Sorca Clarke
Longford-Westmeath · Sinn Féin · Ireland
“Online platforms that promote and facilitate suicide need to be stopped. I commend the team of The Journal Investigates for its work in exposing these sinister forums, which are banned in other jurisdictions but accessible here. They prey on vulnerable people and they encourage them into irreversible decisions.”
“I agree with the Minister on the issue of consistency. I do not believe anybody in this House would argue against schools with the greatest need having the greatest level of support.”
“This is about fairness and equity. The Minister mentioned the HP deprivation index. In the HP index, Granard scores higher than seven out of the ten areas that have been chosen in Longford. This does not make sense. Sacred Heart has been a DEIS band 1 school for 20 years. Since then, the demand on the school has increased dramatically.”
“Are there some learnings the Minister and her Department can take from this situation so that no other school is left in this position? If Sacred Heart meets that threshold for DEIS plus, can the Minister ensure it receives that designation without any further unnecessary delay?”
“When DEIS plus schools were announced in May, St. Joseph's and St. Michael's in Longford town were rightly included. However, Sacred Heart school in Granard, despite sharing the same DEIS history and facing significant educational disadvantage, was excluded and is now awaiting the outcome of an appeal.”
“The additional supports that would come with DEIS plus, the extra leadership, enhanced family supports and the additional educational resources would make a real and tangible difference to the children that this school educates.”
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“It allows people to look at it, engage with it and ensure that those of us who have been handed the responsibility of managing and developing legislation act as quickly as is appropriate.”
“I understand that completely. My concern is that “not later than five years” can mean four years and 364 days. I want to see something that is more tangible, and I think it needs to be put into this Bill. While five years is a standardised approach, two and a half years is much more effective because it allows us, as legislators, to make the appropriate changes as soon as possible. It means those who are delivering the care, receiving the care or advocating on behalf of those receiving the care can point to a definitive line or definitive timeframe and say that the review will be done within two and a half years. If the full review was to be done within the four years and 364 days, that is well and good, but two and a half years is a halfway point.”
“Including a two and a half year review would bring us in line with international human rights frameworks that demand timely scrutiny of coercive and high-impact legal provisions.”
“It would also highlight emerging issues coming through. The Bill, when passed, will affect some of the most vulnerable people in our society, many of whom are in crisis, especially those subject to involuntary admission. If legislation has unintended negative consequences, a five-year review may allow significant harm or inequality to persist for too long. A two-and-a-half-year review would ensure earlier accountability and correction where needed. A shorter-term review will allow almost real-time monitoring and course correction during the lifetime of the Act and not just afterwards. It could improve public trust and give Members of the Oireachtas, the health committee, service users, clinicians, stakeholders and third parties concrete data and feedback to inform ongoing legislative improvements.”
“I move amendment No. 9: In page 21, line 9, after “Act” to insert “and shall carry out an interim review after 2.5 years”. This is an area that has me very concerned. While five years is some progress, it is not enough. The Government has the opportunity here to put some very real and substantial oversight into the Bill by accepting the Sinn Féin amendment which proposes the carrying out of an interim review after two and a half years. Five years is too long; it needs to be much quicker than that. Without the two-and-a-half-year review, my serious concern is any unintended consequences will not be highlighted quickly enough for us to be able to make meaningful decisions and changes. We could see implementation failures. Reviewing after two and a half years, however, would allow us to ensure those do not become embedded as the norm.”
“It also lays the foundation for more holistic support by acknowledging both mental health difficulty and psychosocial disability. This amendment seeks to ensure the provision of multidimensional support. That is not just medical treatment but everything else a person needs to overcome the illness they have and to live their best life.”
“The definition of a mental disorder does not sufficiently capture those struggling with mental health issues, particularly those who do not have a formal diagnosis, which may be a result of various factors, including lack of access to diagnostic services. The term "mental disorder" implies a clinical and medical model of mental health but ignores the social, cultural and sociological factors which contribute to mental distress. Recovery-based models emphasise empowerment, self-determination and social inclusion. This reinforces my previous statement on how words matter. Acknowledging psychosocial disability would also better align us with the UN Convention on the Rights of Persons with Disabilities and the social model of disability where the term is used.”
