I am concerned that rushed legislation will be poor legislation which we will have to revisit. I too am concerned that, despite telephone calls, I have not been able to consult with the sort of people I would like to have been able to consult, such as the Mental Health Coalition. I know my colleague, Deputy Dan Neville, tried to contact Amnesty International to obtain its view on the Bill. Nobody was aware of the manner in which this legislation would be presented to us, but I am sure the Psychiatric Nurses Association, Schizophrenia Ireland and other consumer groups would have a view. This is what makes me nervous about taking this legislation without having had time to examine it fully.

A couple of obvious questions spring to mind. Naturally, as a GP, I am only too well aware of the difficulties that present, particularly at night. In one experience I had as a young doctor, I arrived at a house and was asked whether I was the garda, such was the situation - I will not go into the details but a weapon was certainly involved and it was not a nice situation to be presented with, although it worked out to the good in the end. The Garda Síochána is fully committed but its members are under a great deal of pressure, although we will not go into the broader political talk of how the country is rife with crime and gangland killings. Gardaí cannot always get to a scene in a timely fashion and, while there is a certain attractiveness in what the Minister of State says, like Deputy O'Sullivan, I would have grave reservations about regulation. The current individuals concerned may be of the highest calibre but there appears to be no proper regulation, no regular inspections or a proper selection process from an independent body such as HIQA, Health Information Quality Authority. These companies could change hands and different people could be employed from those originally in place.

Have all these people been vetted by the Garda? Have they all been trained in matters of hygiene? Have they all been trained in restraint? The Minister of State mentioned the need for staff to sometimes talk a patient down. Are these people trained in counselling techniques and how to deal with high-energy, disturbed behaviour? Are there standards for the vehicles such people will use? Are there standard instructions for how often they should be cleaned after use by someone who, for example, may have been covered in blood or who may have become incontinent? All such issues must be addressed by standards which apply to this or any other agency used for the purpose of protecting patients.

Currently there is no regulation of the ambulance services whether public or private. I am in receipt of knowledge today of a situation in which one private ambulance operator took over another only to find some 20 people in the operation had never been vetted by the Garda and that the inspections carried out had been of a very cursory nature. If a firm has 100 employees and it claims they have all been vetted it is easy to check this by counting 100 forms vetted by the Garda. However, it is possible for a firm to state it has only 20 employees and produce 20 forms while in practice employing 100 people. There are so many loopholes at present that I could call for the regulation of ambulances to be addressed under the Health (Miscellaneous Provisions) Bill too. We must have such regulation if outside agencies or bodies are to be used. I caution that some two or three weeks of this session remain and we could revert to this section and allow time for consultation with interested groups. That would ensure we would not find ourselves returning to the whole Bill because people expressed serious concerns. We may do our best but such people would have a greater knowledge of these areas and may recognise problems we cannot see.

I wish to raise the serious and important issue of the need for the Irish Medicines Board to address and assess medical devices that come to the market. The former Minister of State, Deputy John McGuinness, has alluded to this matter in the past. I realise this is slightly off the point but the medical devices industry is worth €6 billion, representing 9% of our exports, and it employs some 26,500 people. It has the advantage of access to the European market. If the board is efficient such that it can assess devices rapidly and get them to the market it confers a very significant opportunity to grow the industry.

However, there is not enough staff in the Irish Medicines Board. I trust the recruitment ban will not interfere with such an important industry. Having said that I do not wish in any way to demean the issue of mental health or the need to regulate the sector and the agency we propose to put in place. Unless the Minister can include the amendments there is no way I could vote for the amendment, although I recognise it is badly needed and a significant issue exists in this case. However, I do not wish to fall into the trap of rushed legislation leading to bad legislation and more problems later on. I believe the Minister of State has no wish to find himself in the courts again and nor do any of us.

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