Letters to the Editor: Let's find the real causes of failures in the HSE's Camhs service
A correspondent questions the 'transparency, accountability, and basic Hippocratic ethical morality' of the HSE's Camhs service in Co Kerry. Picture: iStockÂ
Ann OâLoughlin (Irish Examiner, April 2) reports on the background to a case launched against the HSE in the High Court by âthe parents of a 17-year-old girl who took her own life while under the care of the Child and Adolescent Mental Health Services [Camhs] in Kerryâ in 2021.
This case is the most damning indictment associated with a major healthcare scandal which encompassed a litany of gross failures in the regionâs Camhs service.
There could surely be little to offer in defence of the well-documented scenario, with much media cataloguing of the clear dereliction of duty, and yet the psychiatric profession has closed ranks to dilute any responsibility pending by claiming recruitment shortfall was central to the grim saga.
The latest College of Psychiatristsâ governance proposals for Camhs focuses primarily on the recruitment issue as key to all ills pertaining. One wonders if that recruitment dilemma is merely about psychiatric biomedical posts or other creatively psychodynamic therapeutic posts which are especially worthy players in any childrenâs mental health service.
The central malaise in the Camhs template is the predominant profile of the biomedical approach, begging the obvious question as to why the Camhs teams have be controlled âpyramidicallyâ, with a biomedical leader atop in every case ensuring the prescription pad trumps and suffocates all other interventions to the fray.
The shameful travesty of the Kerry Camhs revealed the grotesque extent to which âbiomedicaliaâ rules the roost, with the paltry defence emerging that recruitment problems were at the core of the tragedy.
Had the medical doctor/trainee psychiatrist at the core of the treatment farrago simply consulted and conformed to the standard Monthly Index of Medical Specialities prescription advisory glossary, the over-dosing that eventuated could never have happened. The practitioner in question was thereafter moved on to another position away from the area.
So much for transparency, accountability, and basic Hippocratic ethical morality. Recruitment issues were clearly not the causative feature of the protracted over-prescription to many of the children involved.Â
The original âVision for Changeâ policy document (2006) clearly identified a comprehensively varied therapeutic team for Camhs and adult mental health services, but alas all initial funding was designated to install psychiatrists primarily as before any other team members were recruited, thus copper-fastening the dominance of a biomedical orientation, which has sadly flourished ever since, with debilitating and dwindling effect.Â
A creative spread of appropriate psychodynamic therapies have never crystallised, curtailing the development of wide-spectrum therapeutic options.
One can only surmise that the current faltering Camhs situation owes more to self-orientated professional career protection than open-minded therapeutic coherence and egalitarian cooperation.
Recruitment of various modalities of therapists is, of course, certainly an issue in this regard. Letâs hope a forensic appraisal of the festering Camhs malaise ensues to illuminate the authentic complexion of a distorted template of care, and not masquerade behind the quintessential camouflage of recruitment vagary.
It is now entirely clear that the US president, vice president, and other senior Trump team members including the press secretary wouldnât pass politics, history, or economics 101.
So the toxic combination of power and ignorance now sets a large part of the world agenda.
One day we will wonder how this mistaken cocktail was made yet again.
Like quite a few Australians, I have holidayed on Norfolk Island, a very small island about 1,600km from Australia.
It is a beautiful island, with a horrific history as a cruel penal colony and its only real industry is tourism.
It however has been hit with a 29% tariff, by US president Trump, on non-existent exports. There are a number of other such islands.
There are many that find the new tariffs offensive, inappropriate, unnecessary but in this case just plain stupid. How many other Trump-led initiatives will be regarded in the same way?
I think the fourth category will poll the highest.
Responding to parliamentary questions about the Central Bankâs authorisation of âIsraeli war bonds for sale in the EU⌠despite all the evidence that these are used to fund the genocideâ, finance minister Paschal Donohoe declared: âI do not intend introducing legislation that forbids the Central Bank of Ireland to fulfil its regulatory duties.â
Nobody has asked the minister to forbid the Central Bank from fulfilling its regulatory duties; quite the opposite.
Numerous TDs, senators, and councillors have insisted that  the Central Bank should proactively fulfil its regulatory duties, and invoke the powers granted to it under EU regulations to end its facilitation of Israeli war crimes.
EU Regulation 2017/1129, which governs endorsement of bond prospectuses, states that âthe disclosure requirements of this regulation do not prevent a member state or a competent authority⌠from imposing other particular requirements in the context of the admission to trading of securities on a regulated market, notably regarding corporate governanceâ.
This had already been placed on the record in a joint committee debate, and was cited in a parliamentary question again this week. It is frustrating to hear a government minister retread old ground as though the pertinent facts had not been supplied.
Further, the ministerâs claim that action by his department âwould imperil or undermine the independence of the Central Bankâ is at odds with the âlegislative frameworkâ that he purports to cherish. EU Regulation 2017/1129 clearly empowers âa member stateâ as well as âa competent authorityâ (ie the Central Bank) to take action âregarding corporate governanceâ.
Regrettably, I must agree with one TDâs conclusion that âthe minister never answered the questionâ.
With Israeli aggression and expansionism running rampant, this issue is not going away, and our Government must address it.
Responding to parliamentary questions on Thursday, finance minster Pascal Donohoe did not dispute that Israel Bonds fund genocide, apartheid and the illegal settlements in the occupied Palestinian territories. Nor did he dispute that facilitating the sale of Israel bonds is in violation of the Geneva Convention and international human rights law.
Shockingly, he sought to justify taking no action to stop the Central Bank acting as the gateway to Europe for Israel bonds reiterating the patently absurd claim that the only relevant law is the EU Prospectus Regulation.
The minister failed to acknowledge in any way the International Court of Justice (ICJ) Ruling of January 2024 that Palestinians have a plausible right to be protected from genocide. He repeated the highly questionable dismissal by governor of the Central Bank of the ICJ advisory ruling of July 2024 that Israel is committing the crime of apartheid and that the entire regime of military occupation of Palestinian territories is illegal.
Having considered both the ICJ January and July rulings, the Office of Parliamentary Legal Advisers recently concluded that a bill âcan provide for restricted access to its financial services on the basis of public policy grounds that are rooted in the Irelandâs fundamental interest in pursuing its international law obligationsâ.
Over 62,000 people have been murdered in Gaza, over one thousand since Israel unilaterally broke the fragile ceasefire on March 18. Over 18,000 children have been murdered, tens of thousands injured.
The pictures coming from Rafah today are of total destruction of the environment.
The Central Bank of Ireland is not just a cog, but the lynchpin, of Israelâs fund-raising campaign in Europe. This is unconscionable. The Government must act to stop the Central Bank funding genocide.
When Mick OâDwyer was training the Wicklow team, I needed a Wicklow jersey for an âall counties nightâ in the USA.
I asked the Wicklow County Board for one. My request was ignored.
I contacted Micko. Next day, two jerseys arrived in the post.
