1st March 2004
All countries must be in a position to close their borders if an influx of people with an infectious or contagious disease seems likely but I accept the criticisms of colleagues who say that the recent Immigration Act does little to help prevent such instances. That I spoke against it, and voted against it, made little difference to the outcome from a practical point of view but I would like to tell you that being unable to affect such ludicrous and inoperable legislation annoys me as much as those who will be expected to work it.
The big excuse about the legislation was that it was a "temporary" piece of legislation which had to be rushed through in an "emergency". I have seen far too many pieces of "temporary" legislation exist for many years to feel that this is a good excuse for bringing in bad legislation - it will be there for years.
The Bill introduced into the Seanad allowed for immigration officers, who need not have any medical qualifications, to refuse entry to people with "disease or disability". There was no right of appeal in the Bill nor is there in the Act which has now passed into law.
Obviously someone realised that the word "disability" was going to cause trouble, memories of the Special Olympics and the warm feelings we all had then still being vaguely felt, so an amendment which was nearly worse in its description of "mental disorder" was put in by the Government. All this lead to talk of "Fascism" in the Seanad and the opposition and independent senators left at committee stage to allow the Government senators bring this piece of legislation through on their own, the first time I have seen this in my twelve years in the Seanad.
Off the Bill went to the Dáil where things went from bad to worse thanks to further Government amendments on how to keep disease out of Ireland. An immigration officer could refuse entry to someone who appeared to suffer from the following:-
- Diseases subject to the International Health Regulations for the time being adopted by the World Health Assembly of the World Health Organisation. (At present there are Plage, Cholera and Yellow Fever).
- Tuberculosis of the respiratory system in an active state or showing a tendency to develop.
- Syphilis.
- Other infectious or contagious parasitic diseases in respect of which special provisions are in operation to prevent the spread of such diseases from abroad.
- Drug addiction.
- Profound mental disturbance, that is to say, manifest conditions of psychotic disturbance with agitation, delirium, hallucinations or confusion.
Now this was bad enough but the Minister for Justice's arguments in the Dáil regarding our need to be able to protect ourselves from disease were even more bizarre. For example SARS. We must be protected from SARS by being able to refuse entry to someone who arrives at an airport with obvious signs of the disease. No mention was made of the detailed instructions sent out by the National Disease Surveillance Centre months ago which not only told us in detail what to do regarding isolation, advice to contacts and so forth, but even covered the cleaning of the plane. Now, refusal of entry and back on a plane to infect another two hundred people seemed to be in order.
The last straw was section 6 which sounded like someone with a florid attack of schizophrenia. No wonder the Schizophrenia Association objected so strongly about it. No one could contemplate treating such an obviously ill person in the manner suggested in the Act, that they be refused entry. What could happen if they injured themselves or others on the journey back? Was there no onus on the State to give them care?
When the Bill came back to the Seanad in a form nearly worse than it had left it I objected again and had support from opposition senators when I called a vote against the final passing of the Bill. All the opposition made no difference to the final outcome.
Now I do not expect the Minister for Justice to consult the medical profession on matters of law but surely it would be wise of him to ask his officials to seek a little help on medical matters? The National Disease Surveillance Centre was not consulted nor, it would appear, were the useful guidelines on how to prevent entry of disease into this country even read. No Public Health doctors were asked how the Act was to be implemented and, seeing that they and the Minister for Health and Children are still at loggerheads over twenty-four hour cover, it would have seemed wise to get their views. The Act allows for the appointment of medical immigration officers with the permission of the Minister for Health and Children but that Department does not seem to have been asked about this either.
As for the need to get some help from the psychiatrists regarding the seriously mentally ill who were to be excluded from our green and pleasant land, they were out of the loop, too.
Apparently we were to be cheered that this legislation was changed to cover all people trying to enter, not just non-EU nationals. Indeed, I suppose Irish citizens are covered by it as well, so look healthy and behave quietly and circumspectly at airports! Having read really serious reports about the treatment of those from ethnic minorities in psychiatric institutions in Great Britain it would be good if we were told now and then who is stopped coming in here.
In the midst of all this, our excellent European Union Commissioner for Health and Consumer Affairs, David Byrne, has brought forward plans for a European Centre for Disease Prevention and Control. This has been agreed by the European Parliament. He is supported by our Minister for Health and Children. Let us hope it is supported, too, by the Department of Justice.
Senator Mary Henry, MD
