Liam Quaide
Cork East · Social Democrats · Ireland
“The Department is not funding the teams. That is the main issue. There is a stark double standard here. In mainstream CAMHS, multidisciplinary staffing is treated as basic good practice.”
“I already established, earlier this year, that the staffing levels of CAMHS-ID teams across the country are abysmal. These are children and teenagers with very complex needs. They experience major challenges across all aspects of their daily lives, including with communication and learning.”
“I ask about CAMHS-ID services, which are specialist teams for children and adolescents with a moderate to profound intellectual disability and coexisting mental health difficulties. According to the HSE, and by its own admission, no CAMHS-ID team nationally is staffed to the level recommended in its own model of care.”
“This is a particularly vulnerable cohort of young people, and the lack of investment is particularly stark. The Minister of State should not look at me with an expression of incredulity because we have seen this across primary care and in child, adult and older adult mental health services. This is all out in the public domain.”
“Their needs are often more complex than those of young people attending standard CAMHS. I am asking the Minister of State for a clear commitment. When will the Government move beyond small, incremental additions year by year and fully fund CAMHS-ID teams in every region? When will that happen?”
“Worried, anxious, fearful, angry, afraid, powerless, terrified, scared, overwhelmed, abandoned, hopeless. Words like these came up again and again in a survey the Social Democrats conducted in the run-up to this motion.”
The complete record
Every one of 623 lines we hold for Liam Quaide, in date order, each linked to its source. Free to read, in full, without an account. Page 2 of 13.
“I commend my party leader, Deputy Cairns, and her colleagues in the party, including Ellen Casey, on taking a lead on this Bill. Eight years ago, people in every part of this country voted to remove the eighth amendment from the Constitution. They did so because they had listened to women. They listened to women who had been sent away from their own country at moments of profound grief, fear and medical crisis. One of the central issues in that campaign was the tragedy of fatal foetal abnormality. Women and couples told the country what had happened to them. They described receiving devastating diagnoses in Irish hospitals and being told the care they needed could not be provided here.”
“If nurses were asked to carry the health service during Covid, those still living with the consequences of the pandemic should not be abandoned. The tribute nurses need is not sentimental social media soundbites; it is protection at work, proper staffing, fair treatment when injured or ill and a health service that stops asking them to absorb the consequences of political failure.”
“Long Covid, as we know, can involve debilitating fatigue and pain, cognitive difficulties, breathlessness, post-exertional crashes and a range of other symptoms that make ordinary life extremely challenging, not to mention returning to demanding clinical work. The special Covid leave with pay scheme for public health service employees with long Covid has now ended, with remaining staff moved onto the ordinary sick leave scheme. I welcome the Taoiseach's recent engagement with unions on this issue, but I also want to mention the many nurses as well as other healthcare workers who fell outside eligibility for special Covid leave with pay and who remain disabled by their symptoms and unable to return to work. If nurses are central to the future of healthcare, safe staffing is imperative.”
“That is not just frustrating but over time, it is corrosive. It damages morale. It pushes experienced nurses out. It makes recruitment more difficult. It affects patient care. The State cannot keep speaking about retention while ignoring the conditions that drive people away. I want to briefly raise healthcare workers living with long Covid. During the pandemic, healthcare staff were asked to answer the call of duty in settings that were fraught with danger and uncertainty. Many were exposed to Covid before vaccines were available, before PPE was consistent and before the long-term consequences of the virus were properly understood. Some people are still living with those consequences.”
“It means appropriate security where needed and ward and service environments that reduce risk rather than compound it. It means proper follow-up after incidents and psychological support. It means managers and senior decision-makers treating workplace violence as a major occupational hazard, not as background noise in a health service under pressure. Assaults are only one part of the wider picture. Nurses are also dealing with injuries from moving and handling, exhaustion from unsafe staffing, missed breaks, relentless pressure and the psychological toll of trying to deliver safe care inside a system that too often makes that impossible. There is a particular kind of stress and dejection in knowing what a patient needs and not having the staff, time, beds, equipment or community supports to provide it.”
