Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank the Ceann Comhairle for selecting this Topical Issue matter. If memory serves me correctly, this is our fourth time to have a Topical Issue debate on this and it is normally on a Thursday night and it is normally No. 4. In saying that, I thank Deputy Pringle for raising this important issue for discussion and his continued work and advocacy on such issues in Donegal. I welcome the report by the chief inspector of social services in HIQA into the governance and safeguarding in HSE-designated centres for people with disabilities in Donegal. I welcome the comprehensive nature of the report. It provides clear, practical indications of areas for improvement.

I read the Brandon report which was not made available to the general public. I am still calling on the HSE to make it available. What I have seen in numerous reports that have been published is mirrored in some of what is in the Brandon report. The overview report is the outcome of a regular programme of unannounced inspections by the chief inspector in County Donegal. Eighteen centres were visited in January, bringing the total number of centres inspected in the period from September 2021 to January 2022 to 27. All 27 centres are operated by the HSE.

The chief inspector's regulatory programme followed an escalation of inspectors' concerns about the HSE's governance and oversight of designated centres in Donegal. The purpose of the programme was to assess the HSE's compliance with specific regulations under the Health Act 2007. It is important to recognise that the report found that most residents lived in pleasant comfortable environments and that the centres were managed by experienced and knowledgeable persons in charge. It is also important to recognise that when I travelled to Donegal last October and met family members, they were more than complimentary of the front-line staff. They asked me to acknowledge this at all times, as the Deputy has done this evening. However, the inspections found there was poor oversight arrangements in place in the HSE in Donegal. I wish I could say I was surprised by this but unfortunately some of these issues mirror those outlined in the Brandon report and other HIQA reports from the county.

While substantially compliant with one of the three regulations inspected, the HSE, as service provider, failed to comply with two of the regulations, as has been reported to the Minister for Health. We both received a letter late last year from the CEO of HIQA detailing the agency's serious concerns regarding safeguarding in Donegal. The concerns raised in the letter are echoed in most of the recent HIQA reports. This is a concern for me. Ultimately I, as the Minister of State, need to be assured that services are operating to the highest standards for service users and that families can be reassured their loved ones are being cared for appropriately and their trust in the health service is not damaged.

I took particular note that HIQA states its inspectors found the supervision and governance of centres by middle management and senior management was poor. It is clear from the HIQA report that the HSE can be too reactive to issues instead of being proactive. It does not appear to be a CHO-wide deficit as HIQA notes that in Sligo similar incidents do not occur. It is quite clear that safeguarding arrangements need to be strengthened to ensure any issues that arise are identified, escalated and responded to quickly.

A compliance plan has been submitted to HIQA by the HSE outlining plans to address the governance gaps identified by the chief inspector and improve overall safety. I know HIQA's chief inspector has commenced an inspection programme of individual centres that will take place over the course of 2022 to verify the implementation by the HSE improvement plan.

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