I welcome the Minister of State back to the House. Amendments Nos. 37 and 38 are related. Amendment No. 38 is a physical alternative amendment No. 37. The amendments may be discussed together by agreement. Is that agreed? Agreed.

I thank everyone or being here this morning. Amendment No. 37 replaces subsection (1)(c) in the section on guiding principles for children and proposes new paragraphs (c) and (d) to differentiate between the role of parents and guardians of children who are under 16 and those who are over 16. The amendment clarifies the guiding principles to ensure there is a presumption of capacity for children aged over 16. Where a child has capacity, the views of his or her parents are recorded. That is the important part. This amendment does not represent a change in policy. Rather, it is needed to clarify our policy position and ensure it is clear that children over 16 will be presumed to be able to make decisions about their care and treatment. Where a child lacks capacity, the Bill contains a number of safeguards to ensure that care and treatment can be administered by way of parental consent. These provisions will be discussed again later when we reach the groupings relating to Part 4.

The Mental Health Commission will be the body responsible for publishing codes of practice relating to capacity assessments for children. Prior to publishing these codes, the commission will engage with stakeholders in order to consider every aspect of what capacity assessments for 16- and 17-year-olds should look like, to identify who can carry out these assessments and to identify what supports will be needed for young people and their parents throughout the process. This is an important element of what will happen when the Bill has been passed by both Houses. The Mental Health Commission will step in at that point and will be responsible for publishing codes of practice relating to capacity assessments for children.

When any Bill is passed, there is an enactment stage. In the context of this Bill, it could be up to two years before all the different aspects are commenced. As a result, there will be plenty of time for engagement with the commission, stakeholders and parents in order to consider every aspect of what capacity assessments for 16- and 17-year-olds should look like, who can carry them out and what supports will be needed for young people and their parents throughout the process. I have been asked by some groups, especially those who have 16- and 17-year-olds who might have eating disorders, how it will be managed with the 16- and 17-year-olds having capacity to give consent. This is the area where we will be able to put the safeguards in place.

The Mental Health Commission is the regulator of mental health services and is also responsible for the Decision Support Service, making it uniquely qualified to carry out this function. Extending the presumption of capacity to make decisions to 16- and 17-year-olds is broadly supported among stakeholders, including the Mental Health Commission.

I will briefly set out the consent to treatment provisions for children in the Bill and the protections in place. For the voluntary admission of children under 16 years of age, the parent or guardian of the child is responsible for consenting to or refusing consent to treatment. For the voluntary admission of children over 16 years of age, the child consents to or refuses treatment with safeguards. For the admission of children over 16 who lack capacity it is by parental consent and the parent or guardian of the child is responsible for consenting to or refusing treatment for as long as the child continues to lack capacity.

In the context of involuntary admissions, children who have capacity can consent to or refuse treatment. There are safeguards involved here. People can forget that there are such safeguards in circumstances where children pose a risk to themselves or others. If children lack capacity, the parent or guardian of the child can consent. We also must remember that there are instances where a parent does not give consent, despite the fact that a child might need treatment. Therefore, if the treatment is refused by the parents of a child, an application may be made to the High Court to seek a treatment order and the view of the court on whether such treatment is necessary, in the best interests of the child, to protect the health or life of the child from immediate and serious threat.

I am confident that the safeguards are there to support those who are under and over 16 who either have or do not have capacity.

Where a child is under 16 or over 16 and lacks capacity, the HSE can apply to the District Court to seek a treatment order in limited circumstances. As Senators know, we spoke about this last week when we discussed the changes that coming and that will apply in respect of the family courts when the Bill becomes law. An application for a treatment order can be sought from the District Court where the parent or guardian of a child cannot be found, if Tusla is not already involved, or where the parent or guardian of the child is given the opportunity to consent or refuse on behalf of the child and fails to do so. This is an issue that has been raised quite a lot by Senator Ruane.

It is important to note that where an application is made to the High Court, treatment may be administered to a child for a short period that is limited to 72 hours. Again, this is if the child is at risk of causing harm to himself or herself or to others and the treatment is in his or her best interests. We simply cannot have a situation where children accessing inpatient mental health services are being treated unequally compared with those accessing physical health services arbitrarily. There may be cases where a young person aged 16 or 17 wants to access mental health services but cannot do so because his or her parents do not agree or are unwilling to consent on his or her behalf. This provision will ensure that young people can access inpatient mental health services.

I wish the Minister of State and those in her Department a very happy Christmas.

I thank the Senator.

I know how hard the Minister of State works in respect of area. This is a welcome provision that provides greater clarity on the rights of children aged 16 or older and ensures greater parity with their physical health and treatment rights. Will the Minister of State provide a little more detail on what the term "due weight" means? I am concerned that it could place an unreasonable burden on clinicians, who would be left to determine whose wishes should ultimately prevail. I just want to get an understanding of what is involved. If the Minister of State could provide a bit more detail, I would really appreciate it.

I echo Senator Black's comments and questions. We welcome Government amendment No. 37. This will provide greater clarity on the rights of children aged 16 and older and will ensure greater parity with their physical health treatment rights. As a result, we will be withdrawing amendment No. 38 because what it seeks to do is accomplished by amendment No. 37.

