Statements on Homelessness Wednesday 3 December 2014

PLEASE CHECK AGAINST DELIVERY

According to the Dublin Simon Community, the official count for rough sleepers last month was 168. This represents a 30% increase in numbers since Spring 2014 and double the number since November 2012.

This is a time of many sickening firsts and all-time highs:

  • Emergency accommodation now has over 1600 adults plus 680 children. That’s never happened before!
  • Of the 1600 adults in emergency accommodation, 39% are women. That’s never happened before!
  • Emergency accommodation is turning into long term accommodation with no viable options to transition onto. That’s never happened before.
  • Many have given up looking for emergency accommodation.
  • Others believe themselves to be safer on the streets than in emergency accommodation.
  • Individuals and families are being are evicted from private rental properties every day of the week, unable to meet rent increases in an unfettered market.

We have an Emergency on our hands and it is winter. A very cold winter.

The numbers are steadily increasing and we need to act. Really act. Not a knee-jerk panicky reaction following the tragic death of Jonathan Corry. A dedicated and sustained response that looks at the crisis holistically.

For it is not just a homelessness crisis. This is a housing crisis.

A housing crisis characterized by a shortage in the social housing sector and a serious lack of affordability in the private rental sector, exacerbated by an absence in rent regulation, a rent supplement scheme completely out of sync with actual rental prices and the absence of measures to prohibit landlords discriminating against tenants on rent supplement.

The unprecedented crisis in the social housing and private rental sectors is pushing non-typical candidates into risk of homelessness and homelessness itself, for example, there are as many as 150 families in emergency hotel accommodation, the majority of whom have been pushed out of the private rental sector by spiralling rents.

Aside from the massive cost to the State, this hotel  and B&B accommodation is completely inappropriate, hugely disruptive for families and children, who may have to move schools as a result, and potentially unsafe.

I call on Government to immediately family proof all forms of emergency accommodation and to coordinate with the Child and Family Agency and emergency accommodation staff concerning child protection.

The crisis is in turn putting unprecedented pressure on frontline services and pushing those more “typically” vulnerable to homelessness (those with addiction issues and mental health difficulties and in complex situations such as young people aging out of State care, victims of domestic violence leaving the home) it pushes them  further and further to the margins only to resurface to public and political attention when they die in their sleeping bag, sleeping rough on the door step of the National Parliament.

The recently published Private Residential Tenancy Board Consultant’s Report found that rent control would make the housing market worse.

Focus Ireland rejected this finding. It maintains that rent regulation is a crucial part of a suite of measures, including an increase in rent supplement to reflect the actual cost of rent and tax breaks for landlords to encourage them to rent their properties.

I would also subscribe to a measure of rent regulation against an index as in many European countries or in line with inflation.

There are many initiatives to be commended, however there are “buts” attached to nearly all of them. For example:

  • Housing 2020 and the recently announced Social Housing Strategy but realistically we are 1.5/2 years away from meaningful delivery.
  • The new rent increase protocol agreed with the Department of Social Protection for families at imminent risk of homelessness but it is only available in Dublin and what we really need is a level of flexibility throughout the system and at an earlier juncture.
  • The Housing Assistance Payment, which is receiving a positive response from Landlords in terms of there being a guarantee around rental payment but doesn’t actually prohibit landlords from refusing to accept tenants in receipt of financial support. Also, how are people to find suitable accommodation within the maximum rent limits?

Excellent recommendations have been made in these regards and more by Focus Ireland, Threshold,  Dublin Simon Community and Peter McVerry Trust. The solutions are there. They just need to be implemented.

In closing, I would like to briefly discuss something a number of colleagues in this House said yesterday concerning Jonathan Corry and the fact that he had been offered assistance and accommodation over the 30 years he had been homeless, which de declined to take up.

I sympathise deeply with Jonathan Corry’s family and friends following his death. I didn’t know him or anything about his mental health status but I think these examples of people failing to take up an intervention and seemly choosing to remain homeless needs to be viewed in light of the Dublin Simon’s recent statistics on mental health difficulties among their service users, whereby 71% were identified as having a mental health difficulty.

Of those identified with a mental health difficulty:

  • 63% of individuals have been diagnosed with depression.
  • 46% have been diagnosed with anxiety.
  • 11% have been diagnosed with schizophrenia.
  • 11% have been diagnosed with psychosis.

A very high proportion of people who are homeless have addiction issues.  Furthermore, a very high proportion of people who have a mental health difficulty also have an addiction issue.

I call on the Government to urgently implement the key recommendations from Mental Health Reform:

  • Fully staff homeless outreach mental health teams.
  • Ring fence local authority housing for people being discharged from psychiatric hospitals.
  • On-tap, in-house mental health expertise within homeless services. E.g. Merchants Quay Ireland has an in-house mental health nurse full time, to provide support to clients that other staff members have concerns about. There are anecdotal reports that this has reduced the number of people having to access mental health supports through A&E when in a crisis.
  • Establish a dual diagnosis services for people with a mental health and addiction/alcohol misuse problems.

We have the reports. We have the plans. We have the expertise, particularly in the NGO sector. What we need now is action. Sustained and dedicated.

Statements on the Participation in Sport

April 2nd, 2014. Senator Jillian Van Turnhout speaking on the issue of Participation in Sport: Statements. Seanad Éireann

 

I welcome the Minister. I particularly welcome his openness to all sports and like the emphasis he placed on increasing the participation of women and young people in sport. We need to pay greater attention to this aspect. Previous speakers have referred to the positive role sports play and the benefits are endless. We have a proud sporting tradition in Ireland. One of our proudest moments as a nation was, undoubtedly, hosting the Special Olympics which highlighted our national strengths and celebrated our wonderful athletes.

