Thomas Pringle (Donegal, Independent)
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I thank the Ceann Comhairle for selecting this Topical Issue matter. I also thank the Minister of State for taking this Topical Issue matter and for letting me know she was not available to take it last week when it was selected and that we could defer it to this evening. This deferral was because the Minister of State was not available to take this matter last week and, unfortunately, no one else would be authoritative on the issue. This creates its own issues at this stage as well. It is a potential problem.

The Minister of State's work with residents and the families of residents has been exceptional. The families have faith in her and believe she wants to do what is right for their loved ones. It is clear now, however, if it was not so before, that the HSE does not have the interests of the families at heart. It has the interests of the organisation at heart and, like all bodies, saving the organisation and protecting itself are what are important. Families and residents are secondary to this. Throughout all this time, the HSE has only been concerned with containing the Brandon issue. The organisation has closed ranks at every opportunity, and this went right up to headquarters within the HSE as well. There is no way this is only a County Donegal issue. I believe the HSE at all levels nationally has questions to answer on this issue as well. Brandon and other residents have been let down by the HSE and the Department of Health.

I know the Minister of State wants to set up an independent scoping exercise of safeguarding and disability services in County Donegal. I also know the Department of Health and the HSE are opposed to this. What is the view of the Department of Children, Equality, Disability, Integration and Youth in this context? Will it support this exercise and, if so, should it have been set up and working by now? I raise these issues now because of what has been happening to families and residents in recent weeks in Ard Greine Court residential service. The HSE in County Donegal is now closing this facility and moving the residents to decongregated settings around the county. It is doing this without consultation with the families or the residents themselves. It is hard to believe that after all that has happened, the HSE will still behave in this way.

Some residents are quite elderly and Ard Greine is their home, but the HSE does not recognise this. Once again, it decides and everybody else has to accept its decisions. The brother of one resident said that, after Brandon, it was stated that everything would be person centred. Nothing has changed, however, and it is the same old, same old of the HSE covering its tracks and talking down to the families. Apparently, the HSE has said each resident will be at the centre of the decision-making process for his or her move, but unfortunately no one involved with Brandon will believe this. This is the crux of the situation. So many years down the road from what was an horrific case, and I think it was recognised by everybody how bad it was, the HSE has attempted to cover up, to try to shut this down, to move on and say there is nothing to see in this regard. This is what has been going on for so long.

I know the Minister of State is fully up to speed regarding this matter, but I am concerned now with whether the Government is up to speed on this issue. I know the Minister of State's interest lies in addressing this issue and that she wants to make it work and happen, but I wonder if the Government is also committed in this regard. This is a real problem. It will only be by having full Government commitment that we will be able to force the HSE to deal with this issue. I say this because the HSE as an organisation will not deal with it. This is sad and shows what was done to residents will continue. There is a real risk it could happen again, which is even worse. It is scarier that this potential could be there. Basically, no one involved with the Brandon case believes the HSE is doing things for the right reasons. Does the Minister of State and the Government believe the HSE is doing things for the right reasons?

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for raising this important issue for discussion.

As the Deputy will be aware, in 2018 the HSE commissioned the National Independent Review Panel, NIRP, to review the governance arrangements of a residential service for adults with a disability in County Donegal. The NIRP’s executive summary of the Brandon report was published in December 2021, which was the Thursday before Christmas. This followed a look-back review completed in 2018 and a safety assurance report undertaken in 2020. As part of the HSE response, the chief operations officer established a strategic working group, SWG, in community healthcare organisation, CHO, 1. The objective of the SWG is to develop a new vision for disability services in line with national policy and based on a social and human rights model of service provision for people. This is in keeping with the transforming lives programme, which is focused on enabling people with disabilities to achieve their full potential. The CHO 1 SWG meets regularly to progress actions and oversee progress. I am advised the CHO 1 SWG has progressed the objectives of the group through an identified set of actions and the majority of these actions are now either completed or in progress. The work under way is aimed at ensuring there is a high-quality, robust and accountable governance structure in place, that the voice of service users and their families are heard and involved in the service improvement programme, and an improved and enhanced service model is delivered with positive outcomes for residents.