I thank the Minister of State and welcome what she said. I had concerns about the changes involved and spoke to the Minister of State openly about them. Being a mother, I nearly think of 18-year-olds as children. I know there is the Gillick competency test. This was something I was looking at in the context of the capacity to consent and in establishing if a child possesses that capacity between the ages of 16 and 18. I would like to flesh this out a bit more. Who is going to have the responsibility for determining if those between the ages of 16 and 18 have capacity? What kind of testing - and I know this is probably down the road - will be undertaken to establish that they have capacity? Again, I welcome the Minister of State's acknowledgement of the safeguarding needed in respect of this matter. I think that is so important.

Starting with Senators Black and Harmon, who raised the same issue, these amendments propose the replacement or removal of the term "due weight". We discussed that at length and felt it was more appropriate to remove it from the wording. I thank Senator Harmon for withdrawing her amendment, particularly as the issues she raised are dealt with in amendment No. 37.

In the context of what Senator Costello said, the Mental Health Commission will be responsible for publishing codes of practice in relation to capacity assessments for children. Prior to publishing these codes, the commission will engage with stakeholders and consider every aspect of what capacity assessments for 16- and 17-year-olds should look like, who can carry out those assessments and what supports will be needed for young people and their parents throughout the process.

Professor Philip Dodd, the assistant chief medical officer in the Department of Health, supports me for two and a half days each week in the context of the work I do. He is also a consultant psychiatrist. I am very confident about the supports available to me and about the work I will be doing with the Mental Health Commission. The stakeholders and, importantly, the voices of the parents must also be considered. I am a parent. There are many parents sitting in this room today. When and if the Bill is passed - I am confident it will be passed with the support of all the Senators - we will move to the enactment stage. The Mental Health Commission will have a significant role and will be extremely busy when it comes to governance issues, CAMHS, those living in community residences and changing the age of capacity in respect of 16- and 17-year-olds. We will not be in a position to change all of that until the relevant safeguards are in place. There will be no rushing this. At the same time, I do not want it to go on forever either. We will have to be really sure that when we make the change that 16- and 17-year-olds will have the power to consent in relation to their own mental health, with or without capacity and with and without the support of their parents, their guardians or Tusla. All that can only happen when I am confident that we have the best supports in place to make sure it can happen.

I thank the Minister of State for the early start this morning. We do not normally come in as early as this, so I thank her and her officials. I, too, wish her a good Christmas.

We will not be dealing with the Bill again this week. We had originally planned to do so tomorrow. I put that on the record and thank the Minister of State's officials. It is very intense work because every "t" needs to be crossed and every "i" dotted. I accept that.

What the Minister of State read into the record - and, of course, we will see the report later today - brings greater clarity. One of the biggest issues, as I said earlier, is the concern about the 16- and 17-year-olds. As the Minister of State knows from her office and from correspondence received and as we know from emails and correspondence we have received, this matter has very much exercised the minds of people, and rightly so. There are vulnerable people in every cohort. In this particular cohort, if we were to talk to people involved in advocating for youth workers, the homeless or Tusla - I am going to come back to that organisation in a moment - there are huge concerns about vulnerable people and what is in their best interests. As the Minister of State has confirmed again this morning, the term "due weight" is being taken out. That is important. When there is a weighting system, it is about which way the scales tip. It depends on whether a parent, a guardian or Tusla is involved.

I have been highly critical of Tusla. I know enough about it, as does the Minister of State. There has been a lot of concern about people in the care of Tusla. The agency has got it wrong many times, but it has also got it right many times. I am not here to knock it. Tusla deals with vulnerable people, as does our Prison Service. Many of these people are very challenging. The best of us are challenging, but some people who have added complexities and difficulties are exceptionally challenging. The establishment does not like people who challenge it. It is too easy to write people off and say that they have mental health issues or complications and that we are washing our hands of them. We know people have gone from this State into other jurisdictions to be cared for. That is just the reality of that situation. I do not want to open all that up. I will just say that people are more vulnerable if they are sent out of the State to be cared for. This does not happen too often, but it does happen. There are reasons for it. I am not sure if it is a good reason in terms of a lack of facilities within our services, but hopefully that will change. That is important.

There is the issue regarding guardianship and the level of commitment of a guardian. Not all guardians are willing ones. Circumstances put people into these roles. It could be a member of an extended family who becomes a guardian. People have legal responsibilities if they take guardianship on. I welcome that the Minister of State spoke about the guiding principles and indicated that they are going to be worked out at some point. I also welcome her comments on safeguards, which are important, and codes of practice.

That will obviously be an evolving process once the Bill is commenced. That is welcome. As we are not going to get through more than two or three sections today, it would be helpful to have a note on that. Again, it will mostly be on the record and we can read it again. That is the sort of clarity people are looking for.

The Children’s Rights Alliance and different advocate groups have already been in touch with us. If I was to read out all the emails I have received since we met last week, we would be here all day. I am not sure if they are all correct and I would not read them into the record. People have different agendas, backgrounds and experiences, which is why they come from different positions. We have to see through many lenses. That is the challenge for us all.

I welcome the clarity the Minister of State has brought to this. It is helpful and I am happy to support amendment No. 37.

I meant to say that the amendment gets rid of due weight for over-16s. Again, I am looking for a little clarity. It says due weight must be given to the decisions of under-16s. I ask for more clarity on under-16s with regard to due weight.

