Dan Boyle (Green Party)

This Chamber has a proud history of independent thought and action and I believe we have more freedom in this regard than Members of the other House. More use should be made of Private Members' time which should be in putting that independent thought and action into practice. Far too often, when motions on the Government side are moved, they are self-congratulatory. Far too often when they are moved on the Opposition side of the House, they unfairly attribute all the woes of the world to the Government and its actions. However, this proud Chamber has an opportunity for investigation that I do not believe may be found elsewhere in the Irish political system. In moving this Bill tonight, I and my colleague, Senator de Búrca, are trying to use that independence to highlight an issue which otherwise might not get the attention it deserves in terms of public discourse and the need to have appropriate legislation on the Statute Book.

It is clear that greater attention should be paid to whole area of mental health. I am sure the Minister of State, Deputy John Moloney, who has moved into his job recently, is discovering this on a daily basis. There have been moves towards a more humanistic and humane approach to dealing with the issue in our public policy, yet many gaps in provisions remain. We have a far-reaching and generally accepted policy document in A Vision for Change, yet the legislation on the Statute Book contradicts many of the policy goals it recommends. In the legislation we are moving in Private Members' time the Green Party is attempting to point out where those inconsistencies lie.

There is a need for wider debate about the whole question of the rights of mental health patients and the discrepancies that exist between the types of treatment and the freedom of choice on offer to people who are being treated for mental health ailments as opposed to that enjoyed by patients suffering from general medical conditions. We need to have a debate on how people are admitted to institutions and how they are given particular medication, but that is too wide-ranging a subject to deal with in the context of this Bill. The Bill concentrates on two procedures which are the subject of debate in the medical and psychiatric communities and which cause a great deal of discomfort to those suffering from mental health disabilities. If the introduction of the Bill further promotes this debate, it will have performed an important function.

The Green Party wants two sections of the Mental Health Act 2001 amended. The Bill proposes the deletion of section 58 and its references to psycho-surgery or what is more commonly known as lobotomy. I accept deletion of the section would be inadequate because it would create a legal limbo. There is still a need to strengthen the legislation by putting in force a legal prohibition for a practice that, thankfully, no longer is happening on a regular basis. While it exists on the Statute Book, it represents an unnecessary temptation for those who want a surgical approach to dealing with psychological difficulties.

The second procedure, covered in section 59 of the Mental Health Act 2001, is more controversial. There is a debate about the use and extent of electroconvulsive therapy. Even in its current condition, its use is widespread. The most recent statistics show that 840 people have been subject to ECT treatment in one year. The average course for the treatment for an individual averages at four to six incidents in one year. This means the procedure is conducted between 4,500 and 6,000 times on nearly 1,000 people every year. That proves a reliance on a therapy that needs to be questioned. The legislation is purporting to control whether people can opt into the use of this therapy or whether there are circumstances such a therapy can be thrust upon them.

The Mental Health Act specifies the role of the Mental Health Commission in this area. However, the statistics make no differentiation whatsoever as to whether recipients of ECT have done so on a voluntary or involuntary basis. That speaks for the weakness of the existing legislation and highlights the need for it to be reformed in a dramatic way.

Using Private Members' time to introduce this Bill and the request to the Minister to take a particular position is an unorthodox use of the Green Party's position in the House. The Bill is about recognising that a problem exists and the need for an appropriate Government response to have legislation that reflects on an inconsistency for many people who live with mental health difficulties. I ask the Minister to look on the legislation favourably. I accept that the deletion of section 58 would create a legal anomaly. Senator de Búrca pointed out much needs to be added to the Bill on Committee Stage to make it more acceptable and determine whether these procedures are voluntary or involuntary.

The concept of advanced consent does not exist in our legal system and needs to be teased out on Committee Stage. I believe it has validity. If people are affected psychiatrically, their ability to give informed consent is obviously constrained. An important legal concept we are willing to put on the Statute Book is for an individual, who knows in advance when they are fully mentally aware of the nature of the treatment, to be willing to accept it at any date in the future.

I ask the Minister to initiative a review of these two procedures. It is the Green Party's intention to ensure this legislation receives as much support as possible from all Members. The understanding of the Minister will be part of that process. I am confident that having listened to the arguments the Minister of State will ensure this legislation is improved.