Sports have many positive effects on society and, as legislators, we have a role in increasing participation and interest. Colleagues have referred to the economic benefits, but I would focus on the physical benefits and mental well-being of society. If we can improve mental and physical well-being positively, this will reduce health care spending in the long term, which everyone would like to see.

The Minister mentioned the GAA. I will not get into the current debacle about pay-per-view television and so on. However, he referred to emigrant clubs. One person tweeted me and asked about creating a role for these clubs which promote the GAA abroad and giving them a voice. There should be a two-way conversation.

Like many colleagues, I was on the edge of my seat as I watched the Six Nations match between Ireland and France which demonstrated the power of sport. We all became video referees that day in deciding on whether there was a forward pass. I congratulate the team, but I also congratulate the national women’s rugby team on its success last year.

We have a fantastic history in sport and the development of new sports. One example is the mixed martial arts, MMA, fighter Conor McGregor who is promoting the sport on the world stage and acting as a role model for a different group of young people by promoting new possibilities in sport. We must encourage the development of new sports. It is imperative that we recognise the contribution of Irish women on the sports field because they encourage participation. Katie Taylor brought back a gold medal from the Olympics Games held in London in 2012. Little work was done in the country while her gold medal fight was on. The participation of females in sport can sometimes be under-reported. It is welcome that RTE has begun to broadcast women’s rugby matches, but I would like other sports to be treated more equally. I do not expect coverage to be equal, but it needs to increase. It is welcome that women’s rugby games are being moved from lesser stadiums to the main grounds such as Wembley Stadium and the Aviva Stadium. This should be encouraged in other fields.

I spoke to a camogie player who wanted to participate in women’s rugby 7s as an opportunity to go to the Olympic Games. Opportunities are opening in sports to be part of the games. Paralympic sports have also developed. I recently read a fascinating article about wheelchair hurling and how it was developing. The possibilities are endless. While preparing for the debate, I learned more about ultimate frisbee and tag rugby. Cricket has also become popular at grassroots level, given the national team’s success. I know many young people who are involved in the sport. Initiatives such as the get-into-cricket scheme are welcome because they provide a significant boost for the game.

We should support all sports to enhance choice. One of the issues I have relates to schools. If pupils attend a large school, they usually have a choice of sports to play, but they do not in small schools. Children are either good or bad at a sport and may not necessarily be exposed to other sports.

That is why I wanted to raise the issue of the French municipalities and the centres sportifs. Bringing sports together in a community is something we really need to look at. We must decide whether club or community will dominate. I would like to see that communities would have a stronger role and when we, as a State, are investing, we encourage organisations to come together.

The Minister mentioned the GAA. In my community, it is not the sole sporting organisation which will have territorial rights on pitches and on its turf where one cannot use it. Even though those pitches and sporting facilities lie idle during certain times of the day and certain times of the year, they have a dominance at one time, they lie idle, but they belong to that sporting discipline and they cannot share it. We need to look at how we can encourage people to share. When we are looking at the sports capital grants, we should ask what other sports in the community will be able to use this facility when it is not actively being used by the particular sporting discipline.

We need to discourage fragmentation and give young people the opportunity, as they do in France, where there can have different sports, such as tennis, swimming and rugby, under the one roof together, working in harmony rather than being seen to be in that competitive space, because we need to give people an exposure to the different types of sports.

I say, “Well done”, to the Minister on the Giro D’Italia. I wish Ireland every success in the tender for the rugby world cup. It is great to see us coming together as an island to work to hopefully bring it here in 2023. Sport is of immense importance.

I thank my colleagues in Fine Gael for moving this motion. It has given me an opportunity to research and learn more, which is part of our role as Senators.

I will finish with a powerful quote that I found from a US legend, Dean Karnazes. He said, “Some seek the comfort of their therapist’s office, others head to the corner pub and dive into a pint, but I chose running as my therapy.” That sums up sport. We should be encouraging people to get out and participate in a community. That is what we should be looking for as a society.

Statements on Free Speech, Homophobia and the Role of the State Broadcaster

February 18th, 2014. Senator Jillian Van Turnhout speaking on the issue Free Speech, Homophobia and the Role of the State Broadcaster.

I welcome the Minister to the House. I thank Senator Zappone for taking the initiative on this debate. Instead of focusing on a single definition of homophobia, we need to acknowledge that homophobia presents itself in a wide spectrum, ranging from violent hate crimes to far more subtle forms of discrimination.

I, too, commend Panti’s address at the Abbey Theatre on 1 February, and my colleague, Senator Mac Conghail, on using our national theatre in the way it was so rightly used for a noble call. She articulated so succinctly the impact of subtle discrimination and homophobia on a person’s psychic and mental well-being, causing them, in her words, to check themselves at the pedestrian crossing. The number of views, and the number of languages in which that video has gone around the world, shows the power that words can have.

It is very important, however, that we do not have debates about important social issues in isolation from each other. Social issues are invariably interrelated – homophobia, self-harm, suicide and suicidal ideation – and, tomorrow, we will have a debate on mental health and well-being. This is particularly true for young people and, in this context, LGBT youths. A report in 2008 was published jointly by BeLonG To, GLEN and the HSE, called Supporting LGBT Lives. That report found that 50% of LGBT youths have thought about suicide and 20% attempted suicide. LGBT young people are seven times more likely than their heterosexual counterparts to experience mental health distress. It has also been established that young people identify their sexuality at age 12, on average, and the average age of coming out is 17. This five year period in which young people come to terms with their sexuality is vital. Living in a society where anti-gay bias exists can lead to many difficulties in this critical adolescent period.

