Mary Butler
Waterford · Fianna Fáil · Ireland
“Major improvements are happening across services: enhanced access to proactive and preventive healthcare to support a better quality of life; the embedding and upscaling of women's health initiatives put in place through the implementation of the previous women's health action plans, including, as the Senator knows, free contraception, sp…”
“In relation to any proposal, a proposal for a new location requires a detailed business case, a premises, support from the regional HSE management, and the necessary funding to resource the staffing of the service. That is where I come into it and what I will be trying to do.”
“We are currently working closely with it to support the expansion of Jigsaw services to Waterford and the south east, as well as to County Clare. The location of Waterford was picked because we have no services in the south east at all. It is great that we will have the hub and spoke model the Senator spoke about.”
“That is where I do not agree with the Senator. I believe €180 million of funding ring-fenced for women's health, when we have come from a low base, is absolutely unbelievable.”
“The plan will build on our knowledge of women's health through research and innovation and will spotlight important areas such as endometriosis and cardiovascular health. Recently, the Minister announced €2 million in funding for women's health research.”
“This plan will continue to focus on how we can improve access to specialist endometriosis care and treatment. As the Senator knows, we have established two super-regional specialist centres, one in Tallaght University Hospital and another in Cork, alongside the development of five regional endometriosis hubs.”
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“It was also necessary to update definitions used in the Mental Health Act, which are changing, such as the definition of "mental disorder", "approved centre", "clinical director", the "Commission", and the "Inspector". These amendments update these definitions in other enactments. The amendments also provide for further amendments to the Assisted Decision-Making (Capacity) Act 2015. Significant work has gone into making sure this enactment interacts appropriately with the 2015 Act. Officials in the Department will continue to work with their counterparts in the Department of Children, Disability and Equality ahead of Report Stage to progress any further necessary amendments. An important amendment I would like to highlight is amendment No.”
“I move amendment No. 278: In page 160, after line 13, to insert the following: “PART 8 AMENDMENT OF ACT OF 2015 Amendment of section 2 of Act of 2015 203. Section 2 of the Act of 2015 is amended, in subsection (1)— (a) by the deletion of the definition of “Act of 2001”, and (b) by the insertion of the following definition: “ ‘Act of 2025’ means the Mental Health Act 2025 ;”.”. These amendments are placed in new Parts 8 and 9 of the Bill and relate exclusively to references to the Mental Health Act in other enactments. As the Mental Health Act 2001 will be repealed in due course with the full commencement of this enactment, it was necessary to ensure that all references to the Mental Health Act are updated.”
“I thank the Deputy for raising this really important issue of cancer care. While still too high, cancer mortality rates in Ireland are falling faster than the EU average, having fallen by 17% between 2011 and 2021 compared with the EU average of 12%. Five-year survival rates for patients have greatly improved since the first national cancer strategy. They are 65% for patients who received a cancer diagnosis in the period 2014 to 2018 compared with 44% in 1994 to 1998. The Deputy raised specific issues with cancer services in University Hospital Limerick. I will ask the Department and the Minister's office to come up with a written response and we will get it sent to the Deputy.”
“I thank Deputy Kenny for raising this serious with dermatology and other services in Sligo University Hospital. I will speak with the Minister for Health later this afternoon and get a written response to him. I am not over the detail of that. We will get him a response later today or early tomorrow morning.”
“As the Ceann Comhairle will be aware, since she was at the meeting last Thursday, the majority of issues on the Order of Business for this week were agreed. There was rolling dissent, which rolls over every week, but the majority were agreed. On the defective blocks, as Deputy Mac Lochlainn knows, legislation was agreed at Cabinet only two weeks ago. I have explained that to the Deputy. That is moving forward. In response to Deputy Murphy, as indicated at the Business Committee last week, statements on the situation in the Middle East with the Tánaiste will be scheduled for three and a half hours next Wednesday. On the request from Deputy Collins for a debate on education and the capitation grant, we will be speaking to the Minister about it.”
