Mick Wallace (Wexford, Independent) | Oireachtas source

I welcome Deputy Clare Daly's Bill, which is a simple and common sense measure that clarifies the law in line with the recommendations made in reports and that will bring some relief to people who are fed up of having to deal with a cumbersome and bureaucratic entity that seems more interested in satisfying checklists than providing genuine care and assistance under is its mandate. The appeals officer report for 2015 makes it very clear that a combination of a lack of clarity in the legislation - and from Caranua - as regards precisely what supports are available to survivors and a certain level of inflexibility, bad communication and nonsensical waiting times for decisions coming from Caranua all mean that the emerging needs of many former residents are not being met.

The role of Caranua is to manage a scheme of support for eligible survivors that addresses their current needs and improves their well-being. Instead, we have numerous reports of survivors being misled or not informed by Caranua as to the supports to which they are entitled. People have been asked to get multiple quotations for work, along with professional evidence of their medical clinic conditions and living circumstances, only to be told that they were wasting their time. They then have to wait, sometimes for months on end, for an official decision so that they can then proceed with an appeal.

While around 5,000 applicants have had success in receiving assistance, the experience of many in the community is that the real function of Caranua is to act as an impediment in their path to avail of the assistance they were promised. The decisions of Caranua are often inconsistent and, as the appeals board has stated, sometimes illogical. In addition, there is the issue highlighted by the appeals officer, namely, the ineligibility of survivors who were not previously in receipt of a settlement to access the fund.

The appeals officer said that the circumstances of such individuals can be equally as harrowing as those of applicants who are eligible and, as he mentioned in his annual report for 2014, it can seem particularly harsh and unfair to deny, without exception, all persons who have not received awards the opportunity to benefit from the fund. Some stated in the course of their appeals that fellow survivors who had benefitted from the redress board can go on to secure further assistance by applying to Caranua, when they were denied assistance not just once but twice because of their particular circumstances. Deputy Clare Daly's Bill will address the illogical and unnecessarily punitive shortcomings of existing legislation.

The Bill also addresses the situation whereby applicants are left waiting, sometimes for months, for decisions and for notices of such decisions. Most importantly, the Bill provides for clarification of the purposes for which applicants can use the funds. This is critical because the literature builds up expectations about what is possible, which ultimately results in wasted time and stress for everyone involved.

The measures in the Bill are reasonable and based on the findings of the appeals officer reports. Many in the community of survivors would like to go much further and do away with Caranua entirely. These calls have been made publicly. Their dignity has been affronted by Caranua and emotional distress has been inflicted upon them by the manner in which the fund is being applied. They have called for Caranua to be dissolved and its functions taken over by a Government Department.

Deputy Clare Daly's Bill does not go anywhere as far as that. Rather, it provides for a number of reasonable changes to the current legislation that will mean that the work of Caranua should run more smoothly, that the fund would be used for things that are closer to the real-world practical needs of those it was set up to benefit and that much of the lost time and stress could be avoided in future. If the State is going to set up a bureaucratic entity to administer an expenses fund that is part of the redress for previous harm caused by it, is it too much to ask that it does not emulate the box-ticking maze of unclear terms and conditions, waiting times and general grinding alienation that is the hallmark of the neo-liberal mode of managerialism that successive Governments have used to destroy the notion of public services, be it social housing, education, social welfare and health services? I do not know whether the Minister has seen Ken Loach's film "I, Daniel Blake", but it is worth watching because it is a very good example of the problems bureaucracy can cause for people who are trying to access something to which they might be entitled.

Public services are supposed to be centres providing welfare, good education, health and elder care based on human need and governed by human rights. They are now often service-delivery operations with productivity targets. What can be counted and ticked off in a box is what matters. The appeals officers reports describe a situation where there is routinely a severe lack of communication and joined-up thinking, and repeated instances of a failure by those working in Caranua to consider the needs of applicants in a holistic and caring manner.

These people suffered horrifically from the tyranny of church and State when they were at their most vulnerable. Children are the most vulnerable people in the world because they are completely dependent on their carers and minders. Now, many are in their old age, the second most vulnerable stage of life, and are only looking for what is theirs and what is owed to them by the church and State, but must deal with the tyranny of numbers.

We have a terrible history in the context of care in this country, particularly mental health care. For two centuries, we had barbaric conditions in psychiatric hospitals. It was a major business. More admissions to mental institutions meant more profit. There is a correlation with what is happening in America today, where prisons have been privatised and over 2.5 million people have been incarcerated. People running prisons are campaigning for governments to incarcerate more people in order that they can make more money. It makes for a very sad situation.

In the past, all that was needed to commit someone was a priest and the word of a male family member. In the 1950s, 20,000 people were labelled as mentally ill and were locked behind bars. Thankfully, this level of coercive detention has seen a dramatic decline in the past 30 years and we have closed almost all such institutions. It is unfortunate that 70% of those in prison face mental illness challenges. One would wonder whether we are using prisons to manage people rather than actually dealing with their problems.

Today we do not have as many cell walls to restrain people but we have a mental health system that believes biochemistry is the defining factor in mental health issues. General practitioners, GPs, and psychiatrists prescribe powerful medications to people after asking them a series of questions on a checklist. They box tick and the person gets put in a box. These questions are about how the person is feeling and what his or her body is doing. There is no question about what is going on in the person's life or about his or her social situation or past. A checklist is met and a biochemical illness is diagnosed. The pharmaceutical industry says it has the answer and we must take its word as its trials are all done in-house now, with much secrecy surrounding the results. In Ireland, 250,000 people are on selective serotonin reuptake inhibitors, that is, powerful painkillers for the brain. Who needs cell walls when we have outsourced the asylum to people's minds in their own homes?

When a child or adolescent in south Wexford reports to the mental health services with an emergency situation, he or she will not be seen by anyone or receive any treatment if the child psychologist is not available. The child psychologist could be on holidays or the child might have presented out of hours. In those circumstances, no care of any kind can be given to the child until the boxes are ticked, no matter how well qualified the other people are. Sometimes these children are sent home and other times they are detained on a ward in the general hospital. When they do get assessed and are adjudged to have a mental illness, they get a drug prescription. Sometimes, if one of the ten acute care beds that are designated for children and adolescents in the south of Ireland is free, the child will be driven to Cork, which is the nearest place for those living in Wexford with such a bed. If they are judged not to have a mental illness, they are told they need psychology services, where there is a two-year waiting list. Quite plainly, the health service has no interest in talking to children and trying to help them feel they belong to this world. Instead we label them and load them up with drugs or put them on endless waiting lists when they cry for help.

Children are dependent and vulnerable. In years to come, when we look back at this current period, the biggest indictment of our time will be how we are failing the rights of children in terms of housing, basic needs, health care and mental health care. Supports are being ripped away by a succession of neo-liberal Governments and the services that exist are run by managers who barely know what care means. Care and love cannot be measured but their performance targets can be. In the age of precarious work, their heads are always on the chopping block so they have to conform.

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