Dáil Éireann debate -
Wednesday, 9 May 2012

Vol. 764 No. 4

Topical Issue Debate

Inter-Country Adoptions

Deputy Charlie McConalogue

I thank the Leas-Cheann Comhairle for putting this important issue on the agenda given its urgency. I ask the Minister for Children and the Minister of State, Deputy Perry, who is present, to intervene to ensure there will be Irish Government representation at a meeting being held by the Kazakhstani Adoption Authority this Friday in Kazakhstan to liaise with countries which would wish to have inter-country adoption agreements with Kazakhstan. It is crucial that every action is taken by the Government to ensure we have representation at that meeting. There reason is that many citizens in Ireland are keen to adopt from Kazakhstan, as are many families who have indicated an intention to adopt from other countries as well. Were we not to ensure every opportunity is taken for Ireland to be represented at these talks with the Kazakhstani Government, it could lead to undue delays in trying to ensure that Kazakhstan is opened as a country through which we will have an agreement to have inter-country adoptions.

This is all the more important because as a result of Ireland signing up to the Hague convention at the end of November 2010 we have seen a significant drop in the number of inter-country adoptions by Irish citizens. Those adoptions have decreased from a high of 397 in 2008 to below 200 in 2010 and 2011. Most of those adoptions were based on transitional agreements made with countries prior to Ireland's signing up to the Hague convention. We are now in a position where Ireland must establish new procedures with many of the countries that have signed up to the Hague convention while also seeking to establish bilateral agreements with some of those countries that were the main base for previous Irish inter-country adoptions to ensure we can resume adoptions from those countries.

In that context and in the context of the many citizens and families throughout the country who are willing to offer a loving home to children in need of that, it would be a major setback and disappointment for those families if the Minister of State and his Government did not take every step to ensure the opportunity of the meeting this Friday is taken up. I understand the Adoption Authority of Ireland has been in touch with the Irish Embassy in Moscow with regard to this. This would be the most appropriate way of ensuring at relatively short notice that Ireland is represented. I see no reason this should not be the case. What investigations has the Government undertaken to ensure this comes to pass and that we are represented at the meeting on Friday so we can ensure as soon as possible a process is established by which prospective Irish parents can apply for inter-country adoptions with Kazakhstan?

Minister of State at the Department of Jobs, Enterprise and Innovation (Deputy John Perry)

I thank the Deputy for raising this very important issue. I am taking this topical issue on behalf of my colleague, the Minister for Children and Youth Affairs, Deputy Frances Fitzgerald.

With effect from 1 November 2010, inter-country adoptions can be effected with other countries which have ratified the Hague Convention on Protection of Children and Co-operation in Respect of Inter-Country Adoption, known as the Hague adoption convention, or with countries with which Ireland has a bilateral agreement. Kazakhstan has ratified the convention. The Hague adoption convention is a formal state-to-state agreement between countries developed on a multilateral basis. It is a co-operative agreement drawn up to allow countries mutually to support one another in protecting the best interests of children in the inter-country adoption process. It is designed in such a way as to allow for mirrored mechanisms and structures mutually to assure countries of the safety and standard of inter-country adoptions in those countries.

The Adoption Authority of Ireland, AAI, performs the function of a central authority under the Adoption Act 2010 in accordance with the convention. In choosing to deal primarily with other Hague countries, the AAI has the mechanism to work collaboratively with equivalent structures in that country. Each central authority has the responsibility to oversee standards in respect of those parts of the process taking place within their respective jurisdictions. This mutual arrangement is designed to give the AAI, the Government and, most importantly, those involved in the adoption process assurance as to the standards being set and the oversight of the system.

If a country has ratified the Hague adoption convention then the Adoption Authority of Ireland may establish administrative arrangements, as provided for in section 72 of the Adoption Act 2010. The key difference between an administrative arrangement and a bilateral agreement is that governments are bound to one another by a bilateral agreement while administrative agreements are related to the sequence and process arrangements in place to support the safeguards already agreed between states. The Adoption Authority of Ireland works with central authority counterparts in the establishment of administrative agreements while bilaterals are government to government agreements.

