Thomas Pringle (Donegal, Independent) | Oireachtas source

I am glad to see the Minister of State here and that she is responsible for this area. She seems to be responsible for everything because she seems to be the only Minister or Minster of State I see in Parliament taking anything and everything that is going. Fair play to her. If one positive comes out of this legislation, it is probably that the Minister of State is the one who is responsible for it, because she will actually make something of it. That is the weakness of it as well. We must rely on people like her to ensure this will work. The danger is that if she moves on, through a change of Government, promotion or whatever, this will fall down again. That is the problem. It is the problem with everything. Other Members have highlighted that disability matters have homes in so many different Departments. Trying to get one Department to do something is bad enough but when you have two, three or four Departments with responsibility, you may forget about it. That is the reality. Even though we bring in legislation here and this Bill is good on paper and looks good, I have serious doubts about how it will operate in reality. That is the real problem we all face. Somehow, we must face up to it and deal with it. I do not know what the solution is yet. If I get that knowledge, I will let the Minister of State know.

I am thankful for the opportunity to speak on this Bill. I understand it will amend the Health Act 2004, the Disability Act 2005 and the Health Act 2007 to transfer policy, functions and funding responsibility relating to specialist community-based disability services from the Minister for Health to the Minister for Children, Equality, Disability, Integration and Youth. The Bill will also provide for consultation in joint functions of the Ministers to provide for revised corporate governance and accountability arrangements of the HSE. Seeing how that operates will be interesting in itself. There is definitely something badly wrong with the HSE as an organisation and I do not know how that is going to be addressed. I appreciate this transfer makes sense on paper. However, I note that responsibility for the delivery of specialist community-based disability services would be retained within the Health Service Executive following the transfer. This would mean the HSE would be expected to report to two Ministers about different aspects of its functions. I am sceptical of how this will work. The HSE fails in being accountable to one Minister. What makes us think it would properly accountable to two? That is a real problem.

The Minister of State is aware of this and I will speak a wee bit more later on about our own interactions on the Brandon report and how that shows up what is wrong with the HSE. That is the crux of the problem. Unless we deal with the HSE, by kicking it up the arse or kicking it out the door and getting something else in place, then we are on a hiding to nothing from here on in. I often think if you were an alien coming down to look at Ireland, you would think it a great country if all you could see was the legislation we had. You would think this was a great place with great legislation. It says everything and does everything and it is on the box. However, if you looked at the implementation you would say this is a completely different country and ask how this could be. That is the crux of the problem.

As I said, a very recent example of this is the Brandon report, which details multiple incidents of sexual abuse that took place at Ard na Gréine in Stranorlar, County Donegal. The National Independent Review Panel was commissioned to carry out the report, which was then submitted to the HSE in 2020. When the Minister of State asked for a copy of this report in 2020, she was told this was not possible and that she would get it in due course.

When the HSE provided the Minister of State with a list of recommendations stemming from the Brandon report in April 2021, to ensure the recommendations were appropriate, she again asked for a copy of the report and was again refused. Following this, she continued to request a copy of the report. However, the HSE was not forthcoming and at one point thought it would be enough just to show the report to her on a screen, as far as I know. The HSE did the same thing to me in respect of a different report that had no bearing on the Brandon report. I will take this opportunity to commend the Minister of State, as I am certain this report would not have been given to her Department if it were not for her persistence. That is a tribute to her and the work she did to make sure it happened, which is vitally important. This issue will go on for a while yet and will be important to how the HSE does its business.

I hope this persistence continues; I know that with the Minister of State in place it will. Despite what we have been told, the families do want this report published. That is vitally important. The HSE is saying they do not, but the families do. I know that for a fact because I have talked to many of these families regarding this. I also know that some families, whose loved ones were involved in the Brandon report, have not been even contacted by the HSE, despite what it says. This is part of the weaknesses. We have had to rely on the HSE to do much of this, including contacting the families, telling the truth and so on. We are relying on the HSE to do the right thing but it has not. That is shocking, even at this stage, when things have been going on for so long.

It leads us to ask how we will know the HSE will do the right thing in future. The instance of the Brandon report is very important, and there may be less important matters, but it shows how difficult it is for us in this House to ensure the HSE will be accountable in future? The fact that the HSE refused outright to report to a Minister of State is incredibly concerning. It is supposedly a State agency, yet this shows it is not truly answerable to the Minister of State. It makes one wonder who is really calling the shots and why the HSE has been given the power to do this. The HSE has probably gained this power of pottering on and doing its own thing over the years, but it seems it is not accountable to anybody and can do what it wants. That is very concerning. It begs the question how it will be possible for the HSE to be accountable to two Ministers, when it so obviously and openly fails to be accountable to one. This is something that seriously needs to be looked at. These agencies need to be accountable to the Minister who oversees them, otherwise what is the point of that Minister? What is the point of elected representatives, such as us, when our institutions are not even answerable to us? This is a serious matter and it should not be overlooked or brushed under the carpet. I would like to see this investigated further because it is very necessary.

I am wary of Bills such as this that provide for certain functions to be covered by two Departments. While the technical aspect may appear to be an effective distribution of regulation and oversight, I have concerns about how this will be carried out in practice. As I said earlier, in this country, whatever hope you have with one Department, it is very limited with two, non-existent with three and good luck to you with four because it is just a waste of time. That indicates something is badly wrong with our system of government and about accountability to the House. As I said, I do not know exactly how we can resolve that, but a good step would be to make people accountable, whether they like it or not. We are accountable every five years and we can lose our jobs straightaway, but what head of the HSE, or person in one of its sections, or in Departments, would lose their jobs for blatantly doing things wrong, for punishing people, not dealing with families in a fair and safe manner, not informing families about how their loved ones are being treated and so on? These are very serious issues that need to be dealt with and unless this legislation can deal with them somewhere along the line we will be at a loss, despite the good words of the Minister of State.

Like other Deputies who have spoken on this Bill, I would like further clarity on the practical issues that may arise from this, particularly the accountability arrangements of the HSE and how the budget will be set. I am cautious in my support of this Bill. Although I believe it makes sense on paper, I wonder how this may be put into practice. I would like to see my concerns taken on board and addressed, as I believe there have been real flaws in how inter-departmental issues have been addressed in the past. This needs to change in order to properly facilitate the future transitioning of powers from one Minister to another. I would also like to see the accountability issues between the HSE and Ministers addressed. I hope this will be addressed by the Minister of State and that these issues may be discussed on Committee Stage and as the Bill progresses.

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