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Dáil Éireann debate -
Wednesday, 10 Dec 2014

Vol. 861 No. 2

Leaders' Questions

The House will be united today in anger, shock and horror at the revelations in "Prime Time: Inside Bungalow Three" last evening. I commend RTE and "Prime Time" for an excellent example of public service broadcasting at its best. The revelations were shocking and they represented violations of human rights of senior citizens with intellectual disabilities. These citizens, Ivy McGinty, Mary Garvan and Mary Maloney, among others, had their basic human rights violated to an extraordinary degree. They were subject to torture, physical abuse and emotional abuse and the treatment was without question degrading. They were kicked and dragged, at times they were shouted at and they were not even allowed to attend to the basic necessities of life, which was revealed harrowingly in the programme.

There are many lessons to be learned from it. The Minister of State, Deputy Lynch, said to the programme that she could not give an assurance that this type of behaviour was not happening in other centres. I put it to the Taoiseach that we need to give that assurance and the Government needs to work very quickly, in terms of devising an action plan for every centre, to ensure we can give that assurance to other relatives of people with intellectual disabilities in similar centres across the country.

Professional staff should be recruited. It has emerged that the staff in bungalow three, for example, had at most ten hours training which, in itself, is disgraceful. One could see that from the programme itself. The culture that was allowed to fester should be wiped out completely. I feel for the relatives because they trusted the HSE and people to care for their loved ones, people with severe intellectual disabilities, and that trust has been breached. It is clear we need an independent inquiry, separate from the HSE and even from HIQA, into Áras Attracta, into what happened and into the culture and practices there so that we can learn lesson for the future.

In June 2011, a report was published by the congregated settings working group which fundamentally challenged the existence of these congregated settings and stated that "Congregated provision is in breach of Ireland’s obligations under UN Conventions. The provision contradicts the policy of mainstreaming underpinning the Government's National Disability Strategy". It also stated that "The ethical case to move people from isolation to community, and in some cases, from lives lived without dignity, is beyond debate". There were approximately 32 recommendations in that report from June 2011 and I believe a national implementation group was established. Can the Taoiseach outline the progress in implementing those 32 recommendations? A seven-year plan was outlined for the implementation of the recommendations, which involves all the stakeholders and all the groups working with the HSE.

The report stated that the case for taking action now to address the situation of people living in congregated settings is powerful and unassailable. It also mentioned the ethical case to move people from isolation to the community. Will the Taoiseach outline the progress made in regard to the implementation of those recommendations? Will he also answer my question on the need for an independent inquiry?

Stop cutting respite services.

Last night's programme was another example of what we had in Leas Cross some years ago. This was frightening, sickening and infuriating. People will legitimately ask the question, how this could happen in 2014 with trained nurses and health care workers qualified to FETAC level 5. It was not an example of care but an example of control of fragile, vulnerable and voiceless people. I found it sickening.

The situation here is that following a HIQA inspection earlier in the summer, 59 recommendations were made to be implemented and they have all been implemented, including 400 hours of training. Some 100 hours of those 400 hours were allocated here.

As Deputy Martin is aware, a number of investigations are going on at the moment. The television coverage, on which I have commended RTE, has all been handed over to the Garda. I do not want to say anything here that may prejudice, in any way, the outcome of those investigations or whether criminal prosecutions will take place but the rights of these defenceless and voiceless people were trampled on. This was not an example of any kind of standard in terms of care and consideration but was an example of control.

As Deputy Martin will be aware, the chief executive of the HSE wrote to the chief executives of all the service providers and they are being called together next Tuesday because the question being asked is, is this an isolated incident? Can we be assured this has not happened, and is not happening, in any other centre? I mention the report written by Mr. Christy Lynch, chief executive of KARE, who independently chaired the review of the services and who is acknowledged as a genuine expert in this field.

His services are quite exceptional. We cannot afford to have any loss of concentration on what happened. This is absolutely disgraceful. It is appropriate that the HSE would call all those chief executives together early next week. It is also important that the investigations under way be concluded quickly in everybody’s interests, including those in Áras Attracta, some of whom I know, and their families. Many genuine health care workers who take pride in the job they do have had their names and reputations damaged by what happened.

I do not rule out what Deputy Martin says about investigations but it is important that the investigations under way be concluded and that we have an opportunity to discuss them here and that the HSE, the Department and Ministers involved see their outcome. I do not want to prejudice anything that might arise from the investigations currently being concluded by the Garda Síochána.

