John Moloney (Laois-Offaly, Fianna Fail)

I thank Senators for their contributions. I acknowledge the sincerity of the Green Party in this debate. I also acknowledge that ECT treatment is controversial. I am glad that I do not sense any political involvement in this, as it is a genuine attempt to ensure our mental health services are reformed, which is the continuing role of a Minister of State with responsibility for mental health issues.

We are speaking specifically about involuntary treatment, which has always been the way. I must accept that it is a year since we debated this issue, but I have spent the last 15 months travelling around the psychiatric hospitals. I have done this for a number of reasons and I always made sure that the press were never notified, nor were political colleagues. I did that at all times to ensure we built a belief that we were trying reform the mental health services. On most occasions when I visit a hospital, I ask to meet the staff who deliver this treatment and visit the ECT rooms.

I am taken by the many valid points raised by Senator Fitzgerald, including that on the variation in treatment across the country. Without trying to lead to a cosy proposal I might make shortly, I made the point at the Joint Committee on Health and Children that it was no longer sufficient to make a yearly statement on mental health services. Since taking office, I have believed it is important we tie down the commitments and recommendations made on the reform of mental health services in A Vision for Change which has been running for four years and has five or six left to run. From the outside, I saw the importance of having in place a director for mental health who would have as his or her only brief the driving of the reform of mental health services. I am pleased to say Mr. Martin Rogan is now in place. However, it is not just a matter of having a person in place but of having someone who will be directly responsible for driving reforms. I have always insisted on the person in question not being responsible to the Minister, lest there be any argument about political motivation. The job description for the post of director should be to be specifically responsible to the monitoring committee charged with delivering reforms. That is now in place as part of the building blocks. The other part concerns the 14 clinical directors.

I will come to the net point shortly but I wish to establish my own credentials first. Clearly, we cannot be true in our talk of reform unless funding and capital are provided. I have made proposals in this regard to the Government. I made this point also at the Joint Committee on Health and Chidlren; therefore, it is not just a matter of talking about talks behind closed doors. I have proposed a five-year capital programme on how we should develop and put in place all of the capital programmes required. I accept that capital programmes are not the answer to every issue and are only part of our public commitment to deliver reforms. My proposal is that whatever is raised in the mental health sector from the sale of 800 properties should go back into mental health services specifically and that there should be a clear money trail from the sale of the properties down the line to the commitments and recommendations made, whether in regard to intensive care units, intensive care rehabilitation units and the Central Mental Hospital. I wish to deal with these issues in the context of mental health service reform.

In the past year I have received many submissions from people who believe we should remove ECT, a matter which has arisen in today. There are three public positions on ECT — there are those who are totally opposed to the treatment, there are those who are in favour of it and, as I have come to realise having listened to the debate, there are those who are in favour of it, provided certain safeguards are in place. I concur with the latter. I am not here to argue the pros and cons, and that is not a cop-out because I will come to my net point shortly.

A year ago submissions and presentations were made to me on the need to remove ECT from mental health services. I was taken by the debate. I have since had the opportunity to meet those who administer the treatment, as well as those who are totally opposed to it. I accept that in some cases the treatment does not work but that it does in others. While I do not want to make either case, it has been suggested ECT does not work. Only last week, however, I received a letter from a person who offered to come to a committee of the Houses, perhaps the Joint Committee on Health and Children. The person has a severe mental illness — he is catatonic — and wrote to make me aware of the fact that he put his survival down to the treatment in question.

I am making the case to convince myself in the sense that, on the one hand, I have evidence that suggests there is an argument for the retention of ECT, although I am not swayed by it, but, on the other, there is evidence on the other side of the argument. I do not use the phrase "putting this out for wide consultation" because what it means in political speak is that I let the issue run for months or even years and that the next person coming after me would have to pick up the pieces. I accept from what I have heard from the Members who have moved the motion and all who spoke is that this is a very serious issue. While I do not want to respond in contradictory terms, when the point is made that we had a year but did nothing, I must say the opposite. I will try to show the House what I mean. First, as part of the programme for Government, in which my party and the Green Party are involved, we have considered not just continuing reform of mental health services but also a review of the Act.

The second issue can be confirmed by many hospital staff. The third issue is as follows. The Mental Health Commission has promised to meet me before 10 December to outline its views on how we should deal with unwilling or unable people. A fortnight ago I met the representatives of the College of Psychiatry of Ireland. Let me clear to the House because I must respond to the point made, although I accept it was not meant as a criticism. The established mental health service providers are totally in favour of ECT. While this might be so, as Minister of State and with the officials who work in the Department, I am not advancing that case in any way. What we are suggesting is that this is such a huge leap — the word "courage" was used — I must have the courage to make the right decision. In that context, I will meet tomorrow the representatives of the hospital consultants.

All of this has been a process in the past year to ensure I am properly informed before I make a recommendation to the Government. I ask Members to consider that we have been genuine in our attempts to come to an informed conclusion. I have also invited the representatives of the College of Psychiatry of Ireland, as well as those who propose the abolition of ECT, to come to the Houses on one day, when those in favour of its retention and those in favour of its abolition can make a presentation to members of the joint committee. Rather than put the issue on the long finger — it is far too serious for that — I give a commitment to the House that by March I will have completed the consultation process. I will know the pros and the cons and at that point it will be up to me to make a decision. I also give a commitment to the House that not only will I make recommendations — I am not a professional and bow to those who are — but also that the relevant Bills will be ready by then.

I wish to respond to some of the points made. Senator Fitzgerald made the point that mental health issues should be to the fore and that the process for ensuring this should be directed through the Joint Committee on Health and Children. I will ask the Chairman to facilitate those people who in the run-up to March want to make written submissions and, if time is available, to take some verbal presentations.

The issue is serious and the word "courage" strikes me. I will try to deal with the matter more specifically. I must also have the courage to ensure the plight of those who cannot protect themselves by securing treatment is examined. I have the courage in that context to ask that we do not make the decision on this legislation now. I ask that Committee Stage be adjourned to allow me make a genuine attempt to address the issue.

It is not a matter of trying to be cosy politically or to escape my responsibilities in this portfolio. I do not want to ignore the genuine commitment of the proposers of the motion. I have been as active as a Minister of State can possibly be in this Department for the past 15 months and I have made it clear that in February I will host a public appraisal of where we are with A Vision for Change. I will deal with the level of commitments of what we will do with regional directors and, more importantly, of dealing with the capital programme.

By March I will bring forward a nationwide proposal on using local radio and personalities, including people involved in Shine and other mental health groups. We will go the regions and promote the concept of eliminating the stigma in mental health. I will do that publicly but in the meantime I ask to be allowed space to work. I will ignore nobody and take all into account. The time for decision will be March and I ask people to allow me that space. I ask the Green Party Members to adjourn the debate on Committee Stage until then.