“There was almost 11,000 incidents reported involving nursing staff over those three years. Mental health services accounted for almost 7,500 incidents. Disability services represented over 3,470 and acute hospitals recorded almost 4,000. This means nurses being threatened, punched, kicked, spat at, grabbed, sexually harassed or verbally abused while carrying out their work. We need to be careful and humane in how we discuss these realities. Many incidents happen in settings where patients may be extremely distressed, frightened, intoxicated, psychotic, cognitively impaired, traumatised or unable to regulate their behaviour because of disability, illness or crisis. However, none of that takes from the impact of these assaults on staff. A serious response means safe staffing levels. It means proper training in de-escalation.”
“They are often the people who notice when a patient is deteriorating; the professional a family turns to when they are frightened or confused; and the worker trying to hold a service together when staffing is short, beds are unavailable and the wider system is failing around them. If the tributes being paid today are to mean anything, we must be honest about what many nurses are asked to endure. One of the clearest examples is violence and aggression at work. A HSE response to a parliamentary question I submitted last year showed there were almost 17,800 reported assaults on HSE staff between 2022 and 2024. These included physical, verbal and sexual assaults reported through the national incident management system. The category of worker most affected was nurses.”
“International Nurses Day should not be treated as an annual exercise in sympathetic, soothing words about how great our nurses are. Nurses do not need another round of empty public praise or applause that carries no willingness to improve their working conditions behind it. Our nurses need a health service that take their safety, their working conditions and their health and well-being seriously. Of course, we should recognise and celebrate the work nurses do. Every day, in hospitals, community services, mental health wards, disability services, older person services, emergency departments and public health settings, nurses carry an enormous share of the health service.”
“We all know it has been obstructed because of diplomat pressure dressed up as legal complexities. History will not look kindly on the cowardice and dishonesty of the Government in respect of this Bill when such destruction and evil are being visited upon the Palestinian people. When will the Taoiseach finally intervene to progress this Bill?”
“It is becoming almost impossible to find words to describe the dehumanisation of Palestinians by the Israeli State. In recent days, a Palestinian family in the West Bank buried their 80-year-old father. Israeli settlers then arrived and claimed the cemetery land as part of a settlement. The family was forced to exhume his body and rebury him elsewhere under the watch of Israeli soldiers. This is all part of an escalating campaign of terror, displacement and annexation in the West Bank and East Jerusalem. Yet, the occupied territories Bill, which would cut trade links with these illegal settlements, remains in cold storage. That Bill was voted through by a majority of TDs in January 2019, introduced by current Minister of State, Deputy Niall Collins.”
“The Taoiseach and I both know that if this family were to choose to relive their harrowing experience in the national media, a meeting would likely happen very quickly. This is a devastated family seeking basic assurances that the serious issues arising from the tragedy are being acted on. Will the Taoiseach intervene with the Minister again on this issue?”
“Two weeks ago, I raised with the Taoiseach here a tragedy involving a young man who died in east Cork last year in the context of a prolonged wait for an ambulance to reach him and what the HSE has referred to as "omissions" in the administration of care at the scene. I followed up our exchange by emailing the Taoiseach's office with a clear outline of the efforts made by the family to secure a meeting with the Minister, Deputy Carroll MacNeill, beginning on 29 January, four and half months ago. That first request from me was acknowledged immediately by the Minister's office. Since then, three follow-up emails from me, as well as direct contact from the family, have elicited no further response. I have also not heard back from the Taoiseach's office yet.”
