Madam, - I refer to Karl O'Brien's article of October 20th last in which it is claimed that negotiations on mental health panels have foundered. These negotiations have been terminated by the Mental Health Commission and the HSE, which delivered an ultimatum to the Irish Hospital Consultants' Association that unless it agreed to a particular set of proposals the negotiations were at an end.
The IHCA accepted the HSE proposal on the appointment of 13 extra consultant psychiatrists to meet the added workload which will arise following the implementation of the Mental Health Act, Part II. The single major point of difference was the IHCA's request that a guarantee would be given in respect of the appointment of extra consultants in 2006 to meet normal service developments. The IHCA proposed that at least 10 extra consultants should be appointed to meet service developments. This figure is modest in view of the remarks of the Inspector of Mental Hospitals who, in her recent report, recommended the establishment of at least 70 extra consultant psychiatrist posts.
It seems extraordinary that the Mental Health Commission is prepared to import psychiatrists from outside the jurisdiction to act on mental health tribunals. Surely the added expense involved in such a process would more than fund the 10 extra consultants which the IHCA has sought. But then, of course, value for money has never been a high priority with many within the health services.
The ineptitude of the Mental Health Commission in preparing for the implementation of the legislation is well illustrated through its original target of establishing mental health tribunals in November 2004. Today, almost 12 months later, they are still not ready to meet the requirements of the new legislation. As your article quite rightly pointed out, the legislation provides for a very strict code governing the involuntary detention of patients. Failure to comply may leave consultants and clinical directors liable to severe penalties.
Neither the Mental Health Commission nor the politicians, both of whom criticise consultant psychiatrists, will have any such liability.
The proposal that full-time and part-time appointments, and engagement on a sessional and case-by-case basis would be made by the MHC to meet the requirements of involuntary detained patients is as daft as it is profligate. But then of course, there is always plenty of taxpayers' money to spend on the wild and the impossible. - Yours, etc,
FINBARR FITZPATRICK, Secretary General, IHCA, Dundrum, Dublin 14.