All this demonstrates the extent to which homophobia presents in society and impacts on the individual. The survey found that 80% of LGBT people have been verbally abused because of their identity. This is simply unacceptable. LGBT people must be treated as equal citizens and we must actively work to eradicate homophobia and any type of discrimination from our society. I believe we live in a society that is obsessed by labels. We need to celebrate difference, and this can only be done through robust, open and constructive debate. I was involved in a campaign a few years ago for which the slogan was: “We need to keep labels for jars, not people”.

I, like many of my colleagues, am concerned by the speed and, indeed, indecent haste with which RTE responded to Rory O’Neill’s comments on “The Saturday Night Show”. The decision to issue compensation, an apology and a right to reply to some of those perceived to have been injured may well have been disproportionate in the absence of a legal finding of harm done, especially given that compensation was paid out of taxpayers’ money. I am also uncomfortable about the absence of commentary around the fact the presenter of the show in question prompted Rory O’Neill to identify individuals by name. I think RTE’s decision is worrying on a number of levels. I feel it has negative implications for freedom of expression and also the manner in which debates around marriage equality will be conducted in the future. We all need to accept that robust and sometimes volatile discussion will take place around sensitive issues, and we should embrace this, not censor it.

It is evident, in the aftermath of the comments debacle, that people on panels were tripping over themselves trying not to say the wrong thing. That does not bode well for healthy and open debate. The upcoming referendum on marriage equality will see many different views. We need to ensure freedom of expression remains intact at all times. We need to send a message to young people that discrimination will not be tolerated. Homophobia does exist. There are real consequences for the targets of this abuse.

It is of the utmost importance that our national broadcaster ensures open and fair debate where both sides can communicate their argument in a fair and sensible manner.

04 March 2014: Quarterly Meeting of the Joint Committee on Health and Children, The Minister for Health, James Reilly TD, and The HSE.

Questions submitted in advance by Senator Jillian van Turnhout and response received:

Question 9: Work undertaken by the HSE’s National Oversight group

Question 10: Allowing Pronouncement of death by advance Paramedics

Question 11: Poor performance in Children’s rights alliance report card 2014

 

Question 9: Work undertaken by the HSE’s National Oversight group

To ask the Minister to outline the work undertaken thus far by the HSE’s National Oversight Group that was set up to coordinate a response to requests for day service or rehabilitative training places for young adults with a disability, and to detail particularly the work undertaken in engaging with young people who require these services and their family members.

Revised Process to support School Leavers and those exiting Rehabilitative Training 2014

In line with the Social Care Division Operational Plan 2014, a revised process is being implemented this year to ensure a more streamlined approach to the assignment of places to School Leavers and those exiting RT places. A summary of key elements of the process is outlined below:

 

  • Providing for the emerging needs of the estimated 1,200 additional young people leaving school and rehabilitative training programmes using a newly developed streamlined approach (€7m and 35 WTE) and for emergency cases (€3m and 15 WTE).

Implement a standardised process to:

  • Identify, in conjunction with the Dept of Education and service providers the young people who will be leaving school or exiting a RT Programme who have a requirement for ongoing HSE-funded supports by 1st February, 2014.
  • In respect of those identified as having a requirement for ongoing support, identify and agree the supports required, with a specific focus on responses to those who have complex service needs.
  • Identify the service providers with capacity to respond to the individuals who require support by 1st April, 2014 and agree the allocation of additional resources in respect of individual placements as required.
  • Advise the school leaver and their families of the placement location and service they will be receiving in September, 2014.  Notification of placement will commence in May and all families will be advised no later than the 30th of June.
  • Implement a communications process with all stakeholders.
  • Building on the learning from 2014 review and refine the process for engagement and implementation in 2015.

 

An important aspect of the new process has been the establishment of a National Oversight Group, consisting of representatives of umbrella organisations, representing the Disability Service Providers, service user representation and senior staff from the health service. In addition, the health service has assigned a full-time Project Lead to work to co-ordinate the implementation of the Project in 2014.

Work has been ongoing on the 2014 process since October/November 2013. The Oversight group met and agreed the timelines. A template was agreed for collection of information regarding each individual seeking to access health funded services. A letter was circulated by the National Council for Special Education to all mainstream schools to ensure that individuals with disabilities and their families would be aware of the revised process. The Health Service Guidance officers engaged with the special schools directly. The National Disability Governance Group, which includes Lead Area managers and disability specialists meets monthly and receives updates on progress.

Following the meetings of the Oversight group the Regional Disability Specialists/Disability Managers engaged with local service providers to ensure a complete profile of each individual seeking to access service was submitted.

Each application is being reviewed to establish if the applicant is appropriate to specialist disability services, has the capacity to attend rehabilitative training programme or attend day services.

In relation to engagement with service users and their families the position is that in Dublin for example Individual meetings have occurred with the following:

a) School Leavers

b) Parents/Guardians

c) Teachers/Principals

d) Clinicians/Health Care Professionals (as appropriate)

 

Continuous communication with school leavers and parents/guardians on any issues or concerns arising regarding transition from school are ongoing with the Guidance service.

I am pleased to report that the deadlines set in the Operational Plan have been met in that in excess of 1400 applicants were received by February 1st 2014. The next milestone is 31st March and Disability Services are online to meet that target date where a review of service users’ needs and current service provision will be completed.

Tbe process commenced on October / November 2013

  • We achieved an agreed approach across the disability sector.
  • We will identify and implement a prioritisation process by the end of April 2014
  • We will consider appropriate placement options by end of May 2014
  • We will advise Individuals/Parents/Guardians of placement no later than 30th June 2014

A summary of the current position is that:

A total of 1407 number has been identified, 905 school leavers, 427 RT exits work is continuing on a further 75 who have been classified as other or no category.