If a child has a mental illness or mental disorder, whether they are self-harming, suicidal or dealing with any of the myriad issues children face - in many cases, it could be emotional distress or bullying - due weight has to be given to their voice. It is important that the voice of the young child, young teenager or young person is heard. It is important their voice is included because you cannot just decide to treat a young person in a certain way. Parents sometimes do not agree with certain types of treatment. Let us take as an example a young transgender child, an issue on which I can speak with authority. There are times when a 14- or 15-year-old - they could be 15 and a half or 15 years and 11 months - might want to go down a specific pathway and they do not have the support of their parents or guardians. It is really important to give due weight to the voice of the child in that case and that their voice is heard in the notes in their file as well. I am really strong on that. It is very important.

I thank Senator Black for all the work she does in this area. I did that during the previous session too but it is important to acknowledge the Senator's work. We had a stand-alone Oireachtas committee on mental health. I would love to see it back up and running, even if it was only for two years. It might be important to have it up and running to tease out various issues while we enact the Bill. I would certainly support that. I may speak to the Senator in the new year to see if we can get that committee up and running.

To respond to Senator Boyhan, we have robust protections in place in the Bill to ensure treatment can be given to a child when he or she needs it. As I previously mentioned, if a child, or a parent or guardian on behalf of the child, refuses consent, an application can be made to the High Court to seek a treatment order. The order will be made in cases where the treatment is necessary to protect the health or life of the child from immediate and serious harm and where it is in the child’s best interest.

The Senator spoke about Tusla. We have 12,000 people working across mental health through the HSE every day of the week. We also have a large number of whole-time equivalent staff working in Tusla. I believe, as I know the Senator believes, everybody who goes into work every day does so with the best of intentions to support young people and adults through what can be a very difficult journey. The 16- and 17-year-olds who do not have capacity and are not in a position to consent are a very small cohort of young people but a very important one. That is why we have spent so much time trying to make this part of the Bill as strong as possible. I welcome all the Senators' support. It is much appreciated.

The Minister of State spoke about young people. Another group who are important, and this is also part of her brief, is the elderly. There are a lot of people in the psychogeriatric category. From speaking to people in psychiatric services in Dublin, I know in some cases it is difficult to get engagement with any member of the family. That is the reality. Family members come in, the patient is deposited and no one seems to get back. This is a challenge for the services. It does not happen too often but it does happen. It is important we do not lose sight of that. I know the Minister of State has not lost sight of it. She is fiercely committed to this part of her brief but there are a lot of people in care without capacity or it is presumed they do not have capacity. A lot of elderly people have capacity. A relative of mine is 99 years old and is still going strong, with loads of capacity, so I am hopeful for myself. Let us not lose sight of the elderly in the psychogeriatric area because they are also important in terms of this legislation.

I agree with the Senator wholeheartedly. That why I focused on supporting older people in budget 2026. We are very lucky in Ireland to have one of the highest life expectancies in the European Union. Women here live a little longer than men. Notwithstanding what the Senator said just now, the facts bear that out. We have very high longevity, thank God. We have invested greatly in the last five years. When I was Minister of State with responsibility for older people, we invested in home care, day care, meals on wheels and supporting older people to live their best lives for as long as possible in their own home with the correct wraparound supports. The Senator’s point is really important because we have an ageing population and we are seeing more presentations with older people in relation to psychiatry of later life. That is why we have funded additionality in budget 2026.

The Senator mentioned sending young people abroad for treatment. When an issue was raised here last week involving an eating disorder and a specific case, I said we did not have to send any child abroad, predominantly to the UK, in relation to eating disorders. We have not done that. I reassure everybody in the House when that particular case was mentioned last week, I met the parents of the child yesterday.

That is great. It is important to note, however, that we still send people outside the State in exceptional or very challenging circumstances. That is not an ideal situation and we need to monitor it. That has to be a priority for us. We talk about children’s advocacy, children’s rights and the UN convention. This is an issue of concern to the advocacy groups. It has to be an issue of concern to Tusla. It says it does not necessarily have the resources or the specialties to deal with it. This applies particularly to children who may have already been committed to some sort of care order or institutional care and even that placement becomes very difficult and the system cannot cope. That is a challenge, more so when the parents do not see themselves as a stakeholder or do not wish to be a stakeholder in that collaborative rehabilitation. We must always be conscious of that challenge and keep a keen eye on it. We need to constantly assess it. I drafted a parliamentary question for a Member of the Dáil to submit, which I think will be done in January. It seeks the costs involved every month for the last 12 months. While it is hard to so, somewhere along the line, we have to assess the outcomes, not in terms of value for money but in terms of the human experience and how it has graduated or assisted in the rehabilitation or support of the individual.

Amendment No. 38 is out of order.

Amendments Nos 39 to 41, inclusive, are out of order due to a potential charge on the Revenue.

I move amendment No. 42:

In page 23, between lines 29 and 30, to insert the following:

“(2) No child shall be precluded from accessing mental health care or treatment by virtue of the fact that they are acutely drug or intoxicant affected, or are addicted to drugs or intoxicants.”

I move amendment No. 43:

In page 23, between lines 29 and 30, to insert the following:

“(2) No child shall be precluded from accessing care or treatment by virtue of the fact that they present with a concurrent mental health disorder and a substance use disorder.”

I was out ill last week so I was not here in the Chamber. The Minister of State can rest assured I watched both debates from home in my bed.

