Keith Swanick (Fianna Fail) | Oireachtas source

I welcome the Minister of State to the House. Along with my party, I will be supporting the Bill. I am disappointed that it is necessary and that there are still many residential centres that are non-compliant with HIQA regulations. While I appreciate that measures are being taken to make said centres compliant, it is unfortunate that the deadline needs to be extended by a further two years. Ideally, Fianna Fáil would like to see more people with disabilities living independently and less need for residential centres. However, as long as we have them it is important that they are well regulated and compliant with regulations.

The Health Service Executive, HSE, funds services for approximately 8,000 people in residential support settings, including 1,400 places at HSE-run units at a cost of €900 million per annum. The Health Information and Quality Authority, HIQA, which today published its annual overview report, assesses disability homes against 18 standards during each inspection,

including residents' rights, health and welfare needs, staffing levels, medication management and governance. On publication of today's report, Ms Mary Dunnion, chief inspector of social services and director of regulation at HIQA, said that the initial inspections carried out in 2014 found that there was a lack of understanding of how to meet the requirements of regulations and standards and that where there were competent people in charge who had sufficient oversight of the quality and safety of the service being provided, centres were able to meet the regulations and standards. It is important to note that where there were competent people in charge standards were met.

In 2015, HIQA carried out 561 inspections of the 937 designated centres for adults and children with disabilities in 2015. There were 741 inspections in total. At that time, more than one third of the HSE-run homes inspected did not comply with any of the standards. For example, in Cregg House in County Sligo, where there are 108 residents, there was major non-compliance in 19 of the 23 areas inspected: exits were locked, there were no push buttons nearby to facilitate an exit in the case of a fire, staff were constantly in reactive mode, and patients had received excessive chemical restraint in the few months prior to the inspection.Recently the HSE has taken control of three homes run by the Irish Society for Autism. The centres which care for 47 residents are Cluain Farm in Kinnegad, Dunfirth Farm in Johnstownbridge and Sarshill House in Kilmore, County Wexford. The criticism levelled at these institutions was damming. They were labelled as unsafe and chaotic. Again, drugs were used as chemical restraints, residents left the homes without being noticed or recorded, many residents self-harmed, management was poor, staff were badly trained and inspectors found deficiencies in the administration of anti-psychotic, sedative and pain relief medication.

In 2014 we had the horrendous debacle of the Aras Attracta controversy. How can any of us forget those degrading images of vulnerable human beings on our television screens? Their treatment flew in the face of any semblance of human nature. Regressive, neglectful care such as was highlighted cannot be tolerated. The answer, of course, is to move away from the congregated setting model and opt for more supported placements in the community. What is needed is integration, not segregation.

The HSE prioritised the transition of just 150 people in 2015. In December 2015 the projected outturn was only 112. The number of people living in congregated settings is 2,725. The programme for Government states its objective is to reduce this figure by at least one third by 2021. At this rate, it will be 2031 before everybody is out of a congregated setting. We must be mindful to respect the trauma residents can experience when being moved to unfamiliar surroundings and aware that unsupported relocation causes great stress. It is not all that long ago when a UN special committee on torture issued a report which came extremely close to describing institutionalisation as a form of torture.

While we will support the amendment, it is time to redouble our efforts to end congregated settings. It is time to redirect funds from this malfunctioning and often antiquated system to the people who can instigate change for the betterment of service users and to ensure the service user will be listened to through assisted decision-making legislation.