In the case of Kazakhstan, the AAI has written to its counterpart central authority on three separate occasions, starting in September 2010, to begin the process of developing an administrative agreement for inter-country adoption. To date there has been no reply from the Kazakhstani authorities on the matter.

The AAI and the Department of Children and Youth Affairs became aware in the past two days that the Kazakhstani adoption authorities intend to hold a meeting on this coming Friday with representatives of Kazakhstani Government institutions and diplomatic representatives of foreign embassies and consulates. It is important to state that neither the AAI nor the Irish embassy were made aware of the meeting by the Kazakhstani authorities.

Unfortunately, it will not be possible for someone from the AAI to attend this meeting at such short notice. The Irish Embassy in Russia has also informed the Department that it will not be possible for the embassy to attend the meeting in Kazakhstan on Friday afternoon and nor is it in a position to authorise any group to attend on its behalf. However, the embassy, at the request of the AAI, will request information from the relevant authorities on the position for Irish couples hoping to adopt from Kazakhstan as soon as possible. In this regard, the AAI has indicated it is willing to open discussions with the Kazakhstani authorities at any time. In the interim the AAI is completing a review of Kazakhstan's adoption legislation.

The Adoption Act 2010, which provides the legislative framework for adoption in Ireland, is designed to provide a framework to ensure all adoptions are effected in the best interests of the child and to the highest possible standard. The phrase "in the best interests of the child" is absolutely key in this regard. It must not be forgotten that inter-country adoption is a service for those children who cannot be raised by their birth parents or cared for in their own country. The interests of the child must always be paramount throughout the adoption process. This is best achieved through the full implementation of the highest national and international standards governing adoption practice. This is the primary concern for the Adoption Authority of Ireland in conducting its business as it relates to inter-country adoption.

Deputy Charlie McConalogue

I am very disappointed with the reply from the Minister of State. It is simply not acceptable that this is the approach taken by the Minister for Children and Youth Affairs and the Government. The reply made no reference to an effort having been made by the Government to establish whether an invitation would be issued for Irish attendance at the meeting in Kazakhstan. All I heard is that no one is able to attend and that in the past year three letters were written by the Adoption Authority of Ireland to Kazakhstan without reply. This is an opportunity for our country to become part of negotiations with the Kazakhstani Government to ensure inter-country adoption can be opened up. It is not good enough to say the Government is willing to open negotiations at any time especially when communication has not been what it might have been over the past year.

We should ensure we are represented at the meeting with the Kazakhstani Government at which will be representatives of other countries seeking to establish inter-country adoption agreements with Kazakhstan. If we do not attend we will let down the many families throughout the country waiting on action from the Government and its engagement with the Kazakhstani authorities to establish an agreement whereby they can proceed with an inter-country adoption. Many families have already adopted from Kazakhstan and are seeking to adopt again and ensure their child has a sibling from the same country. It is not acceptable that the Minister of State can say the embassy in Moscow cannot attend this meeting. The embassy in Moscow must send a representative. Anything less than this does a grievous injustice to the families awaiting action from the Government to proceed with their adoptions. Has the Government made contact with the Kazakhstani Government to see whether Ireland would be welcome at the meeting - I have no doubt we would - instead of coming to the House with a reply stating we cannot make it?

Deputy John Perry

The Government contacted the Kazakhstani Government on three occasions but received no response. We were not officially notified of this meeting so there is no point in looking for a second invitation. The meeting will take place and the Government became aware of it two days ago. The Adoption Authority of Ireland is quite prepared to enter negotiations with the Kazakhstani Government on the potential inter-country adoption so it is disingenuous of the Deputy to say we are not fulfilling our duty. We have made every possible attempt-----

Deputy Charlie McConalogue

You are making no effort now.

Deputy John Perry

We are making an effort.

Deputy Charlie McConalogue

Not in recent days.

