Saturday, March 17, 2007

INSIDE POLITICS - WAVING OR DROWNING (SHAMROCKS)?

Being St Patrick’s weekend, the Cabinet are away doing (delete where applicable) thankless drudge work/damn all; working to exhaustive schedules/lounging beside a pool; and drowning the shamrock/drowning the shamrock.

They may deprive the population of admiring their extremely tight-fitting but fabulous flesh-coloured outfits on parade stands all over the country today.

But one thing is guarantedd, they won’t be slouching when they come back knowing their collective and individual futures are on the line.

People are still in the thinking mode that goes: The election will happen towards the end of May and isn’t that a full two months away?

But the reality is that the 29th Dáil is down to its last 11 or 12 days and counting. So, when it comes to proposed Bills, unless the guillotine is applied with the abandon of France 1789, most of the priority legislation is going to disappear down the plughole.

For over the next couple of days, Government chief whip Tom Kitt will be marshalling his colleagues like a RyanAir check-in attendant. Hand-baggage only. No heavy stuff. No frills. Only stuff you can carry on board. You need to travel light from here on in.

So a lot of the worthy and useful stuff will be chucked out for the expedient reason that they don’t win elections. And only the real essentials will remain.

And of course, they will all revolve around the big three issues that will win or lose this election – Iraq, questions surrounding Bertie Ahern’s governance, and Eamon O Cuiv’s handling of the Dingle controversy. Ok, a little joke there. Predictably, the star issues are economy, crime, and health.

That’s why a doorstep of a new Criminal Justice Bill (CJB) was published on Thursday, less than a year after another massive CJB became law. The phrase ‘rush to judgement’ doesn’t do justice to the haste with which it came. It’s a runaway train. New mandatory minimum sentences. New electronic monitoring. A radical erosion of the right to silence. And sorry for being so crude, but it will become law quicker than fresh dung sliding off a shovel.

And that’s why too the Government is so keen to resolve the row with consultants by the end of March – to proclaim that, yes, folks, we have turned around that elusive corner on health.

You look at McDowell’s spontaneous combustion act for a not strictly necessary CJB and compare it with the perfectly still surface of that backwater known as mental health policy.

In January 2006, the Government published a report called a Vision for Change. It presented the findings of an expert group on mental health policy. Well-researched, well-argued, nobody demurred from its own recommendation that ‘A Vision for Change should be “accepted and implemented as a complete plan.”

When it was published groups like Mental Health Ireland said it gave the “country a second, and possibly last, chance to develop balanced and integrated modern mental health services.”

A second chance? Yes. There was an earlier document called Planning for the Future. That was published in 1984. It took 22 years for successive governments to fail to fully implement that one. Last year’s plan is already showing early signs of the slippage that doomed the 1984 plan. And that’s why the groups are getting so nervous and concerned.

Their problem is that, electorally, they are nowhere. They campaign in huge and complex areas. But unfortunately they affect a minority and, ergo, don’t sufficiently influence electoral outcomes.

In fairness to the Government, there has been progress. But it has been halting and limited, and not helped by the off-the-wall comments we occasionally get from the junior minister in charge Tim O’Maley.

Sure, the number of people with ID placed inappropriately in mental hospitals has gradually fallen to about 250. But where are they going? According to Inclusion Ireland, hundreds have ended up transferred from inappropriate mental hospitals to even more inappropriate nursing homes where inspections are geared towards standard of accommodation, not towards activation, quality of life, or development of potential.

There is O’Malley’s plan to sell 10 old mental hospitals to raise new funds. When is that is going to happen? In two years? In five years? A decade? The C&AG identified one home with 250 residents where “a custodial culture had developed largely due to constrained resources”. That was shocking. These are the most vulnerable people of all in our society.

As Dr John Owen, chairman, of the Mental Health Commission referred in its 2005 report to the severely mentally ill.

“These people still make up the majority of inpatients and while many have been
discharged to alternative community residences this has often been an exercise in relocation, serving the priority of closing mental hospitals rather than a
treatment and rehabilitation exercise in its own right.”

Sad. More sadly, there has been no rush from our political masters – or indeed from ourselves in wider society - to right this appalling situation.

This is my column from today's Irish Examiner

2 comments:

Dan Sullivan said...

I sometimes wonder if our generally appalling treatment of those with a mental illness is in some way related to a fear that the cause was in some way contagious.

And it is just my own view but Tim O'Malley is coming from the wrong professional (drugs for everything) and political (inequality is good!) background to be charge of this area.

Harry McGee said...

Dan, One of the points I was trying to make in the column was a rephrasing of the old saying: the road to Hell is paved with good intentions.
A minister may promise to tackle a wrong in society and will usually make a statement venting off like a modern-day Tom Paine about the rights of man.
But there are so many opportunities for non-completion of the promise that it's often impossible for the public and media to satisfactorily track it.
The problem can be kicked into touch by hiring consultants, or getting an expert group to report, or conveing a cabinet sub-committee or some horrible inter-departmental amalagam.
The when the report is finally made, it can be subject to a period of consultaton by stakeholders.
Or a green paper can be drawn up. And then a white paper.
Sometimes, a Bill will be published.
But that can often languish for several years before appearing on the order paper of the Oireachtas.
And when eventually legislation is enacted, it can take several years before all its sections are given the force of law.
So when you see a document like Vision for Change, you are not been cynical when you think of Planning for the Future and the 22 years they spent implementing only bits of it.
When will the psychiatric hospitals be sold off? When will we see properly resources multi-disciplinary staff in every region of the country? When will the number of people with ID inappropriately placed in hosptials or nursing homes be reduced to zero? Nobody can say.