I am somewhat disappointed by the Taoiseach’s response. There is a compelling need for an independent inquiry. One could be established that would not jeopardise any criminal proceedings. There are fundamental issues that go to the heart of what happened at Áras Attracta that need independent investigation, separate from the HSE and HIQA. The Government should move on that and consider that as a response of substance to the revelations in yesterday’s "Prime Time" programme. Nothing less will suffice. There has been a fundamental breach of trust which can only be restored by a fully independent inquiry into what happened.

In terms of assurances for similar centres, I do not think calling the chief executives together next Tuesday to ask them if everything is okay is sufficient. I have no doubt most of them will say yes, it is grand. If we have learnt anything from the revelations yesterday it is that we cannot take any glib assurances that things are grand and fine in a particular institution.

It is a trust issue.

I thought an action team would have been established with resources to go to every centre in the country similar to Áras Attracta and carry out a thorough examination of practices and culture, to give that assurance to relatives and to affirm the basic human rights of people living in other centres. I am not casting any aspersions on the hundreds of good staff out there who do good work.

The Taoiseach did not address my most important question about the report of the congregated settings group, which is fundamental to last night’s programme because it recommends that the country should move from congregated settings to a community model over a seven-year period. It states:

... the Working Group took the view that the case for taking action now to address the situation of people living in congregated settings is powerful and unassailable. The ethical case to move people from isolation to community, and in some cases, from lives lived without dignity, is beyond debate.

That report involved everybody and was published in 2011. Will the Taoiseach give me some sense of the progress on the 32 recommendations of that report? Where are they now?

Christy Lynch wrote the congregated settings report. I do not think anybody can question his experience or independence.

I am asking what has happened to the report.

He wrote the congregated settings report.

No more than so many other things, the capacity to implement that report in terms of the economy and the shortage of housing just has not happened. That is the unfortunate reality.

The Government can cut tax for a couple of hundred million euro. That is the debate in this society.

I do not think the Deputy would argue with the report. It was written by somebody-----

I think it is very good. It is an excellent report.

It is being moved along but it is not implemented.

It is about the institutionalisation problem in this country.

Mr. Lynch is the former vice chairman of the Equality Authority. He is a former chairman of the Federation of Voluntary Bodies. He is the project manager of the congregated settings review that is being implemented but not to the extent that one would like because of that issue.

We know all this. Nobody is asking about Christy Lynch.

How many of the recommendations has the Government implemented?

There is an action team in there at the moment. Three people have been brought in from outside the country. The head of that is the person who is really experienced at dealing with challenging behaviour in different settings. That is quite complex, as the Deputy can understand. It is not a case of wanting to say "Here is an answer" by calling the chief executives together. The Minister of State at the Department of Health asked whether we can be sure this is not happening or has not happened in some other location. Every chief executive and manager in these positions has a duty and responsibility to see this does not happen in the facilities where they are in charge.

I listened to Mr. O’Brien talking this morning about the need for the possibility of having continuous undercover agents or whistleblowers-----

Did anything happen on the recommendations? That is what we need to know.

Let us take the opportunity to have a far more detailed discussion of these matters in the House in order that the Deputy can get an up-to-date detailed report from the Minister for Health about this as it moves along. I do not object to that in the interests of information for everybody. It is a matter of deep concern to us all personally.

It is a trust issue as well.

Last night’s very important RTE documentary on Áras Attracta in County Mayo provided a shocking insight into the treatment of vulnerable citizens with intellectual disabilities. As the Taoiseach has quite properly acknowledged, this programme has deeply upset and disturbed citizens, not least the relatives of those involved and those with family members and loved ones in care. What we witnessed was nothing less than the physical, mental and emotional abuse of the most vulnerable of our citizens.

HIQA has stated that following an inspection of Áras Attracta last February, it raised its concerns with the HSE which then put in place an action plan. HIQA also states that it found substantial improvements during a follow-up inspection in May. The Minister for Health says the HIQA recommendations were implemented. If this was the case, the systems in place in care homes have been a catastrophic failure. Does the Taoiseach know what, if any, oversight mechanisms are in place in these institutions? While the HSE has ordered an investigation under an independent chairperson, Inclusion Ireland, the national association for people with intellectual disabilities, has said this is not adequate. Inclusion Ireland says it is not appropriate for the social care division alone to investigate its own service. Will the Taoiseach put in place a fully independent root and branch investigation?