Throughout the engagement a range of challenges continue to arise as the process is streamlined. The process is flexible enough to address many of these however a consistent theme that is emerging relates to some locations where the physical infrastructure is at maximum capacity and alternative accommodation will need to be identified. The health service is committed to appropriately supporting this group of young people to ensure that optimum outcomes are achieved

 

Question 10: Allowing Pronouncement of death by advance Paramedics

To ask the Minister for Health/HSE to give an update on progress regarding allowing pronouncement of death by advanced paramedics (as is allowed in other jurisdictions but currently not in Ireland) as recommended by the Pre-Hospital Emergency Care Council, and on allowing pronouncement of death by senior nurses. 

 The Pre-Hospital Emergency Care Council (PHECC) is responsible for clinical practice in pre-hospital care. PHECC approves clinical practice guidelines (CPGs) for all aspects of the clinical work of registered paramedic practitioners in Ireland.

There are two key PHECC CPGs in relation to the death of a patient – for recognition of death and for cessation of resuscitation. The procedures set out in these guidelines allow practitioners to cease treatment and resuscitation where a patient cannot be revived.

Currently, Irish paramedics, unlike paramedics in other jurisdictions, do not pronounce death. After a paramedic makes a clinical decision to cease treatment, a medical practitioner is required for pronouncement of death.  I am advised that PHECC is examining this issue through the Forum on End of Life in Ireland, with a view to engaging in broader consultation on this matter and developing appropriate and recognised clinical and legal procedures to resolve it.
The Nursing and Midwifery Board of Ireland (NMBI) is responsible for specifying standards of practice for registered nurses and midwives. NMBI has developed a Scope of Practice framework to enable decision making and development of practice for all aspects of a nurses’ clinical practice in Ireland. In addition NMBI provides guidance to nurses and midwives on their scope of practice and has published professional guidance to nurses regarding their scope of practice for pronouncement, verification or certification of death. The guidance outlined the processes required to develop an organisational policy to include the appropriate clinical governance supports and the professional responsibilities and authority for nurses to be involved with the pronouncement of death in a care setting. The HSE is consulting with the Directors of Nursing Reference Group on this matter.

 

Question 11: Poor performance in Children’s rights alliance report card 2014

To ask the Minister to give an update on the worrying E Grade his Department received for Mental Health in the Children’s Rights Alliance Report Card 2014, with emphasis on a number of key areas including the need to ensure all children under 18 receive age-appropriate and timely mental health services and treatment and can the Minister advise when the Child and Adolescent Community Mental Health teams will have the appropriate provision of in-patient beds and the 150 staffing posts filled to achieve this end. 

 

The Government has prioritised reform of all aspects of mental health services in line with A Vision for Change, including additional and improved quality care for children in both residential and community based settings. Total HSE Mental Health funding in 2014 is significant at around €766m. In this context, additional funding of €90 million, and around 1,100 new posts, has been provided over the last three Budgets. This has been primarily directed to strengthen Community Mental Health Teams for adults and children; specialist community mental health services for older people with a mental illness, improving services for those with an intellectual disability and mental illness, and enhancing Forensic Mental Health services.

Key to developing Child and Adolescent Mental Health Services (CAMHS), as per A Vision for Change, is the establishment of 99 multi-disciplinary CAMHS Teams providing acute secondary mental health care in the community, including hospital liaison and Day Hospital services. In 2008, there were 54 CAMHS Teams. There are now 66 Teams in place – 60 Community, 3 Adolescent, and 3 hospital liaison mental health teams.

The additional €90m provided for mental health over 2012–14 is being used, in part, to expand and enhance the skill mix of CAMHS Teams.  Around 230 new posts were allocated to CAMHS Teams over 2012-13, and recruitment of these is well advanced.  Of the 150 posts approved in 2012, 136 or 91% are complete with 8 further posts at an advanced stage in the recruitment process.  Of the 80 posts approved in 2013, 35 or 43% are complete, with a further 18.5 or 23% at an advanced stage of the recruitment process.  In summary, of the 230 new posts approved to CAMHS in 2012 and 2013, 197 or about 85% have been filled or are well advanced in the recruitment process.  Outstanding CAMHS posts will be filled as quickly as possible.

There are a number of posts for which there are difficulties in identifying suitable candidates due to various factors including availability of qualified candidates and geographic location. Alternative approaches being considered for posts not fillable in the normal way.

Just over 14,000 referrals were received by the Child & Adolescent Mental Health Teams in 2013.  This represents nearly 1,000, or 8% more, than projected in the HSE National Service Plan 2013, while the target of 70% of referrals being seen within 3 months was maintained.

A Vision for Change recommends the provision of 80 Child and Adolescent psychiatric in-patient beds nationally.  In 2008, there were 16 such beds and at present there are 51 beds operational country-wide, with more planned.   Capacity will be enhanced also, with the completion of the CAMHS Forensic Unit as part of capital developments now underway for the National Forensic Mental Health Service, and the National Children’s Hospital. In addition, improved community based services, coupled with increasing bed capacity, are all aimed at discontinuing the practice of placing children and adolescents in adult acute in-patient units, except in exceptional circumstances.  Admissions of children to adult units have decreased by almost 60% from 2008, when there were 247 reported, to a provisional figure of 106 in 2012.

The review of the Mental Health Act 2001, already well progressed, is a key step in providing a revised and more modern mental health legislation in this country. The Programme for Government contains a commitment to review the Act, informed by human rights standards and consultation with service users, carers and other stakeholders.