I want to speak to section 10 in the context of a wider issue that came sharply into focus during last week's debate, and that was Ireland's repeated reliance on international human rights conventions in rhetoric without fully translating those obligations into domestic law. Last week, we heard frequent references to the UN Convention on the Rights of Persons with Disabilities. What was far less acknowledged, however, was that this Bill also directly engaged with the UN Convention on the Rights of the Child, a convention that Ireland ratified 30 years ago and carries very specific obligations when it comes to children, liberty, autonomy, participation and protection from arbitrary detention. Neither convention is meaningfully embedded in the text of this legislation, though. Signing conventions is not legislating for them. Ireland has signed and ratified both the UNCRPD and the UN Convention on the Rights of the Child and that creates obligations but ratification does not protect a single child or adult unless those rights are given into law.

I have a few questions around this for the Minister of State. Is it not the responsibility of these Houses to legislate for the conventions that we sign? If we acknowledge these obligations, why are they not clearly reflected in section 10?

I dealt with this comprehensively last week. We spent a lot of time debating it.

I wish the Senator well now that she is back again. She was keeping up with the debates. When we are invested in a Bill, we all do that. I am glad the Senator is well again. I will take this opportunity to remind everyone that there is an awful flu circulating and if we can, we should encourage our older loved ones, our children and our vulnerable as regards the flu vaccine that is there to support people. We have a huge amount of people in hospital at present with flu and it is very serious for older people. Mr. Bernard Gloster will be delighted that I put that on the record of the House.

I went into this matter in detail last week. On the Senator's statement that the conventions are not invested in any legislation at present, that is a matter for the Minister for children, disability and youth affairs. As to wanting to get to the stage where we proof every single Bill in relation to the rights of the child, I believe that we have already done so across this Bill. Significant efforts have gone into each section to ensure that the best interests of the child are upheld, and where there is an infringement of a child's rights, such infringement is subject to very stringent legal safeguards. We spent an hour last week debating this with Senator Boyhan. It was a good debate. It was important that it was put on the record of the House that that is the situation. I have no doubt it will be dealt with.

At this stage, I need to get this Bill passed. I need to get the enactment up and running. I need to make sure of that because there are a lot of people in this country who are dependent on the new changes in this Bill, especially in relation to their human rights, to come into play.

I was listening to the debate. Some of the questions around this were answered but some were not. I understand that it is for the Department of children but, equally, does this Bill not give us the opportunity to begin to legislate? We are quick to sign up in other Departments, for instance, the Department of justice. We opt in on Article 3 nearly every other week. We are quick to do that but when we are bound by the UN and we sign up to something, is this not the perfect legislative opportunity for us to begin to put the conventions into legislation as opposed to throwing them to a different Department as if they are its responsibility? It is all of our responsibility, collectively, in this House to legislate from here on in.

I believe there is a balanced approach in the Bill to mental health treatment, enshrining the best interests of the child as the primary consideration in all decisions. I believe that we have done that.

We started drafting this Bill four and a half years ago. There are 220 sections in it. We are on section 10. I have been on my feet now for the fourth time in the last two weeks and I will continue to come in and be on my feet. I thank the Senators for facilitating that as well. That is important to put on the record.

I will not be here on Thursday afternoon because I will be in the Dáil. That is the reason behind it. I have obligations in the Dáil as well.

I am confident that we have put significant effort into each section. As to reaching the time when we will have to align legislation, I believe we are already there. I am not going to go back to the drawing board now to restart the Bill.

When this Bill was being drafted, with the support of the Attorney General and the Office of the Parliamentary Counsel, we were cognisant every step of the way. I am a mother myself. As I said on the record on several occasions, my own child was in the care of CAMHS for two years at 14, 15 and 16 years of age. Senator Costello said that as well, as have other parents. There is nothing more focused in my mind than making sure that this Bill is child focused but it has to be adult focused as well and we have to get the balance right between advocacy and treatment. That is really important while bringing a commonsense approach to it as well. That is why giving due weight to under-16s is really important. I believe the responses I gave last week set out clearly on the record of the Seanad that we are ensuring that the best interests of the child and the adult are upheld, and where there is an infringement of a child's rights, such infringement is subject to very stringent legal safeguards.

I will not go into great length because, in fairness, the Minister of State was very patient and we had a good debate. I certainly received a lot of feedback from the debate. People are not particularly happy.

I suppose the word that we perhaps did not hear enough of was the "ambition" of the Government. The Minister of State explained to us all that, of course, it was an all-of-Government approach to the two UN conventions but it is important that we send out a clear message. I cannot put words into the Minister of State's mouth but we on this side of the House are ambitious to see it done. Clearly, that has to be a priority or we have to make it be a priority. We have to continue to get TDs to ask parliamentary questions - predominantly those in opposition because they are the Opposition. The Government could initiate this, but it will just have to come down to us here, with Commencement matters and motions, keeping the pressure on the Government to live up to its commitment. The State is a signatory, after all, to the Convention on the Rights of Persons with Disabilities and the UN Convention on the Rights of the Child.

In the last few days, I have constantly taken calls from people saying that they are not happy. They do not see the comforts that the Minister of State talks about. They are coming from a particular focus of their own experience. I think we need to be ambitious. I appeal to the Minister of State, who has vast experience in this area. This overlaps much of the Minister of State's work in her Ministry. We see people going out there and strongly advocating for these two important conventions to be transposed into domestic law. I do not know what we are doing, quite frankly, that we have not done it.