Deputy John Perry

If you listened to the reply I gave it is quite clear. The child is the main focus. I will repeat what I stated:

The AAI and the Department of Children and Youth Affairs became aware in the past two days that the Kazakhstani adoption authorities intend to hold a meeting on this coming Friday with representatives of Kazakhstani Government institutions and diplomatic representatives of foreign embassies and consulates. It is important to state that neither the AAI nor the Irish Embassy were made aware of the meeting by the Kazakhstani authorities.

Deputy Charlie McConalogue

You are aware of it now but you are making no effort to ensure representatives from the Irish Embassy attend.

Deputy John Perry

They have not been made aware by the Kazakhstani authorities-----

Deputy Charlie McConalogue

You are now.

Deputy John Perry

-----and that is a fact. It is like going to a meeting one has not been invited to attend.

Deputy Charlie McConalogue

You have not asked-----

Deputy John Perry

We are very much aware of the meeting. We have requested information from it and we intend to enter meaningful negotiations on what can be done. We are very much aware of the urgency of this issue and it will be dealt with decisively by the Minister, Deputy Fitzgerald.

Deputy Charlie McConalogue

That is not good enough.

Higher Education Grants

Deputy John O’Mahony

I thank the Ceann Comhairle for selecting this topic. This originates in the centralisation of CAO applications which has been flagged for some time but is due to be implemented in September. I understand this involves new applications so it will mainly affect leaving certificate students applying for grants for the first time.

We all witnessed the difficulties in the old system with delays and backlogs, particularly in recent years. All public representatives have received appeals at local level to sort out those problems.

However, the reason I raise this matter today is that there is a fear among some parents and students that what was a backlog at local level will now be 66 times greater and cause a total bottleneck at national level. Local authorities in the past provided information evenings for parents and students on how to fill in forms and get them in on time and so forth. What plans are in place to get this system up and running in a smooth, streamlined way that will not end up causing a bigger problem than the one it is designed to resolve? Will there be information evenings or will information be provided through the schools? Will there be help-lines and websites available? Will applicants get quick responses to inquiries? A positive aspect of the old system was that students or their parents were able to call to the local office and meet somebody face to face. Will we be confronted with help-lines which nobody answers? The success of this system will be gauged on how little public representatives are involved. In other words, if it is successful and there are no problems, we will not hear about it.

We saw what happened with the centralisation of the administration of medical cards. While that situation has been alleviated to some extent, I am raising this matter in the Topical Issues Debate today because prevention is better than having to implement a cure when there is a crash under a mountain of applications. The system will apply to new applicants, that is, students going into third level for the first time. They have enough trauma and enough issues to overcome without being faced with a situation similar to that which has occurred in the past, where students were threatened with being unable to sit examinations because the grant had not been paid. What plans are in place to ensure this system works?

Deputy John Perry

I am replying on behalf of my colleague, the Minister for Education and Skills, Deputy Ruairí Quinn, and I thank Deputy O'Mahony for raising this important matter.

The Student Support Act became law last year, providing for fundamental reform of the student grants system. In practice, what this means is that, instead of four different student grant schemes with different terms and conditions, there is now just one consolidated scheme which the Minister introduced in 2011. The Minister has also made arrangements for the designation of a single grant-awarding authority under the Act, which will replace the existing 66 grant awarding bodies - local authorities and vocational education committees, VECs - for all new applications from 2012-13. These developments will make it far easier for students applying for grants and should make the processing of applications more efficient and consistent.

It is planned that the new universal online grant application system will go live from 28 May next. It will be operated by Student Universal Support Ireland, or SUSI, which has been established as a unit of the City of Dublin VEC. SUSI will commence operation for all new grant applicants for the 2012-13 academic year and it is intended that all new grant applications will be made online. The new application process will be applicant-centred and aims to provide a more efficient service for the student. The existing 66 grant awarding bodies will continue to deal with the renewal of applications for their existing grant-holders for the duration of their current courses.

