THE Health Minister, Robin Swann, established the Mental Health Champion’s office with no legal power to take meaningful decisions.
This is despite official concerns being raised with him about the level of effectiveness and independence of the Mental Health Champion if the office were to be established in this way, which it eventually was.
An internal Department of Health (DoH) paper from January 2020, released under Freedom of Information (FoI) legislation and seen by The Detail, outlines how this decision would see the Mental Health Champion “funded by the department/Executive without formal legislation or powers”.
It adds that questions can be raised in relation to the "effectiveness of a funded appointed champion that does not have statutory powers to act”.
Minister Swann was also presented with an alternative vision for the Mental Health Champion’s office, which would have required legislation.
This may have taken longer to implement but, according to the ‘options paper’ and in contrast to the decision that was actually taken, would have led to a “fully independent champion”.
The document adds that this would have created “certainty of the purpose” of the office, with legislation capable of including “statutory powers and requirements” – akin to Northern Ireland’s Children and Young People’s Commissioner or the Older People’s Commissioner.
However, this option was dismissed by Minister Swann. Instead, the Health Minister recommended a choice of office for the champion to his Executive colleagues which had a less clear purpose and no real power.
Sara Boyce, a mental health rights campaigner with Participation and the Practice of Rights, said her organisation “works every day with people who have experienced trauma and emotional distress, more often than not made worse by a failing system which lacks transparency and accountability”.
“These families know only too well that simply continuing with the same, outdated approach to mental health will not work,” she told The Detail.
“What’s needed is bold thinking about our approach to mental health, as well as clear lines of accountability when things go wrong.
“Instead, the evidence shows that the Mental Health Champion’s office was intentionally created without any real powers or independence from government.”
Siobhan O’Neill became the Mental Health Champion in September 2021, but already took on the role on an interim basis in June 2020.
Her team costs just under £500,000 per year and is based in the DoH’s headquarters, Castle Buildings, on the Stormont Estate – having moved here in April 2022 from the Patient Client Council’s office where it was previously based.
The Mental Health Champion’s office recently delivered its first annual report to the department and other Stormont ministers in June 2022, but it has not been published.
The DoH told The Detail the office is “developing an independent website, where the annual report will be published in due course”.
Minister Swann ultimately informed the rest of the Executive that as legislation would take time to implement, it was his view a “funded appointed champion without legislation” was the best choice.
On April 27, 2020 – two months before Siobhan O’Neill was appointed to the role of Mental Health Champion on an interim basis – the DoH’s head of mental health and capacity, Tomas Adell, wrote that Minister Swann “told us to proceed with the creation of a MH Champion, with speed”.
The Detail asked the DoH why the speed of implementing such an office was prioritised over one requiring legislation, which would have legitimate power and unquestionable independence from the department and the Executive.
A DoH spokesperson said the decision was “expedited in direct response to the unprecedented situation at that time in respect of the Covid-19 pandemic”.
The spokesperson also said the department will consider an “option for legislation" for the Mental Health Champion in the future, but made no firm commitment to progressing this.
In addition, the January 2020 options paper acknowledged that there was uncertainty around the legality of the type of office which Minister Swann chose for the Mental Health Champion.
The document says: “There are legal questions that would have to be considered further if this is a preferred option. In particular, how the person can be appointed and how funding streams can be identified without falling foul of public procurement requirements.
“This option would also require careful consideration of how the person is appointed. Without a transparent selection process, there are risks that the champion can lose their independence and therefore some effectiveness.”
Furthermore, in April 2020, the DoH’s Tomas Adell said: “It is not a formal appointment and we don’t think it would legally require a competitive process, but we don’t know for certain.”
Mr Adell then acknowledged that “further work is required on this point”.
By contrast, the options paper states that – had the more robust Mental Health Champion’s office been selected – it would “remove the risks associated with all other types of (possible) champions which would be reliable to the goodwill of (the) department (and) of others when seeking information, requesting funding or requesting change”.
It adds: “A statutory established champion would also remove the legal challenges for (the) appointment and selection process.” However, this choice was rejected by the minister.
The DoH maintained the appointment of Siobhan O’Neill as Mental Health Champion was not a formal public appointment and said this was because her office “is not a prescribed body”, and therefore the department did not have to go through a “formal public appointment process”.
However, the department also said that the appointment “was carried out in the spirit of the Commissioner of Public Appointments Northern Ireland code of practice and closely followed that of a public appointment”.