“in relation to the proceedings on the Second Stage of the Criminal Justice (Terrorist Offences) (Amendment) Bill 2025, the following arrangements shall apply: (a) subject to subparagraph (ii), the proceedings shall, if not previously concluded, be interrupted and stand adjourned after 3 hours and 24 minutes and the order of speaking and allocation of time shall be as follows: (i) the arrangements for the first speaking round shall be in accordance with those contained in the table immediately below (to be read across, not down); (ii) where speeches conclude before the 3 hours and 24 minutes have elapsed and no other member is offering, a Minister or Minister of State shall be called upon to make a speech in reply which shall not exceed 10 minutes; and (iii) members may share time; and (b) the proceedings shall not be resumed on Thursday.”
“the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the following extent: (a) Questions to the Minister for Health pursuant to Standing Order 47(1) shall be taken as the first item of business followed by Questions to the Minister for Culture, Communications and Sport; and (b) topical issues may be taken earlier than 7.24 p.m. and shall in any event be taken on the adjournment of proceedings on Second Stage of the Criminal Justice (Terrorist Offences) (Amendment) Bill 2025, or where those proceedings conclude within the allotted time, on the conclusion thereof, with consequential effect on the commencement time for Second Stage of the Transparency and Social Value in Public Procurement Bill 2024 and on the time for the adjournment of the Dáil; and 2.”
“the following arrangements shall apply to the proceedings on the Motions for Revised and Second Further Revised Estimates for Public Services [Votes 7 to 12, 14, 15, 17 to 22, 24, 27, 28, 31, 37 to 39, 43 and 44]: (a) the motions shall be moved and decided together by one question which shall be put from the Chair; (b) the proceedings thereon shall be taken without debate; and (c) any division claimed thereon shall be taken immediately. In relation to Thursday’s business, it is proposed that: 1.”
“the proceedings on the resumed Committee Stage of the Mental Health Bill 2024 shall be taken no earlier than 5 p.m. and shall, if not previously concluded, be interrupted and stand adjourned after 1 hour and shall not be resumed on Wednesday; 4. the proceedings on Committee and remaining Stages of the Finance (Local Property Tax and Other Provisions) (Amendment) Bill 2025 shall, if not previously concluded, be brought to a conclusion either at 10.44 p.m. or after 4 hours, whichever is the later, by one question, which shall be put from the Chair, and which shall, in relation to amendments, include only those set down or accepted by the Minister for Finance; and 5.”
“the proceedings on the Motion re Offences against the State (Amendment) Act 1998 and the Motion re Criminal Justice (Amendment) Act 2009 shall, if not previously concluded, be brought to a conclusion after 3 hours and 32 minutes and the following arrangements shall apply thereto: (a) the two motions shall be debated together, with separate questions put on all proceedings thereon; (b) the order of speaking and allocation of time shall be in accordance with those contained in the table immediately below (to be read across, not down); (c) where speeches conclude before the 3 hours and 22 minutes have elapsed and no other member is offering, a Minister or Minister of State shall be called upon to make a speech in reply which shall not exceed 10 minutes, whereupon proceedings shall be brought to a conclusion; and (d) members may share time; Gov SF Lab Gov SF Mins 35 25 15 15 5 SD Gov SF IPTG Gov Mins 15 15 5 12 15 SF ITG Gov SF OM Mins 5 12 15 5 8 3.”
“the ordinary routine of business as set out in Schedule 3 to Standing Orders is modified to the following extent: (a) the time allotted for Government Business shall be extended in accordance with the arrangements for that business and the Dáil may sit later than 9.30 p.m.; (b) any motions to be taken without debate shall be taken on the conclusion of proceedings on the Finance (Local Property Tax and Other Provisions) (Amendment) Bill 2025; and (c) the weekly division time shall be taken on the conclusion of proceedings on any motions without debate, and the Dáil shall adjourn on the conclusion of the weekly division time; 2.”
“the resumed Statements on Nursing Homes and Care for Older Persons shall not exceed 1 hour and 32 minutes and the order of speaking and allocation of time shall be as follows: (a) the speaking slots from the arrangements for the statements from Thursday, 12th June, 2025, shall be continued from the point at which they were adjourned; (b) following the statements, a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed 10 minutes; and (c) members may share time. In relation to Wednesday’s business, it is proposed that: 1.”