SUSI has a comprehensive communications plan which is already well under way. Various stakeholder groups have been targeted, including school principals, guidance counsellors and existing awarding authorities. Students themselves are being targeted through social media and other multimedia channels informing them about the role of SUSI and the process of grant application. In addition, the communications strategy will be supported by print media advertisements in the national press and local and national radio. Following the online launch, the availability of the grants online system will continue to be widely publicised.

Another significant part of the customer service strategy is the SUSI support desk, which will deal with e-mail and telephone queries relating to the application process and grant scheme. This support desk is already available during office hours and an extended service will be available when the online application system is launched. The service will provide a comprehensive response to queries from students, parents and other information providers nationwide.

The formulation of the 2012 student grant scheme is currently being finalised. The 2012 scheme and regulations will be issued to coincide with the go-live date for the online grant applications system on 28 May 2012. I am sure the Deputy will agree that this is a positive example of genuine public sector reform. I thank the Deputy for raising this matter and for his comments on it. He will agree that the fundamental reforms being delivered in this area have the potential to be transformative in their effect. The establishment of a single student grant awarding authority will provide both for significant improvements in the student experience of the grant system and for substantial efficiencies for the State in the administration of support to students to ensure access to higher education.

This fundamental reform of the student grant system also represents a concrete development in meeting the objectives set out in the action plan for the education sector under the Croke Park agreement. I believe it will ensure a better and more consistent level of customer service for all those who rely on these critical supports.

Deputy John O’Mahony

I welcome the Minister's comprehensive reply. The key issue is to prepare the way, and all those methods of advertisement, including the website going live on 28 May, are welcome. I am glad the Minister is using social media as well to convey the message. If all this information is disseminated to the parents and students in advance, there will not be a problem. The Minister referred to a help-line or telephone line. Will applicants who use that line get to speak to somebody or will they be left hanging on? This was the big issue in the medical card area, where people were left hanging on the telephone or had to leave a message but nobody got back to them. The other issue that arose was where an application was not filled out correctly. When further information was sent in, the original application and the new information were not connected. These are the pitfalls that helped create the mayhem in the medical card system for the first six months. Will those pitfalls be avoided in this case?

Deputy John Perry

I assure the Deputy that the Minister, Deputy Quinn, is a transforming Minister in the education area. This is a major transformation in the grants system. While the Deputy referred to the example of the medical card system, we are dealing with a completely different cohort of people in this area. They are very much into social media and the Internet. There is also the involvement of local radio. In addition, this will only apply to new applicants. I am confident that we are dealing with a highly intelligent student base who will be familiar with social media and can make their applications online. It will be a keep-it-simple application.

Given the access to information, I sincerely hope there will not be much requirement for telephone guidance but if it is required, I am assured it will be provided in a very effective way that will allay concerns. A one-stop-shop for grants is a tranformational concept. It will certainly ensure that people will know where they stand, and I have been assured it is designed to keep everything very simple. Applicants will fill in the boxes and provide the relevant information. It will be a user-friendly website. I accept the Deputy's concerns about people not getting through on the telephone and so forth. That concern prevailed in the medical card situation but I assure him there will not be a repeat of that in this area.

Services for People with Disabilities

Deputy Michael McCarthy

I thank the Ceann Comhairle for selecting this matter. My interest in it was born out of the frustration I felt on recently receiving a reply to a parliamentary question confirming there are no plans at present for the development of a national autism strategy or for the introduction of specific legislation on autism. Such a statement is disappointing given the increasing prevalence of autism in Ireland and because the Department's stance is wildly out of sync with international standards. In this context, I appeal to the Minister to review the position and to consider taking a different approach, based on the arguments I am about to outline. I note for context that in the United States, the number of children diagnosed with autism has doubled over the past decade. While no equivalent figures are available yet for Ireland, an estimated 600 children are born here each year with this condition and that figure is rising. It is hard to determine whether the increase can be attributed to an actual rise in the incidence of autism, improvements in diagnostic tools or greater access to psychological services. However, there is no doubt but that autism has risen dramatically in Ireland in recent years.