The review has been delayed due to a number of factors, including the wishes of members of the Expert Group to first see details of the Assisted Decision Making (Capacity) legislation, which was published in June 2013. Due to the high level of inter-connectivity between both sets of legislation, members of the Expert Group reviewing the Mental Health Act felt it would be necessary that the Capacity Bill should be finalised before they completed their own review.

Work is continuing on the completion of the report of the Expert Group, and members are carefully deliberating, re-examining and refining their recommendations on key central issues such as consent to treatment, capacity, criteria for detention, and treatment of children under the Act. It is expected that the final report will be completed in the near future, after which its recommendations will be considered at Ministerial level.

While noting the contents of the recent report by the Children’s Rights Alliance on Mental Health services, real and significant improvements have taken place on implementing A Vision for Change and modernising mental health services across the country over the last three years.  Nonetheless, historic deficiencies remain to be addressed.  The aim is to strive for equity in providing high quality services, while balancing residential and community-based provision.  This approach has already been proven in many areas at local level. The Government will retain its commitment to mental health, and focus on up-grading all aspects of mental health care, in line with evolving service demands and resources available overall for the Health sector, for 2014 and beyond.

to move to the following access targets:

–          6 month target inpatient / day care

–          9 month target for outpatient

–          again with hospitals effecting full compliance with performance targets in the first half of the year and subsequent maintenance for the remainder of the year

Free Speech, Homophobia and the Role of the State Broadcaster: Motion

February 18th, 2014

I welcome the Minister to the House. I thank Senator Zappone for taking the initiative on this debate. Instead of focusing on a single definition of homophobia, we need to acknowledge that homophobia presents itself in a wide spectrum, ranging from violent hate crimes to far more subtle forms of discrimination.

I, too, commend Panti’s address at the Abbey Theatre on 1 February, and my colleague, Senator Mac Conghail, on using our national theatre in the way it was so rightly used for a noble call. She articulated so succinctly the impact of subtle discrimination and homophobia on a person’s psychic and mental well-being, causing them, in her words, to check themselves at the pedestrian crossing. The number of views, and the number of languages in which that video has gone around the world, shows the power that words can have.

It is very important, however, that we do not have debates about important social issues in isolation from each other. Social issues are invariably interrelated – homophobia, self-harm, suicide and suicidal ideation – and, tomorrow, we will have a debate on mental health and well-being. This is particularly true for young people and, in this context, LGBT youths. A report in 2008 was published jointly by BeLonG To, GLEN and the HSE, called Supporting LGBT Lives. That report found that 50% of LGBT youths have thought about suicide and 20% attempted suicide. LGBT young people are seven times more likely than their heterosexual counterparts to experience mental health distress. It has also been established that young people identify their sexuality at age 12, on average, and the average age of coming out is 17. This five year period in which young people come to terms with their sexuality is vital. Living in a society where anti-gay bias exists can lead to many difficulties in this critical adolescent period.

All this demonstrates the extent to which homophobia presents in society and impacts on the individual. The survey found that 80% of LGBT people have been verbally abused because of their identity. This is simply unacceptable. LGBT people must be treated as equal citizens and we must actively work to eradicate homophobia and any type of discrimination from our society. I believe we live in a society that is obsessed by labels. We need to celebrate difference, and this can only be done through robust, open and constructive debate. I was involved in a campaign a few years ago for which the slogan was: “We need to keep labels for jars, not people”.

I, like many of my colleagues, am concerned by the speed and, indeed, indecent haste with which RTE responded to Rory O’Neill’s comments on “The Saturday Night Show”. The decision to issue compensation, an apology and a right to reply to some of those perceived to have been injured may well have been disproportionate in the absence of a legal finding of harm done, especially given that compensation was paid out of taxpayers’ money. I am also uncomfortable about the absence of commentary around the fact the presenter of the show in question prompted Rory O’Neill to identify individuals by name. I think RTE’s decision is worrying on a number of levels. I feel it has negative implications for freedom of expression and also the manner in which debates around marriage equality will be conducted in the future. We all need to accept that robust and sometimes volatile discussion will take place around sensitive issues, and we should embrace this, not censor it.

It is evident, in the aftermath of the comments debacle, that people on panels were tripping over themselves trying not to say the wrong thing. That does not bode well for healthy and open debate. The upcoming referendum on marriage equality will see many different views. We need to ensure freedom of expression remains intact at all times. We need to send a message to young people that discrimination will not be tolerated. Homophobia does exist. There are real consequences for the targets of this abuse.

It is of the utmost importance that our national broadcaster ensures open and fair debate where both sides can communicate their argument in a fair and sensible manner.

25 July 2013: Quarterly Meeting of the Joint Committee on Health and Children and the Minister for Children and Youth Affairs, Frances Fitzgerald TD.

Question 3: Childhood Obesity

Question 4: National Consent Policy

Question 5: Counseling service for mothers

Question 3: Childhood Obesity

In light of the growing childhood obesity epidemic in Ireland and Government policy as set out in Healthy Ireland-A Framework For Improved Health and Wellbeing 2013-2025, to ask the Minister for Health why under the new Framework for Junior Cycle the status of physical education and SPHE (amongst others) has changed from a subject to a short course, thereby reducing recommended teaching time, and what will now be done under Healthy Ireland to ensure physical education and social, personal and health education in schools gets the priority they need?

