Margaret Murphy O'Mahony (Cork South West, Fianna Fail) | Oireachtas source

As the Minister will be aware from taking the Bill through the Seanad, Fianna Fáil will be supporting this Bill. However, it is somewhat disappointing that the Bill is necessary and that more time is needed to render residential centres compliant with Health Information and Quality Authority regulations. Not all disability residential centres will have achieved the standards required to be registered by 31 October 2016 and, therefore, it has become necessary to move the deadline out by two years. Are the Minister and HIQA confident that all will meet this new deadline?

It must be said that we would all like to see more people with disabilities living independently and that fewer residential centres would be needed. However, as long as we have them, it is important that they are well regulated and compliant with that regulation.

We cannot ignore the background against which we are debating this Bill. There have been many shocking revelations in the past week and it is crucial we tackle these issues head on. On Thursday night last, the "RTE Investigates: Lost in Care" programme exposed how the HSE failed in its duty of care and protection to hundreds of adults with intellectual disabilities - some of most vulnerable people in the country. Many viewers will have reacted with anger and disappointment. Sadly, there may not have been great surprise at the revelations as we are witnessing yet another failure of care by those whom we trust to provide it.

The Minister has had a number of meetings with HSE officials in recent days. I trust he gave them the clear message that this cannot go on and that rather than have these matters exposed by whistleblowers or leaks, we need to know now what other deficiencies remain in the system. What other internal reports are there? Is there more to come? What reassurances can the Minister offer? Has the HSE offered him reassurances and, if so, is he reassured? The Minister must have doubts because we all do. It is simply outrageous that, in many cases, the HSE did not even have a file on the individuals in question and, in some cases, where files existed, the detail and the record keeping were completely inadequate. It is shameful. It is as if the 200 defenceless and vulnerable citizens our health service would not even dignify with a record were seen as non-persons.

In one case, the absence of information led to a vulnerable woman being frequently returned without any supervision to her family home even though it was known that she had been sexually abused in childhood by a family member. We also learned of a man with Down's syndrome who spent his whole life in residential care and went for 16 years without any contact from officials. The HSE states there are no current safeguarding issues. However, I suggest the Minister follows the policy of trust but verifies issues. After all, it is just over 18 months since the Áras Attracta exposé.

Last week's revelations came in the wake of other revelations earlier this year about "Grace" and allegations that children and adults with intellectual disabilities, some of whom are mute, were seriously sexually assaulted at a foster home in the south east. This resulted in almost the last act of the previous Dáil being the establishment of a commission of investigation into the allegations. Five months on, the commission is yet to get up and running and there have been concerns expressed that its scope will now be too narrow.

Is there a case, in view of last week's programme, to set up a more wide-ranging commission to look at all residential centres? Surely, we need to be honest with ourselves and find out the full truth of what happened. Can the Minister or anyone be confident that more revelations will not be made in the months and years ahead?

The Bill we are debating amends the 2007 Health Act which provided for the establishment of HIQA incorporating a new and independent inspectorate and registration authority for residential services. While the 2007 Act was steered through by the former Minister, Ms Harney, the establishment of HIQA was a key element in the health reform programme initiated by Deputy Micheál Martin when he was Minister for Health.

It is all about standards and their enforcement and the need to ensure that an independent organisation with teeth was created to provide accountability.

The purpose was to ensure that the standards set would be applied consistently and on a national basis and, where necessary, action could be taken quickly and effectively to protect service users. It is fair to say HIQA has had an impact.

Early last Thursday, before the RTE investigation programme was broadcast, HIQA published its annual overview report on the regulation of designated centres for adults and children with disabilities. It pointed out that the initial inspections in 2014 led to the finding that residents living in many large congregated settings were not being adequately protected or kept safe and that institutionalised care practices, ongoing for years, had an adverse impact on the quality of life for residents. However, it is welcome that HIQA is now reporting that regulation has brought cultural change to the sector, steadily leading to improvements in the standard of care provided to residents. The report really highlights the need for further action to help support people with disabilities to live in a community environment. The report makes it clear that regulation has helped bring about steady improvements in the standard of care provided to people with disabilities, although it nonetheless highlights that further work is needed.

The recommendations made through the 2011 HSE report on congregated settings are yet to be implemented, with congregated settings or institutions with ten or more residents being replaced with supported placements in the community. It is estimated that approximately 3,000 people with a disability were living in congregated settings as of December 2014, at the time of the Áras Attracta programme's transmission. Sadly, not much has been achieved in moving people into community-based environments since. The HSE prioritised the transition of just 150 people from congregated settings in 2015 and yet it only managed to move 112 people last year, which is wholly inadequate and must be addressed. Regrettably, the Government has not made this a real priority in the programme for Government. It is unlikely to make any serious inroads as the reduction targeted is only in the region of 900, which represents just a third of the total figure. At this rate it will be 2031 before congregated settings come to an end. I urge the Minister of State to step up the campaign to bring the practice of outdated congregated settings to an end.

The Minister of State might agree that we cannot wait until 2031 for this to happen. I have praised HIQA and its achievements but I know some people feel it could be doing more for people with disabilities. In February 2015, Inclusion Ireland published The Distant Voice working paper, which analysed the HIQA inspection of 123 units providing residential services for over 700 people with disabilities across Ireland during 2014. Inclusion Ireland claimed that only 11% of residents across 50 reports were asked about communication needs, which is in stark contrast to the position in the UK, where persons with a disability are part of the inspection process. Is this something that can be provided for so we can ensure people with a disability are represented in the inspection process?

Fianna Fáil will support this Bill but if a further extension is required in 2018, there will be great disappointment and many questions will be asked. There is much we must do during this Dáil to improve the lives and opportunities of people with disabilities. That is a priority for me and my party. Before the end of the year I look forward in particular to the promised legislation for ratifying the UN convention on the rights of persons with disabilities. I welcome that the Minister of State with responsibility for the disability brief is at Cabinet, although Fianna Fáil wants to see a Department with disability inclusion specifically in the title.

Since my appointment as Fianna Fáil spokesman on disability, I have met representatives of a number of organisations working in the disability sector and all these groups have expressed their frustration at the slow pace of change in the area. They also pointed out there is a need for real political leadership to drive forward positive and inclusive reform of the disability sector in Ireland. People with disabilities must be prioritised in the upcoming budget. The Government must demonstrate its commitment to improving the lives of people living with a disability. We want an Ireland in which people with disabilities are given the resources they need to live their lives as full and equal citizens. It is our goal to realise this objective.

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