At present, Ireland is the only country within the British Isles that does not have autism-specific laws or a national autism strategy in place. In 2008, the Welsh Assembly Government issued an autism strategy and began to implement it immediately. In 2009, the House of Commons brought into force the Autism Act 2009 and quickly followed it the following year with its strategy for adults with autism. In 2011, the Scottish Government launched its national autism strategy and the Autism Act (Northern Ireland) 2011 was passed. The latter legislation compels the authorities there to publish an autism strategy within two years of the Act being passed. In recent years, there has been a general move towards implementing autism-specific strategies in many western democracies. As the aforementioned examples illustrate clearly, this movement has been prompted by the increasing prevalence of autism, the soaring cost of providing autism services, a squeeze on resources and the need to prioritise such resources effectively. There are many lessons to be learned from the Government's counterparts in the British Isles. For example, the proposed Scottish autism strategy Bill would place a statutory duty on the Government to prepare and publish a strategy to meet the needs of children and adults with autism and to consult with appropriate organisations and people. It also would oblige local authorities and local health boards to comply in respect of the provision of diagnostic services, the identification of children and adults with autism locally, the assessment of their needs, the planning and provision of services, the training of staff and leadership at local level.

As I noted earlier, approximately 600 children are born in Ireland each year with autistic spectrum disorder. However, these are merely approximate figures as the absence of a national autism strategy leads to an abject absence of prevalence rates. Naturally, this has huge implications for the provision of services nationally, as without access to a reliable bank of statistics in this area, it is difficult for service providers to know what policies and guidelines should be put in place for future planning of services. One should bear in mind that behind the figures are real individuals, real households and real families who are struggling with this condition. Autism spectrum disorder is a complex and lifelong developmental condition and while some people can live relatively independent lives, others have high dependency needs and require specialist care.

Autism also presents a significant public health challenge to the State. Until such time as a national autism strategy has been put in place in the State, there will be an ongoing cost to society of the resources that are wasted. For as long as services fail to be properly targeted, ineffectiveness and waste will continue and society will fail to equip people with autism with the right supports that ultimately will enable them to lead independent and productive lives. If one borrows from the example of the United Kingdom, components of a national strategy could include a national autism programme board similar to that which exists in the United Kingdom, a programme to develop training with health and social care professional bodies, autism awareness training for those who work with people with autism and guidance on making available public services for adults with autism, such as improving buildings, public transport and communications. In conclusion, the latter point already has been addressed in the HSE national review of autism services that was published in February 2011. It undertook to carry out a review of existing services and aimed to identify pathways on how services can be accessed and delivered.

Minister of State at the Department of Health (Deputy Kathleen Lynch)

I thank Deputy McCarthy for raising this issue. As he noted correctly, this is an issue that is increasing and of which the Government must take account. Autism spectrum disorder is a complex neurodevelopmental condition that both affects approximately one in every 100 citizens in Europe and has an impact on their families and society at large. Policy in this area aims to enable people with complex disabilities, including those with autism, to live as independently as possible within the community. The Government is committed to providing specialist disability supports to enable each individual with a disability, including those with autism spectrum disorder, to achieve his or her full potential and maximise independence, including living as independently as possible.

The management and delivery of services related to autism is the responsibility of the HSE under the Health Act 2004. It provides services for individuals with autism spectrum disorders from childhood to adulthood, either directly or indirectly, by both statutory and non-statutory service providers. Services are provided in a variety of community and residential settings in partnership with service users, their families, carers and a range of statutory, non-statutory, voluntary and community groups. It is worth noting that a number of Departments have responsibility for the provision of services to people with autism. The Department of Health is responsible for health-related aspects, while the Department of Education and Skills has responsibility for education aspects. Moreover, the Department of Children and Youth Affairs also has a role in respect of services for children. In recognition of the cross-departmental issues arising on autism, a principal officer now has been appointed in the Department of Health to promote a co-ordinated approach to the needs of children, adolescents and young people with complex disabilities, including autism.