“I echo the call by my colleagues for a nearer term review of the legislation. The idea of a child in serious distress who needs urgent clinical assessment and therapeutic supports and that potentially happening in a Garda station is a cause for concern. In relation to independent complaints and advocacy, as I said, what has transpired in Bloomfield Hospital and in Kerry CAMHS, particularly what transpired in Bloomfield Hospital despite the consecutive very high compliance ratings that the Mental Health Commission applied to that facility, has made the case for those safeguards very compelling. This is something we need to come back to. Overall, however, I welcome this Bill, and I commend the Minister of State on it.”
“As we know, the extension of mental health commission regulation into CAMHS and community adult mental health services was already part of the Bill prior to the Seanad process, as was the clear recognition to the rights of 16- and 17-year-olds to consent to mental health treatment. Both of those measures are very progressive. The fact that a dedicated section on pharmacological restraint has been introduced is also positive. There was a serious gap in oversight there that needed to be addressed. I think that can be improved on further with the tighter definition that Mental Health Reform has proposed. There are issues that are a cause for disappointment, particularly around independent advocacy and independent complaints mechanisms. We really need to address those issues.”
“I commend the Minister of State on the epic undertaking that has been the very complex journey of this Bill and the vast amount of work she has put into it. It is fair to say that it is not a perfect Bill but it is a substantial improvement on the existing legislation. In the round, the Social Democrats are happy to support it. A number of important improvements were made to the Bill when it was before the Seanad process. Those are very welcome. In particular, I refer to the prohibition on the use of electroconvulsive therapy on minors. That is both significant and welcome, as are the stronger provisions around capacity assessments and the removal of a provision that would have allowed a consultant psychiatrist override the treatment refusal of a person with capacity for up to 72 hours pending a High Court decision.”
“I want to support the points made by Deputies Sherlock and Clarke and to come back to what I said on independent advocacy and independent complaints. What was the obstacle to enacting independent advocacy and independent complaints? It seems they would be basic parts of human rights-oriented legislation. They seem uncontroversial. I would not imagine there was lobbying against them. It is low-hanging fruit and it is a shame it is not part of it.”
“Mental Health Reform has also called for a comprehensive system-wide review of sedation practices, including therapeutic sedation, rapid tranquilisation and pharmacological restraint. This reflects a long-standing concern of mental health advocates that there is insufficient clarity, consistency and oversight in this area. It is important that the Mental Health Commission code of practice resulting from this is robust and addresses less visible forms of coercion, including over-sedation and the misuse of pro re nata , PRN, or as-needed medication.”
“I want to make a more nuanced point on pharmacological restraint. I welcome this, as I said. Mental Health Reform has also welcomed the recognition of pharmacological restraint as a restrictive practice that must be regulated. It has also warned that the definition may be too narrow to capture the full reality of how people can be pharmacologically or chemically restrained. That concern is well founded. As I was alluding to earlier, it is not enough to say, as per the Bill, that medication was given for treatment if, in practice, the effect is to control behaviour, limit autonomy or movement, suppress mobility or render a person unable to engage meaningfully or exercise control over his or her own body. That is a weakness of this.”
“That is not to say that it is done with sinister intention, but it needs to be recognised, monitored and carefully managed. It is also recognised and regulated in mental health services in England, Scotland and Wales. As stated, I welcome the inclusion of this section. It has been stated previously that the definition could be better safeguarded. To say that it is used for treatment does not quite go far enough, but at the same time, I recognise the progress made on this and want to validate it.”
“It is worth noting that for people who have already experienced significant trauma in their lives, pharmacological restraint can be traumatic and can compound the very distress that the mental health services are meant to alleviate. That was a regressive intervention on the college's part and I am glad that it was not agreed to. It is not just Mental Health Reform or cohorts of service users who are saying this; the UN Committee on the Rights of Persons with Disabilities, the European Committee for the Prevention of Torture and the Irish Human Rights and Equality Commission have said it. The World Psychiatric Association, in its 2023 position statement on alternatives to coercion, explicitly identified chemical or pharmacological restraint as a form of restraint, which it is, experienced by people in mental health services.”