I am aware that on 4 October 2012, the Minister for Education and Skills, Ruairí Quinn, TD, published A Framework for Junior Cycle which outlines his plan to reform the junior cycle in post-primary schools. I understand and am supportive of the overall vision being pursued with the framework and my Department will assist the Department of Education and Skills in achieving this vision. We believe that if the reforms are implemented as envisaged, they may increase student engagement with school due to the decreased emphasis on rote-learning and the broadening out of areas in which students can achieve recognition for their achievements. This will have a positive impact on health and wellbeing. I am aware that the Department of Education and Skills is supportive of health and wellbeing and I welcome the inclusion of wellbeing as one of the eight principles underpinning the Framework for Junior Cycle.
A position paper on Social Personal and Health Education and Physical Education has also recently been developed by a working group of relevant experts in the HSE which has been shared with the Department of Education and Skills. It is worth acknowledging that several health indicators in Ireland demonstrate positive trends in the health and wellbeing of adolescents in the last 10 years. Trends in the Health Behaviour of School-Aged Children Reports (ESPAD), for example, record declines in cigarette use, alcohol use, binge drinking and illicit drug use.

Research evidence from an international perspective points to the need to have comprehensive all-encompassing strategies for health behaviours which involve multiple settings, including the school setting, if progress is to made in improving health and wellbeing. Improvements in the trends on health behaviours are most marked since 2002/2003, the years that the SPHE programme was required in junior cycle. It is likely that the roll-out of the SPHE programme has had a positive influence on the health behaviour of young people.

Healthy Ireland which was launched in March contains a commitment to fully implement SPHE and PE and this was agreed with the Department of Education and Skills. As the Senator will be aware, Healthy Ireland contains a vision of an Ireland where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility.

Clearly, the creation of healthy generations of children, who can enjoy their lives to the full and reach their full potential as they develop into adults, is critical to the country’s future. Responsibility for prevention programmes cannot rest solely with my Department, the HSE or, indeed, the Department of Education and Skills but must be shared across Government Departments and all of society.

Officials in my Department will continue to meet with officials in the Department of Education and Skills to address issues of concern including these matters.

Question 4: National Consent Policy

What implementation plans are in place for the new National Consent Policy (May, 2013) for use in health and social care, particularly the education and training of staff who are expected to implement and deliver the policy

The HSE Consent Policy was developed by an advisory group and a wider stakeholder group. These groups included representatives of the staff who will use the policy on a day to day basis and the document reflects the needs of practitioners. The principle of consent and the knowledge of the importance of obtaining consent are expected of all staff employed or contracted by the HSE. Knowledge of the importance of consent is, and has long been, a professional requirement for health and social care professionals. Therefore the main focus of support for the policy is providing guidance rather than training and education of staff. At a local level there is a training requirement for new staff on local protocols and documents/forms used for consent, and this will continue.

The definitive document (HSE National Consent Policy) is in itself a guidance document and has been supplemented by the publication of a brief summary entitled ‘Seeking Consent: A Brief Guide for Health and Social Care Workers’. This provides practitioners’ guidance on how to use the policy in service settings.

To support staff in the hospital services the HSE will review the consent forms that currently exist for common procedures with the view to development of nationally agreed forms/templates. This will reduce variation in information provided and improve the quality of the consent process; and reduce training requirements as staff move around the system.

Children and Family services provide particular challenges in the area of consent. The Children and Families Services are developing an implementation plan to address particular requirements that arise in the delivery of services. The plan is being prepared at the moment.

Two service user guides have also been developed and published to help patients and service users understand the consent process and what they can expect from their healthcare provider and professional.

A log is maintained of all queries raised with the Quality and Patient Safety Directorate in regards to the use of the policy and these will inform the updating of the policy and other guidance as required.

Question 5: Counseling service for mothers.

Given that an estimated 28,500 women in Ireland are diagnosed with perinatal depression, post-natal depression and pregnancy or childbirth related post-traumatic stress disorder each year, to ask the Minister for Health what efforts are being made to tackle delays of 9 months and more for mothers to be seen by a professional counsellor in the public health care system?

Pregnant women access a range of services including primary care, obstetrics and ante-natal and post-natal services. If the individual herself, or any of the healthcare professionals caring for her during her confinement have a concern, they should first access their GP or Primary Care team in the normal way. Where an individual is assessed as requiring referral for specialist mental health services, their GP would refer to their local General Adult mental health service.

For women with a recognised mental health need, they may discuss the management of their pregnancy with their consultant psychiatrist as it may be necessary to alter their treatment programmes as some medications as contraindicated in pregnancy.

All community mental health teams would have experience of such presentations and collaborate with the obstetric services to ensure a safe delivery and appropriate aftercare.

For women with a previous history of post-natal distress or depression, there is an elevated risk of recurrence and this would be actively managed through high frequency review by the GP who assess when it would be necessary to engage with the specialist mental health services if at all.

Access to counselling for all medical card holders, including pregnant women, is now available through the Counselling in Primary Care Service. The detail of this new service and pathway of referral is attached in Appendix 1.

If an individual is being treated within the specialist secondary care mental health services and counselling is indicated clinically then the appropriate intervention by a trained health professional would be made available.

There are 123 General Adult Community Mental Health Teams nationally. The HSE, in its 2012 Service Plan, prioritised €35m and 414 WTEs for reinvestment in mental health to progress the objectives in the Programme for Government. One of these objectives was to enhance General Adult and Child and Adolescent Community Mental Health Teams.

The HSE, in its 2013 service plan intends to build on this investment with a further €35m to strengthen General Adult and Child and Adolescent Community Mental Health Teams.

In addition, there are three peri-natal Psychiatrists based at The National Maternity Hospital Holles St, The Coombe and Rotunda Maternity Hospitals reflecting the number of births at these centres each year.

Of the 414 posts allocated in 2012, 389 posts have either been filled, or under offer or awaiting clearance. These posts include multidisciplinary team members across all the health professions.