“and shall in any event be taken on the conclusion of the resumed Statements on Nursing Homes and Care for Older Persons, with consequential effect on the commencement times for the items following in the ordinary routine of business, namely, oral Parliamentary Questions to the Minister for Transport, and topical issues, and on the time for the adjournment of the Dáil; 2. the proceedings on the Motion to Instruct the Committee on the Social Welfare (Bereaved Partner’s Pension) Bill 2025 shall be taken without debate and any division claimed thereon shall be taken immediately; and 3.”
“Thursday's business shall be Criminal Justice (Terrorist Offences) (Amendment) Bill 2025 (Second Stage) (if not previously concluded, to adjourn after 3 hours and 24 minutes) . Thursday evening business shall be the Second Stage of the Transparency and Social Value in Public Procurement Bill 2024, sponsored by Deputy Mairéad Farrell. Proposed Arrangements for this week’s business: In relation to Tuesday’s business, it is proposed that: 1. the ordinary routine of business as contained in Schedule 3 to Standing Orders shall be modified to the extent that private members’ business may be taken earlier than 6.12 p.m.”
“and if not previously concluded, to adjourn after 1 hour) - Finance (Local Property Tax and Other Provisions) (Amendment) Bill 2025 (Committee and remaining Stages) ( if not previously concluded, to conclude either at 10.44 p.m. or after 4 hours, whichever is the later ) - Motions for Revised and Second Further Revised Estimates for Public Services 2025 [Votes 7 to 12, 14, 15, 17 to 22, 24, 27, 28, 31, 37 to 39, 43 and 44] (back from Committee) (to be taken without debate, to be moved together and decided by one question and any division claimed to be taken immediately) Wednesday’s private members' business shall be the Motion re Legislative and Structural Reforms to Accelerate Housing Delivery, selected by the Independent Technical Group.”
“I move: Tuesday's business shall be: - Motion to Instruct the Committee on the Social Welfare (Bereaved Partner’s Pension) Bill 2025 (without debate and any division claimed to be taken immediately) - Statements on Nursing Homes and Care for Older Persons (resumed) (not to exceed 1 hour and 32 minutes) Tuesday's private members' business shall be Motion re Presidential Voting Rights, selected by Sinn Féin. Wednesday's business shall be: - Motion re Offences against the State (Amendment) Act 1998* - Motion re Criminal Justice (Amendment) Act 2009* * Two separate motions to be debated together and to conclude within 3 hours and 32 mins - Mental Health Bill 2024 (Committee Stage, resumed, section 198) (to be taken no earlier than 5 p.m.”
“I move amendment No. 273: In page 157, between lines 10 and 11, to insert the following: “(4) Where the Commission assigns a legal representative from a panel to an affected person under subsection (3) , the Commission shall assign the legal representative who was previously assigned by the Commission on behalf of the person in respect of a relevant matter specified in paragraph (a) of section 195 unless— (a) the legal representative previously assigned is unavailable, or (b) the person wishes to be provided with the services of a legal representative on the panel other than the legal representative previously assigned.”.”
“I move amendment No. 270: In page 152, line 23, to delete “Chief Inspector” and substitute “Chief Executive Officer”. Amendments Nos. 270 and 271 have been grouped. These amendments were prepared following consultation with the Mental Health Commission. Further to my previous comments in relation to the grouping on the role of the chief inspector, these amendments provide for the authorisation to inspect records held by a service to be given by the chief executive officer rather than the chief inspector. Furthermore, the purpose of inspecting records is amended to relate to the "Commission of its duties" instead of the ‘"Chief Inspector or the Assistant Inspectors of his or her duties’.”
“I move amendment No. 267: In page 151, to delete lines 12 to 17 and substitute the following: “(6) The responsible consultant psychiatrist or the relevant health professional who orders, initiates or applies a restrictive practice shall have due regard to— (a) the will and preferences of the person regarding the application of a restrictive practice, and (b) the view of any nominee in relation to such will and preferences, and those views shall be recorded in writing in the person’s medical record and care plan.”.”
