Oireachtas Joint and Select Committees

Wednesday, 4 October 2017

Joint Oireachtas Committee on Health

Adult Safeguarding: Discussion

9:00 am

Ms Sarah Lennon:

We were asked how we can be sure during the process of decongregation that the community will be better. The short answer is that we cannot be sure. I suppose it is a bigger issue than decongregation. It is actually a question of deinstitutionalisation. Decongregation involves between 2,500 and 2,700 people. Deinstitutionalisation is a bigger issue. It depends on what we understand to be an "institution". The definition of an "institution" that is used by the committee on the UN conventions includes many other places where people with disabilities can live, including community group homes. It may also include people's private residences. We are talking about between 2,000 and 3,000 people moving to the community. A significant number of people with disabilities live with their ageing parents, who are receiving support but might not be known to us and are certainly not being considered in terms of service provision.

I represent Inclusion Ireland on the national safeguarding committee. We represent people with intellectual disabilities. We view institutions of all kinds as abuses in themselves. They are certainly fertile ground for abuse to take place in. We face significant challenges as we consider how we can get the community right. I suggest we should perceive those challenges as opportunities. We have many tools at our disposal. Interagency working has been mentioned all day. A significant number of laws and policies which are partially commenced or not commenced at all would make community living a significantly more abuse-free environment for people.

The deprivation of liberty safeguards are a significant piece of work for the Department and the committee to do. The decision support service has a huge role to play. Clearly, the provision of independent advocacy is a significant area that has been teased out. Another important structural change that needs to be brought in involves drawing up personal budgets for people with disabilities and putting in place personal assistance to help people to live in their own homes.

I would like to offer a couple of observations on the Bill itself. It is really welcome. It is being introduced in response to a number of things that have happened, such as the Áras Attracta and Grace cases. The focus on prevention is really important. If we recognise that vulnerability is constructed, and that we are all responsible for constructing it, we need to do more than react when abuse takes place. We need to put in place the structural changes that are needed to prevent abuse from occurring in the first place.

I think the committee should consider the idea of being able to take care of oneself, which has not really come up in this debate to date. It is a part of the legislation. We need to reflect on issues of self-neglect or a lack of self-care and the boundaries around that. If we are taking a neutral or non-status approach to defining who this legislation applies to - such an approach is to be commended - we need to be careful that we do not become subjective in terms of what constitutes self-neglect and self-care. An important conversation needs to take place in this context. The boundaries of that conversation will need to be managed carefully.

Those of us who work in the area of disability have seen that independence is critical. It can be difficult for children with disabilities to receive services within the likes of Tusla, the Child and Family Agency. They often have to return to the HSE for investigation or management. For that reason, the independence of the national adult safeguarding agency that is being mooted in this legislation is critical. Training is also important, as is an awareness of the multitude of people we could be talking about here, including people with disabilities, older people, people with acquired brain injuries and people with mental illnesses. A significant number of people will not sit comfortably within the groups I have identified. Resources and training will be needed. The independence of the agency will be absolutely critical.

I would like to suggest some recommendations that this committee can make. The Department of Employment Affairs and Social Protection has a personal advocacy service at its disposal, but the statutory powers that go with it need to be commenced.

In the interim, an important move would be if that part of the Citizens Information Act 2007 were commenced. While it agrees with the likes of an agency as proposed by Mr. Mervyn Taylor, Inclusion Ireland also proposes an advocacy agency which would have oversight of all of the statutory and voluntary advocacy services.

The other critical part of this legislation is the idea of the will and preference of the person. Earlier we spoke about children's first legislation. It is a different concept when we talk about adults. Whatever we put in place in terms of investigations, mandatory reporting and advocacy, it is critical that people with disabilities and others who are being represented are not subject to any investigations or anything that takes place around safeguarding but that they are actually active participants and their will and preference are recognised. The best way to do that is through independent representative advocacy. That message has been heard loud and clear today.

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