Gabrielle McFadden (Fine Gael) | Oireachtas source

I will endeavour to speak to the Bill rather than score political points. It is a basic human desire to have one's voice heard. Whatever the context, each of us likes to know that our opinions will be listened to and, more importantly, taken seriously. This is particularly true when it comes to decisions made on our health and on treatments for ill health, and this should be as true of mental ill health as of any other illness. The fact that someone's capacity may be impaired by mental health difficulties does not and should not mean that they are not entitled to have their views heard and their values respected.That is why I am supporting the passage of the Bill today.

Many people, in their more nostalgic moments, yearn for a time when people had more respect for doctors, teachers, the clergy and other authority figures, but that time was also characterised by a society with very unequal power relations, where the ordinary folk were spoken down to by authority figures. The experts told us what to do and we did not question it. They did the talking and we did the listening. The attitude that the doctor or the teacher knows best and the unquestioning acceptance of anything said by the clergy are now, thankfully, gone. Nowadays most doctors, teachers and others who interact with the public have a more enlightened approach and have come to understand that allowing people's voices to be heard and treating them with dignity is important as it demonstrates that the service user is valued. In the field of health care, patient-centred communication and shared decision making are even more important. People may feel vulnerable when they experience ill health of some sort and treating them respectfully is a matter of common courtesy. More important, scientific evidence demonstrates that a patient-centred care model contributes to improved outcomes for patients, better use of resources, decreased costs and increased satisfaction with care.

This Bill supports the right of inpatients to make decisions about their own treatment and starts from the basis that people should be presumed to have capacity to make decisions about their own welfare rather than the clinician deciding what is in the best interests of the client. The Bill focuses on the will, preferences, beliefs and values of a person. I am not for one moment suggesting that all doctors involved in the provision of mental health services are currently approaching their patients in a paternalistic manner. I am saying, however, that by putting this legislation in place we are making an important statement about those who suffer from mental ill health. As a society we are saying that their voice matters and will be listened to. This is important because such an approach fulfils the basic human desire to be heard, which I would characterise as a human right. We need to move towards a more human rights-based mental health system.

The Bill is only one step in reforming our mental health system but an important one. By passing it and working towards implementation of some of the other recommendations to come from the expert group on mental health reform, we will begin to move towards the fulfilment of international human rights law, including our obligations under the European Convention on Human Rights and the UN Convention on the Rights of Persons with Disabilities.

I support the Bill because the approach outlined in it promotes positive interaction with the patient. It promotes better treatment and better outcomes. Most important, it promotes well-being because it clearly states that the person's voice matters.