“I believe the introduction of nominated persons for adults and for children is a positive step and will encourage people to involve their family members and loved ones in their care and treatment. Amendments Nos. 266 and 268 are technical amendments to replace the term "person" with "adult" in order to provide consistency throughout the Bill. Amendment No. 267 is a technical amendment that rewords the subsection to make it clearer that, along with the will and preferences of the person, the view of the nominated person in relation to the person’s will and preferences must be taken into account by the consultant psychiatrist ordering, initiating or applying a restrictive practice. Amendment No. 269 is a technical amendment to correct references to other sections.”
“I move amendment No. 266: In page 150, line 32, to delete “a person” and substitute “an adult”. Amendments Nos. 266 to 269, inclusive, have been grouped. These amendments relate to the section providing for nominated persons. When a person is in a registered acute mental health centre, they may nominate a person of their choosing to act as their nominated person. This is new and is something that we have been looking at for a long time. This person may be a family member, a friend, a representative of an advocacy service or anyone else they select. This nominated person, with the person’s consent, will be entitled to receive certain information on behalf of the person during their admission. The person concerned may consult them or ask them to attend certain meetings during their admission, such as meetings on discharge planning.”
“I move amendment No. 263: In page 148, between lines 29 and 30, to insert the following: “(5) A member of a child’s multidisciplinary team shall consult with other members of that multidisciplinary team when preparing or revising a care plan.”.”
“I move amendment No. 259: In page 147, to delete lines 17 to 22 and substitute the following: “(3) A member of a person’s multidisciplinary team, after consultation with other members of that team, shall— (a) review the care plan on a regular basis with the frequency of review based on the individual needs of the person concerned, and (b) where necessary or relevant, revise the care plan after such consultation and, insofar as possible, in consultation with the person concerned.”.”
“The purpose of this section is to ensure that there is a more standardised approach to care planning and that people have the opportunity to play an active role in the creation of their care plans. The purpose of this section is not and was never to infringe on clinical decisions. As such, it is important that section 181 remains in the Bill and that the commission be permitted to make regulations regarding care plans as necessary.”
“This will ensure that the form that care plans take can be standardised, meaning a person in one registered acute mental health centre will have a care plan in the same form as someone receiving treatment in another centre. Furthermore, the text referencing the setting of goals has been removed. The purpose of this section, and other sections related to care plans, is to ensure that care plans are given the appropriate attention and that people, where appropriate, can be active participants in creating their care plans. With regard to amendment No. 264, I do not intend to support it. This amendment seeks to delete the existing section 181. Section 181 relates to the making of regulations regarding care plans by the Mental Health Commission.”
“265 has been prepared to amend subparagraph (a) of section 181 such that the reference from "content of the care plan" will read the "form of the care plan". This amendment will ensure that the clinical content of any care plan remains, as rightfully it should, the responsibility of the person’s multidisciplinary team, as Deputy Clarke spoke to earlier. It is not and never was the intention of this section for the Minister to dictate clinical matters. The amendment to this section makes this policy clearer and should dispel any confusion. It does not allow for a standardised approach to be introduced to what the form of the care plan looks like, if this is deemed appropriate.”
“I move amendment No. 258: In page 147, line 7, to delete “that assessment no later than 14 days after that person’s admission” and substitute the following: “that assessment, no later than 14 days, or such shorter period as may be prescribed, after the date of that person’s admission”. The following amendments have been grouped, as the Ceann Comhairle has said. Some stakeholders raised concerns that subparagraph (a) of section 181 represented political overreach into clinical decisions regarding a person’s care and treatment. It was never the intention that this provision would allow any Minister to dictate clinical decisions in a care plan. This subparagraph has been amended to provide absolute clarity. Other amendments to these sections are mainly technical in nature. Amendment No.”
“I move amendment No. 256: In page 146, lines 33 and 34, to delete all words from and including “(1) For the” in line 33 down to and including line 34 and substitute the following: “(1) An advanced electronic signature may be used for the purpose of any signature under this Act.”. These are technical amendments to include the term "advanced" in this section on electronic signatures and their use. They update the section throughout to read "advanced electronic signature".”