I did an analysis of a lot of Commencement matters here and business taken under the Order of Business, and the three issues that come up most are housing, hospitals and healthcare, and disability. From all sides of the House, they are the same issues. Some Senators might perhaps forget that they are in government, but there are the same issues about water leaking into schools, no school extensions, and problems in Limerick and lots of other hospitals. I am not singling out Limerick for the sake of my colleague here, Senator Maria Byrne, because she is a great advocate for Limerick and Limerick hospital, but they are the same issues. Mental health and the disability sector are huge in that top cohort of concerns for people.

My appeal here today, in the broader appeal to the audience outside of this Chamber who are listening in and who are an important audience to our parliamentary processes and debates, is that we crank up the initiative and bring to bear some pressure on the Government so that these two conventions can be ratified. I am not expecting the Minister of State to reply. I merely want to share that with her because it is important. I really want to see ambition in this area so that we can align these with the Minister of State's legislation and with other legislation, as I know it goes over a wide field.

The decision was taken to rule out amendments Nos. 39 and 40 in my name. I have to accept that. There are rules that guide our parliamentary processes. I want to touch on them. This is part of the section and they fall within that section. A note was provided to the Cathaoirleach in relation to those. I ask that they be read into the record again because we will have another opportunity for amendments on the next Stage of this Bill when we come back. However, section 39 was a guiding principle to apply in respect of children. I sought to delete the clause "in so far as is practicable". Children who are not in State care are very vulnerable and it touched on that. I asked to have that taken out but I was told there would be a cost to the Exchequer arising from that. We might as well render ourselves redundant and useless in here if everything we speak about is subject to that constraint, but I will talk about that later. My other amendment was also ruled out of order. It begs the question of what are we doing here at all, if everything has an implication on cost. I want to flag those amendments. I circulated those amendments to many advocacy groups. I explained and circulated the letter that was provided to me. However, it is important that people understand because we look back on these proceedings and the printouts, and it is important we understand it is not a failure on our part to advocate. It is a system that we have to operate within. I accept that but it is disappointing that these amendments were ruled out of order.

There are other imaginative ways to address this and I have asked for the wording of these amendments to be recalibrated into other sections of this Bill which will be coming down the track. Under the processes, when we finish whatever section we will finish today, it will be open to us to submit other amendments. They were important amendments and I want to put that on the record. I ask the Cathaoirleach to read into the record the reasons set out in the note supplied to him in relation to the amendments.

In regard to amendment No. 39, the ruling is under Seanad Standing Order 42. The Standing Order of the Seanad is in relation to Bills and amendments that involve charges. I will read into the record Standing Order 42. It states:

An amendment to a Bill, which could have the effect of imposing or increasing a charge upon the people or upon the revenue, may not be moved save by way of Government amendment.

Amendment No. 39 deleted the clause "in so far as is practicable" from section 10(1)(d), which provides that a guiding principle in respect of children shall be that, "in so far as is practicable, that care and treatment shall be provided in an age-appropriate environment, and in close proximity to the child’s home or family". Deleting "in so far as is practicable" has the effect of removing any flexibility in the provision of such services and may require the State to provide increased availability of age-appropriate centres throughout the country. The amendment therefore was ruled out of order.

That has nothing to do with the merits of any amendment put forward by any Senator. That is in relation to the ruling of the House. It is regarding the Standing Orders of the House, which were agreed by all Members, on the issue around having an amendment that has a charge or potential charge on the Revenue. It is nothing to do with the amendment itself; it is in relation to Standing Order 42 and the potential charge.

I know that is the case under the Standing Order. It is important that it be read into the record. There is also amendment No. 40, which is also in this section.

Again, that relates to Standing Order 42 of the Seanad, which I have read out. Amendment No. 40 provided that a child could not be placed in an adult unit for more than 72 hours before being transferred to an age-appropriate environment in close proximity to their home. The restriction of use of adult facilities could give rise to a charge on the Revenue as the State would be required to provide increased availability of age-appropriate centres across the country. Again, I go back to the point on the issue of Standing Order 42 in relation to charges. Any amendment that proposes that charge, whether the amendment has broad support or not, if it is introduced by a Senator and not by the Government, has to be ruled out of order under Standing Order 42.

I thank the Cathaoirleach for clarifying that. It is rarely used and rarely asked for but that clarity and the Cathaoirleach reading that into the record is something we should exercise more often because these records stand. I accept that these are the Standing Orders we have all signed up to. We can amend our Standing Orders, of course, though it would be very difficult, given the huge majority on the other side of the House. However, I operate within the rules. That is a rule as well. Now it is on the record.

