Ms Maeve Lewis:

I thank the committee. At One in Four, we provide psychotherapy and advocacy support to men and women who have experienced childhood sexual abuse and to their families. We also offer a prevention programme to those who have caused sexual harm to children. Working with an average of 700 clients per annum, we have a deep understanding of the long-term impact of childhood trauma on the individual. We recognise that a particular set of supports is needed by survivors, who may be very vulnerable as a result of their childhood experiences.

One in Four broadly welcomes the proposed Bill and believes that, if enacted, it will provide a structured support system to survivors of residential abuse. We welcome, in particular, the provision of health services without charge, including a free nursing service, free home help, free dental, ophthalmic and aural services, a free counselling service, a free chiropody service and a free physiotherapy service.

However, we have identified several omissions in the proposed legislation. In the absence of a designated support agency, many survivors will have difficulty in accessing information about their entitlements, negotiating any roadblocks they may encounter and identifying appropriate services. Some survivors have a low educational attainment and may be suffering from chronic complex post-traumatic stress disorder, PTSD. Some will not have the confidence to be assertive in claiming their entitlement. Thus, there is a vital need to provide for a professional advocacy service to assist survivors in availing of the proposed supports.

While it is very welcome that counselling services are identified as a necessary support, the reality is that all the specialised counselling suffers from long waiting lists. For example, at One in Four, our waiting list is now over one year and the same is true for other services. Survivors of institutional abuse deserve to have timely access to well-trained, experienced trauma psychotherapists and counsellors and no provision is made for this in the Bill.

Many survivors still experience shame and stigma associated with their childhood experiences and will not always feel able to identify themselves as survivors to front-facing staff in the health services. All medical and public service staff working in front-line roles, therefore, should be afforded trauma-informed practice training so they can identify survivors and be aware of the different specialist supports they may need.

Regarding survivors overseas, it seems to us that the €3,000 allowance is a relatively small sum and may not cover the costs of the health services in other jurisdictions. It also will reduce in value over the coming years due to inflation. The sum of this allowance should not be specified in legislation and should be awarded through a needs-based assessment.

Turning to the use of data, privacy concerns are very salient for survivors and every thought needs to be given to the security of sensitive data as they move from agency to agency.

We have always understood that many survivors dread the possibility of ending their lives in a care home, provoking, as it might, traumatic memories of their childhoods in institutions. It would be useful if the Bill could include a section stressing that every effort would be made to ensure that, insofar as possible, home help and nursing care would be provided for survivors in their own homes.

No provision is made in the Bill for the provision of professional support for survivors who may be engaging with criminal or civil justice processes in relation to their alleged abuser.

To conclude, this Bill is a welcome development in providing ongoing support to survivors of institutional abuse, enshrining in law their right of access to a variety of vital services. However, we consider that the Bill could be improved if the concerns we have raised here were to be considered. Survivors of abuse in institutional care were abysmally failed by the Irish State in their early years.

It is incumbent now on us as a society to ensure as they age, that they are afforded the highest quality appropriate services they so richly deserve.