Olivia Mitchell (Dublin South, Fine Gael)

I welcome the opportunity to speak on this Bill. It is rare that we find ourselves amending an Act passed as recently as 2006. Nevertheless, it is clear that difficulties have emerged with the earlier legislation, which itself was welcome as a significant improvement on the law as it previously stood.

The two major changes proposed in this Bill pertain to the mechanisms for determining whether an accused is fit to stand trial and conditional discharges, which was not working under the 2006 Act. These changes are welcome. In regard to the first mechanism, the former practice whereby a jury decided whether a person was fit to stand trial resulted in gross abuses of people's rights because it required sick people to undergo trial. People who should have been in hospital were unfairly exposed to the rigour of the law. The new mechanism introduced by the 2006 Act allowing a judge to make the decision was infinitely preferable. However, as the requirement on a judge to reach a decision quickly and in the absence of expertise brought us into conflict with our commitments under the European Convention on Human Rights, we are now amending that Act. Judges were making what appeared to be arbitrary decisions in the absence of objective expertise or advice from forensic psychiatrists. It was also possible that decisions were made without due consideration because of the short time spans involved. The amendments provided in the Bill are welcome in this regard. Deciding on a person's fitness to stand trial is a grave responsibility for anybody and I am sure judges will welcome the amendments.

The interface between the health service and the criminal justice system is fraught with difficulties and tensions. Mental disorder and illness are catch-all terms which encompass a continuum of conditions ranging from very mild to extremely severe. Many films have been made about the idea that those who appear the sanest are the most ill. Judges do not like to be called "laymen" but nevertheless they do not always have the requisite expertise and the input of forensic psychologists is essential. An accused person who is incorrectly determined fit for trial is subjected to the full rigours of a criminal trial and, possibly, a prison sentence which would be totally inappropriate. Prisons are not nice places, even for the healthiest people. They represent a considerable abuse for those who are not of sound mind. The potential for the abuse of human rights is enormous.

Having to face confinement for an unspecified time, as in the case of those deemed unfit for trial, has considerable implications. A decision made on this should only be made in the very strictest of conditions and it should be informed by fairness and the very best expertise available. This Bill is very welcome in that it gives judges access to the best expertise available. It also ensures decisions will not be made in haste. It provides for a 14-day referral to the Central Mental Hospital, where a person can be assessed to decide whether he or she is fit or unfit. Decisions made in haste by a judge could result in an accused regretting those decisions for a very long time. I welcome the provision in this regard.

I welcome the second measure, which clarifies and facilitates the termination of a person's detention. The former legislation was dreadful in that, under it, a decision had to be made by the Minister. Effectively, the decision was never made by a Minister. Even when somebody was found fit to be discharged on medical grounds by the psychiatrist, a decision on the finding had to be made by the Minister. Inevitably, decisions such as those are too susceptible to political considerations and public opinion on the crime for which one was incarcerated. The 2006 Act, in setting up the review board to make such decisions, represented a huge improvement. Without this improvement, people languished completely unnecessarily in the Central Mental Hospital, probably for much longer than they would have had to spent in an ordinary prison had they been deemed fit to go to trial. Detention, for many, was for an indefinite period.

The procedural defects in the 2006 Act are obvious and have been the subject of court cases and various recommendations to the Minister. I congratulate the Minister on acting on these recommendations. Incarcerating people needlessly in the Central Mental Hospital is a considerable abuse of human rights. A provision to make conditions of discharge binding rather than mere recommendations is missing in the existing legislation but is provided for in this Bill. That is welcome.

Recovery is not a black-and-white issue. People may be partially recovered or not so ill as to justify incarceration in the Central Mental Hospital, yet they may not be well enough to be discharged without supervision or on the assumption that they will never relapse into mental illness. That decisions cannot be made in this regard results in people languishing in the hospital. The intent of the 2006 Act was not being met as a result of the failure to provide supervisory powers for the board. The safety of the public must be of paramount importance, in addition to the human rights of those incarcerated in the Central Mental Hospital. The changes in the Bill represent an attempt to ensure that we will comply with our obligations under the European Convention on Human Rights.

I regret the persistent use of the word "insanity" in the Bill. Irrespective of its legal definition, it is an out-of-date term. It is pejorative and very stigmatising. I ask the Minister of State to consider a different, less pejorative term for future legislation.

The Minister of State says there will be no cost associated with this legislation. I question this; it must be incorrect. Beds in the Central Mental Hospital come at a premium. One benefit of the proposed legislation is that people will be discharged and not kept unnecessarily. Nevertheless, patients will be referred to the hospital regularly and surely will have to be assessed by forensic psychiatrists, thus giving rise to a resource issue. Quite apart from the assessment, if people are to be discharged, placed under supervision and monitored in the community, perhaps while receiving treatment, surely there will be cost implications. I hope we are not making another mistake in assuming that, by passing another law, we will solve a problem when a lack of resources will prevent its implementation.

The Minister of State said in his speech that he is considering designating centres other than the Central Mental Hospital in Dundrum as locations where people may be assessed. That would be welcome but it would not overcome the problem associated with the general shortage of psychiatrists, particularly forensic psychiatrists.

I want to raise the issue of the future of the Central Mental Hospital in Dundrum, which is in my constituency. In the old days of the health boards, of which I was a member, I visited the Central Mental Hospital on a number of occasions. In the early years of those visits, people were still slopping out. Conditions have improved slightly in that this is no longer happening but, by any standard, the conditions are Dickensian. They are appalling conditions in which to place sick people and to have staff work. The building is unsuitable and is in an unsuitable location. I am probably not telling the Minister of State anything he does not know because I am sure he has visited the building.

While we may be meeting our commitments under the European Convention on Human Rights to the letter of the law, we must remember the physical conditions in which people are being kept for indefinite periods are really appalling in this day and age. While the Minister of State said Thornton Hall will not go ahead and that alternative locations are being considered, my worry is that an alternative location will not be announced until the terms of the public private partnership are agreed. I am worried that there will never be another public private partnership. Where are the developers who might have been involved in such partnerships? Most are unable to obtain credit. If we are to depend on the private sector, will the development ever happen? Is there a plan B if we cannot get the private sector to participate? Will the Minister of State clarify what is happening in this regard when replying? Important as this legislation is, the reality is that people are living their whole lives and dying in the Central Mental Hospital in Dundrum. The conditions are really appalling. I ask the Minister to consider this.

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