The Health Service Executive published a national review of autism services in February 2011. The aforementioned review outlines the historical background, the current models that exist, the gaps in service provision and the need for a consistent and clear pathway for individuals to access services in the least restrictive way. The report highlights the imperative for a clear focus on the individual and his or her family in ensuring the needs of the individual remain at the centre of service provision. It is intended that future provision of services for children and adults with autism will be developed having regard to the Government's commitment to mainstreaming, that is, to enable people with a disability to have access to the same services as the general population, as well as receiving the appropriate support and intervention to address individual needs. No plans are under consideration at present in the Department of Health for the development of a national autism strategy or for the introduction of specific legislation on autism. The recommendations of the national review of autism services report will be implemented through the reconfiguration of existing service provision and having regard to the most efficient and effective use of resources available in the current economic climate. The Department of Health's forthcoming value for money and policy review of disability services will set the wider context for achieving a person centred disability service overall. I again thank the Deputy.

Deputy Michael McCarthy

Unfortunately, identifying the cause of and finding the cure to autism still eludes the medical profession. In the meantime, however, the best approach is autism-specific education and early intervention in order that people with the disorder can live culturally, socially, economically and spiritually fulfilling lives. I welcome the Minister's recent pledge to invest €2 million in additional funding for early detection and treatment services over the next two years. I suggest that to ensure the effective utilisation of this investment, a national autism strategy be developed and implemented. In addition, a huge opportunity arises, in the context of Ireland's Presidency of the European Union in 2013, to make autism a European Union priority from a policy perspective. Many challenges exist at European Union level in respect of autism and Ireland's Presidency affords it a glorious opportunity to put this issue at the centre of its agenda for the Presidency. For too long, people with autism have been falling between the cracks of an overweight system and as a result, many people have led lives that were not as fulfilled as they could have been. This is no longer acceptable and a national strategy provided for by legislation would both transform services and would change attitudes across society. The Minister of State has demonstrated great bottle and passion for her briefs within the Department of Health and I believe this to be another area in which the right thing can be done for those who unfortunately suffer from this condition.

Deputy Kathleen Lynch

The matter is not currently under consideration. What the Deputy proposes has neither been ruled in nor out. Additional resources have been made available in recognition of the prevalence of autism. As stated by Deputy McCarthy it is difficult to know if this is as the result of clearer diagnosis or an increase in the incidence of autism.

We need to gather data, similar to that which we have in respect of other disabilities, on this issue. I acknowledge there is a need for discussion around whether autism is a disability. It has for instance been suggested to me that the inclusion of an additional question in the census might be of assistance in this regard. We will need to consider this. We cannot plan unless we have the type of data and information we need to be clear on where money needs to be expended. Some €3 million will be allocated over the next three years to the early detection and treatment of autism. Despite the allocation of additional funding to other disabilities no sustainable service has been put in place. We need to ensure that when money is invested in development of a service, that service is sustainable. This is important in the context of autism in particular given that structure and the need to know what is happening is important not alone to those affected by autism but their families.

It is hoped that the gathering of information and the putting in place of a sustainable structure will lead to a better service for everyone.

Inquiry into Patient Abuse

Deputy Caoimhghín Ó Caoláin

Gabhaim buíochas leis an Cheann Comhairle as an seans labhairt ar an ábhar tábhachtach seo. The High Court case settled by Mr. Ronan MacConnoran highlights once again the scandal of what happened to the victims of Mr. Michael Shine. As stated by Mr. MacConnoran's solicitor, no quarter was given by the State side in defending the case. This is one of the greatest scandals ever to blight our health services.