“I move amendment No. 2: In page 16, to delete lines 32 to 35 and substitute the following: “ “mental health difficulty” and/or “psychosocial disability” mean, in relation to a person, any mental disorder, illness or disability, whether of a continuous or intermittent nature, which affects the person’s thinking, perception, emotion, or mood and impairs the mental function of the person;”. We had this debate at length on Committee Stage but it is important and I want to come back to it. Words matter. How people feel about themselves matters, as does how they and others view the challenges they may have with their mental health care.”
“If Fianna Fáil and Fine Gael will not deliver on that right, they can be guaranteed these railroading students will do when the next Government comes in. The future belongs to our youth and it is time this Government stopped mortgaging it.”
“While rents are skyrocketing, the Government refuses students basic protection from market-rate rent hikes. There are no solutions and there is no urgency, just the utter inability to grasp the stark reality for students. While the Government talks about opportunity, its policies shut the door to young people. It had a choice to stand with students or to abandon them and it has chosen to do the latter. Students demand more. They demand fairness and Sinn Féin stands with them in those demands. We would introduce a cost-of-living package, cancel the €1,000 fee hike and reduce fees by another €500 so that this September, the maximum fee would be €1,500 instead of €3,000. We would also permanently abolish student fees within two years. Education is not a luxury but a right.”
“What kind of government looks struggling students in the eye and says, "You're on your own"? That would be those sitting on the opposite side of the House. Fianna Fáil and Fine Gael came into power on a narrative of fairness and support for young people, and access to education, but instead we got the Minister touting that student fees will rise in September. From the Taoiseach, the Tánaiste, and the Ministers for public expenditure and Finance, we have heard a level of verbal gymnastics that was simply staggering when they try to avoid the question of €2,000 or €3,000. That €1,000 increase in a single year is not just a broken promise; it is another betrayal from this say-one-thing-do-another Government. Students are squeezed from every side.”
“We cannot allow history to be overwritten - not at Moore Street or the GPO, which should be spaces that honour our past, enrich our present and shape our future. If we reduce our most historic sites to units of rent, what message are we sending? That profit outweighs our rebel history and our patriot dead. Let us not forget those ordinary people who stood in the GPO in 1916. They did not do it for shops or offices. They did it for an Irish Republic. The least we can do is to ensure that the place that became iconic in that rebellion remains a space worthy of their fight and sacrifice.”
“We are the stewards of this nation's legacy. Legacies are not preserved by erasing them. They are preserved with purpose. Other nations do this as a matter of pride. They enshrine their revolutionary heritage into civic spaces. Why should we do less? Why should we do less with Irish revolutionary heritage? This motion sets out a vision of a 1916 cultural quarter, a living, dynamic cultural space that would educate and inspire, a place where young and old engage with history, not as a distant memory, but of our living heritage, where tourists come not just to buy, but to learn and understand who we are and how we got here. It would be a cultural development with soul and a cultural investment with return.”
“When we speak of the GPO and the Moore Street area, we are not just talking about buildings and laneways, but of the cornerstone of our rebel history in a city that fought an empire. The GPO is not architecture; it was the battleground of striking for Irish independence. It is a monument to selfless sacrifice, and, when heavily shelled by the British forces, leaving much of it in ruins, it now appears Fianna Fáil, Fine Gael and their Independents seek to rebrand that history and what it represents. At Easter 1916, it was ordinary men and women who stood and fought there, not for commerce or for convenience, but for a vision of a republic that was free, proud and sovereign. To now consider converting this sacred historical area into more shops, regardless of class, and office space is quite frankly an outrage and an embarrassment.”
“I cannot fail to take the opportunity to speak further on the issue I raised with the Minister at committee yesterday around the emergency supply scheme, where somebody from a virtual clinic, or leaving as a previous inpatient of a hospital, has 24 hours to get to their GP if they are a medical card holder and will receive only a seven-day supply of medication. There is a very real opportunity for our pharmacists to be more involved in this scheme. It is absolutely bonkers, to be quite frank, that you would have only 24 hours. It also does not reflect the reality of the prevalence of virtual appointments and the lack of need for forms to be filled in triplicate at this point. There has to be a better way of doing it, and a very important part of that would be our pharmacy network.”