The Deputy has raised several important items. He knows as well as I do that if an inspection arrives from HIQA or any other agency, attitudes can change within a facility very quickly. That is why the HSE chief executive has pointed out the possibility of continuing to have undercover agents, whistleblowers and far greater scrutiny of what happens within the facilities. There is a requirement for a person dealing with vulnerable adults in each facility and for a safeguarding team in each region. It is impossible to guarantee that some other incident has not happened or does not happen in any other facility. What do we have to do to ensure that families and particularly the individuals concerned are not being treated in the inhuman way that we saw on television screens yesterday? What is the best thing to do? Deputy Martin pointed to the report on congregated settings. Many people have moved on from congregated settings but not as many as we would wish.

A regime of unannounced inspections is needed to ensure there is a continual stream of information about what happens here. When whistleblowers come forward, they must be protected and the information they provide must be acted upon quickly, efficiently, properly and professionally in the interests of the people who are in these facilities. As we have mentioned, Deputy Ó Caoláin spoke very movingly yesterday evening about his knowledge, which is based on family circumstances, of the challenges that face workers and individuals in these cases. I have to say I found it traumatic to see people who are completely voiceless and helpless being treated in this fashion. It is a case of not having any political division about what needs to be done here. We must do the right thing and do it effectively. The Garda and the HSE have been notified. The 59 recommendations made by HIQA have been implemented. It has been pointed out that the 100 hours of training that were given here were not implemented in any fashion by people who were professionally qualified nurses and FETAC 5 level qualified health care workers. This is just not acceptable. It has got to be dealt with and it will be dealt with.

I think the Taoiseach understands that when something like this is highlighted, his responsibility is to reassure citizens, particularly those affected and their families, that the Government is on the job and knows what to do. We do not expect the Taoiseach to have all the answers. When I come here to ask questions, I do not expect him to trot out all the answers. I asked the Taoiseach two questions. I asked whether he knows what, if any, oversight mechanisms are in place. If he does not know, that is okay, but he did not answer me. I also asked whether the Government will put in place an independent inquiry into this matter. We all know that the treatment of citizens with disabilities is a scandalous legacy on which we need to act. The cut in the respite care grant is an example of this treatment. The State has yet to sign up to the United Nations Convention on the Rights of Persons with Disabilities. The reason we have not signed up to it is that we do not have the legislation in place to allow us to do so. The Taoiseach acknowledged a moment ago that the congregated settings review has not been implemented. These are our responsibilities. What happened in Áras Attracta needs to be dealt with properly. As the Taoiseach has said, there should be no division across the Oireachtas about our responsibilities.

I would like to revisit some of the recent details. HIQA says it has received an average of three complaints a week since it took responsibility for the regulation of these services in November 2013. It is reported that 160 complaints relating to care facilities for people with disabilities have been made but have not been fully investigated. It is claimed that some of these cases involve the type of abusive treatment shown in last night's RTE documentary. HIQA has admitted that individual complaints are not being probed and are merely being filed away. Why is this? Could it be the case that this failure allowed the abusive practices in Áras Attracta to continue until they were exposed by the very fine RTE investigation? The Minister of State, Deputy Kathleen Lynch, has said that the safety of citizens in care homes cannot be guaranteed. I understand why she made that statement. In light of all these aspects of the matter, will the Government commit to a root and branch inquiry into care facilities for people with intellectual disabilities in this State? I repeat that I do not expect the Taoiseach to have all the answers to all these questions. It is now our responsibility. It has been brought to our attention. We have to respond to it appropriately. These are the most vulnerable citizens in this society. They and their families depend on us. We have to respond appropriately. Given that the National Association for People with an Intellectual Disability has said a fully independent root and branch investigation is needed, surely that is the least the Government can do.

I do not think we have a disagreement.

Except on the inquiry.

What affects people when they see something like this going on in this kind of setting and do not do something about it? Would anybody here in this House not act appropriately if they were to be in such a situation?

I am asking the Taoiseach to act.

Yes. I am just making the point that we do not have any disagreement here. In times gone by, the State always denied these kinds of issues. This has happened. We know it has happened. The question is what is the best, right, correct and most effective thing to do now. I recall meeting Christy Lynch a number of years ago. I found him to be quite an extraordinary person. He has the capacity to do a really effective job here. The HSE has immediately responded by getting him to carry out an investigation. I understand three investigations are going on. The first thing we have to do is let that continue. An action team from abroad is working on this at the moment. The results of the Áras Attracta investigation and analysis will be applied elsewhere. The legislation referred to by the Deputy will be debated on Committee Stage here early in the next session. The other point is that HIQA does not investigate individual complaints. When individual complaints are received, they are always part of the overall investigation into facility X or Y that takes place. The HSE has written to the chief executive of each individual service provider. They are all being called together on Tuesday. They have already been warned about this. It is something that is intolerable. Can I give a guarantee to the House here today that this has not happened in some other facility around the country? I do not know. Am I supposed to know? I suppose it could be said that I am. We have to put in place a system whereby the Minister of State with responsibility and the HSE have a continuous stream of up-to-date information about what is happening.

