Finian McGrath (Dublin North Central, Independent)
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I am grateful to the Ceann Comhairle for the opportunity to speak on this very sad case dealing with Mr. Peter McKenna and the Hynes report. There are no winners in this report and I offer my deepest sympathy to Mr. McKenna's family. As a parent of a daughter with Down's syndrome I have a special understanding of the pain, trauma, loss and hurt. I also believe that St. Michael's House should have the opportunity of putting its side of the story on the record and recent events have clearly shown that a grave injustice was done to the caring staff of that institution and their image with the public. I intend to set the record clear tonight.

Founded in 1955, St. Michael's House is a voluntary community based facility providing services to 1,400 children and adults with a learning disability and their families. It is one of Ireland's largest providers of services for people with learning disabilities.

I must also declare an interest as my family are users of the St. Michael's House service and as far as I am concerned it is top class, professional and caring. It was always in favour of a full investigation into Mr. McKenna's case but strongly believes that the second Hynes report is flawed as it leaves out several outstanding issues. I am inclined to agree with St. Michael's House on some core and fundamental points, as follows.

The factual evidence provided to Mr. Hynes by St. Michael's House is dealt with by way of an addendum to the final report. The final report contains criticisms of St. Michael's House that are withdrawn in the addendum. The presentation of a final report with an addendum is confusing, contradictory and unfair.

Mr. Hynes did not interview the staff involved in the care of Mr. McKenna. He did not seek expert medical opinion in considering the course of Alzheimer's disease in people with Down's syndrome. In its conclusion, the report ignores the fact that the proposal to transfer Mr. McKenna to Leas Cross was endorsed by an independent medical expert appointed by the High Court who visited that nursing home and deemed it suitable for Mr. McKenna's needs. Neither does the report highlight the fact that, due to his wardship, the decision to transfer Mr. McKenna was a matter for the President of the High Court who ordered the transfer "immediately and as a matter of urgency".

Mr. Hynes suggests that the main criterion used by St. Michael's House in recommending Leas Cross was simply its registration with the NAHB. This is not the case and St. Michael's House fully agrees with the HSE it would be flawed thinking to expect that because a nursing home is registered it is suitable for all patients.

St. Michael's House used several criteria in recommending Leas Cross, including two years experience with the facility for respite and long-term care, one year's experience of another client with Down's syndrome and Alzheimer's disease, the nursing home matron's 11 years experience in working with people with learning disabilities, the regular monitoring programme St. Michael's House has in place and the fact the Mater and Beaumont hospitals regularly referred clients to Leas Cross.

Mr. Hynes ignores the fact that Leas Cross nursing home in 2000, with 35 residents, was very different from the Leas Cross he visited in 2005, which had 110 beds. He failed to investigate the circumstances of a cancelled medical appointment with Beaumont Hospital or seek any information from that institution. St. Michael's House believes the second Hynes report does no service to the McKenna family or to St. Michael's House.

St. Michael's House will co-operate fully with the HSE in any fair and transparent process to assist the McKenna family in resolving any outstanding concerns. I welcome the fact that St. Michael's House welcomes the HSE's executive summary which acknowledges the shortcomings of the Hynes report — page 3, item 5, page 4, item 9 and page 5, item 9. St. Michael's House continues to be willing to work constructively with the McKenna family and the HSE to address and respond to the family's concerns.

The public should be told the facts about people with Down's syndrome infections and Alzheimer's dementia and the real world situation involved in dealing with the advanced stages. I am dissatisfied overall with the Hynes report as I believe a major part of the story was left out and hence a caring organisation like St. Michael's House has suffered in the public mind. It deserves justice and fair play, just like Mr. McKenna. It also deserves that the truth should be told and hence my attempt to set the record straight in the House. I hope my contribution will assist St. Michael's House and bring the service providers and families closer together.

Seán Power (Kildare South, Fianna Fail)
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I am taking the matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. I thank Deputy Finian McGrath for raising this sensitive matter and giving me the opportunity to outline the position regarding it. I know all Members of the House would like to extend their sympathy to the McKenna family on the death of their brother, Peter. It has been a very difficult time for the family.

Following representations from the Department of Health and Children in October 2001, the Eastern Regional Health Authority launched an independent investigation into matters relating to the care and subsequent death of Mr. Peter McKenna in October 2000 in Leas Cross nursing home. Mr. McKenna had been a client of St. Michael's House, a service for people with intellectual disabilities, and had been transferred to Leas Cross nursing home shortly before he died.

In August 2003 following High Court approval for the release of the deceased's medical records, as he was a ward of court, the Eastern Regional Health Authority initiated an independent review by Mr. Martin Hynes of the events leading to his death at Leas Cross. An initial draft report of Mr. Hynes's findings was presented in October 2003. It was then felt the terms of reference required extension, in particular to allow the views and experiences of the family to be taken into account.

On 23 September this year a copy of the final report was forwarded to the relevant parties. Each party was invited to make comments on the final version of the report within 21 days. The report by the independent consultant engaged by the Health Service Executive was made available to the family by the HSE on Wednesday last, 9 November 2005. The report is now available on request from the HSE.

The report contains an executive summary with overall recommendations in the following areas: advocacy on behalf of the family in respect of any remaining unanswered questions, an integrated complaints procedure, referrals to alternative care, terms of reference for service reviews, written handover procedures, nursing home inspection procedure, internal complaints and concerns for staff and a code of governance for both State and agency provided services.

Progress has already been made by the HSE in implementing some of the actions indicated by the report's recommendations. The HSE will now be proceeding to implement the recommendations in full as soon as possible. The HSE acknowledges in the report that some unanswered questions may remain for Mr. McKenna's family. It has offered to continue to engage with the McKenna family in this regard and to facilitate a meeting with St. Michael's House if the family so wishes.

I would like to express my confidence that the lessons learned from this investigation will be used positively in the future by all parties to protect the interests and quality of services for persons in receipt of care.