“I ask that each and every one of them be offered psychology or counselling supports, given the level of distress these parents are under.”
“I thank my colleague for tabling this question. We recently had CHI and the HSE in the committee on this issue. In the Gallery were representatives of the hip dysplasia advocacy group. Afterwards, I met one of those dads in the car park, a young dad and an awful nice guy. He was in a ball of tears. I do not know this man. I had never met him before and he had never met me. That is the level of distress these parents are under - crying to a perfect stranger in the car park of Leinster House. It is not something I ever thought I would see or something I ever want to see again. I ask the Minister for two things. First, will she meet with the hip dysplasia advocacy group? Second, the HSE gave me a commitment that day to make all supports available to the parents.”
“There are still 226 children waiting on spinal surgery. Of these, 34 children have been waiting longer than six months. There are also many more who were removed from waiting lists because they were left for so long that they have become inoperable. One of these is a young lad called Mikey. He is from Mayo and is aged 16. He has severe scoliosis. Last September Mikey's parents were told by CHI that he is not fit for surgical intervention. The letter did not indicate any pathway for Mikey. His parents have asked many times for a second opinion abroad. Last month my colleague Deputy Conway-Walsh, who is from the county, raised this with the Taoiseach and he stated he was of the view that a second opinion should be facilitated. The family has had no update from CHI in this regard.”
“The HSE said CHI did not even share the report with it until after it was leaked. At a time when we hope to move into the new children's hospital in the coming two years, confidence and trust in CHI has never been lower. What steps is the Minister taking to address this? In terms of the new board members coming in, how does she intend to hold the previous board members to account?”
“There has been scandal after scandal at CHI. There were inappropriate spring implants, possibly hundreds of unnecessary hip surgeries and now a scathing leaked report of an examination of a clinical department at Crumlin hospital. The report has raised exceptionally serious concerns and it follows the Boston review, the HIQA review into unauthorised springs and the hip dysplasia audit. We would not know about the first two reports if it were not for whistleblowers who came forward, and the third report was released by HIQA. The approach from CHI has been unacceptable. It has stonewalled and refused to release the report in full. It has also refused to report the misuse of public funds to the Garda. The HSE took doing this into its own hands earlier this month.”
“Will the Minister detail the steps she has taken to improve governance and accountability at Children's Health Ireland and will she publish the unpublished review of a department at CHI at Crumlin? Will she outline the steps she has taken to address the issues highlighted in the report?”
“There is also concern that the quality might be suffering in some of the Saturday clinics or productivity could be higher during Monday to Friday. How is the Minister ensuring that hospitals are preventing the misuse of public funds and controlling spending and waiting lists initiatives? What is the breakdown of weekend hospital activity between the new public consulting contract and the fee paying service clinics? What action does Minister intend to take if she is not happy or there are unanswered questions when Bernard Gloster and the HSE bring forward the audit report?”
“I thank the Minister. There has been a significant increase in Saturday clinics over the past years. An example of this concerns scopes. More than 10% of scopes are now done on a Saturday but the distribution is very uneven across hospitals. Of the scopes carried out in Cavan hospital, one third are now done on a Saturday, that is 900 out of a total of 2,700. However, hospitals are still conducting fewer scopes than they were in 2019 when all services were provided between Monday and Friday. Waiting lists did not reduce during 2024 but they have reduced this year. The system may be working and I do not doubt Cavan hospital in that regard. However, the CHI revelations are startling and there is real concern that this may be the tip of the iceberg.”
