Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I thank Mr. O'Brien for his contribution. The "Prime Time" programme was very disturbing for people who watched it. It goes without saying that it clearly indicated appalling treatment of very vulnerable people and everybody would condemn such activities. We must ask what can we do to ensure it does not happen again. Clearly, it is a matter for the Garda Síochána to investigate but as legislators and policy-makers, we have an obligation to hold people to account - that includes people in the HSE and others - in terms of ensuring we come forward with solutions to address concerns. The concerns are that this could be happening elsewhere. I do not think any of us can rule that out.

What actions is the HSE taking in the short term in regard to residential units in which physically and intellectually disabled people are being cared for in a congregated setting? The HIQA report and recommendations and the McCoy report and recommendations will have to be implemented.

This is just an observation-criticism but HIQA has reported many times and published many recommendations in key areas of health and the HSE has not always covered itself in glory in responding to, and implementing, those recommendations. I have instanced the whole area of maternity services. Very often resourcing is the issue but sometimes the recommendations made by HIQA are not always implemented in the manner it would have envisaged or in the manner we, and sometimes the HSE, would have liked because of lack of resources. However, in this case, we cannot leave anything to chance because the people being cared for deserve our full protection.

In this case, the student was an undercover person who worked in Áras Attracta between September and November.

There was a report on a death in Áras Attracta made previously to HIQA where HIQA carried out an investigation. The key question is, were there other reports brought to the HSE's attention. One must be asked why "Prime Time" picked Áras Attracta, specifically bungalow 3. Were there reports of abuse, ill treatment, lack of oversight, basic lack of humanity shown to other persons? Were such reports ever brought to the attention of the HSE by anybody working in Áras Attracta or by those resident in Áras Attracta or their family members because it is hard to believe that somebody would merely arrive with a camera and start working in an undercover manner without having some knowledge? I wonder had the HSE any similar knowledge in that context.

There are 90 providers and over 900 residential units. As I asked in my opening statement, what measures can the HSE put in place? Clearly, HIQA carries out inspections. It is now legally charged with that responsibility. However, often the inspections are box-ticking exercises - I do not mean that in any condescending way - in that they involve a template looking at physical aspects such as the square footage, the number of staff per patient and fire exits. Is there a need for us to broaden the remit of HIQA or is HIQA even capable of ensuring that patients, the advocates of patients and family members are also spoken to so that in the context of visiting these residential units, not only are the obvious physical environment and surroundings inspected but there would be discussions with staff and, as importantly, residents?

Mr. O'Brien spoke about a confidential recipient line and Ms Leigh Gath being appointed, and I welcome that. He stated the terms of reference must be drafted and the basic infrastructure around the confidential recipient must be put in place, but that must be done quickly. All staff in these residential care units should be informed that not only will the confidential recipient be in an office, but that there will be a strong promotional aspect throughout all of these residential centres, that all families members and residents will be informed of same in a meaningful and forthright manner that this confidential recipient is there to help and protect, and that the confidential recipient will be given adequate resources.

On the broader issue, while HIQA is statutorily charged with overseeing and inspecting these centres, the HSE is responsible ultimately for what happens in such centres, not only the ones for which the HSE provides directly but also those that it funds. Has the HSE adequate resources? Has the HSE the capability and expertise to investigate itself when complaints are made? That is the key issue. We have seen it in other areas, such as An Garda Síochána where we had to go to the Garda Inspectorate and the Garda Síochána Ombudsman Commission. One always has concerns about an organisation investigating itself. While there is HIQA and other outside bodies which are statutorily charged, there is a strong obligation on the HSE to ensure that it has within its ranks staff who, if such breaches should happen again, are not afraid to act or hold persons to account.

While we are talking about Áras Attracta only, there is concern for those who are cared for in the home environment. I published a Bill on the matter and other Members published Bills in the past. We must accept that while the vast majority of those who care for the vulnerable, be they the elderly or persons with physical or intellectual disabilities, do so for all the right reasons. If this kind of abuse can happen in a congregated setting where professionals are the carers I would be amazed if there were not forms of abuse carried out in the home setting and I wonder is it time for us to put an inspectorate in place for those funded to care for persons in the home setting, for instance, through the carer's allowance, to inspect that environment as well. For example, in my constituency I have come across one or two cases where I was concerned about the individual who was being cared for by persons in receipt of carer's allowance. There is no inspection pathway available other than that of a public health nurse who one could contact to ask to call. I wonder, in the broader context, bearing in mind that a large amount of people are cared for in the home environment, whether we should put in place quickly a statutory inspectorate to address that genuine concern. Senator Colm Burke spoke last week about publishing a Bill. I published one in 2012. It is time we act on this as well.