“I move amendment No. 253: In page 145, lines 14 and 15, to delete “may, and, at the request of the Minister, shall” and substitute “may, and at the request of the Minister shall,”. These amendments concern typographical errors that need correcting. Amendment No. 255 removes the reference to section 76 in relation to absence with leave of a child. It is now included along with the reference to absence with leave of an adult in section 38. Both of these are technical changes.”
“The chair updates the Minister following approval of the report by the NIMC, so a status report already exists concerning the Sharing the Vision policy and timelines. For this reason, I am not in a position to accept this proposed amendment.”
“I am not going to support this amendment because I believe it is unnecessary. We are currently in the second year of a three-year implementation plan for Sharing the Vision. This is the second of three such implementation plans over the lifespan of this policy. Furthermore, it would be inappropriate for the Minister to be answerable to the Mental Health Commission because it is the regulator. Instead, an independent national implementation and monitoring committee, NIMC, oversees the progress of Sharing the Vision's implementation plan. Arising from an independent review of the NIMC structures completed in 2023, the NIMC prepares and approves two status reports for publication on the Department's website every year.”
“I move amendment No. 249: In page 136, line 5, after “may” to insert “, with the approval of the Commission,”. These amendments provide for the approval of the Mental Health Commission to be given to inspectors in sections 166(1) and 166(3) in relation to compliance notices.”
“Unfortunately, I am not in a position to support this amendment. The expert review of the Mental Health Act did not recommend that a profession other than a consultant psychiatrist could become a clinical director of a service. Uniquely among health professionals, doctors have full clinical responsibility for people under their care and are similarly liable for a person's care. It may be that a future review of this enactment will recommend widening the professionals who could become a clinical director, but for such a recommendation to be accepted at this stage, a whole-of-system change would need to occur. I cannot accept the amendment at this time, but I believe it is a matter worth considering in future reviews of this enactment.”
“I move amendment No. 246: In page 135, to delete lines 4 and 5 and substitute the following: “(d) liaising with the Commission from time to time, including in relation to compliance with this Act and when requested to do so by the Commission.”.”
“I move amendment No. 244: In page 134, line 37, to delete “and to the Commission”. These amendments remove the reference to the Mental Health Commission from the notification of day-to-day operations of the registered mental health service in section 164(3)(b). Compliance with the Act in this section has been moved to section 164(3)(d). It is not appropriate for the Mental Health Commission to be notified of the day-to-day operations of the service as it is the responsibility of the service provider and not the regulator to implement the services.”
“I move amendment No. 238: In page 126, to delete lines 29 to 32 and substitute the following: “(5) The Commission may visit a registered mental health service in respect of which a person has applied to renew its registration under this section and take any findings into consideration when assessing the application for renewal.”.”
“I move amendment No. 237: In page 125, between lines 13 and 14, to insert the following: “(2) The Commission may visit a mental health service in respect of which a person has applied for registration as a registered community mental health service within a prescribed period and take any findings into consideration when assessing the application for registration.”.”
“I move amendment No. 236: In page 124, between lines 24 and 25, to insert the following: “(2) The Commission shall visit a mental health service in respect of which a person has applied for registration as a registered community mental health centre within a prescribed period and take any findings into consideration when assessing the application for registration.””
“I move amendment No. 235: In page 123, between lines 22 and 23, to insert the following: “(2) The Commission shall visit a mental health service in respect of which a person has applied for registration as a registered acute mental health centre within a prescribed period and take any findings into consideration when assessing the application for registration.”.”
“I move amendment No. 234: In page 123, between lines 11 and 12 to insert the following: “145. (1) A person who proposes to operate more than one registered acute mental health centre or registered community mental health centre shall make a separate application to be registered for each of those centres. (2) A person who proposes to operate more than one registered community mental health service shall make a separate application to be registered for each of those services, but may, with the agreement of the Commission, make one application for some or all of those services.”.”
“The Mental Health Commission does work with HIQA because it is the regulator in the same facility at times. I take on board what the Deputy said and I agree with her.”
