Séamus Healy (Tipperary South, Workers and Unemployed Action Group) | Oireachtas source

I welcome the opportunity to contribute on this legislation. It is a short but significant and progressive Bill and I am happy to support it. As the Minister of State mentioned, its inception was in 2008 as a Private Members' Bill in the Seanad. I suppose it was given fresh impetus by the report of the expert group published this year.

The Bill provides that ECT cannot be administered to a patient who has capacity but is unwilling to consent to the treatment. The same applies in the case of the administration of medication beyond a continuous period of three months.

It is a progressive Bill that I am happy to support and welcome.

It is widely acknowledged by all stakeholders that mental health services, including those referred to in this Bill, should be provided locally and as near as possible to the service user. Unfortunately, that is not the case in Tipperary. I appeal to the Minister of State to examine acute inpatient mental health services in that county. As she will know, the decision to close St. Michael's inpatient unit in Clonmel, which provided services for north and south Tipperary, was made by the last Government, the Fianna Fáil–Green Party Government, and implemented in 2012 by the current Government. It has been a disaster. There is no doubt that the inpatient services provided to citizens of Tipperary in Kilkenny and Ennis are completely dysfunctional. The decision was taken and implemented without any consultation and against the wishes of almost all stakeholders, particularly those in south Tipperary. They include consultant medical practitioners, general practitioners, the public, service users, carers and their families. Unfortunately, the worst fears of all those individuals who advised against the course of action have been realised.

The Kilkenny unit, in particular, is overcrowded daily. It is running at 110% to 115% of capacity. I am told by patients and their families from south Tipperary that it is difficult to be admitted to the unit and that, having gained admission, one is discharged rather quickly. As we have always said, it is difficult for carers and family members to visit and support patients in the Kilkenny unit. This is what service users and their families have told me and other public representatives throughout the county. There is no continuity of care. When patients are discharged from the unit, they are discharged to a different consultant psychiatrist. There have been quite a number of unexplained deaths, 13, associated with the Kilkenny unit in recent times. Circumstances have been disastrous for service users in Tipperary. I appeal to the Minister of State to review them and provide inpatient beds in Clonmel for Tipperary patients.

I have been asked to draw the Minister of State's attention to the question of assessment of mental health service users in the accident and emergency departments throughout the country, particularly in South Tipperary General Hospital. I am told the assessment procedure is very difficult for all concerned in the units. It is inappropriate and unacceptable that this should continue. This would be dealt with if an inpatient acute unit were provided in South Tipperary General Hospital.

We were promised a Rolls-Royce-standard community-based service. We have a good service but the difficulty is that, despite the best efforts of staff, the community-based teams are not staffed to the standard outlined in A Vision for Change. I ask the Minister of State to address that also. I ask her to review the circumstances associated with the inpatient unit and to agree to reopen beds in South Tipperary General Hospital.

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