“I commend the Minister of State on the inclusion of this section. I note my concern about the levels of professional defensiveness and detachment from the reality of service user experiences exhibited by the College of Psychiatrists of Ireland in its attempts to remove the term "pharmacological restraint" from the Mental Health Bill. It is highly invalidating of the experiences of people. These people do exist and I have worked in the mental health system myself. They are people who have been over-sedated, who have experienced medication in a coercive or overly restrictive manner, even if that is not the intention, over the course of their psychiatric treatment. The notion that it does not exist is just perplexing.”
“It is important to say what has transpired at Bloomfield Hospital in Dublin and in Kerry CAMHS underlines the importance both of independent advocacy and independent complaints. It is fair to say that “Your service, your say” is a dysfunctional complaints mechanism. We cannot ask a vulnerable person, particularly someone who was involuntarily detained, to complain directly to the same system that controls his or her care, medication, leave and discharge. We see a huge amount of disquiet and discontent among service users with regard to “Your service, your say”. That is important to put on the record.”
“A nominated person is not a substitute for an independent, professional advocate. A nominated person may be a family member or friend, they may be supportive but may not have the training, confidence or independence to challenge clinical decisions or help a person navigate a rights-based process. The definition of advocacy should have been stronger. Advocacy should not be reduced to helping someone express their will and preferences, it should support a person to exercise those preferences, vindicate their rights and participate meaningfully in decisions affecting them. Without guaranteed independent advocacy, many people will be left alone at the precise moment the State is exercising the greatest power over them. Related to that, the independent complaints mechanism was also ruled out of order earlier.”
“I wish to speak to amendment No. 93 in relation to advocacy. It is obviously positive that information about advocacy is shared with the person who is involuntarily detained, but being told advocacy exists is not remotely the same as having a statutory right to independent advocacy. It is regrettable that despite a very strong focus on this from some of the interest groups such as Mental Health Reform in each stage of the Bill, that has not been provided for. A person who is involuntarily detained may be very fearful, highly distressed, over-sedated, isolated from family and dealing with teams and professionals using clinical and legal language. Many people in that situation will find it overwhelming. In that context, independent advocacy should be a basic safeguard.”
“I appreciate the attention that the Minister of State has given to this, but I just want to stress that low numbers are not the same as a legal safeguard. If a practice is wrong, particularly when it is tied to under-resourcing, it needs to be resolved through State investment and legal safeguards, not simply reduced. However, I acknowledge that it has been significantly reduced. I understand the Minister of State's concerns about tying the hands of clinicians, as she said before, but their hands are tied if their services have not been resourced sufficiently.”
“There is also a safeguarding concern, because Garda stations can be chaotic, frightening and distressing places to be. A child in crisis may be exposed to shouting, intoxication, displays of violence or other highly charged situations. All of this delays the very thing that the child needs most, which is prompt clinical assessment and therapeutic support. Whatever way this provision is framed, it risks taking children deeper into a coercive and adverse environment when what they need is a health-led, trauma-informed response. I acknowledge and welcome the prohibition of ECT for children. That is a significant child protection and human rights safeguard. Reverting to the admission of children who are placed in adult psychiatric units, I know that is a very small number and has been declining considerably in recent years.”
“I acknowledge the significant improvements that have been made to the Bill through the Seanad process. That is very much appreciated. Amendment No. 276 relates to a very concerning provision in the Bill. A child in serious mental health distress needs urgent clinical assessment and therapeutic support. They do not need the trauma and stigma of Garda custody. A Garda station is not a therapeutic environment. It is not a child-centred or trauma-informed environment. Gardaí themselves are not clinicians. They are not trained to assess severe mental health difficulties or determine whether a child meets involuntary admission criteria. There is a real risk that neurodivergent behaviours, trauma responses or extreme distress will be misunderstood in that context.”