“I want to begin by acknowledging the great work done by staff in Children's Health Ireland, CHI. However, in the past month details of an unpublished report conducted on the clinical department of CHI at Crumlin hospital has been put into the public domain. One of the revelations in the report was a finding of several inappropriate and unnecessary NTPF-funded Saturday clinics conducted by a consultant. The report details how a consultant was facilitated to set up hundreds of appointments for patients who did not need to see him. He then placed these patients on his own waiting lists, which resulted in patients waiting twice as long as they would have otherwise. The report states that 95% of those patients could have been accommodated during normal working hours, that is Monday to Friday, without the need for NTPF funding.”
“(2) The Executive shall, within 6 months after the end of each year, submit a report in writing to the Minister in relation to the aggregate needs identified by services on the basis of information collected in accordance with subsection (1) including an indication of the periods of time ideally required for the provision of the services, the sequence of such provision and an estimate of the cost of such provision. (3) A report under this section shall include such other information in such form and regarding such matters as the Minister may direct and shall be published by the Executive within one month of the date of its submission to the Minister.”.”
“I move amendment No. 264: In page 148, between lines 35 and 36, to insert the following: “Regulations concerning care plans 181. (1) The Executive shall keep and maintain records for the purpose of— (a) identifying persons to whom mental health services are being provided, (b) identifying those services and the persons providing the services pursuant to this Part, (c) specifying the aggregate needs identified by the services, (d) specifying the number of persons to whom services are not being provided or to whom they are not being provided in full, and (e) planning the provision of such services to persons.”
“As I said before, we need to have definitive timelines and future-proofing of mental health services. We also need to be able to forward plan and this is what this amendment seeks to allow us to be able to do. We are also asking that the strategy previously referenced in the Bill "shall be reviewed annually by the Mental Health Commission" so any emerging issues and concerns can be addressed at the earliest possible time. We are asking too that "The strategy shall place an emphasis on shifting care to community-based services as and where appropriate". When the closures of several institutions happened - correctly - several years ago and the move to community care was the plan, what did not follow with this move of the patient and service user was an adequate level of funding to make it effective.”
“I move amendment No. 252: In page 145, between lines 12 and 13, to insert the following: “5-year sharing the vision funding and implementation strategy 177. (1) The Minister shall, within 12 months of the passage of this Act, publish a five-year funding and implementation strategy for mental health services. (2) The strategy referenced in subsection (1) shall be reviewed annually by the Mental Health Commission. (3) The strategy shall place an emphasis on shifting care to community-based services as and where appropriate.”. This amendment is very straightforward and clear in its request. We are seeking to ensure the Minister of the day "shall, within 12 months of the passage of this Act, publish a five-year funding and implementation strategy for mental health services".”
“I move amendment No. 247: In page 135, line 30, to delete “consultant psychiatrist” and substitute “qualified mental health professional”. These amendments seek in similar ways to the previous amendment I spoke on to align the language of the Bill with policies previously published and to promote distributed leadership across mental health services. I believe the role should be competency-based and discipline non-specific, focusing on the relevant clinical and organisational expertise. As I said earlier, there should be the right person at the right time to meet the needs of the patient.”
“We need a commitment that in the case of any moves there that relate to mental health, there will be an amendment brought back before the Dáil so that we can amend the legislation to update it in terms of any future policies or legislation that will be introduced.”
“In terms of the adult safeguarding Bill, any regulation that is applicable here also needs to be put in very strongly. This is not just a HSE versus private provider issue. Of the 95 nursing homes, 52 of them are actually HSE and 40-odd of them are privately owned. In 2023, according to VHI, it paid out €83 million to its subscribers for private psychiatric hospitals. That was an annual increase from €74.5 million in 2022. Since 2019 there has been a 21% increase, so there is that balance there. There is the growing area of private mental health providers that need to be regulated as much as the public providers, but regulated strenuously. We need to take all possible availabilities both now and in the future. I know I am almost speaking as if I had a crystal ball about what may happen into the future in terms of adult safeguarding.”
“I want to speak to amendment No. 234 and in general to this area of regulation. I speak of this and while there is not a direct link, there is absolute correlation. I am going to mention the RTÉ Investigates programme and the HIQA report, HIQA having been in with the health committee this morning. The reason I bring it up is that I do not ever want to see this State being in a position where the abuses we saw of older people in that RTÉ Investigates programme are perpetrated on those who are suffering with their mental health. I am also very deeply concerned that any regulation around this specific area, should there be changes made to the regulations for HIQA that are transferable to the commission, that they need to be part and parcel of it.”
