Mr. Pat Healy:

Regarding the vulnerable adults policy, Deputy Ó Caoláin correctly identified that the elder abuse policy had been in place and working well for some years. Child protection arrangements are also in place. Much has been done to develop this front, but there was a lacuna, in that vulnerable or disabled adults who were not elderly were not covered. Following the establishment of the social care division, one of our first actions was to develop a safeguarding policy, which was published last December and is being rolled out.

The reference to a no-tolerance policy relates to the need for a change in culture. There is a basic expectation that staff at all levels, be they in residential centres or communities, would engage compassionately and appropriately in terms of the care and support provided to the people with whom they engage. However, we have learned and continue to learn that this is not always the case. The no-tolerance policy is meant to drive home to providers and staff across the sector as well as to the public that there is an intention to change. We are not just supporting this with the implementation of the safeguarding policy, which will see safeguarding teams across the nine community health care organisations. Twenty additional social workers are being recruited for these teams, as are some of the principal social workers who will head them up, with the others already in post. We will also support the no-tolerance policy through a six-step change programme and a volunteer advocacy programme, under which we will have residential counsels in our residential centres. The idea is to open up our centres so that people can come in from the outside and there can be a general sense of engagement.

There is a dedicated team for the quality improvement programme. As the director general stated, the team has visited 50 of our centres, representing 25% of the HSE's services. We have prioritised our services because they tend to be found in large congregated settings. The roll-out of the programme is significant and there have been two national summits attended by the Minister and others, including all of the stakeholders. The summits have provided the HSE and the national task force an opportunity to report on progress and others with an opportunity to feed into that process. More summits are planned for the summer and autumn. We will continue reporting.

Regarding community rehabilitation, my colleagues, Mr. John Hennessy, the national director for primary care, and Dr. Áine Carroll, and I wrote a more comprehensive answer that did not find its way to this meeting. We will send it to Senator van Turnhout and engage directly with her on the matter.