“The measure of the response to this tragedy will be whether anything changes. The family have requested to meet the Minister, Deputy Carroll MacNeill, and the CEO of the HSE, Ms Anne O'Connor. They need reassurances that emergency response capacity is being addressed as a matter of urgency. Can those assurances be provided to them?”
“I want to raise the tragic death of a young man in east Cork last year and the serious issues that have emerged from the HSE's review of his care. The young man's family made an emergency call during a prolonged seizure event. The National Ambulance Service was unable to reach him until 47 minutes after that call was made. It is also a matter of public record that the HSE has acknowledged omissions in aspects of the clinical care provided. Behind that careful language is a devastated family, a precious life lost and serious questions about emergency response capacity and accountability. The HSE has said that local ambulance service provision is funded to 95% capacity. However, the family involved have told me they have been informed that service cover in east Cork remains compromised due to funding constraints.”
“It must recognise abuse, coercive control and where conflict is intensified by the court process. Above all, it must not add to the trauma of the children and families it is supposed to protect.”
“Concerns persist about delay, inconsistency and whether authors always have expertise in child development, attachment, trauma, domestic abuse and complex family dynamics. In some cases, they clearly do not have this expertise. A poorly considered report can do enormous damage. It can harden a narrative about a parent that is incomplete or simply wrong. Once it takes hold, it is almost impossible to undo. Privacy remains paramount, but privacy cannot mean parents are left alone in a closed system, unable to speak, get support or understand decisions of such magnitude. We need a careful, humane and accountable family courts system, one that upholds, wherever safe and possible, a child's right to a healthy ongoing relationship with both parents, as well as the parent's right to fairness and due process.”
“It is important to say that these patterns can affect both mothers and fathers. Abuse, coercive control, emotional harm and risks of any kind must always be taken seriously, and so too must the harm caused by false allegations, diagnosis or vulnerability used strategically in the courts system. For a parent who is pushed out of their child's life, the torment is hard to describe or even imagine. The daily grief of knowing that your child is growing up and needing your love and relationship while you are powerless to reach them can break people. I am particularly concerned about court reports that can shape decisions about where a child lives, how often a parent sees them or whether a relationship even survives.”
“I commend Deputy Gogarty on his motion and the strong and sustained support that he and his office colleagues have given many families affected by the issues being discussed here today. As a psychologist working in mental health services, I have seen the fallout when family conflict becomes destructive, entrenched and entangled in the labyrinthine and secretive family courts system. I have supported people whose mental health was weaponised against them and whose distress was treated as evidence that they were unsafe, unstable or unworthy of contact with their child. Sometimes, their distress was stoked and heightened by the system itself to a point that brought them to a psychological brink. I have also seen the devastating impact when children are drawn into adult conflict and, in effect, set against a parent.”
“It should invest in public services as the foundation of balanced regional development and protect Gaeltacht areas as living communities, not just symbols of our national heritage.”
“It must lead to the decisive improvement in the lies of rural people. Can they get a bus? Can they get a home? Can they access a GP? Can their child get childcare? Can a disabled person live independently in his or her own community? Can a small business survive on the main street? Can young people see a future locally? The next Our Rural Future policy should recognise the diversity of rural Ireland. It should move power and resources closer to communities. It should expand Local Link and other forms of rural transport. It should address vacancy and dereliction in a comprehensive way with leadership from local authorities, not through a patchwork of grants that community groups have to scrap over, over a period of years. It should support farmers by diversifying rural economies.”
“Rural economies depend not only on export-led companies but on cafés, trades, childcare providers, tourism businesses, small retailers, mechanics, digital workers, food producers, artists, carers and community enterprises. We need to listen to small rural businesses and hear about what is holding them back, such as insurance, energy costs, broadband, housing for staff, transport, water infrastructure, planning delays, access to finance and the decline of footfall in town centres. We need investment in regional employment hubs, technological universities, health and social care, broadband, public transport, water services, childcare, schools and community facilities. The consultation process for Our Rural Future must be more than a listening exercise. It must lead to a different model of delivery and clear outcomes.”