“I do not disagree with the Deputy. We have 67 approved centres within the HSE. The Deputy is right. The private providers are already regulated by the Mental Health Commission. They would not get their registration otherwise. I do agree with the Deputy on safeguarding, that there has to be that particular crossover. For example, Waterford Residential Care Centre in the city is a fantastic building with 100 rooms en suite. We have 20 beds in there which are psychiatry of later life. The Mental Health Commission regulates that part but the other 80 beds are regulated by HIQA. I just want to give them a shout out because recently they had a visit and their compliance was 100%. Seeing compliance in St. Aidan's of 100%, we have to congratulate good practice as well as calling out the ones that are not.”
“That is for no more than three years, as opposed to a period of three years, so it could be a year and a half or two years. Amendments Nos. 240 and 241 ensure that registration of registered community mental services or registered community mental health services can be for no more than five years, rather than every registration period being for three years. This will give flexibility to the commission to register services for shorter periods of time if it has concerns regarding compliance with the provisions of this enactment or regulations made thereunder.”
“They must visit in person. Amendment No. 237 inserts a new subsection 148(2) that provides that the Mental Health Commission may visit any community mental health service applying for registration, before granting or refusing registration. Amendment No. 238 inserts a new subsection that provides that the Mental Health Commission may visit any registered mental health service applying for renewal of registration. Amendment No. 239 ensures that registration of a registered acute mental service can be for no more than three years, rather than every registration period being for three years. This will give flexibility to the commission to register services for shorter periods of time if it has concerns regarding compliance with the provisions of this enactment or regulations made thereunder.”
“234 replaces section 145 with a new section, providing for separate applications required for the operation of more than one registered acute mental health centre or registered community mental health centre by the same person; and where a person proposes to operate more than one registered community mental health service, they may, with the agreement of the commission, make one application for multiple services. This amendment will provide for a more straightforward approach to registering the larger number of services expected in the registered community mental health service category. Amendments Nos. 235 and 236 insert new subsections to ensure that the Mental Health Commission must visit any acute mental health centre and community mental health centre applying for registration, before granting or refusing registration.”
“We have approximately 1,200 people living in community homes throughout the country - typically of four or five people with enduring mental health conditions with wrap-around supports - but they are not regulated. This is a really important facet of the Bill and one of the first pieces I want to see enacted so we know those people are being well looked after and the premises are fit for purpose. Amendment No. 233 is a technical amendment to a typographical error. Amendment No.”
“I move amendment No. 230: In page 121, between lines 8 and 9, to insert the following: “(f) the duration for which the registration of the centre has effect,”. I spoke at some length on the previous grouping in relation to the chief inspector and set out some of the background to the existing regulatory regime under the Mental Health Act 2001, the development of the Bill, and the planned inspection of all community mental health services. This group of amendments complements those amendments to the role of the chief inspector and they ensure the following. Amendments Nos. 230 to 232, inclusive, insert new subsections to ensure that the duration of registration is included on the register of acute mental health centres, community mental health centres and community mental health services.”
“I move amendment No. 226: In page 116, after line 40, to insert the following: “(3) When making an inspection of any registered community mental health centre under section 128(1) or any registered community mental health service under section 128(2) , the inspector shall inspect the service or centre, as the case may be, for compliance with the provisions of this Act or any regulations or codes of practice made thereunder.”.”
“I move amendment No. 221: In page 116, line 29, to delete “registered mental health service under section 128 ,” and substitute the following: “registered acute mental health centre under section 128(1 ),”.”
“I move amendment No. 220: In page 114, between lines 2 and 3, to insert the following: “(2) In relation to a registered community mental health service, the Chief Inspector shall visit and inspect a representative number of those services within the registration period, taking into account— (a) a geographic area of registration ensuring a balanced representation of inspection across that area, (b) the level of compliance with this Act or any regulations made thereunder of— (i) a registered community mental health service, or (ii) another registered community mental health service with the same registered proprietor or responsible person as subparagraph (i), (c) whether a number of registered community mental health services have the same registered proprietor or responsible person, and (d) such other criteria as the Commission considers appropriate.”.”