“I move amendment No. 228: In page 120, between lines 25 and 26, to insert the following: “ “community mental health services” means a mental health service which provides either urgent or routine care and treatment in a place other than a registered acute mental health centre or registered community mental health centre, including such services as crisis intervention teams;”.”
“It also recognises that the best person on the team is the right person who is there at the right time and can meet the right needs of the patient.”
“Amendment No. 213 is fairly simple. It seeks to align the vision from previously published documents and promote distributed leadership across mental health services. Twice earlier this evening, I spoke on the wrong amendment at the wrong time, but this is the one I was speaking of. Throughout the document, there are references to consultant psychiatrists, whether that be child or adult consultant psychiatrists. There is also a reference to, at the assessment stage, a multidisciplinary approach. At the review stage, there is a multidisciplinary approach, as there is at the discharge stage. However, this section does not recognise that multidisciplinary approach, which we know achieves the best outcomes in the vast majority of cases.”
“I move amendment No. 212: In page 109, between lines 5 and 6, to insert the following: “(3) The Commission shall within 12 months publish a report on the quality and independence of complaints processes and make recommendations for the strengthening of such processes.”.”
“I move amendment No. 211: In page 108, between lines 27 and 28, to insert the following: “(d) the progress towards and resource requirements for the extension of CAMHS towards a CYMHS for young people up to the age of 25, and the development of youth mental health clinical specialty, (e) the estimated number of whole-time equivalent clinicians to fully and safely staff public mental health services, and (f) the estimated level of new additional funding required to provide full and safe services with timely access to care.”.”
“I move amendment No. 206: In page 95, between lines 7 and 8, to insert the following: “(e) prepare and issue a code of practice for— (i) the conduct of psychosocial and capacity assessments, and (ii) the formulation and implementation of collaborative care plans, (f) review and update such codes of practice periodically, and (g) consult with service users, mental health professionals, and other stakeholders in the preparation of such codes.”.”
“I fully agree with the Minister of State's point about social media - I will not drag this on much longer, a Cheann Comhairle - particularly on the issue of eating disorders. This really strikes me. I remember when I was a teenager that the pro-ana or pro-anorexia movement was on MySpace and Bebo. This is not a new phenomenon but we have to get to the bottom of it because people are losing their lives to eating disorders. People are losing years of quality of life to eating disorders. At this stage, in 2025, the Internet has been around for a while and Google since 1998. We need to get a grip on this.”
“What about their families, the ones who are their primary carers and their primary support, the parents who have become the psychologist, the OT and everything overnight because the services within the State system simply are not there to support them?”
“I also have that in a reply to a parliamentary question that it does not keep a record of the children it does not see. To get a holistic and overarching view, those critical pieces of information and data must be collated. The tracking of the child's needs from when they present to when they accept or receive an offer of services is vital. What we will find is children who have been refused an appointment with CAMHS two or three times and who may end up waiting five or six years for any level of services. This is not good enough for anybody. Any child who could be waiting for that extended period puts these figures of 763 kids waiting for more than a year in a ha'penny place.”
“I want to see waiting lists coming down if it means children have been given the service they need. That is the critical part of this. When we look at numbers, the financial is important but the level of delivery is more important, the level of kids who are being seen and getting services. Again, I must put it to the Minister of State it cannot be best practice that CAMHS does not keep a record of the number of children it does not see. Where are these kids going? Have they simply gone from one list to another as they were not on the first list because CAMHS refused to see them?”
“I thank the Minister of State for her comprehensive response. She should absolutely go to every single CAMHS team to find out what the best practice is and have it replicated around the country. This should be standard procedure. However, for those 763 kids who are waiting more than a year for a CAMHS appointment, that is not what their parents or guardians want to hear. They want to know when their child is going to be seen. I am deeply concerned because not only do we have this exploding CAMHS list on one hand, we also have hundreds of children waiting more than a year for psychology. These children are presenting with distress and a very clear need. They either have to go to CAMHS or psychology. It is one or the other, but both these lists appear to be growing at an exponential rate and that is simply not good enough.”