That brings me to discussion of section 10. I will touch on the issues in relation to the amendment I tabled. It has been ruled out of order so I will talk about it in broad brush strokes. The key concern is that under no circumstances should a child be placed in an adult unit for longer than 72 hours. Following this emergency 72-hour timeframe, that care and treatment must be provided. That is my concern and the concern of many professional advocates who engage with the Minister. That is really important. The kernel of it is the children in our State, whom we have an obligation to protect under a special provision in our Constitution. There are issues about the welfare of a child and where the child is placed, whether that is in care or in family circumstances. There are many different circumstances and many of these people whom I call children, in this category of 16- and 17-year-olds, are on our streets in Dublin. They slept out last night. They have mental health issues. They have a complexity of issues. It is about ambition. After all, this is going to be the Minister of State's new Bill that she has initiated and driven through. Hopefully, it will be successful. I have no doubt it will be passed by both Houses. I appreciate the engagement of the Minister of State and her staff with us on each section of it. The really important aspect of this is that these are 16- and 17-year-olds, sometimes even younger. If we talk to any international UN advocacy groups or human rights groups, there are major concerns on this. It is about ambition. We need to put targets in place. We need to say categorically that no child will be incarcerated at any stage. That is challenging and there are difficulties but that has to be our collective ambition.

I am looking forward to the new year when I will engage with the Ombudsman's office and a number of advocacy groups. I indicated last week that that is what I intend to do. I have reached out to some of them already. We will have other opportunities through this legislation to talk about it. The Minister of State talks about challenges and putting kids at risk. I do not want anyone to be at risk. However, it has to be the collective ambition across government that no child would be in care in an adult unit.

I am not in a position to share this information yet but I will be in the new year. I have tried to quantify the number of children in certain mental health establishments and their age profile in the past 12 months. I am hearing different reports from people who provide the services on the ground. It would not be responsible or right for me to bandy around figures until I have hard facts. I am happy to share them here with the Seanad. More than likely, this amendment would never have been accepted anyway. I am glad to have the opportunity to flag my general concern and that of many people outside of this House who are watching these proceedings. My concern is the issue of vulnerable people who are children, although they have special status in terms of being 16 or 17 years of age in relation to medical aspects. There is that deep concern and I share that concern.

I lend my support to what Senators Ryan and Boyhan have said. I appreciate the Minister of State addressed the questions on the convention pieces last week. However, the challenge we have is that we have been hearing from organisations for persons with disabilities and disability rights organisations since last week and before that. They do not feel that this Bill is in fact addressing those convention pieces. We are trying to advocate for those people, who feel that this Bill has not addressed those concerns.

I support Senator Boyhan's comments about the idea of ambition, and 72 hours seems to be a compromise in the context of the window. Last week, the Minister of State referred to the example of a child who might need to be placed safely somewhere and about their being no other beds available. I absolutely respect that, but could there not be a 72-hour hold? We are now speaking about an amendment that was ruled out of order. I am sure Senator Boyhan will table it again on Report Stage. We hear systematically week after week that DPOs, disability rights organisations and human rights organisations do not feel that the Bill meets the human rights and equality obligations we have under the UN conventions.

Regarding those aged under 18 being admitted to adult facilities, I was under the impression that there are only two such facilities. Ambition is being shown, particularly as the numbers have decreased so drastically. I appreciate and completely understand and respect the concerns expressed, which are very valid. The Senators are right to raise them. However, I feel ambition has been shown because the numbers have decreased so drastically. It was my understanding that if a child aged 17 and a half got into difficulty, they could be brought to an adult area but would be in a room on their own. As a result, there is a level of privacy for the patient. We have to acknowledge that also. Perhaps the Minister of State will expand on this matter a little more. That was the impression I was under. I feel that ambition is being shown in this area.

I want to put on record what I said last week. While it is welcome that the Bill recognises age-appropriate care for children, the qualifier "in so far as is practicable" is far too vague and weak. Huge progress has been made in this area, and I commend the Minister of State on that, but I still believe legal safeguards are needed. While the number of children placed in adult units has declined significantly in recent years - the Minister of State is to be commended in that regard - there is a risk of regression in the absence of a legal prohibition, particularly, as I said last week, if someone is not watching the numbers as closely as the Minister of State has been watching them. I am worried about what will happen in the next term if she is not here. Along with investing in child-centred mental health infrastructure, we need staff and crisis response systems that ensure timely access to appropriate care. We have to put safeguards for children in the legislation because even though the Minister of State is doing a really great job, her successor might not be as passionate as she is about this matter.

The Minister of State is doing a great job. There is no doubt about that. To respond to Senator Costello, there is ambition. However, what we are speaking about in terms of ambition is legislating in the context of the UN conventions we signed up to. Under the Convention on the Rights of the Child, especially Article 37, there is a right not to be deprived of liberty unlawfully or arbitrarily, with detention only as a last resort and for the shortest period. The amendments in this regard were ruled out of order, but this would have been a compromise that would reflect that we are taking seriously the convention that we signed up to. We have not done that because the amendments have been ruled out of order. That is the ambition we on this side of the House are looking for to be included in legislation. It is a job for us and for the Government. It is a job collectively for all of us to continue to champion this and make it law as legislators. This is the ambition we are speaking about. It is fantastic that there are only two children in these areas. Previously, the number was a lot bigger. That is a credit to the Minister of State, but we are looking at it through the lens of the UN convention, which states that detention should only be a last resort and should be for the shortest appropriate period.