“This is particularly important in Gaeltacht communities. The Irish language cannot be sustained by rhetoric alone. It needs living communities behind it, affordable homes for young families, schools, childcare, transport, healthcare, digital infrastructure, local employment and cultural spaces. We cannot celebrate the Gaeltacht as part of our national identity while allowing housing pressures, lack or services and a lack of opportunities to hollow out the communities that keep the language alive. A social infrastructure strategy to sustain Gaeltacht communities has to be core to a language strategy. Teanga bheo atá i gceist agus ní mhairfidh sí gan phobal beo. Enterprise policy also needs to fit rural life and enhance it.”
“At the same time, many rural towns and villages are scarred by vacancy and dereliction, with empty upper floors, former houses allowed to decay, commercial buildings lying idle while local groups have no meeting space, and small businesses cannot find suitable premises. Take Ladysbridge in my constituency, where a school with remarkable potential for community use in an expanding village with very few amenities has been left to rot for decades. Dereliction is not just an aesthetic issue; it is State neglect writ large. It speaks of a lack of interest and a lack of concern. Tackling dereliction should be a key part of Our Rural Future, through stronger local authority resourcing, serious use of compulsory purchase orders where necessary and meaningful support to over- the-shop units back into use.”
“The absence of public transport affects employment, education, health, social participation, family finances, disability access and climate action. If Our Rural Future is serious, it should set out a pathway to universal baseline rural mobility, with regular, accessible and affordable services connecting villages with towns, towns with rail and rural communities with healthcare, education and employment. Housing is another central issue. Rural communities cannot thrive if the next generation cannot afford to live in them, if workers cannot move into them, if older people have no suitable options to downsize locally or if families are forced out because there are no affordable homes.”
“It has helped people without cars get to appointments, shops, college, services and to visit friends and family. It has helped local businesses by making towns and villages easier to reach. This is what public transport should do but in other parts of the country, including for much of east Cork, the service simply does not exist in any meaningful way and this is profoundly unfair. We cannot talk about rural opportunity while accepting a situation where one village has a regular bus service and another has a pale shadow of a service; where one older person can get to town independently and another is effectively housebound; or where one young person can access education or work and another is dependent on lifts. This is not a small inconvenience; it is a major quality of life disadvantage.”
“It is a living, changing, diverse set of communities and policy should be designed for the full breadth of those communities, not just for the loudest or most familiar version of them. Caring deeply about nature is not anti-rural Ireland; it is the opposite. Rural Ireland cannot be defended by degrading the very landscape that sustains it. Our policy must reflect that diversity. Policy must be also rooted in everyday experience: whether people can get to work, college or hospital; access childcare or a GP; rent or buy a home; get broadband or remain in their community as they age. Transport is one of the clearest examples. In some parts of the country, Local Link has been transformative. It has given older people more independence.”
“Rural Ireland formed me, just as it formed others here, in its strengths, beauty, constraints, complexities and contradictions and that is the point. Rural Ireland is richer, more diverse and more complex than the caricature often presented in political debate. Caring about hedgerows, rivers, trees, wildlife and soil is not anti-rural Ireland. Wanting rural communities to be more inclusive is not anti-rural Ireland. Gay, lesbian and trans people, migrants, artists, Travellers, and people who simply do not conform to a narrow template of rural identity should feel at home in their own rural communities. A serious rural policy has to start from that plurality. Rural Ireland cannot be reduced to a slogan, a voting block or a lurch into pre-globalisation, anti-science nostalgia.”