Of the 477 posts approved in 2013, 133 posts have been accepted by candidates. A further 16 offers have been made from existing panels. The HSE is establishing new panels and other arrangements to fill the remaining posts.

Currently, our mental health data system is a manual system and the information in respect of service users who may be pregnant is not captured nationally.

Youth Unemployment: Motion

Thursday, 12th June 2013

The Minister is welcome to the House. I very much welcome that Senator Reilly and her colleagues tabled this motion.

It is an important issue for us to debate, and considering the motion and amendment, one could see the glass as being half full or half empty. Nevertheless, it is really important that we are discussing youth unemployment. Unemployment, and specifically youth unemployment, is something that concerns us all across the House. Nevertheless, focus should not be solely on employment as for the age group in question, this is the period in which they are most likely to be in education and training. Unfortunately, the picture remains seriously bleak when we take employment, education and training into consideration.

Some people have already cited the Indecon assessment of the economic value of youth work report of 2012, which was commissioned by the National Youth Council of Ireland. We know Ireland has the fourth highest number of young people not in education, employment or training at 18.4%, compared to the average at 12.9% for the EU in 2011. In April 2013, the figure for young people who are long-term unemployed for more than 12 months was 27,857. I realise that is a reduction on previous months but it is still a considerable number of long-term unemployed young people. Ireland also has the highest number of children and young people under 18 at risk of poverty or social exclusion, with the figure at 37.6%, as compared to the 27% EU average.

We are all aware of the devastating impact that unemployment has, particularly on the social and health aspects of young people’s lives, as well as morale and self-esteem. It is generally accepted that increased social pressures such as financial and employment worries can trigger mental health problems or exacerbate existing issues. Unless concerted action is taken, the mental health of young people in Ireland and Europe will decline in coming years. We know that in 2009, Eurofound, the European Foundation for the Improvement of Living and Working Conditions, which is based in Dublin, conducted research indicating that across 21 EU member states, the cost of exclusion of young people from employment amounted to more than €100 billion. The study considered the cost of social welfare payments and contributions to GNP and it put a preliminary figure for the cost to society at €14,000 per young person who is not in education, employment or training. Some €11,000 would be from unpaid contributions like PRSI and PAYE and €3,000 is representative of benefit payments.

The cost to the Exchequer of youth unemployment is estimated to be €3.16 billion annually. Last December, the Independent group put forward a motion in this House on the importance of the value of youth work. We had good support across the House in our belief that the State must recognise the value of the youth work sector and its potential for a cohesive approach in tackling youth unemployment and exclusion. We know just under 400,000 young people benefit from youth work in Ireland and 53.3% of these are from socially or economically disadvantaged areas. Over 40,000 volunteers are involved in youth work, with almost 1,400 whole-time staff equivalents. Some 26% of young people in Ireland participate in a youth club or youth organisation, and that is the highest level in the EU. The Indecon report proved that for every €1 invested by the State in youth work, we save €2.22 as a State in the long run. This can be contrasted with the fact that youth organisations have received cumulative cuts during the recession, with the cuts running at approximately 30%. Youth organisations could be used as a vehicle in tackling youth unemployment but we are cutting their funding.

The youth guarantee is very important to me and everybody in this House because it will give young people an offer of a job, work experience, apprenticeship, training or combined work and training. It is hoped this will be found within four months of the young person finishing education or becoming unemployed. We should hope it will achieve the target of having 2 million young people out of unemployment by 2014.

I agree with the contention in the motion that the youth guarantee scheme must play a central role in the Government’s strategy to address our young person not in education, employment or training, or NEETs, crisis in Europe. I commend the Government for signalling its support for the youth guarantee from the outset and making it a priority. Given what I have stated on the importance of the youth work sector, I also welcome the determination of the Minister for Children and Youth Affairs, Deputy Frances Fitzgerald, in securing EU agreement on a greater role for youth work in supporting EU policy proposals for youth employment and social inclusion. I welcome the pilot scheme planned for Ballymun. It is good that we will have a pilot but we must consider local circumstances. I am a bit concerned about the length of time it may take to mainstream the process.

I am conscious of the time but I will comment on those who are most disadvantaged. These are the 9,000 young people who have been on the live register for three years or more. They have literacy issues and they are early school leavers. The have a poor relationship with State agencies. We must do much more to tackle the problems of this cohort of young people within the youth guarantee. The youth sector is well placed to work with this cohort, who are the hardest to reach. There should be a joint initiative between the Departments of Education and Skills, Social Protection, Children and Youth Affairs and Jobs, Enterprise and Innovation.
Has the Minister identified additional measures to support young people who are long-term unemployed in avoiding the weaknesses identified in the scheme already in operation in Finland and Sweden?

Address to Seanad Éireann by Mr. Jim Higgins MEP

Thursday, 16th May 2013

I, too, join in welcoming Mr. Higgins to the House. He has history in this House and the Dáil. He recalled a fateful phone call, similar to one I received two years ago this Monday when I was in China. It was a great story. I will never forget the pride I felt when I got that phone call.

I acknowledge the roles which have not been highlighted and in which he played a significant part, namely, the EU suicide prevention and mental health treatment strategies, EU funding for the care of the elderly and the increased access to cross-border health care. He was also involved in children and youth issues, such as childhood obesity and child literacy. These issues are often not played out in Ireland, but are important in terms of the development of EU strategies which filter down to Ireland. His role as quaestor is also very important.

I note his role in introducing a cultural programme. I happened to be present in January when Mr. Higgins met Mr. John Banville. It was an excellent initiative.

