Jerry Buttimer (Fine Gael)

Gabhaim comhghairdeas leis an Aire Stáit, an Teachta John Moloney, agus cuirim fáilte roimhe go dtí an Seanad.

I commend the Green Party on bringing forth this timely Bill. However, if it thinks that putting this Bill before the House will appease its conscience regarding mental health it is sadly mistaken. For too long, our mental services have been severely and chronically under-funded and under-staffed by this Government, of which the parties opposite are members.

The motion before the House has the broad support of my party. I commend those people outside public office such as John McCarthy in Cork who have been to the fore in making mental health a topic about which we can all speak and which we can all seek to demystify. In this regard we are speaking about people and not statistics, people who deserve respect, support and to be nurtured and loved by society.

Of fundamental importance in this debate is not alone the nature and type of intervention provided to those with significant mental health needs and illnesses which are severely debilitating for them and which prevent them from reaching their potential in the community but the question of what supports and protection are put in place for those deemed by experts to lack capacity in respect of decision-making and, ultimately, in giving consent to a very intensive intervention which carries with it an array of known and documented side-effects. Like Senator Cannon, I am not an expert on psychiatry. However, having researched this issue and having consulted widely on it, I believe the role of ECT is, to say the least, dubious. It is an outdated practice. I hope we will ban its use forever. I welcome what the Minister of State had to say in his speech. We are only beginning this process and it is important we have this debate.

There are known risks in regard to ECT, be they cognitive impairment, memory loss, medical complications or physical issues, that need to be addressed. The central issue of concern for me is not whether ECT should be administered but rather the ability of a person to provide informed and valid consent to a procedure that has well documented side-effects. People are what we are about. If we are to have a truly person-centred mental health service we must put people with mental health needs, individually and collectively, at the heart of the decision-making process.

I believe the Minister of State is genuine and sincere. Since I got to know him in this House I believe he is a man of action and absolute sincerity, whatever about some of the people around him. I hope he can take this issue, along with disability, and make it a central part of his remaining term of office.

We must identify and implement strategies that are long term as well as current and focused, which place a strong emphasis on supporting and enabling people to make their own decisions. The Government's document A Vision for Change is long on rhetoric but short on answers. Under-funding and lack of resources have become by-words and by-products.

Regarding the Minister of State's field of intellectual disability, I have been very involved in this area, long before I became involved in politics. In the United Kingdom the Mental Capacity Act has a number of key principles which emphasise the centrality of the individual and the person within that process. I hope that in the debate on mental health we can take the viewpoint that every adult has the right to make his or her own decision. People must be supported as much as possible to make that decision before anybody concludes they cannot do so. People have the right to make what others might regard as unwise or eccentric decisions.

I repeat that we are talking about people. For too long Government has forgotten about people, being driven by economic indicators and by profits and, in consequence, the HSE and other areas have become restrictive. We lose the core of people in community. A Vision for Change was launched with much fanfare. We were promised that the sale of all institutions would give us huge amounts of money, that we would have a pot of gold and community-based supports. What has happened? What is happening? Every week we get telephone calls from people who are struggling. They cannot get social workers at the weekend, or access to the psychiatric wards in Cork University Hospital. Only two weeks ago I was contacted by members of a gentleman's family who were distressed and at their most vulnerable. The very organ that was there to support them did not admit the person concerned. What does that message say to us? We have never had so much money.

Senator Fitzgerald called for an audit by the Mental Health Commission regarding the use of ECT. I support that. She is absolutely right. It is clear that the practice is outdated and must be jettisoned. I know and respect where the Minister of State is coming from as he approaches this subject. He is the driver of the engine and must look at the whole picture.

Alternative methods must be clear and agreed by all stakeholders, a word I use in the sense of "advocates". Human rights and human dignity are the issues about which we should concern ourselves. Let us not categorise people or put them into boxes. In many ways we all struggle in life and every day we do the best we can. It behoves us, as legislators, and it behoves Government, as the voice of the people, to represent the people whom we support.

We are not only discussing ECT, depression or psychosis. I go back to the point with which I started. We are talking about people — our brothers, sisters, mothers, fathers, uncles, people we know. We must strive for and, as leader on this issue, the Minister of State must create a mental health service that is responsive to people, rather than to models of treatment or care. We must recognise the centrality of the person with mental health needs. Unless we have that person's rights and concerns as our first and foremost concern we will have failed.

I commend the Bill and I look forward to future debate, but we need action.