“No one has the right to use it as a cudgel against people who do not fit a narrow version of what rural identity is supposed to look or sound like. I grew up down a bóithrín between two small villages. I spent a fair part of my summers stacking bales of hay and drawing them in on tractors. I also listened to The Smiths and read Sylvia Plath in my more anguished adolescent moments of alienation. I did not play GAA. I found parts of the culture I grew up in quite stifling and insular. Like many people around me, I had mixed feelings of love and hate, and many shades in between about rural Ireland and those feelings have shifted considerably over time. I am just as much a part of rural Ireland, shaped by it and proud to be part of it, as anyone else in this Chamber who invokes the term as a badge or authenticity or moral superiority.”
“Some people, including in this House, seek to appropriate rural Ireland as an identity, restrict who is allowed to belong within that identity and portray anyone who cares about, for instance, climate or nature as somehow hostile to rural life. That is nonsense. Rural Ireland is not a monolith; it is made up of farmers, farm workers, carers, teacher, nurses, small businesses, businessowners, artists, tradespeople, young families, older people, disabled people, Travellers, migrants, Irish speakers, people who go to mass, people who do not, people who play GAA and people who never did. It includes people whose families have lived in the same parish for generations and people who have made their homes there more recently. No one owns rural Ireland.”
“Farmers who remove hedgerows and native trees wholesale from their land often make these decisions within a policy and market framework that has rewarded intensification and treated nature as a nuisance or obstruction, rather than as part of the rich fabric of rural Ireland. Hedgerows, mature trees and wetlands are vital for biodiversity, flood protection, carbon storage, water quality, landscape character and our natural heritage but we also have to understand their destruction in the context of an agricultural policy many farmers are simply locked into. A serious rural policy must support farmers to make a decent living while protecting those habitats and irreplaceable parts of our natural heritage. There is a false and divisive narrative in some of our public debate on rural Ireland.”
“It has sustained families, supported local businesses, creameries, marts, butchers, food processors and small businesses, and given many communities their economic and social backbone. One of the strongest pro-farmer arguments we can make is that rural development must diversify and farming must be supported to diversify. Many farmers are under enormous pressure from volatile markets, rising costs, escalating debt, land pressures, weather instability and environmental obligations. We should not pretend ever-greater intensification of agriculture is a sustainable answer for every family farm or rural community.”
“The consultation on the next phase of Our Rural Future is welcome but the real test is whether this becomes another high-level document full of warm aspiration or actually improves quality of life, economic development, town and village regeneration, inclusivity and protection of our natural and built heritage in rural communities. Rural Ireland needs services, infrastructure, housing, transport and the renovation and repurposing of long vacant and derelict buildings - in short, serious investment in the everyday foundations of a decent quality of life. If we want to see our rural communities thrive into the future, we have to move beyond the outdated idea that rural policy is essentially one version of agricultural policy with a few community grants attached. Farming has been central to rural life for generations.”
“It is not realistic to expect a basic grade occupational therapist to make a referral to the regional executive officer. Without that clarity this risks becoming another reform that looks nice on paper but leaves clinicians arguing and families stuck in limbo. It is fair to say that all this is happening against a backdrop of services remaining severely compromised by a long-standing failure to engage in proper workforce planning and comprehensive recruitment to disability and mental health services.”
“The HSE has repeatedly told committees in the Oireachtas that the single point of access will stop children from being moved around the system, between primary care, CDNTs and CAMHS. It is still far from clear how this is meant to work when services fundamentally disagree. That disagreement continues about responsibility for a young person and that is the real test of this reform. Will the Minister of State now set out whether the Department or the HSE has formally engaged with the College of Psychiatrists on the single point of access, whether the college has indicated full support for the model and whether it has expressed reservations, particularly around disputed referrals or contested cases, and whether she will publish the governance and adjudication arrangements that are meant to operate when these disputes arise?”
“I ask the Minister of State again whether there is an ongoing dispute between CAMHS, primary care and CDNTs about which service best fits a young person's needs. Who has the authority to make a final decision in that instance? Is there a named adjudicator? Is there a formal escalation pathway? Is there a timeframe for determination?”