I will try to wrap this up, because I want to move on. We spent a lot of time debating this last week. If I have to stay here until I turn 60, I will do so. I will not legislate to put children into adult wards. I am amazed that the Opposition is asking me to legislate to put children into adult wards for up to 72 hours. I will never do that. As I said, there have been two children put into wards so far this year. That is not down to me. I have led on this matter, but it is down to all of the staff working day and night, every day of the week, including on Christmas Day and St. Stephen's Day. On Christmas Eve, when we will all be at home, there will be people working 24-7 to support the most vulnerable in society, who are potentially a risk to themselves or others. The two children in question were in an approved centre. They were both aged 17 and had one-to-one support all night long. They also had the support of their parents and clinicians. I have said it before and I will say it again, I will always choose life over death. I will not go back into the matter again. I am not for turning. Anybody who knows me in my role as Minister of State since 2020 will know that I have never wavered on this. I will not do so now. That was a time when we had more than 100 children in this situation. This year, we have had two. These are the numbers I will stand over all day long.

I want to raise a further point. Senator Boyhan stated that children were incarcerated. He may have said that but I do not think he meant it . They are not incarcerated. Incarcerated means to be imprisoned or confined in a jail, prison or similar correctional facility, essentially having one's liberty restricted by authority, often after being convicted of a crime. No children are incarcerated. These children were admitted voluntarily. They were supported by their parents and clinicians. I ask Senator Boyhan to correct the record of the Seanad. I do not think he meant it. I think it is a word he used but I do not believe for one second that I would stand over that children were incarcerated in an adult psychiatric ward.

I did not say that.

The Senator stated that they were incarcerated. I ask him to withdraw that. If he looks up the dictionary, and I did, he will see what the word "incarcerated" means. I do not think he meant it, but I would love for it to be withdrawn from the record.

I am delighted the Minister of State has brought this up, and I certainly commit to looking into it. I will not say it now. I will not make it up while I am on my feet. I served on the board of St. Patrick's University Hospital where children were detained and where the courts incarcerated children aged 16 and 17 and also those aged 15. I am also very familiar with the Prison Service from my work with it. I was appointed by a Minister to both institutions. I am very familiar with the word "incarcerated". In the context of incarcerated to psychiatric hospitals, I did not say that. I said children were incarcerated in care.

I am very happy to give the Minister of State the absolute commitment - and I thank her for bringing this to my attention - that this afternoon I will look at the of everything that has been said here. If there is clarification required, I will be more than happy to come in and provide it next week. Let us be clear of the facts. I ask the Minister of State to look at the printout also. I do not know the point she is making, but she is happy enough. I am happy to give her an assurance that I will look at this in the context in which I have spoken about it and in the context of the definition.

Let us not lose sight of or deflect from the real problem.

I am not deflecting.

Now that the Minister of State has encouraged me, I am going to comment further. She stated that she is not prepared to legislate for any children in adult psychiatric services. I do not want children to be placed in such services. Will the Minister legislate to ensure that it will not happen? She should show me the legislation or tell me when, following the passage of this Bill and having had time to reflect, she is going to legislate. I am happy to support any proposal from the Minister of State, or anyone else for that matter, which categorically states that no child will be placed in a psychiatric setting with adults in order to receive care or support. That is what I would really like, if possible. The Minister of State is committed to that, but can we see it in some form of amendment? The Minister of State is saying "No". We will have another opportunity to deal with that.

The Minister of State also put on the record - and I want to be clear in order to be fair to her - that there two persons under 18 were placed in adult psychiatric care-----

Not at the moment.

-----in the year 2025.

Yes.

Will the Minister of State clarify the age of those involved? Were they minors?

They were 17.

That is okay. This is not what I am hearing, so I need to go back to the people involved. The Minister of State has indicated that two persons under 18 were in such care in 2025.

That is the information that was given to me.

Does this relate to public and private psychiatric services?

No. What I am speaking to in this Bill is the public sector, our approved centres the length and breadth of the country. I am not speaking to private facilities, which do not come under my remit per se, although they do come under the Mental Health Commission in relation to governance and obtaining a permit to provide the supports for those who are detained voluntarily and involuntarily. The information that was given to me was until October, so I do not have the numbers from-----

From the past three months.

The information I have is that two young people, with the support of their parents, were in an adult facility for a very short period. If I legislate for that not to happen, there will be cases of young persons, who are a risk to themselves or others, being left out of a facility overnight. We all know what might happen then. That is the first point.

The second point is that if we legislate to allow such placements for up to 72 hours, I would be afraid that the trend would reverse because people might say there is now legislation in place so under-18s can be kept in an adult facility for that length of time. I do not want to encourage that at all. I want to be able to come in here in the new year and say there were no such cases. I will not legislate to open the door again. That is the way I feel about it. However, I certainly will not legislate to tie a consultant's hand behind their back in real time in a very difficult situation when it is a choice of life over death.

We have spent a lot of time debating this, so I will conclude on my third point because I want to try to move the Bill on. We have to get the line right between advocacy and treatment. It has to be workable. You cannot only look at it from one side. I have to try to meet it in the middle so that we are supporting every person with a mental disorder, illness or condition, whether it is emotional distress or whatever else. We also have to support the clinicians, who are qualified and trained, by ensuring they are able to do their job as well. We cannot lose sight of that in this Bill. The direction of travel for the past week or two has only been in relation to the person who needs the support. There are a lot of people who need support but we need qualified people to deliver that support as well.

That clarification from the Minister of State is very interesting. It is the first time in this debate we have had this differentiation made between the public and private sector. We need to see that in the context of these numbers. I told the Minister of State I had figures that I did not feel it would be responsible of me to share here until there was further validation of them. They are, however, far higher than two. However, it is helpful that the Minister of State has differentiated between the private and public sector.

