Ms Frances Spillane:

Thank you, Chairman. Senator Kelleher asked if the Department agrees that there is a need for a legal framework. Yes, that would be the case. In my opening statement, I explained that we accept that this is a very complex area, so our preference would be to pursue legislation for the health sector initially, as distinct from legislation for all areas. We have consulted with other Departments on members' proposals in the Bill, and we can expand on the comments we have got from other Departments.

The Senator mentioned proposals being brought to Government. We have had an initial discussion with the Minister about this, but we will need to talk to him again in more detail. Expanding on our current thinking, we see the possibility of providing legislation setting out that safeguarding is very much a part of good corporate governance.

In this way we would build on the HSE's adult safeguarding policy, and equally its review of this policy.

We would also build on the experience in the area of children. We have looked at the Children First Act 2015 because we felt there were aspects of that which were very relevant. It provides for some very positive measures, including the preparation of guidelines by the Minister and the requirement that providers ensure that children are safe from harm while availing of the service; in other words, a statutory duty to safeguard. We see a lot of advantages, in terms of changing the culture and raising awareness, to a statutory duty to safeguard vulnerable adults, something that is not there at the moment. The Children First Act provides for risk assessment by each service provider, and the preparation of child safeguarding statements. Again, we feel that these are measures that could translate to legislation for safeguarding adults.

There have been discussions on monitoring compliance. Our view is that if a governance obligation on entities is introduced, HIQA could monitor it as part of the inspection and quality assurance work it does in visiting facilities regularly. We also consider it important to distinguish between vulnerable adults in residential care, and vulnerable adults in their own homes or living with relatives. HIQA is already inspecting both public and private nursing homes for older people and disability centres for children and adults. That is already in place on a statutory basis.

The Government has already committed to introducing a new funding scheme for, and regulation of, both private and statutory home care services. A public consultation was launched in early July, and we received over 2,600 submissions to that consultation by the deadline of 2 October.

We also feel that health professionals, including GPs and public health nurses, are a resource in identifying potential abuse of vulnerable adults living in the community. When I talk about regulation of home care, I am talking about home care services provided by either the HSE or private providers. This would be undertaken with a view to protecting vulnerable adults in their own home.

The question of reporting arrangements is particularly complex. In the area of children, mandatory reporting of child abuse was first recommended in the Kilkenny incest case report in 1993. This was followed by a discussion document on mandatory reporting of child abuse in 1996. The Children First National Guidelines for the Protection and Welfare of Children were issued in 1999, providing detailed guidance on definitions of abuse and reporting arrangements. The guidelines effectively provided for administrative mandatory reporting, so that all health professionals, for example, were under an obligation to report any cases of child abuse that they came across in their work. This extended across the health services, including in respect of people in hospitals and all other areas. The guidelines were in place for a good 11 years, and were then revised by the Department of Children and Youth Affairs in July 2011. This was followed in April 2012 by the publication by the Minister of the heads of the Children First Bill. The Children First Bill was published in April 2014 and signed into law in November 2015. The Act provides for mandatory reporting of child abuse, and is due to come into operation shortly.

I thought it would be helpful to outline that timeline for the committee, to show how long it has taken to move from the Child Care Act 1991 to the situation today, where we are about to introduce mandatory reporting. From the time of the Kilkenny incest report in 1993, approximately 22 years have passed. Experience of the development of practice and awareness in child protection services has influenced our thinking on the similar work that needs to be done in the area of adult safeguarding.

It may be seen from the timeline that the development of child protection practice policy and legislative proposals has taken many years, and the question of mandatory reporting is still quite controversial. Our view, subject to Government approval, is that we should await the experience of mandatory reporting in child care services before introducing any such requirement for reporting in regard to vulnerable adults. It is important to note there has not been the same focus on elder abuse procedures and practice. Public education and awareness-raising is also essential.

To come back to the Assisted Decision-Making (Capacity) Act, we feel that is very important in terms of awareness-raising. A director has recently been appointed and funding of €3 million has been provided in the budget for setting up the decision support service and an important part of the role of the decision support service is to promote awareness of the Act. The Act is all about helping older people to make decisions themselves and provide them with support in making those decisions.

At last week's meeting of the committee, the chair of the national safeguarding committee, Ms Patricia Rickard-Clarke, noted that the question of mandatory or voluntary reporting needs huge concentration in terms of what is appropriate. Looking at other jurisdictions' mandatory reporting systems does not necessarily work. That is an outline of our thinking at the moment.