Mick Wallace (Wexford, Independent)
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During the ongoing controversy around this case, at least one manager with no experience and no professional qualifications relating to child abuse was appointed to the area. There was transparency in respect of the appointments process and the job was not advertised. It was an in-house promotion. That is a contributory factor in the case.

The dysfunctionality of the HSE in general is a contributory factor. I do not think the Minister of State, Deputy Kathleen Lynch, would deny that. It is symptomatic of a broader malaise within the organisation. Someone must be held to account. A few investigations were carried out into this matter but they were either in-house or involved former members of the HSE who had gone into the private sector. The abuse was investigated in the 1990s but the matter was mishandled and the girl concerned ended up spending an extra 12 years in the place to which this matter refers. I wonder whether someone will be held to account for what happened.

The incestuous nature of how the HSE works reminds me of some other organisations in the country. The contribution of the director general, Tony O'Brien, to the PAC today is worrying. He confirmed that Ann remains in full-time, seven-day residential care with a voluntary provider and makes regular visits home to her mother. It appears he is being economical with the truth. He answered a question that was not asked in order to mislead in respect of the situation somewhat. Ann was making visits on and off to her home right up to the age of 15-----

Olivia Mitchell (Dublin South, Fine Gael)
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I must call on Deputy Clare Daly to make her contribution.

Mick Wallace (Wexford, Independent)
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-----but that is not clear from the director general's statement today.

Clare Daly (Dublin North, United Left)
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We do not have time to go into the range of issues surrounding this case but it is a fact that more than one vulnerable adult was left in a situation where they were appallingly abused and exploited because of the mishandling of the situation by the HSE. I am very pleased that the Ministers have decided to have a commission of investigation. From the very beginning we believed that two things were necessary: first, that those responsible for this injustice would be held to account; and, second, that the issues would be publicly and independently aired. That is an absolute necessity given the litany of inquiries which have taken place on the issue, which did not deliver anything. Deputy Wallace is correct. Rather than trying to address matters, the position adopted by the HSE, which is still in evidence today, was to shore up, lawyer-up and cover up and be incredibly economical with the truth. That is what it smacks of to me.

Grace remaining in the foster home for 13 years after the initial allegations of abuse were investigated is horrifically unique. It is a fact that the information was in the hands of the HSE. In 1996 a decision was made by the social workers on the ground to remove that young woman. That is a fact which is backed up. We know that subsequently the foster father contacted the then Minister for Health, Deputy Noonan, and petitioned to have what he called his "beloved daughter" kept with the family. We do not know what happened after that. The Minister of State, Deputy Kathleen Lynch, informed us that the Minister for Health at that time, Deputy Noonan, and Minister of State, were not in any way responsible for that situation but the fact is that a documented case conference decision to remove that young woman from the foster home before August was subsequently reversed in October 1996 and the young woman, Grace, remained there up until 2009. People need to know who made that decision and who will pay the price for it.

Kathleen Lynch (Cork North Central, Labour)
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I know we are very restricted when it comes to the time allocated for the Topical Issue debate but I genuinely thank the two Deputies opposite for raising the issue as it is something that has preoccupied me for quite a considerable time.

I welcome the opportunity to address the allegations of abuse in a foster home in the south east which are a matter of grave concern to me and to the Government. Every person who uses disability services is entitled to expect and receive care of the highest standard and to live in dignity and safety. Our aim must always be to ensure that people maximise their potential and live rich and fulfilling lives. They and their families trust us to care for them with kindness, compassion and respect. While it is clear that real issues have been raised about the protection of vulnerable people in the south east, it has also been very difficult to establish the facts with certainty. The matters relating to the south east were raised by the Committee of Public Accounts in 2015 in the context of the procurement process for reports into these matters and the extended period of time during which it has not been possible to publish them.

