Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

I welcome the opportunity to contribute to the debate on the Bill. I commend the Minister of State and his Department for their quick and comprehensive work in bringing forward the Bill which not only fixes the legal issues which arose from the High Court's ruling but also improves the rights of patients in terms of their access to a review of their detention and creates a fairer and more humane approach to the unfortunate but often necessary measure of involuntary admission and treatment. The finding by Mr. Justice Gerard Hogan that long-stay detention of an individual in an inpatient unit without the opportunity for a review is unconstitutional is right and should have come as no surprise to any of us.

Four years ago, in its review of the Mental Health Act, the expert group recommended the revising of the Act and many other issues related to patients' rights. The group made a total 165 recommendations, many of which have not been acted on or even acknowledged by the Government. The reality is that not only do we need to pass the Bill and look at the expert group's review, we also need to push forward with a comprehensive, modern and progressive new Mental Heath Act to put patients' rights at the forefront of care provision in Ireland. I will return to this broad issue, but I would first like to address the amendments I have submitted to the Bill.

I have submitted two amendments to the Bill, but I will not be pushing the second one after discussing the finer details with the Minister of State, Deputies James Browne and Alan Kelly and having spoken to other experts. The intent was to allow greater latitude for the patient as to when he or she would seek a tribunal, but I now believe it is no longer necessary to include that provision in the Bill. The first amendment I am seeking to make to the Bill specifies that a patient involuntarily detained and under a renewal order should have the right to one review of each order and not, as the language may suggest, one review in the overall detention period. We should be very careful about the conditions under which we allow the State, through the health service, to take such serious action as to deny the liberty of an individual. It should never be done just for the sake of it or willy nilly. The detention should continue to be treated with seriousness. We should never allow the process to develop into a vicious cycle which perpetuates the detention. The approval of one detention order should not make its renewal, if sought, an easier or less serious endeavour. In fact, given the desire for services in the interests of patients to be based on a recovery model which seeks to avoid admissions and detention, where possible, everything should be done to ensure a renewal order will not be necessary. Therefore, it should never be seen as an easy option, with a low bar for justification. If a criminal deserves a free and fair trail, with a heavy burden of proof, the completely innocent sufferer of a mental health issue should be afforded no less, if not a great deal more, in terms of their right to liberty.

I hope the Minister of State will agree that this proposal would be a worthwhile addition to the Bill and he has told me that he will agree to it. I also thank Deputies James Browne and Alan Kelly. I have found the Minister of State to be someone who is interested in upholding and improving the rights of patients, but so far action has been lacking. I have been waiting for a very long time to move forward with Sinn Féin's Bill on advance healthcare directives. The Minister has been open to working with us on the issue, but it has been a long drawn-out process, given the far greater resources at his disposal. I will be seeking to move forward with the Bill as soon as time is available in the Dáil. The issue is clearly of importance and the Bill seeks to deal with it appropriately. It has been developed with experts in the field. I hope we will be able to rely on the support of the Minister very soon, as well as that of Fianna Fáil and other parties, to enable us to have the Bill passed on Second Stage and to work together to have the best Act finalised and in place for the people we represent.

The Bill we are debating is important, but it should not stall all of the other issues concerning patients' rights. Last month in response to a parliamentary question the Minister said the general scheme of a new Mental Health Bill was in the works and that a draft would be sent to the Mental Health Commission by the end of the year. Unfortunately, while I do not doubt that that is his intention, or what he is being told, when it comes to the Government, there is a long and storied history of deadlines being made and passed and very little happening in the realm of mental health. When I took up this role in 2016, I was told that a review of A Vision for Change was being worked on. We are still waiting for it and not exactly hopeful that we will receive it, given how little the Committee on the Future of Mental Health Care received in the way of information from the group once it was finally set up. I am also still waiting for the review of the role of suicide crisis assessment nurses. In every reply I have received to a parliamentary question I have asked since 2016 about this role I have been told that it is under way. We have also been waiting for the review of Jigsaw. Again, we have been told that it will be available by the end of the year. We were told that there would be mental health services 24/7, but we have been given very little information on the development of the plan or how it is being implemented. Unsurprisingly, the first concrete piece of information on the move to the provision of out-of-hours care services indicates that "some" will be in place at the beginning of 2019. December and January will be extremely busy months for the HSE and the Department of Health if all of these deadlines are to be achieved. My point is that we need to commit to solving some serious legislative problems in the coming months. So far, we have had little to give us hope this will be done. Let us start by getting this Bill over the line, continuing with advance healthcare directives and getting the mental health Bill ready to ensure the quality of service patients in the mental health service and their families deserve.

We have been talking about timeframes and so on. I conducted some research. Before I was elected to this House, the Assisted Decision Making (Capacity) Act was signed into law in December 2015. It replaced the Lunacy Regulation (Ireland) Act 1871. I hope we can work together to resolve this matter speedily. It is a proud moment for all of us that we can work together to put these measures in place. It is not always about scoring political points in this Chamber; it is also about caring about people and doing the right thing. I will be following up on the Assisted Decision Making (Capacity) Act because it is vitally important. We need to work together. I am very passionate about this issue. I congratulate the Seanad on the speed at which it got this Bill to this Chamber. It is ironic that it could be the last Bill the President signs into law because, as we all know, we are facing into the next big election.

I am very proud and I am very grateful to everyone for working together on this.

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