Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank Deputy Pringle for his correspondence with me today in respect of this matter. I know he will tread carefully as he deals with what is obviously a sensitive issue.

Thomas Pringle (Donegal, Independent)
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I thank the Ceann Comhairle. I hope to deal with this issue in a sensitive way. I wish to discuss the Brandon report. This is something I have been raising with the HSE for some time. I had hoped it could be dealt with sensitively, delicately, privately and professionally. Unfortunately, this has not been the case and I feel I have been left with no choice but to raise this publicly.

The Brandon report contains an investigation into multiple incidents of sexual abuse that took place at Ard na Gréine disability residential home in Stranorlar, County Donegal, and details poor management at this facility. Initially, the HSE in Donegal conducted an internal report into the matter. At the same time, I had discussed this issue with the previous Minister of State, Finian McGrath, who requested a separate report from the HSE in Dublin. I am very glad I did this. It is clear that the HSE management in Donegal could not be trusted. It seems they attempted a cover-up, due to the fact that the two reports did not match up. Following this, the matter was referred on to an independent body, which drafted the Brandon report. The report was then passed on to the HSE, which has had the report since February 2020 and has chosen to take absolutely no action on it.

A whistleblower first raised this issue in 2008 and since then has been in touch with the HSE, HIQA and the Garda in relation to it. This person had great faith in whistleblower procedures and in the system but the system has let them down because I am standing here 13 years later, having exhausted all possible avenues, and still nothing has been done. This fact is incredibly concerning. I was first approached by this whistleblower in October 2016. I was appalled to hear of the shocking incidents that had taken place in this home and I was even more appalled to hear that no action had been taken on this. The whistleblower informed me of the sexual assaults of up to 19 different residents.

When HSE management was made aware of this, it isolated the alleged offender and following this the incidents stopped. The alleged offender was then inexplicably returned back among fellow residents and the abuse began again.

To my knowledge, this report has gone to the highest level in the HSE. Those at the highest level in the HSE have known about this for over a decade and they have decided not only just to sit on it, but to make an effort to cover it up. I would call on the Minister of State to find out who exactly in the HSE is aware of this report and whether this has gone to the board of the HSE.

Although these incidents took place a while ago, the cover-up is still ongoing. Not only is it completely outrageous that this has been allowed to happen, but how can we expect future whistleblowers to feel supported, protected and listened to when disclosing possible wrongdoings if this is not being acted on? How can we expect people to trust the system and trust these institutions if they are all choosing to ignore such astonishing wrongdoings?

I call on the Minister of State to address this with the upmost urgency. I call on her to read the Brandon report and investigate why action has not been taken on this issue. I call on the Minister of State to put in place procedures to ensure this does not happen again, which is most important. We must do this in order to protect the integrity of institutions and procedures in this country, and most importantly, we owe it to the families of all who have been affected. These are families that have been left in the dark and have had no acknowledgement of the terrible wrongdoings that have occurred at Ard na Gréine. These families need and deserve to see the full report and people need to be reassured that something like this can never happen again.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Pringle for raising this issue, and most importantly, for bringing these matters to the attention of the HSE in 2016 on foot of concerns raised with him by a whistleblower. These concerns relate to the care and safeguarding of vulnerable service users in a HSE residential service for adults with a disability located within community healthcare organisation, CHO, 1, which comprises the counties of Donegal, Sligo, Leitrim, Cavan and Monaghan.

As the Minister of State with responsibility for disability, I stand here simply shocked at what I have learned has occurred, some of which the Deputy has also detailed. In addressing such a sensitive issue, it is important that I am as open and transparent as I can be, while also protecting the identities of vulnerable people involved. I am mindful that I do not provide further detail which would otherwise identify the location and service users concerned. In addition, it is important to note that these matters are also the subject of an ongoing Garda investigation.

In terms of a timeline of events, in December 2016, in light of concerns raised by Deputy Pringle, CHO 1 commissioned a look-back review. The purpose of the review was to investigate these concerns and a serious incident management team was established in CHO 1, consisting of the head of social care, the general manager and the disability services manager. In November 2018, the look-back review report was accepted by the HSE. It found that there were serious safeguarding concerns impacting service users in the residential service between 2003 and 2011. This resulted in open disclosure workshops being held for the staff involved in making disclosures arising out of findings in the look-back review and open disclosure meetings with the families of those affected with living relatives during November 2018.

In December 2018, in light of the findings of the look-back review, the HSE national director for quality assurance and verification commissioned the national independent review panel, NIRP, to carry out the Brandon report. A key remit of the NIRP is to seek to determine what the relevant services in the case might have done differently that could have prevented significant harm or improved the quality of life of the persons concerned. Although the NIRP is part of the HSE, it is independent of all HSE operations at both national and community level. It utilises the HSE's incident management framework to examine circumstances related to people who use community health and social care services where there are major concerns about how the services involved managed the care of an individual or group of individuals.