There are scores of victims, many of them in counties Cavan and Monaghan, which I represent here. In 2009, I met with one of them, Mr. Patrick Cusack of Carrickmacross, who was first abused by Mr. Shine when 11 years old and an inpatient at Our Lady of Lourdes Hospital in Drogheda. Mr. Cusack returned to the hospital at aged 19 when very seriously ill with meningitis and was, when in a semi-conscious condition, again abused by Mr. Shine. As stated by Patrick: "My life was turned upside down. It took me another 20 years before I started to deal with the extreme pain that his sexual abuse had caused."

The pain of the victims has been compounded by the slowness of the system in responding. An inquiry is clearly necessary because of the complete failure of the system to respond appropriately to the very serious complaints made by those who suffered abuse at the hands of Mr. Michael Shine. Major questions remain to be answered by the hospital management, the former health board and its successor the HSE, the Department of Health and Children, an Garda Síochána and the Director of Public Prosecutions. A major questionmark hangs over the thoroughness of the original Garda investigation into the conduct of Michael Shine, which investigation culminated in his 2003 acquittal on charges of indecent assault on six teenage boys. The role of management at Our Lady of Lourdes Hospital in Drogheda must also be probed. Its role in the Neary case was nothing short of reprehensible. Are we expected to believe management was not aware of the activities of Michael Shine and did not conspire to cover up his many abuses carried out over so many years?

A public inquiry is necessary to answer these and other key questions. The call by Dignity 4 Patients for a public inquiry is supported by One in Four, the Rape Crisis Centre, the Children's Rights Alliance and Barnardos. Crucially, this demand was supported on 30 June 2009 in a Dáil motion tabled by the then Fine Gael spokesperson, now Minister for Health, Deputy James Reilly. I have repeated in my request for this Topical Issue Debate the core wording of the Minister's then wording of the motion. The principal author of the wording before the House today is the now Minister for Health, Deputy James Reilly who, when Fine Gael spokesperson on health called for "a credible inquiry to investigate how complaints relating to allegations of abuse by Michael Shine in Our Lady of Lourdes Hospital, Drogheda, were dealt with by the Hospital, An Garda Síochána, the Director of Public Prosecutions, the Health Board, the Health Service Executive, the Department of Health and Children and any other relevant party".

That motion also called for appropriate services for victims. It is a great matter of disappointment to note that the Minister, Deputy Reilly, has failed to establish an inquiry and has presided over a significant cut in funding to Dignity 4 Patients which represents all of the victims of Michael Shine. That cut in this current year is so severe it is not only restricting its ability to represent these victims but is making its project impossible. The Minister must act now according to his own words by establishing an inquiry. I appeal that in the interim the funding stream be restored to Dignity 4 Patients.

Deputy Kathleen Lynch

I thank Deputy Ó Caoláin for raising this issue, which needs to be dealt with. I am taking this matter on behalf of the Minister for Health, Deputy James Reilly.

We are all agreed that the abuse of trust and attack on the dignity of patients by Mr. Michael Shine was a terrible betrayal by him of his patients. The professional conduct of Mr Shine has been the subject of a number of inquiries. In 1995, the Medical Council instigated a fitness to practise inquiry but this was delayed pending the outcome of separate legal proceedings, including criminal and judicial review proceedings. Following a Supreme Court judgment in July 2008, the Medical Council recommenced an inquiry and on 25 November 2008 formally notified the Minister of its decision to remove the name of Dr. Michael Shine from the medical register. The Medical Council made its decision following its consideration of the report of its fitness to practise committee, which found the person concerned guilty of professional misconduct in respect of three of nine allegations made by male patients.

A review of the hospital's response to the allegations against the consultant was conducted in 1995 by an independent review group chaired by Dr. Miriam Hederman O'Brien. The review group recommended that common written protocols for dealing with allegations of sexual abuse by members of staff be introduced and applied in all health care institutions. The Trust in Care guidelines, which were published in 2005, deal with the recognition, prevention and management of cases of abuse. The review group also emphasised the importance of having in place a complaints system to deal with allegations of sexual abuse. A regional complaints policy and procedure is in place covering the Drogheda Hospital. In addition, a support service has been made available to all staff in the hospital on a confidential basis. The Hederman O'Brien review has helped inform the development and updating of policy in this area.