As Mr. Higgins said, Ireland’s Presidency is very important and set a number of milestones. I would like to join the recognition of the roles played by Irish Ministers. We all have a sense of pride when we hear about the Minister, Deputy Coveney, on the news, delivering a deal people said would not be possible within this Presidency. We should not underestimate the deal which has been struck, and the officials who support that work

I want to raise the role of citizens in Europe. I have a concern that Europe has steered off its path slightly. We should return to its original path, where all voices, no matter how small, were heard equally, and where the understanding and promotion of diversity of culture and ideas were to the fore. Last week I had the opportunity while in Vienna to speak in the Austrian Chancellery on the Future of Europe Group report on striking a balance between unity and diversity. It has not received much publicity in Ireland, but 11 foreign Ministers from EU member states, not including Ireland, came together and wrote a paper on what they believe is the future of Europe. My difficulty with the report is that it progresses a very top-down approach. If one really reads into the report, one will find it looks at the common security policy and similar areas on which we could co-operate, rather than issues which directly affect citizens.

We need to be careful with our engagement on EU issues. I would welcome a debate in the House on the future of Europe. The report to which I referred is interesting. It comprises only seven pages but there is a lot of content. It is very interesting that although the foreign Ministers have all put their names to it, it is on only one official website, that of the German Foreign Minister, Mr. Westerwelle, for debate.

There is often a perception that popular sentiment towards the EU has turned sour because power has moved to the centre of Europe between France and Germany. It should be noted that the European Movement Ireland committee commissioned a RedC poll earlier this year which found 85% of respondents believed that Ireland should remain part of the EU and 83% of Irish adults believe that, on balance, Ireland has benefited from its membership of the EU. We should not underestimate those figures. We can have a serious and engaging debate with the citizens of Ireland. They see the benefits of the EU and we should examine how we can develop that further.

I would be interested to hear the opinions of Mr. Higgins on how, post the Irish Presidency which will be over soon enough, we can ensure the EU agenda focuses on the issues that most affect our citizens and how we can best generate engagement with and support for the EU with people. I refer to the “critical friend” approach, whereby a really good friend will tell one what he or she likes or does not like.

I have concerns about the multiannual financial framework. It is close to completion. We have a deal which will have to be discussed and rebalanced every year because we will not grasp the nettle. We will propose a budget but each year the Parliament will have to grapple with it. I would welcome Mr. Higgins’s thoughts on that.

I echo his congratulations to the Minister, Deputy Coveney for his role in common fisheries and CAP. I am not from an agricultural background, although having spent 12 years on the economic and social committee with farmers’ representatives I learned more about farming than I ever needed or wanted to know. It is tremendous that Ireland has played a role in bringing people together.

SPHE Curriculum – Motion

20th July 2011

I thank the Minister of State, Deputy Kathleen Lynch, and the Minister, Deputy Quinn, for attending the debate. I also thank my fellow Senators for contributing to the debate. We have had a very rich discussion and have shown the reason and basis for the motion. A statistic I would like to add to the evidence put before us this evening is that half of lifetime cases of mental health disorders begin by the age of 14 and three quarters by the age of 25. In Ireland, a recent survey conducted by UNICEF, Change the Future: Experiencing Youth in Contemporary Ireland, found that half of all young people aged between 16 and 20 have experienced depression; more than one in 10 anorexia; more than a quarter have felt suicidal; and of those experiencing ongoing mental health difficulties, only 18% are receiving help. The role of SPHE and RSE in schools plays a key part in addressing some of these issues.

During the debate we heard about the report from Dail na nOg and the report of the Department of Education and Skills carried out with the crisis pregnancy agency in 2007. One of the aspects we would like to follow up is an audit on what is happening in schools in regard to SPHE and RSE. That is a specific step we would like taken with, hopefully, the full endorsement of the motion by the House. School principals are a key driver and good teachers play a key role, which the Minister has acknowledged in the reforms he is undertaking, and we would like consideration to be given for the issues we raised to be tied into the Croke Park agreement.

The Minister referred to the junior cycle review and we hope the debate will strongly contribute to it. What he is doing with this review and the literacy and numeracy strategy is essential and important. He referred to unlocking the bridge to universities. We ask him to give equal attention to the senior cycle in secondary education. While we need to focus on the junior cycle, we equally have to focus on the senior cycle. I would like to ensure there is not an imbalance and that we do not say we have ticked the box because this has been done in the first three years of secondary education. It will not have been covered because children are developing emotionally and physically and they said this in the research conducted by Dail na nOg. The senior cycle is equally important to unlocking that bridge.

It is also critical that the training of teachers is not ignored. Many Members outlined their experiences. I recall clearly at the launch of the Dail na nOg report one young teacher sharing her experience. She was in her 20s and she was the last teacher into an all-boys school. She was given the SPHE hours because that is what one gets when one is last in. She had no training in this area and she was expected to uphold the ethos of the school but she was given no direction on how to do that. She had a class of young boys with no training. That does not lead to quality SPHE teaching but she could not say ¬¬¬¬____because she was in a vulnerable position as the last teacher into the school. As Senator Moran said, life experience is essential. While in-service training is needed, life experience is also needed and I ask the Minister to give consideration to this.

I would also like to acknowledge the role of non-formal education and, as Senator Mooney mentioned, the role of Foroige. Many youth work organisations in Ireland play an essential role in non-formal education and they could also play a role in SPHE.

The Independent group will not go away regarding this issue. We hope the motion is fully endorsed and we will come back to this early in 2012 regarding the next steps we have outlined. We will ask what has happened and we hope we can support the Minister in moving this essential issue forward.

The Lancet

In July 2021, Jillian co-authored an article in the world-renowned medical journal “The Lancet”