In August 2020, the Brandon report was submitted to the HSE. In mid-October 2020, Deputy Pringle approached me about the report. In early December 2020, I held a video call with the HSE to discuss the concerns raised with me by Deputy Pringle and sought a copy of the report. The HSE informed me at that point that a number of internal processes associated with the findings of the report were still in train and that this was not possible at that time but would be done in due course. In April 2021, in a meeting with the HSE, I was provided with a list of five recommendations stemming from the Brandon report. To ensure the recommendations were commensurate with the findings of the report, I once again requested a copy of it. Over recent weeks, both the Department and I have written to the HSE to request a copy of the report but it was not forthcoming. Earlier this week, on Tuesday, following correspondence with the HSE CEO, a redacted version of the report was finally shared with me for viewing on a screen. I understand that this process was similar to that provided to the board of the HSE, which recently also had an opportunity to view the report on a screen.

Today, I wrote to the chair of the HSE board once again seeking a physical copy of the report. From what I read on Tuesday, I found the report to be stark. The scale of the abuse detailed and the seeming breakdown of policies and procedures at the site were both appalling and devastating. The HSE has assured me that there is no ongoing risk to service users and that national governance and accountability structures to oversee implementation of the recommendations arising from the report are in place. My overarching concern is a question over whether the current system is safe and appropriate, not just in the CHO, but more broadly across all the health and social care systems, and that those who have been victims and their families are being supported.

To paraphrase from the letter I sent to the chair of the HSE board earlier today, and as the Deputy has said himself, I remain extremely concerned with the length of time that it has taken the HSE to reach a conclusion regarding the examination of these serious and significant matters, including the process of concluding the NIRP report. Therefore, I am again seeking definite confirmation of the timeline for publication of the report's findings and recommendations, as well as the process in place for engagement with the service users and families affected by these matters and the supports that have been put in place for these individuals.

Thomas Pringle (Donegal, Independent)
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I thank the Minister of State for her frank and honest response. It is quite stark that a Minister of State has to come into the House and make a speech like that in response to this issue. This should never have got to this stage and it should have been dealt with long before now. It is a serious problem when the HSE behaves like this towards a Government. We all want this to be dealt with and resolved and for the families to be protected.

It is also vitally important that a future whistleblower can feel confident that he or she can come forward and have his or her concerns listened to. I thank the Minister of State. I hope the HSE is listening to this and that it will respond now because this has gone on for too long and it cannot be allowed to continue. It is mind-boggling that the Government of the day cannot get answers from the HSE on this and cannot get a resolution to it. That is shocking and maybe it signals that there is something more wrong in an arm of the State. I know the HSE has some semblance of independence but there has to be something wrong when it will not respond in a proper and timely way. There are also other organs of the State that have questions to answer around how this was dealt with and that all has to be examined.

I want to pay tribute to the whistleblower, who has paddled their own canoe on this for years and has tried to raise it solely from the point of view of trying to improve a service and benefit the service users. That has to be commended and I would like to pay tribute to the whistleblower for that because it is important. I thank the Minister of State for her frank response. I know this will probably keep going because we will have to try to get answers from the HSE. I hope the HSE is listening to this debate and that it will come forward because that is the right, honest and decent thing to do.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for his persistence on this matter. I also acknowledge the role of the whistleblower.

I confirm to the House that I have been given an assurance by the HSE that there are new policies and processes in place in CHO 1 to manage safeguarding concerns, including in the residential service that was the subject of the Brandon report. The independent review carried out by the national independent review panel is critical and I am keen to see the learnings from the report made public and acted upon. It is also important to outline to the House that, taking account of the HSE board's governance and oversight responsibilities, I have sought, by way of letter to the chair of the HSE board earlier today, to provide the Department of Health with its consideration as to the robustness of the fitness for purpose of the HSE services on critical incident reporting; incident management processes; safeguarding systems and process; and the HSE's oversight of safeguarding systems for services provided in sections 38 and 39 organisations, including arrangements in place through service level agreements.

In addition, I have, as a matter of urgency, requested that the HSE, taking account of the HIQA national standards on safeguarding, conducts a review and audit of the current implementation of the safeguarding standards. As a Minister of State, I need the reassurance that standards on safeguarding are being met right across the country. The independent review carried out by the national independent review panel is critical and I am keen to see the learnings from the report made public and acted upon so that we can better inform how we care, support and safeguard our most vulnerable service users in the future. For any of the affected families that are watching these proceedings, I want to send my assurances that I will not stop working until the report is published.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank the Minister of State and Deputy Pringle for raising this matter. The Minister of State talked about the parents who may be watching these proceedings. Any members of the public watching these proceedings will wonder if they live in a democracy or an autocracy when a State agency can deliberately and protractedly frustrate the efforts of a Minister of State to get information about a fundamentally serious matter that would cause anyone with any humanity to respond with alacrity. I thank everybody in the Chamber who is involved in this matter.