James Browne (Wexford, Fianna Fail) | Oireachtas source

As the Fianna Fáil spokesperson on mental health, I intend addressing the mental health aspects of the budget.

The enactment of the Mental Health Act in July 2001 by Deputy Micheál Martin, was a game-changer. In the decades prior to 2001, mental health attitudes were all too often still mired in stigma, prejudice and a paternalistic attitude of lock them up for their own good. The importance of positive mental health did not get the coverage or support back then that it gets today. The Act was the first real reform of mental health legislation in this country for over half a century. In addition, the creation of the Mental Health Commission in April 2002 created an implementation body to ensure that the intention of the Act was fulfilled. The main objective of the Act was to address the civil and human rights of mentally ill persons while additionally putting in place mechanisms by which the standards of care and treatment in our mental health services could be monitored, inspected and reviewed.

Following on from this reforming Act, A Vision for Change was developed under the then Fianna Fáil Government as a strategy document which sets out the direction for mental health services in Ireland. It describes a framework providing and supporting positive mental health across the entire community and providing accessible, community-based, specialist services for those with mental illness. It was developed by an expert group, which combined the expertise of different professional disciplines, health service managers, researchers, representatives of voluntary organisations and service user groups. It had broad support from patient groups and medical professionals and across the political divide.

A Vision for Change is a detailed strategy which proposes a holistic view of mental illness and seeks to address the many co-factors that can impose on one's mental health, such as biological, psychological and social factors that contribute to mental health problems. It proposes a person-centred treatment approach which addresses each of those elements through an integrated care plan, reflecting best practice, and evolved and agreed with service users and their carers. Special emphasis is given to the need to involve service users and their families and carers at every level of service provision. It is based on a recovery model that seeks, where possible, to keep those with mental health problems centred in their communities and retain their involvement in their family and social circles. While the document may be in need of updating, the principles it was founded on and its fundamentals remain sound.

As a republican party, Fianna Fáil believes that mental health policy is ultimately a question of citizenship. It is about a right to be able to participate in society on an equitable basis. That demands those with mental health problems being encouraged to seek help and ensuring that the rapid and expert help they require is available when and where they need it. We all know that currently is not the case. In the absence of the necessary mental health supports, these citizens are denied their rights to participate fully in their society. It has become clear that if we are to achieve the ambition of transforming the lives of those with mental health problems in this country, we need to drive a fundamental cultural shift in the attitudes of our health system, and that means giving mental health parity of esteem with physical health. That is why Fianna Fáil, in the confidence and supply agreement to facilitate a minority Government, made the implementation of A Vision for Change a condition of that agreement. The preamble to that agreement states, "The Confidence and Supply votes are dependant on the full implementation of the policy principles attached to this document (Appendix 1)". Within Appendix 1, one of the terms states, "Fully implement 'Vision for Change' in the area of mental health". The confidence and supply votes are dependent on the full implementation of the policy principles attached to this document. We agree to facilitate budgets consistent with the agreed policy principles attached to this document which run over a full term of Government.

The Government needs to understand that a commitment to increase investment by €35 million annually is a commitment to increase investment by €35 million, not to partially increase it or put in place initiatives with a full-year value of €35 million but only to spend €15 million in 2017. The Government tried that in 2016, announcing €35 million while withholding €12 million. It was forced into an embarrassing U-turn in June last. It must be borne in mind too that Fine Gael pledged to increase funding for mental health by €175 million.

Last week on budget day, the Minister of State at the Department of Health, Deputy McEntee, pledged to initiate €35 million in mental health spending in 2017. There was concern that this means only a partial spending of the €35 million. Such concern is justified on the basis of what the Minister stated today in the Dáil. The Government seems determined to repeat the mistakes it made last year when €12 million was withheld. It seems that only €15 million will be drawn down in 2017.

The confidence and supply arrangement commits to fully implement A Vision for Change in the area of mental health. I want to see a multi-annual plan for how that will be done. I want to see put in place the reforms necessary to deliver long-lasting improvements in our mental health services. Government credibility on this matter is stretched thin, especially in view of what happened in 2016. To restore credibility, we need a clear commitment on funding and an implementation plan with clear measurable goals with a multi-annual service plan.

In the time remaining, I will address the issue of Brexit. It would appear that many of those who campaigned for Brexit never expected the referendum would be passed. Since the referendum, the UK Government appears lost as to what to do. They are divided but even if they were united, they have no plan. They are totally unprepared. Equally, the Government here seems to be totally unprepared for the decision taken. We need to seek real measures to protect our industries against the consequences of what is, according to the Taoiseach, probably the most serious economic event in the past 50 years.

We have seen sterling weaken to 91p against the euro and most economists predict it will go to parity by the end of the year, with some saying that within another year these values could reverse. In my county of Wexford we are almost totally reliant on SMEs, on the agrifood, on the fabrication sector and on tourism, which is extremely vulnerable. We are in a similar position to the Border countries, and while we do not have a land border with the UK, we have a harbour and a ferry with links directly to it and the majority of our tourists come from the UK. Those industries are the most vulnerable. They are significantly employment reliant. They have a very thin margin and are not in a position to take any hits. We need the Government to take significant steps to provide support for those industries. Counties like Wexford did not see any recovery in the past few years and are only now starting to see a small element of it. There are no shock absorbers for those industries. They cannot take any further hits and they need supports from the Government. The Government needs to set out quickly a clear plan on how it will protect those businesses. We have already seen with the mushroom industry the consequences of what is happening and we will see more of that happening in the concrete industry, the agricultural industry, the agrifood sector and the tourism sector. While some steps were taken by the Government in its announcements in the budget, they were nowhere near sufficient. Full support needs to be provided for those industries or alternatively we could find ourselves in a situation that could be even potentially worse than what we saw during the economic collapse.

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