In response to the concerns raised and the ongoing delay in publishing reports commissioned by the HSE, I appointed Conor Dignam, SC, to undertake a review into these matters, taking account of the ongoing Garda investigation. This review remains in train and Mr. Dignam will report back at the end of April. I have received assurances from the HSE that the person at the centre of the Conal Devine inquiry, who we are now calling Grace, was removed from the foster family in 2009. I understand that Grace is in full-time residential care with a voluntary service provider. Matters are complicated by the fact that there is an ongoing Garda investigation and the HSE has been precluded from publishing the Devine and Resilience Ireland reports into the matter pending completion of that investigation. While this may be frustrating, it is important that we do not prejudge the outcome. Instead, we must remain focused on the questions that, in my opinion, remain unanswered.

In view of the seriousness of the issues raised and the need to establish the facts, the Government has today approved the establishment of a statutory commission of investigation. This is subject to the agreement of terms of reference and the approval of the Oireachtas. I am in no doubt that the work undertaken by Mr. Dignam, SC, will make a key contribution to informing the drafting of the terms of reference for a commission of investigation. Additional resources have been allocated to Mr. Dignam to allow him to accelerate the completion of his report. Both the Minister, Deputy Varadkar, and I have requested copies of the Devine report and the Resilience Ireland report from the HSE under section 40C of the Health Act 2004. This is an important development as we believe direct access to these reports will assist our understanding of the relevant facts surrounding these disturbing allegations. It will also assist in bringing forward detailed proposals for the establishment of the commission of investigation. I hope that early in the life of the new Dáil, we will approve the establishment of the statutory commission of investigation and that it will also be approved by our colleagues in the Seanad. I again thank Deputies Clare Daly and Mick Wallace.

Mick Wallace (Wexford, Independent)
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As the Minister of State knows, Deputy Clare Daly and I contacted her almost a year ago about this and we did not jump all over it. It needs to be acknowledged that there is something seriously amiss with how the HSE operates. This is only one issue. We have been told other things over a period that makes us very concerned about the behaviour of certain members of the HSE in the south-east region. There seems to be a culture of dragging matters out, delaying, issuing denials and then bringing in the legal people. Those to whom I refer seemed to be concerned with minimising liability and a damage limitation process. The ethos is poor and it is not good enough. Something has to change.

Clare Daly (Dublin North, United Left)
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That is the key point. One of the whistleblowers at the centre of this case has made the point that, sadly, it is not the only such case. In his opinion, it represents dozens of others in the same region over a 20 to 30 year time span. It is fair to say there is a systemic problem in the HSE. It is very much the old attitude that when the church or State is threatened, the response is to say nothing, admit nothing, call in the lawyers and see what happens. That mentality has traditionally done untold damage to citizens and vulnerable people in Ireland. It is not good enough for service users. It costs the State a huge amount of money later on, not only in the emotional damage to citizens but in the financial cost to the taxpayer. The modus operandiappears to be that when a mistake is made, even if it is innocent, it is not investigated properly. The response is that the HSE investigates itself and the people who are doing the investigating are former HSE staff under new guises of Tusla or one of the other independent companies that operate in this area. It is really the HSE investigating itself. That is why we have had the problem and that is why people have remained there. Some people who are currently employed by the HSE are responsible for that and have to be dealt with. I hope we all return to address this matter in the next Dáil because it is a matter of urgency. I am glad the commission has been decided upon but we need to look at its terms of reference.

Kathleen Lynch (Cork North Central, Labour)
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I will conclude by thanking Deputies Clare Daly and Mick Wallace because they were involved and it is important that they did not use the issue to ingratiate themselves. It should be acknowledged that they pursued the issue in a very professional and dogged way. As it is such a delicate and sensitive area, whistleblowers need to feel as if they have the space and security to bring serious concerns, firstly, to their employers and, secondly, to whomever they think can pursue the issue. The terms of reference of the commission of investigation will be crucial. As far as I can see - I may be wrong - Conor Dignam's report and the two reports that have already been concluded should feed into the terms of reference. It is essential that there is a political input because, as politicians, we are responsible to every citizen in the country, not only to those who go out and elect us. We have equal responsibility to those who do not. I hope what we are doing will allow us to have a very clear overview of what happened, how and why it happened and, after that, to establish what process to put in place to ensure that people are never again left in this vulnerable position.