I was struck by what Deputy Ó Caoláin said last night. These people are voiceless. They are completely vulnerable. We saw it on our television screens. The question is what we will do about it. There are three investigations going on. It is possible that criminal charges will be levied here. That does not solve problems for the future. The lessons learned from Áras Attracta will apply to the rest of the system. The legislation will be dealt with on Committee Stage early in the new year. The action team led by an international expert in challenging behaviour is already doing its work. The chief executive of KARE, Christy Lynch, who has complete independence, is already drafting his report. I am not ruling out the question that Deputy Martin asked. It is important to let these investigations conclude so we can find out what is there and what further needs to be done. I do not rule it out, but we need to conclude what is under way at the moment in terms of these investigations so we can see what happens. We can then put that in the system so this should not happen anywhere else. I know this is a cause of great concern for the families of people in other facilities. I am sure the health care workers in the other units in Áras Attracta feel very damaged when they consider that this happened in the complex or campus in which they work.

As we speak, thousands of people are making their way to Dublin for this afternoon's protest. I believe they are coming for two main reasons. They want the Taoiseach to listen and they want to get answers. Yesterday, the Taoiseach claimed once again that all the issues of concern with regard to water charges have been addressed. I hate to break it to him that the thousands of people who will be outside Leinster House this afternoon disagree with him. I agree with the Taoiseach that this is about more than water. Many people, including some who are in favour of water charges, have major concerns about the circumstances surrounding the creation of Irish Water and the awarding of the metering contracts. They want some very specific questions to be answered, but those answers do not appear to be forthcoming. I asked some of those questions when I spoke on the Water Services Bill 2014 in this House last week, but I am still waiting to receive answers. I have also tabled parliamentary questions.

One of my parliamentary questions was flatly refused and the answer to the other was so anemic that it was a non-answer. The questions referred to the circumstances surrounding the awarding of the Irish Water metering contract and how the company, Millington Limited, was able to acquire Siteserv and, thus, GMC/Sierra Limited at a significantly reduced cost from IBRC, a deal that saw the State lose €105 million. GMC/Sierra went on to win the metering contract.

There are some known facts. We know that the bids had to be in by 30 June 2013. We know that one of the companies awarded one of the major contracts did not exist until 15 July, weeks after the closing date for bids. As such, I wish to ask some of the questions that I asked but to which I have not managed to get answers. If the closing date for applications to be considered for the contract was 30 June 2013 according to a parliamentary reply last year from the former Minister, Mr. Phil Hogan, how did GMC/Sierra, company registration No. 530230 and which did not come into existence until 15 July, manage to win a contract? How could a company that did not satisfy the requirement to have a tax clearance certificate be considered for the contract?

How did the procurement process satisfy EU rules? Why did IBRC choose to accept a bid from Denis O'Brien's Millington for Siteserv when it was actually the lowest of the bids and resulted in a loss to the State of €105 million?

Deputy Murphy is asking me specific questions about details of contracts.

Can we have the answers?

I do not have the answers to her questions.

Bring back Big Phil.

I will take the Deputy's questions, though, and find the answers for her from Irish Water.

Big Phil has gone to Brussels.

I welcome the fact that the Taoiseach has committed to giving me the answers. I ask him to put them on the public record-----

-----rather than providing them to me directly. It is essential that we move to address people's concerns. There has been a sizable engagement on this issue for some considerable time, mostly via social media and online. It is critical that this be above board. We all know that European rules apply to these matters and that one must comply with statutory provisions on the treatment of employees, conflicts of interest and tax clearance certificates. These are specific requirements. It is critical that everything be above board. Otherwise, an entire set of other issues will dog this company if it survives, about which there is a major doubt.

As I recall, the only discussions we have had at Cabinet sub-committee meetings about that was that there would be regional contracts awarded for the installation of meters and that those contractors would be entitled to employ subcontractors and that there would be a requirement that a 25% allocation would come off the live register, that is, people who might have been involved in the construction sector before.

As I said, the Deputy has asked very specific questions. I will have those transmitted to Irish Water today. I hope we do not get a watery reply. I will see that the detail the Deputy has asked for is provided. Of course it should be on the public record.

Short and savvy, like the Taoiseach's own answers.

Can we have extra time for that, a Cheann Comhairle?

(Interruptions).
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