Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Thursday, May 10, 2007

INSIDE POLITICS - DAY ELEVEN

Bertie Ahern's financial woes have disappeared off the radar screen over the past few days and we have returned to what passes for 'normal' business during an election campaign.

There's a huge element of artifice about what happens. Yesterday, we got a classic example of a phoney war; lots of hot air about an issue (corporation tax) where the policies of all parties (even the supposedly radical SF) are ad idem.

Most days during the campaign, all the parties hold briefings. Meanwhile, the Leader's go on manic whirlwind tours of the country where they do silly things firstly on behalf of upholding democracy and secondly on behalf of attracting the attention of the lenses.

RTE yesterday showed a great piece of archive footage from 1969 featuring Longford-Westmeath TD Gerry L'Estrange addressing a crowd outside Mass (in fact RTE has put a lot of fascinating archive material on its website including FF's embrace of American canvassing techniques in 1977; Pat Kenny explaining the use of computers in 1982; and a Liam Cosgrave address from 1973. You can find them all here.)

Nowadays, there are few speeches. It's all to do with the photo op - the most surreal was Pat Rabbitte and Breda Moynihan-Cronin on top of a jarvey in Killarney, bringing the famous Tom Parlon-Mary Harney donkey and cart photo from 2002 to mind.

The party's choose their own particular schtick each day and then try to anticipate what their rivals are going to say. Sometimes you feel like there's a secret coven where they all secretly agree in advance they are going to spar on an issue. At other times, it's more like throwing all the balls in the air and seeing which ones the media pack will catch and then kick.

Today it was health. Fine Gael insisting that the biggest broken promise of all by this Government was its promise to provide 3,000 extra hospital beds (it's part of the health strategy that runs out in 2011). The Government, particularly health minister Mary Harney countered by claiming that the FG proposal to provide an extra 2,300 beds would be impossible to achieve within five years. FG Deputy leader Richard Bruton insisted it would be, said that that FG would prioritise the first €850 million of the €2.6 billon provided for capital health spending in the NDP.

At least there was some meat in this particular sandwich, if you don't mind the distortion of a political metaphor. There are real differences between the two alternative alliances when it comes to health. And at least when you hear the debate there is a little bit more Gerry L'Estrange about it; a little bit less modern political leaders - there is debate and argument and the welcome (figurative) return of the soapbox.

Saturday, April 07, 2007

OUTSIDE POLITICS - TRAVELLERS

The graph looked like one of those elegant long-necked bottles they sell fancy hooch in. It was broad at the base and then quickly became very thin before tapering off slowly at the top.

A couple of minutes later another graph appeared. It was roughly similar but roughly in the roughest sense of the word. If that second graph was a bottle, it was a bottle of stout, a small squat one at that.

The two graphs represented two different human realities in Ireland. They were part of a presentation by the Central Statistics Office on its analysis of demographic trends from the 2006 Census.

Both of these graphs reflected life expectancy. The first graph depicted the 'settled' population. It showed - unsurprisingly - that people are living longer, hence the elegant long neck.

The second graph was truly shocking. It reflected the same set of statistics as they related to travellers. The proportion of travellers under the age of 20 is enormous but the fall-off after that is shocking, truly shocking. The percentage of travellers who can hope to live behind the ages of 60 is tiny, beyond 70 infinitesimally small, and beyond 80, almost non-existent. Thus, the small squat stout bottle.

The grim and obvious truth is that there's a section of Irish society who, on average, can expect to live up to two decades less than their settled counterparts. That's more than shocking. It's a scandal.

Now, in fairness, the CSO statisticians entered a couple of caveats. The questions relating to travellers in the latest census were new ones that gave rise to variances and certain unreliabilities of comparison. For example, the birth rates, says the CSO, suggests that the actual population of travellers is perhaps a couple of thousand higher than the actual figures. The corollary is that the lower life expectancy figures may also be slightly skewed.

But only slightly. When you see these graphs - the elegant long-necked bottle and the fat squat stout bottle - the only word that can form on your lips is scandal.

This week, the junior minister with responsibility for equality Frank Fahey announced the identity of those who would be on the National Traveller Monitoring and Advisory Committee.

This is not to beat Fahey who has proven to be more pro-active than most other ministers in this regard (with the exception of Chris Flood). But if you look at the ancient beginnings of this committee and its eventual destination way off in the future, it tells a tale of the inertia and inaction that characterises non-priority stuff for government.

Bear with me for a couple of seconds because while the following prose mightn't whizz off the page, it is important. Way back in 1995 - that's 12 years ago - a task force on the travelling community reported its findings. A committee called the traveller monitoring committee was set up to monitor implementation of its recommendations and ten years later produced its second and final progress report.

So what was produced in that decade between 1995 and 2005? What great benefit was derived by society and by its travelling community? This is the equality department's own language describing the situation as it was in 2005: "There was a general view that it needed to be revitalised and made into a more dynamic and forward looking national forum."

In other words, not much happened that made a difference to the lot and lives and status of travellers. And so now we have a new initiative. And it's worthy. And it's headed up by a well-respected former civil servant, Kevin Bonnar. And part of its mandate will be to oversee strategies that increase the participation of travellers in wider society, including finding employment opportunities.

But then, it's part of the Towards 2016 partnership agreement. And when I see the date 2016, I automatically think of long-fingering and another report being produced that year telling us all that we haven't done enough and saying we should all do more to improve the lot of travellers.
Examiner columnist and Barnardos chief executive Fergus Finlay put it well this week, when talking about another group on the margins of priorities, children.

"I've been involved in writing political manifestos before and I know that at the last minute someone says, 'We need to throw something in there about children'. So it ends up on page 40 of the manifesto."

Because the grim reality is that tangible and real improvements for marginalised people in Irish society can only happen if there is real political will. And for travellers, for those with mental illness, for families who have children with autism, or intellectual or other disabilities, or for the poor and dispossessed, children and adults, there is no real political will.

Political parties pay a lot of lip service to it. But they know that people are more likely to vote with their pockets rather than their conscience.

This is my column from today's Irish Examiner

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