Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Seanad for giving me the opportunity to address these resolutions that seek to extend the sunset clause in two pieces of legislation, namely, the Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act 2020, and Part 5 of the Emergency Measures in the Public Interest (Covid-19) Act 2020, both of which are due to expire on 9 November.

First, I shall address the extension of the Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act 2020. The spread of Covid-19 has created an unprecedented situation both in Ireland and globally. I do not believe it is possible to overstate how serious a threat Covid-19 continues to pose to our economy, society, health and wellbeing. To date, Ireland has recorded over 53,422 cases and, sadly, 1,868 deaths. I know this House will wish to extend its sympathies to the bereaved families and friends of all who have lost loved ones.

When the Government brought this legislation before the Oireachtas six months ago we were really at the start of what has turned out to be a continuously evolving and uncertain journey. While we managed to suppress the virus to very low levels of transmission over the summer, recent trends and the current disease profile are very concerning. All indicators of disease incidence and severity have continued to worsen in recent weeks. In the last week alone we have had almost 9,000 cases and the national 14-day incidence rate now stands at 291 per 100,000. We have also seen outbreaks of Covid-19 continue to occur in the community, hospitals and, most worryingly, in long-term residential care settings. In response to the rapidly deteriorating epidemiological situation across the country, this week the Government has had to make some very difficult decisions to protect public health by moving the entire country for the next six weeks to level 5 of the plan for living with Covid-19.

While progress has been made in terms of the development of possible vaccines, therapeutics and diagnostics, it is internationally accepted that Covid-19 will continue to represent a grave public health threat in the medium term. Unfortunately, this means that there is still a need for non-pharmaceutical public health measures of the kind that came into effect overnight and are facilitated by this legislation. Ireland is not alone in this crisis. Indeed, all across Europe and much of the rest of the world, Covid-19 infections are on the rise and increasingly countries are having to introduce more restrictive measures in response. I fully accept that these measures place extraordinary limitations on lives and livelihoods, limiting who we can meet, how far we can travel and requiring some businesses and services to close their doors. Government does not take these decisions lightly and always seeks to balance all considerations, including public health, economic and societal, to ensure that any measures taken are proportionate to the level of threat, but regrettably we need to retain these measures as part of our national response. They proved essential in allowing us to suppress the virus in the first half of this year and they will do so again. Critically, they will support us in protecting our key priorities of maintaining health and social care services, keeping education and childcare services open and, above all, protecting the most vulnerable members of our communities.

These laws are necessary for now, and their main aim is to protect people and save lives. However, in the spirit of proportionality, I recognise that the extension of these extraordinary measures must be temporary, and I will repeal them as soon as it is safe to do so. I assure Senators that they will be continually reviewed and assessed in light of emerging evidence. Therefore, I am proposing an extension of seven months up to 9 June 2021, as this is in line with the timeline of the Government's medium-term strategy, Resilience and Recovery 2020-2021: Plan for Living with Covid-19. I am asking Senators to support this motion.

I turn now to the extension to the measures in the emergency measures Act amending the Mental Health Act. The measures in Part 5 of this Act amend the Mental Health Acts 2001-2018, specifically relating to the role of independent consultant psychiatrists and the holding of mental health tribunals. Mental health tribunals are made up of a solicitor or barrister, who acts as chairperson, a consultant psychiatrist and a layperson. Tribunals review the detention of every person involuntarily admitted and detained under the Mental Health Act within 21 days of admission and thereafter every three or six months. The tribunal either affirms the order detaining the patient or refuses it, following which the patient is released.

The Mental Health Commission, the independent regulator of mental health services in the State, approached the Department of Health in March of this year to raise its concerns over the need to ensure that these tribunals continue and that each patient's right to a review of his or her case is protected. In addition, there was a need to protect the health of both patients and healthcare staff and to ensure that the potential for Covid contamination was minimised.

Following detailed discussion with the commission and the HSE, the Department, in consultation with the Office of the Attorney General, introduced the measures to ensure that these tribunals could continue. These measures provide for a cascading approach to the role of the independent consultant psychiatrist and mental health tribunals. This approach means that, where possible, the current system of review is conducted as normal. In the event where, due to Covid, this is not possible, alternative measures are in place to protect the rights of the patient. The measures allow a consultant psychiatrist conducting an independent examination of an involuntarily detained patient to do so remotely in scenarios where a personal examination cannot take place. They also provide for mental health tribunals, the bodies which review the detention of every involuntary patient, to consist of only the chairperson if members cannot attend due to the spread of Covid-19.

I emphasise that all patients are examined in person by their responsible treating consultant psychiatrist at the point of admission and throughout their care, as appropriate. The independent examination by a second consultant psychiatrist still takes place, be it in person or remotely. The Mental Health Commission has been monitoring the implementation of the new measures on an ongoing basis. It has informed the Department that the new measures have worked well overall given the circumstances and that, while the current situation is not ideal, it has ensured that the rights of patients are upheld and that every patient has received his or her hearing.

As of this week, no one-person tribunals have been required, and the full complement of a legal professional, a consultant psychiatrist and a layperson has reviewed all involuntary detentions, either remotely or in person. This, however, does not lessen the requirement to have these contingency measures in place since they may yet be required to protect the health of both patients and front-line healthcare staff. Furthermore, other supports have been provided to patients during this period, including the additional involvement of interpreters and the use of videoconferencing for interactions with legal representatives and the independent consultant psychiatrist.

I reiterate that both resolutions propose a new date for the sunset clause of 9 June 2021, and these measures will not be continued indefinitely. The measures are also subject to ongoing review. I note that the temporary measures may be ended earlier by ministerial order should the public health situation improve to such a point that the measures are no longer needed.

The measures temporarily amending the Mental Health Act must continue beyond 9 November as part of our efforts to protect our most vulnerable and our healthcare workers. The proposal to extend the measures is supported by both the HSE and the Mental Health Commission. I ask all Deputies to support the continuation of these measures in a timely manner.