Mental Health Bill 2024: Committee Stage (Resumed)
Seanad Éireann — 2026-01-20
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Mary Butler (FF), Waterford

Everyone is very welcome here tonight to the beautiful Seanad Éireann Chamber.
I have listened intently and believe it or not, we are on the same page. First, I have a track record when it comes to advocacy because I was the Minister of State for older people who started in June 2020 and introduced patient advocacy services across all nursing homes in the country, about 480 of them. When I went into the role, there were many advocacy services in the HSE-run facilities but there were not in the private, which the Senators will know comprise 80% of the nursing homes, or the voluntary services. They are all now in place. The National Advocacy Service for People with Disabilities also currently delivers the patient advocacy service under contract with the Department of Health. At present, I am engaging with the patient advocacy services. It is in the programme for Government to have them rolled out across mental health services and it is only right and fitting.
As we know, patient advocacy services are an independent, free and confidential service which can provide support to people who wish to make a complaint about the care they or a family member have received in a public acute hospital or in a public or private nursing home. It also provides support in the aftermath of a patient safety incident. As per the current contract of the patient advocacy service, PAS, with the Department of Health, which runs to October 2027, the service has commenced work in relation to looking at the area of advocacy and mental health, and how patient advocacy services might progress within this area. I have scheduled a meeting with the service in the next two to three weeks.
I want to see patient advocacy services in all mental health facilities. I am saying two things to the House tonight. First, we heard about this already but for those who may not have been there on the night, we have included in the Bill a nominated person. This is the advocate Senator Black spoke about. The wording of the Bill has been carefully put together to ensure a nominated person can be any person of the admitted person's choosing. It can be a family member over 16 years of age or a loved one, friend or carer. Otherwise, a person can appoint a peer advocate or a professional advocate to act as his or her nominated person. That is in the Bill and is one part of it.
The next part relates to the patient advocacy services we want to deliver. We are currently working on them. It is not appropriate to put it into primary legislation but I will certainly look at it in secondary legislation. I will do more than look at it, I have already asked my officials - two of them sitting behind me who have put phenomenal work into this Bill and I thank James and Lorraine for the hours and years of work they have done - to look at how best to give effect to access to advocacy supports for people in approved centres by way of secondary legislation. It is not appropriate to put it in primary legislation. There is no entitlement to advocacy supports in primary legislation in similar areas, be it disability or older person services. It does not exist but I am giving the Senators my commitment. All I have is my word.
I am currently working with patient advocacy services on this. I will certainly look for funding to do it quicker than what we hoped because it will take a little while for the Bill to be enacted, as the Senators know. We have two things. When the Bill goes through, we will have the nominated person in place and that is very clear in primary legislation. The person has to give consent to that. They may not give consent and may not want anyone. As for the patient advocacy services, as I said, I have form. I have done it across the board in all older person services. It is there in all 480 to 500 nursing homes we have. It is in disability services. It is now being rolled out into mental health services. The patient advocacy services themselves had to ramp up significantly since 2020 and that is what they are doing. All I can say is I give my word, if that is enough, that we will more than look at this because I want to see it. I will write it into secondary legislation.
If the Cathaoirleach does not mind, I want to make one comment. I want to address the issue Senator Boyhan raised, which he also has raised with my office, regarding Bloomfield Hospital and I understand his concern. My main concern and priority is for the welfare and well-being of the patients in Bloomfield, people whom I would regard as some of the most vulnerable people in our entire health and social care services.
For anyone who does not know, for people who live in Bloomfield, it is their forever home. Many of them have Huntington's disease, which is a very difficult disease. Some of them have enduring mental health conditions and some have acquired brain injuries. I would say the most vulnerable people in Ireland possibly live in Bloomfield. It is entirely unacceptable to me that vulnerable people who deserve the highest standards of care would be subjected to mistreatment in any form. I am very disappointed management in Bloomfield did not see fit to inform the HSE, the Mental Health Commission, the Department of Health or me as Minister of State, of these incidents. I had to hear of the existence of an independent report commissioned by the hospital from a journalist. I thank the whistleblower who came forward with this information.
I am reassured by the swift action taken by the Mental Health Commission, which began an inspection of Bloomfield Hospital on the evening it became aware of these concerns within two hours. For the first time ever, it had to go into a facility in Ireland. I have dealt with having to have HIQA in various nursing homes at different times but never in my five and a half years as Minister of State, have I had to deal with the Mental Health Commission going into a facility. It was there within two hours.
I understand the inspection process has been rigorous and thorough and the commission is now preparing its report, which it will provide to me in due course. I have been monitoring the situation at Bloomfield closely, working with my officials in the Department and with senior regional and national HSE management since the concerns were brought to my attention, including over the Christmas period. I have met and spoken with the regional executive officer, the IHA, the chief social worker and the national lead for mental health services repeatedly in recent weeks to make sure patients in Bloomfield are receiving the appropriate and expected quality care. The HSE has been providing support and guidance to Bloomfield Hospital staff since 18 December. This has included the support of a HSE safeguarding team. I have met the chief social worker several times in the past five weeks.
The 17 service users outlined in the report have been reviewed by their respective clinician teams and no immediate issues of concern were identified. As regards the proposed sale of the hospital, the HSE and the Mental Health Commission are seeking assurances in relation to safeguards for an appropriate transfer of operations of the service, subject to any sale of the property. I am privy to more detail that I cannot share here in the House because I do not want to prejudice enforcement action the commission may take. I am continuing to monitor the situation closely.
As the Senator raised it, I thought it was important to put the detail on the record of the House. I have put it on the record of the Dáil already but I felt it was important to do so here tonight. I thank Members for the opportunity to do so.

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Record URI: https://data.oireachtas.ie/akn/ie/debateRecord/seanad/2026-01-20/debate/main
Retrieved: 2026-08-14T04:54:31+00:00
Sitting date: 2026-01-20