This is a national policy in a new Bill on mental health. All services are subject to inspection. There are many beds in the private psychiatric services. I am familiar with two or three facilities just in Dublin that have huge capacity. They do a really good job and work very closely with the State. They are not private and exclusively on their own. Many of them have substantial public capacity.

That is through the service level agreement.

They are very broad, both in the day patient sector and the private sector. Therefore, we are not comparing like with like. All these services have to be subject to probity, and I am not suggesting they are not. This is primary legislation for mental health and all of them are subject to it. The situation is an evolving one and, as the Minister of State said, her figures are for up to October. We do not know what will happen next year. There are a lot of challenging issues. We see in our schools that guidance counsellors have a lot of young people presenting with very serious, complex mental health issues that need a variety of interventions.

We have to be very careful about bandying around numbers. Across the board, in the public and private sector, we do not actually have the statistics today on the number of people involved. The position is always changing. In an ideal world, there would be nobody affected but we do not live in an ideal world. There are always challenges. One never knows what is coming down the road at any of us within weeks or months. That is an important point.

I was hoping we could come to some arrangement and set out the ambition in legislation that no child would be in a public or a private service with adults. I do not draw a distinction between public or private once the service is doing what is meant to be doing and there are proper governance controls in place, which I suggest there are. In an ideal world, we do not want any children in psychiatric services, particularly residential psychiatric services, with adults. It is not appropriate. Best practice tells us it is not good. Advocates say it is not good. The people involved who had experiences have not had good experiences. That is my ambition for this area.

Before I call other Senators, people in the Visitors Gallery must not talk during the debate.

Please. It is Senators only who contribute in this room. Everybody else is a guest and must comply with the rules of the House.

I know the Minister of State wants us to move on, and I will let other Opposition Members speak for themselves, but I was not suggesting we should legislate to hold children for 72 hours. The fact is the legislation does not commit to not holding children in adult units for any period of time. I was supporting the idea of having a compromise within the legislation. By no means was I suggesting we should provide in any legislation for holding children for any period of time in an adult unit. It is important to correct that.

Are public patients put in private services? Does the public system use private providers in these cases for children, or any patients, for mental health services? On the question around resourcing and the challenges with having resourcing for age appropriate units, if a child is in an adult unit, I assume they will be in a private room and taking additional staffing away from the adult unit. How can we balance those resources in a way that can facilitate? I know we have talked about the numbers and that there have only been two cases in 2025. Is there a question about rejigging resources because we would still be removing resources from another aspect of the service provision?

In relation to private capacity, we have service level agreements with some of the private hospitals. I will give an example. When St. Loman's Hospital was closed in Wexford in 2011 additional capacity was bought at University Hospital Waterford for Wexford and Waterford patients. We have a service level agreement with St. Patrick's in Dublin. That would not be unusual. There are people who have been involuntarily detained in private facilities as well. We need to focus on a child who has been involuntarily detained. That will always be done through a court order. That will depend on what capacity is available. In the main, my understanding is the child would be placed in HSE facilities if the capacity was there.

Senator Boyhan said he has different figures but I have to work with the details I get. I get updated monthly on that. I get updated weekly about waiting lists in our inpatient facilities such as Merlin Park Hospital, St. Vincent's Hospital, Eist Linn and Linn Dara. We are speaking about a very small cohort of people.

To go back to Senator Stephenson's point, she said she did not say we should legislate. The point I made was that if we wrote into legislation that it is acceptable for a young person to be detained in an adult facility for their own safety, with the support of their parents and one-on-one supports for no longer than 72 hours, I think it would open a crack in the door. All I want is to see the number get to zero. I will very happy when that happens. At the same time, I think Senator Costello asked last week about what we would do if it was our child and we had a decision to make in real time, at 2 o'clock in the morning, with a consultant and clinical nurse specialist who are trying to support a young person who is at risk of suicide. What if the only option for the child is to be placed in an adult facility overnight, not in a ward with an adult or in a room with an adult but in a room on their own with an en suite bathroom - I use that word lightly because I have been in all of these facilities - and with one-on-one support overnight?

All the staff want to is keep that young person safe, well and monitored until they can be moved to the appropriate facility. Will we ever see a situation in Ireland where we will have inpatient beds in every town and village for people under 16 or under 18 who are unwell? No, we will not, and you do not see that in any country in the world. We have to be realistic. This is where I believe advocacy is overtaking care. I am trying to find the balance. If I have to debate this for another week, I will not change my mind.

Before I read out the question, I remind visitors to the Gallery that the only people allowed to speak in this Chamber are Members of the Seanad and the Ministers who are here to take the legislation. If there are further contributions from the Gallery, they will be removed.

I welcome Scoil Mhuire from Trim in County Meath, guests of Deputy Dempsey. They are most welcome to Seanad Éireann. One of the protocols of Seanad Éireann is there is no homework for the rest of the week. Make sure you tell your teacher that.

The rest of the year.

It is Christmas so there is no homework for the rest of the year.

I move amendment No. 44:

In page 23, after line 36, to insert the following:

“Guiding principles to apply in respect of persons with dual diagnosis

11.Services shall provide integrated care pathways for individuals with a dual diagnosis and the range of services including home, community and inpatient care as appropriate.”.