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

I welcome this opportunity to contribute. I reiterate the demand recently made on the Government by my friend, Deputy Cullinane, that plans be made not simply for the Irish worst-case scenario if there is no Brexit deal but for all reasonably possible eventualities. This was a fair and reasonable demand already but now, with new developments making no deal less likely and other arrangements far more likely than previously thought, we should not be caught on the back foot by the British Government's ability to change course. The vote in Westminster last night, while not legally binding, is a sure sign that there is consensus in the House of Commons that the prospect of no deal should not be advanced any further. The reality is that Brexit presents massive challenges for any Irish Government on a whole range of issues, whether there is no deal or a soft deal or whether it happens at all.

Brexit has the potential in Ireland to upset and frustrate a great many things taken for granted over the years since the Good Friday Agreement. One is the use of healthcare services in the North of Ireland and Britain by people living in the South. Treatment for eating disorders is just one of the examples. The HSE has described the position of the people from the South who receive eating disorder treatments in the NHS as "unclear". This is deeply worrying considering the details. The number of cases of eating disorders in the State has risen sharply in recent years. What was previously considered by most to be a problem experienced only by teenage girls is in fact much more widespread. With every year, there is a greater incidence among the population. Eating disorders are now far too common among all groups, male and female. Also on the increase is the number of people who are seeking care and treatment in the South of Ireland who are referred to services that are accessible only through the NHS. It is quite an indictment of the seriousness with which the State and the HSE take eating disorders that this is the case but even more so that the problem has not been addressed in the context of an impending Brexit and the risk of a hard border. The HSE has refused to provide figures on the numbers accessing treatment with the NHS. Bizarrely, it states that this could identify those being treated. No matter how low the numbers, the issue remains for these individuals in vulnerable positions. It must also be remembered that they have most definitely been on the increase. That demand does not go away with Brexit or a hard border; in fact, it is only compounded. The Department of Health estimates that in the region of 200,000 people may be affected by an eating disorder, with an estimated 400 new cases among men and women each year. Surely we must begin the process of developing adequate services in this State for residents of this State to seek care for eating disorders as they need it. These issues are not going away.

We must also ensure that, through an arrangement to avoid a hard border, we will protect the treatment of people who currently have to go outside the jurisdiction. Many of these people may be dependent on the oversubscribed, underfunded and understaffed child and adult mental health services from which they were referred if Brexit brings the care they are currently receiving to an end.

The inevitable increased demand requires increased provision, and this is clearly not happening. We need accurate figures on the numbers of patients who may be affected by Brexit due to their specialised care needs. This must inform the development of adequate services within the State, with a transitional model for those already receiving care outside the State. The need for investment, strategic planning and a reorganisation of our affairs to deal with the problem of an internal border on our island, which we do not have the political ability or power to unilaterally remove, should have been clear for many years. Brexit has brought it into sharp focus and we must act now.

Brexit has also highlighted that the EU is not immune from legitimate criticism. While many of the arguments made most loudly and obnoxiously by the right over the course of the Brexit campaign were spurious and deliberately misleading, the EU remains a deeply undemocratic entity which has hardwired neoliberal economics into the workings of its member states. It has little accountability or interest in the opinions of the people of Europe. As we see a groundswell of far right, anti-EU voices across Europe, we must ask how we can fight for a more democratic and fair Union which is welcoming and tolerant. After this debacle ends, we cannot allow normal business to resume. A truly social Europe of free nations, in co-operation for the improvement of the lives of all workers is needed, not the Europe of austerity, privatisation, gravy trains and centralised control in the hands of the unelected elite.

We want an Ireland of prosperity that is shared fairly and an Ireland of public provision of essential services in which the market is subservient to the people and not the other way around. We should not accept a Europe that is anything less than that.

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