Keira Keogh (Mayo, Fine Gael)

This case goes to the very heart of trust in our public institutions. It fills me with a deep sense of sorrow but even more than that a deeper sense of responsibility to speak here on the final report of the Farrelly commission. Grace's case, or story we might better call it, casts a dark shadow over how we cared for one of our most vulnerable citizens. She is at the centre of the deeply troubling and unsettling report. Grace, who is now 40, was at the time just a young girl with profound intellectual disabilities who was non-speaking. What happened to her is not simply an institutional failure; it is a failure of humanity.

Grace's story was as a result of systemic failure that spanned decades. It is a story of neglect that was hiding in plain sight. The commission, as we know, was tasked with examining the care that was provided in a State-funded placement where despite multiple warnings and significant safeguarding concerns, Grace was left in a placement where allegations of sexual abuse had previously emerged. The report laid out a pattern of delay, deflection and denial. It also unmasks a system that failed to act, failed to protect and failed to listen. Years passed where critical information was buried in bureaucracy. Professionals involved in this case were constrained by poor communication and what appears to have been a worrying culture of risk aversion rather than child-centred action. We have to call this what it is, a profound and shameful failure to protect a young vulnerable girl.

It is an unpleasant thought that in 21st century Ireland, a vulnerable person in State care who was placed there for her protection could be left in a place where serious risks had already been documented. We have to ask: where was the joined-up thinking? Where was the accountability? More importantly, where was the basic human compassion? I understand that the agency has made a series of apologies, two to Grace and one to Grace's mother. In the first apology to Grace it cites the various failures she experienced: inadequate monitoring and oversight of her care; absence of the necessary liaison between those responsible for her placement in the foster home; inadequate action in a timely manner to remove her from her foster home after significant concerns had been raised; and an absence of the necessary protocols and arrangements to support the placement of vulnerable children, and children and adults with a disability in foster families.

It also apologised to Grace's mother for the failings in the care provided to her daughter while placed with a foster family for 20 years up to, remarkably, 2009. I welcome those apologies, but Grace was failed, not in one isolated incident but repeatedly. It is troubling to think that the very people who failed her were the ones who had a legal, moral and ethical duty to protect her. We owe Grace and all the current and future vulnerable children a radically reformed system that places dignity, safety and accountability at its core.

The Minister, Deputy Foley, was right to acknowledge that the situation is very dark and distressing. However, it is not enough to acknowledge it; we must act. It is not enough to say we regret and it is not enough to say this must not happen again. Grace, who is at the centre of this report, deserved dignity, safety and care but she did not receive any of these. We must act and we must do so with urgency and compassion, recognising that Grace's experience must never be repeated.

I thank the commission for its final substantive report and I pay particular tribute to those who stepped forward to make protected disclosures related to the handling of Grace's case and also to the whistleblowers and people who did speak up about Grace. Their courage and persistence were instrumental in her finally being moved out of the foster home where she had been for 20 years. It is never popular or never easy to challenge wrong as an organisation. It often comes with personal struggle to those who reach out, but it is brave and the right thing to do.

I believe we must go further than that in every setting, be that schools, care settings, hospitals, playgrounds and even WhatsApp groups and chats in the bar. We must constantly challenge our peers and colleagues when we are uncomfortable with what is being said or what is being done, especially when it comes to vulnerable children and adults. We must have conversations even if it is just a response to a behaviour we have seen or an interaction that we are just not sure about - just something that makes us feel a little bit uncomfortable.

It is important to say that since Grace's circumstances came to light, significant changes have been made to help safeguard against circumstances like this ever occurring again. However, shortcomings identified highlight the importance of being ever-vigilant and continually enhancing our approach to safeguarding of all people in society. An expert-driven, non-statutory safeguarding exercise is now planned to identify learnings from the commission's findings to inform present-day safeguarding policies and practices. This is welcome and urgent.

The programme for Government also sets out a commitment to advancing the right and improving the lives of people with disabilities. We will prioritise the publication of and fund a new disability strategy setting out a vision to 2030. We intend to adopt a whole-of-government approach which is made clear in the appointment of the Minister of State, Deputy Naughton. We must implement the United Nations Convention on the Rights of Persons with Disabilities and the optional protocol to the convention. There will also be a national implementation and monitoring committee with enhanced political oversight to ensure delivery of the strategy.

As Chair of the Oireachtas Committee on Children and Equality, a member of the disability committee and someone who worked for 19 years as a behaviour consultant with children just like Grace, I feel this case deeply and professionally. I have seen at first hand what happens when a child is described as non-speaking. I will not say non-verbal because these children can often communicate very well through their gestures, sounds, body language and actions. Too often behaviour can be described as challenging without the message that children are trying to communicate being picked up on.

I like to think of one of the superstars whom I had the privilege to work with.

He might have been described as non-verbal and non-speaking, but his story changed because although he was unable to sit still, speak with his voice or complete tasks like inset puzzles, he received lots of therapy and support from his parents. We discovered he could type. After that, we realised the boy did not have any cognitive difficulties. In fact, he knew all about space and even Donald Trump; I do not know whether that was a good thing. We also learned that he felt and understood things immensely. This boy would not have been able to communicate his ideas 20 years ago. Those were the days before augmentative and alternative communication, AAC, devices.

The wonders of modern technology, meaning non-speaking children have access to AAC, means that the future is bright for children like Grace, who was unable to give a submission to the report. She would be able to advocate for herself and tell her carers when she needed to use the bathroom, wanted to listen to music or had suffered harm by another. Let us be honest. No child should need to use their voice or a device to explain how they have been failed. Grace was failed repeatedly by the very people and institutions that were supposed to protect her.

I have also seen the effects of systems that are too slow or overburdened, but none of what I have seen compares to what Grace has endured. Grace was failed by those who did not listen to her in whatever way she was communicating and did not advocate for her. The circumstances of her case were truly unacceptable and rightly caused great concern when they came to public attention. I am very mindful, however, that the circumstances involved extended to the 1980s 1990s and 2000s and there has been a marked change in the way we as a country operate in respect of child safeguarding, in the way vulnerable children are looked after when in the care of the State and also the manner in which vulnerable adults with disabilities are cared for in the range of services available to them.

We have seen significant steps taken from the development of foster care standards to the creation of the Ombudsman for Children Office and HIQA, the establishment of Tusla and the commencement of the Children First Act 2015. A number of advances in safeguarding have also been developed in the adult safeguarding area, including the establishment of HIQA, which inspects residential services and centre-based respite services., the development of a HSE adult safeguarding policy in 2014, and the establishment of a HSE national safeguarding office in 2015 and regional safeguarding protection teams. The HSE published an independent review of its safeguarding policy and procedures in 2024, which led to the appointment of a HSE chief social worker for the first time.

We have done a lot more but I look forward to working with my colleagues on the disability matters committee to ensure people with disabilities do not fall through the cracks. We need to close the gaps between agencies and this requires a whole-of-government approach. We must be robust in ensuring protections for our most vulnerable. We must not allow the Farrelly commission report to become just another document that collects dust. The report must be a catalyst for change and for a glaring light shining down on all of the services we have for people with disabilities, transparency and lasting change.

We must continue to challenge our biases when we meet children and adults with perceived profound difficulties who are non-speaking. We must not presume that they are not able to advocate for themselves. We must never again allow silence or inaction. We must make this a turning point that signals to every vulnerable person in the country that they will be heard and protected.

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