Moving on, Ard Greine Court residential service, which was the key focus of the initial service improvement workstream under the SWG, has undergone significant changes in the past year, with improvements to the current service delivered, safeguarding and compliance with national standards. What is not in my script, which the Deputy is reading, is that it is important to say I have met with family members in the past six weeks. I also met with a whistleblower in the past six weeks. It is unfortunate to see that the lack of communication evident in 2018 is still there in 2023. As I previously indicated, I am currently developing a safeguarding assurance exercise to be undertaken by an independent expert, which would build on the improvements in safeguarding already under way in CHO 1.

My hope is to ensure the voices of residents and their families, as well as those working in the area, contribute to the ongoing effort to continually strengthen safeguarding policy and practice. The aim, which is the question the Deputy has asked me about the support in this context, would be to have this process up and running by the end of June. My circulated script refers to the end of the summer. I will be three months in this Department by then, having moved in on 1 March 2023. I would hope to have this in place by the end of June. That is three months, and I have always said it would be three months in the context of moving from one Department to another. I have the support of my officials, and my assistant secretary, Mr. Colm Ó Conaill, has been more than helpful in ensuring I am able to work at pace to ensure I can put an independent person, along with that expert review panel, in place.

The residential disability services are subject to registration and inspection by HIQA in accordance with the provisions of the Health Act 2007. The purpose of the regulation is to safeguard and support the delivery of person-centred care to vulnerable people of any age receiving residential care services and to ensure their health, well-being and quality of life are promoted and protected. HIQA published 33 inspection reports from January to March 2023 on disability services designated centres in the community healthcare system in counties Cavan, Donegal, Leitrim, Monaghan and Sligo. The findings of HIQA’s regulatory programme and the mechanisms put in place by the HSE may inform wider safeguarding practice, governance and policy, as appropriate. The ultimate aim is to ensure services are safe for clients, those working in the services are appropriately supported, the families are completely reassured their loved ones are getting the best possible care and attention, and all the safeguarding regulations are being adhered to.

I will revert to the Deputy.

Thomas Pringle (Donegal, Independent)
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I thank the Minister of State for what she added to the reply. The written reply leaves a lot to be desired and was obviously something that was written by departmental officials or the HSE. It bears very little relationship to reality. It states the objective of the strategic working group is to develop a new vision for disability services in line with national policy based on a social and human rights model of service provision for people. That sounds great but it is not happening. That is the sad part of it.

The reply also states that CHO 1 SWG meets on a regular basis to progress actions and oversee progress. It is not making much progress. Just consider how the families were treated just two weeks ago regarding the decongregation that is happening in Ard Greine Court. There is something wrong in the HSE if this is what it is saying is a high level and what it wants to give to us in the House. Reading this reply, anyone would think everything was rosy in the garden and it would make me wonder why I am raising this issue at all.

We know, unfortunately, what is happening on the ground. It is not being recognised. I thank the Minister of State for her interventions. I hope the review will be set up in June because that needs to happen very quickly. The families have no respect for the HSE and what it is doing, which is sad. After what has happened with Brandon, the system has not been rebuilt and that is the real problem. The review group the Minister of State is putting in place needs to work very well for Donegal and the whole country. There are major problems right up to the top of the HSE. Those have to be addressed.

Anne Rabbitte (Galway East, Fianna Fail)
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It is incumbent on me to ensure the independent expert review group that is put in place with an independent expert is not seen through a medical but rather a social care lens. The person, and his or her environment and family, should be seen in the round, and the person should be put at the centre. As we read in the Brandon report, it should not be about episodes and every outburst being viewed through a medical lens as an episode requiring a medical model, as opposed to understanding the underlying conditions an individual has.

In terms of the independent expert group, I have always said it should be about reassurance that the HSE works, HIQA does its job and people who are working in services know the proper protocols, who to reach out to if something is inappropriate and how to link in with Tusla or An Garda Síochána and go up the chain within the HSE to be able to highlight possible red flags without fearing to speak out or that they will face repercussions. That is the reassurance I want.

The Deputy is correct. Families need to be reassured that their loved ones are in a safe environment. Safeguarding legislation currently sits with the Department of Health, as I have said. It was transferred from one Department to another. Safeguarding is a priority. If it does not go at the pace that I think is required to meet the needs of those in residential, respite and day services in the disability sector, I have the support of the Minister, Deputy O'Gorman, to progress our own safeguarding legislation.