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Spain reveals new budget cuts

A woman is arrested by riot police during a demonstration by Spanish coal miners in Madrid this afternoon. Photograph: Denis Doyle/Getty Images

Irish Times

Spain unveiled new austerity measures today designed to cut €65 billion from the public deficit by 2014 as violence broke out on the streets of Madrid.

Prime minister Mariano Rajoy, who yielded to EU pressure to try to avoid a full state bailout, announced a 3 percentage point increase in the main rate of VAT on goods and services to 21 per cent and cuts in unemployment benefits and civil service pay. His speech was interrupted by jeers and boos from the opposition.

“These measures are not pleasant, but they are necessary. Our public spending exceeds our income by tens of billions of euros,” he told parliament.

Analysts said the draconian savings plan, tearing up several of Mr Rajoy’s campaign promises, showed Madrid was already under de facto supervision from Brussels even though it has not requested a sovereign bailout and retains access to bond markets.

Some said the tax increases could exacerbate the recession. Spain won softer deficit targets from its European Union partners this week and also negotiated rescue aid of up to €100 billion from the euro zone’s bailout fund for its crippled banking sector.

In line with recommendations from the European Commission, Mr Rajoy announced new indirect taxes on energy, plans to privatise ports, airports and rail assets, and a reversal of property tax breaks that his Popular Party had restored last December.

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Outdated assessment process in mental health – Deference to authority figures is no longer the order of the day.

PAT BRACKEN

OPINION: THE STEERING group on the review of the Mental Health Act 2001 has just published its interim report. This highlights the contradiction between the paternalistic ethic that informs the Act and the recovery approach advocated by A Vision for Change (the national mental health policy) and the Mental Health Commission.

A key element of the recovery approach is the promotion of patient “empowerment”, including the right to define the nature of one's problems and to be centrally involved in decisions about treatment.

This approach involves questioning the sole authority of the medical perspective in mental health issues.

The report is to be welcomed. But to get beyond paternalism, we (patients, carers, psychiatrists and other professionals) will have to consider how to deal with risk situations without ceding decision-making power to a single professional group.

Consultant psychiatrists are given huge powers and responsibilities under the terms of the Mental Health Act. An application for involuntary detention may be made by a relative or other named individual and a GP is required to support this with a recommendation order.

However, once an individual is detained power resides with the consultant psychiatrist. And they are endowed with the authority to determine the nature of the problem, plus the vocabulary that will be used to describe it.

Moreover, the psychiatrist has the power to determine what treatment will be used, how it will be used and its duration. It is also within the psychiatrist's power to decide what risks to the patient's health will be tolerated.

They can order electroconvulsive therapy even if the patient, or their family, refuses it. Though the patient is seen for a second opinion shortly after admission, this is also carried out by a psychiatrist. The three-person tribunal team that reviews the admission order always includes a psychiatrist.

The powers invested in psychiatry are a legacy of the asylum era and can no longer be justified on scientific or moral grounds.

The 2001 Act not only predates A Vision for Change but also the massive cultural changes we have witnessed in recent years. Scandals involving politicians, banks, financiers and the Catholic Church have seriously undermined trust in our major institutions. Deference to authority figures is no longer the order of the day.

The medical profession has not been without its scandals either. There is evidence that a significant section of academic psychiatry, internationally, has been corrupted by its links with the pharmaceutical industry. Read more…