John Gilroy (Labour) | Oireachtas source

I thank the Cathaoirleach and welcome the Minister to the Chamber. It is sometimes not easy being a Minister for Health. I seem to remember a previous Minister for Health was criticised when he was accused of trying to put some primary care centres into his constituency. If one is to believe the Sunday newspapers published last week, the current Minister for Health is attracting some comment for doing precisely the opposite, that is, for not siting the children's hospital in his own constituency. I suspect the Minister for Health's lot is not always a happy one. While I have a considerable amount to say, I will go through the points quickly before reaching the main substance of what I wish to say. I wish to raise with the Minister part of his own opening address, in which he stated it is his wish and desire to see the level of agency staff being reduced. While I believe everyone shares that view, he also stated that where possible, nursing graduates would replace agency staff on a two-year contract. Is this the same two-year contract that was condemned roundly by nursing representative bodies last year and which has a starting pay rate of €22,000 per year or is this a different two-year contract? I seek clarity in this regard. I also wish to mention briefly an impending crisis in the nursing profession on foot of the recent announcement by An Bord Altranais agus Cnáimhseachais, The Nursing and Midwifery Board, of an increase of 50% in registration fees. I note the representative bodies are encouraging their members not to pay this fee and by January, several thousand pupils will find themselves unregistered. Is a contingency plan in place in this regard and does the Minister have an opinion on it?

As for the main point about which I wish to speak to the Minister, he may be aware that I have a particular interest in mental health. A debate has been scheduled here next week with the Minister's colleague, the Minister of State, and I am not always uncritical of those services. I wish to make two points with regard to the Mental Health Act 2001. They are not in any way locally focused and many might suggest they are a little obscure, but I have spoken about them several times. Section 59 of the Mental Health Act pertains to the administration of electroconvulsive therapy, ECT, to patients who are unable or unwilling to give consent. I believe this part of the Mental Health Act must be amended urgently. The Minister of State has given some indication that she is open to or at least predisposed towards amending this part of the Act but does not appear to have moved on it in any way. The benefits of ECT are contested and while there is some evidence of efficacy, it is not uncontentious. Surely, the agreement of two consultant psychiatrists should not be sufficient to give an invasive procedure to any patient? I do not suggest that ECT should not be used - I do not agree with it myself - but there is a case that it should be a requirement for any involuntary administration of ECT to be argued before the Circuit Court or perhaps the High Court.

Section 58 is another obscure part of the Mental Health Act, so obscure that I have never seen or heard of it during my 30 years as a psychiatric nurse or even during the 20 years before I entered the service. Section 58 of the Mental Health Act pertains to psychosurgery, which "means any surgical operation that destroys brain tissue or the functioning of brain tissue and which is performed for the purposes of ameliorating a mental disorder". I do not know what this provision is doing in a modern Mental Health Act, as psychosurgery has been discredited since the 1950s. I seek the Minister's opinion as to whether Members should attempt to delete it altogether. They should not simply amend it but should absolutely delete it, as I consider it to be barbaric in a modern mental health service that one would find oneself being comfortable in speaking about psychosurgery as an intervention in the treatment of mental health. As I noted, the Minister's colleague, the Minister of State, will come to the House next week and I will have some points to make, not all of which will be complimentary. Indeed, I will have a great number of very harsh things to say about mental health services, some of which have been addressed by Senator van Turnhout. I will raise some more next week but in the meantime, I look forward to the Minister's comments.