This learning has been given practical effect through, for example the publication of the Children First Guidelines in 1997 and, more recently, the establishment by Government of the Department of Children and Youth Affairs with a full Minister at Cabinet. Early in 2011, my colleague the Minister for Health indicated that the issues raised by the case of Michael Shine, former consultant at Our Lady of Lourdes Hospital, Drogheda, would be the subject of an inquiry by an Oireachtas Committee. This was dependent on the powers that had been proposed under the 30th amendment of the Constitution. As it was not possible to proceed as proposed, the Minister is now considering how best to deal with the issues involved. These considerations must take into account that Garda investigations are ongoing, investigation files have been submitted to the Director of Public Prosecutions and civil cases are pending against Michael Shine. It would be wrong to do anything that might impede these investigations and pending cases.

The Government will take all of this into account and remains determined to ensure a fair and satisfactory outcome for all the victims concerned and hopefully to give them all the closure they deserve in dealing with the terrible treatment they suffered.

Deputy Caoimhghín Ó Caoláin

We have to recognise that the long delay in these Garda inquiries is only likely to lead us to one place - Michael Shine will have passed on. There will be no opportunity for his victims to face their abuser and to give account of the terrible vista he visited on their young lives. It is understandable that among the voices of the abused, there are those who believe that indeed is a subtext, an agenda, that is being allowed to unfold. It is a very serious matter and it has to be taken seriously. These are very hurt people.

As the Minister of State rightly said, we are all agreed that this inquiry must happen but if everything is predicated on when the Garda inquiry will conclude, surely there must be cross-departmental action here and surely the Minister for Justice and Equality must be encouraged to speak to the relevant authorities within the Garda. What prospect is there, after all these years, of new and further information presenting that would significantly alter all that we already know? We need to have this opportunity. These people are deserving of closure.

I appeal to the Minister of State not to just note this and walk away but to speak to the Minister who already is totally conversant with the whole situation and who sponsored a motion in the House only three years ago which I happily spoke in support of and voted for absolutely. I appeal for a cross-party approach. This is not something for Government and Opposition to be adversarial about. We are of one mind but we need to proceed with one clear intent and that it to bring closure at the earliest opportunity.

My final appeal - the Minister of State did not refer to it in her reply as it was not part of what had been constructed for delivery here by the Minister - concerns the situation in regard to Dignity for Patients. I can personally assure the Minister of State that the service it gives is critical to the well-being of those very hurt people today in 2012 as at any point in time in the past. If we are to allow that funding stream to virtually dry up, as is the situation in this current year's provision, we are compounding a terrible pain and hurt and we cannot be a party to that. I urge the Minister of State to immediately intervene to ensure there is adequate support in order to allow the work of Dignity for Patients to continue until that closure we are all agreed must happen is achieved.

Deputy Kathleen Lynch

As the Deputy said, I do not think there is any disagreement as to what has happened to these people. We are all agreed about the breach of trust that occurred. I hope people will recover but it is very difficult to see how that recovery will occur. The difficulty we have in terms of an inquiry is that I do not believe there is any stomach in the House or among the public for another public inquiry, no matter the circumstances or what we believe. Our difficulty is that the constitutional amendment in regard to inquiries which could have been carried out by committees of the Dáil Éireann was rejected by the people.

I very much take on board what the Deputy said about the conclusion of other inquiries going on. Let us see a way forward from them because they are taking an inordinately long time and we need to ensure they are brought to a conclusion as quickly as possible, no matter what the outcome. While the Garda inquiries are going on, there is a barrier there which we need to try to get over. The only way to get over it is to bring the inquiries to a conclusion. I agree entirely with the Deputy on that and I will pursue that matter with the Minister for Justice and Equality.

In regard to the funding, unfortunately, the circumstances are as we find them. However, I will not just note what the Deputy said but I will convey his sentiments to the Minister in the strongest possible terms.