“I have to put it to her at this point that the reply to a parliamentary question I received last week stated the current waiting list for CAMHS is 4,554. In 2020, when the Minister of State came into government, it was 2,112. This is an increase of 215%. Each and every one of these children, because they are children, is in distress. They are not numbers; they are children whom our services have identified as having a moderate to severe mental health need. We all know that CAMHS does not correlate and does not retain information on children whom they do not see in their service who may be referred back to a GP or a psychologist.”
“Alongside the proposal for CAMHS reform and for stronger regulation, the amendment ensures that service users in all age groups have recourse for when things go wrong. Individuals in mental health services are often in a position of reduced power. They may feel their voice is not as strong or as powerful as others. The amendment seeks to strengthen the complaints system to give them a real avenue to be heard and to be protected. The requirement to publish a report within 12 months ensures urgency and action. Knowing that a complaints system is independent and thoroughly in line with the asks of service users helps to produce a healthcare system that is open, just and patient focused. I heard what the Minister of State said earlier when she criticised my opening remarks on funding for mental health services.”
“Sinn Féin has consistently highlighted how many families and service users have felt ignored or failed by the existing complaints system. We have not been alone or in isolation in raising these concerns. The amendment is a direct response to this and to concerns raised by others, such as the Mental Health Commission. By mandating a formal review and report within a set timeframe, the amendment seeks to ensure the State would critically assess whether current systems are working, where they are working, where they are not working, and what action needs to be taken. Independent and trustworthy complaints mechanisms are fundamental to a culture of continuous improvement and accountability in all health services.”
“This is to provide transparency on how far current resources fall short and to put pressure on the Department, the Government, policymakers and all of us to ensure the gap is closed. By embedding these reporting requirements into law, the amendment seeks to ensure that progress on workforce planning and youth mental health reform is regularly scrutinised. It is about long-term planning, transparency and meeting the mental health needs of young people and adults alike, and ensuring policy and practice are aligned with our wish, desire and intention to ensure we have a fully functioning mental health service for all who require it. Amendment No. 212 would ensure that complaints processes are not only functional but genuinely independent, fair and effective in protecting the rights and dignity of service users.”
“The amendment would ensure that the Government plans, tracks and resources this crucial reform. While I understand the Minister of State's position that in her opinion it does not belong in primary legislation, I fundamentally disagree. Primary legislation is where it needs to be. The amendment also seeks to acquire an estimate of figures for whole-time equivalent clinicians and staffing shortfalls, and the pressure on the system to move towards full safe staffing levels. Without this level of detail, and without this level of data, no Department will be in a position to react as quickly as it should where these issues present or may arise. The amendment also seeks to mandate estimates of the funding required for full, safe and timely access to services.”
“By requiring regular review and consultation with service users and professionals, the amendment would ensure that practice evolves with changing needs and maintains accountability. The inclusion of consultation with stakeholders echoes the standards set by the World Health Organization and UN bodies, ensuring policies are responsive to those most in need. Amendment No. 211 directly aligns with our previously introduced Bill to regulate and reform CAMHS by establishing clear reporting and accountability on progress towards creating a comprehensive youth mental health service up to the age of 25. Extending CAMHS to the age of 25 through a children and youth mental health service, CYMHS, model reflects the reality that mental health needs do not stop at 18. That clear cut-off is not always as clear for some younger people.”
“Amendment No. 206 seeks to require a formal code of practice for assessments and care planning, ensuring all service users receive a consistent rights-based standard of care in all services. Sinn Féin seeks clear binding guidance on any assessments carried out, including capacity and care planning, to help to protect individuals' rights and ensure ethical accountable decision-making. We seek to mandate collaborative care plans. The amendment reinforces recovery-oriented practice and ensures that individuals are partners in their own treatment decisions. The amendment proposes a national code of practice to give mental health professionals clear expectations, reducing inconsistency and uncertainty across services.”