Bernard Durkan (Kildare North, Fine Gael)
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Question 12: To ask the Tánaiste and Minister for Health and Children her plans for the delivery of services in primary care, medical and surgical facilities, special hospital needs and community services; and if she will make a statement on the matter. [4226/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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With effect from 1 January 2005, under the Health Act 2004, the Health Service Executive has responsibility for the delivery of health services. Under section 31(1) of the Act, the executive is obliged to prepare, adopt and then submit to me for approval a service plan for the financial year or other period as may be determined by me. Subsection (8) provides that not later than 21 days after receiving the service plan, I shall either approve it or issue a direction under subsection (9) that it be amended. If I approve it, under subsection (13) I am obliged to ensure that a copy of the approved plan is laid before both Houses of the Oireachtas within 21 days after it has been approved by me.

The national service plan will be informed by the guiding principles underpinning the health strategy, namely, equity, people centredness, quality and accountability. The plan will cover all the major programmes of care.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 13: To ask the Tánaiste and Minister for Health and Children the action she proposes to take on foot of the Health Research Board findings of wide variations in the use of electroconvulsive therapy between the health board areas; if she has satisfied herself that adequate procedures for its use are in place; if she will undertake a thorough review of the use of this highly controversial treatment; and if she will make a statement on the matter. [4157/05]

Tim O'Malley (Limerick East, Progressive Democrats)
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The decision to prescribe ECT is a clinical one. I am informed that ECT is administered in accordance within the guidelines on protocol for the administration of ECT as set out by the Irish College of Psychiatrists, formerly Royal College of Psychiatrists of Ireland. The protocol is comprehensive and provides guidance on the prescription of ECT by the consultant psychiatrist, administration of anaesthetic, preparation of the patient, patient's consent, the administration of ECT and pre- and post-ECT nursing care plan.

The report of the Health Research Board, Activities of Irish Psychiatric Services 2003, states that the use of electroconvulsive therapy, ECT, has been declining in recent years due to the availability of other treatments for mental illness, particularly depression. However, the rate of reduction has varied between former health board areas and between services in each area. This fact has been noted by the former inspector of mental hospitals in his report for the year ending December 2003. The inspector also indicated that he had monitored the use of this treatment and of the facilities for its provision during his inspector of mental health facilities. Any deficiencies noted by the inspector in facilities or practice had been highlighted in individual reports.

The Mental Health Act 2001 contains provisions relating to the administration of electroconvulsive therapy which, when fully implemented, will provide further safeguards to involuntary patients being administered this treatment. The Act provides that the Mental Health Commission will make rules providing for the use of such treatment and ECT will only be applied in accordance with these rules. In advance of these rules being provided, Dr. John Owens, chairperson of the Mental Health Commission, recently expressed his concern at the disparity in the use of ECT and has indicated that this matter will be investigated by the commission.