I move: "That the Bill be now read a Second Time."
I am delighted to have the opportunity to debate the Vulnerable Persons Bill 2015, which I submitted quite some time ago. It was No. 1 in the lottery system but every second week at the business meeting it was not drawn. I thought it was stuck to the bottom of the raffle drum.
I thank Ms Sarah Ekada, who, while completing an internship with my office, was instrumental in the development of the Bill, along with David Mullins and my daughter, Triona. What is also remarkable about Ms Ekada is that although her family originally emigrated here from the Democratic Republic of the Congo, she has sought to advance at all times the welfare of our own most vulnerable citizens. Today, she cannot attend this debate as she is at a conference in France doing this very work. She is a person of deep faith with a commitment to human dignity and for that she is to be commended. She is a credit to her family.
Elder abuse is one of the most serious and vicious activities that can be perpetrated upon vulnerable persons. It often takes place in great secrecy, hidden even from other close members of the same family who may be unaware of what is taking place. We know parents want to help their children. They want to be able to assist them where possible, including financially.
The fundamental point at issue here is that such assistance must always be a personal choice, and one that is made free of coercion, manipulation or threats. Where such a right to financial autonomy and the control of a person’s own finances is under threat, and where it involves brute physical, emotional or psychological pain, the State must become involved to vindicate and protect such rights. It has been clear for well over a decade that elderly people who are perhaps experiencing the onset of dementia also experience a very real pressure to transfer over management of their funds. That is understandable in some respects. However, as far back as 2013, the Law Reform Commission was conscious that the elderly constitute a significant and growing group who may also need specific support and protection from the legal system. Its report found that while the majority of elderly people do not need any special legal support or protection, there is a significant minority who, because of illness, disability, impaired mental capacity or social and economic dependency, do need protection. They may require protection from physical or mental abuse. They may need protection from the misuse of their money or property. The commission also found that at some stage they may need help with making decisions and, ultimately, they may need a substitute decision maker. As the report outlined, this matter is of interest to everyone and not just the current generation of elderly people. Any one of us could become a vulnerable adult in need of protection and there is nothing more certain than that.
To give a concrete example of what I am speaking about, I will refer to a case dealt with by my office, which was very distressing to all concerned. I will not give any names for obvious reasons. A lady wrote to me in 2015 because she was very concerned by the treatment and abuse her mother and father were receiving at the hands of her brother. Despite having 37 people who could corroborate the abuse her mother and father received, it took years for effective action to be taken. The HSE senior case worker for elder abuse involved was also verbally assaulted on many occasions. He declined to engage with the brother due to the level of verbal abuse. The public health nurse also referred the case following some disturbing interactions. The shoulder of this lady’s mother was broken in the presence of their youngest brother. Can we imagine? The days prior to her final hospital visit also deeply unsettled the neighbours.
The lady claimed to me, and it was subsequently verified, that the Garda never questioned the brother who was being accused of the abuse. This was despite the fact that the elderly mother was found tied up in her bedroom by a neighbour who needed some time to unravel the flex of the hoover with which she had been tied up. Just imagine. The mind boggles. Even the hospital consultant found the alleged abuser's behaviour aggressive, with a family doctor recalling him as a very troubled man. Despite all of this, the DPP's decision was that the evidence available was insufficient to prosecute. This case highlights the extreme difficulties families have in finding appropriate legal protection for their loved ones.
From an organisational viewpoint, and from information provided to me by the HSE and the Minister for Health, it is absolutely clear that the problem and scale of elder abuse remains hidden in the shadows of our culture. We know from the most recent data that at least 8,000 cases of alleged abuse or neglect of adults were reported to the HSE. We also know from a RED C survey carried out by the National Safeguarding Committee, NSC, that 16% of people admitted they knew a vulnerable adult close to them who had experienced financial abuse. The survey also found that one in three people believe vulnerable adult abuse to be widespread, suggesting the public believes there is a problem with safeguarding those who are limited in their ability to protect themselves.
In 2016, I appealed to the HSE and the Minister for Health, Deputy Harris, to increase the number of HSE case workers assigned to process and combat elder abuse. Sadly, it fell on deaf ears. I am not aware of any significant subsequent increase in resource allocations that would allow us to state greater inroads have been made in tackling this specific crime. I was informed by the head of operations and service improvement in the HSE's services for older people that only 31 senior case workers for the protection of older people were employed on a local health office area basis between 2011 and 2015. Clearly it is not being monitored and we are scratching at the surface and not dealing with it. The Taoiseach and the Minister for Health claim the budget is €17 billion, with €1 billion more in the Estimates every year. There are massive overruns but gaps across the board. In this case we have the distressing situations of the people who built up this country and gave us all that we have today. The years from 2011 to 2015 were also when more than 13,000 referrals of such abuse were recorded and assessed by senior case workers in the HSE. We need to know what the Government and, specifically, what the Minister has done to address this gaping deficit in service provision. I hope when he replies the Minister of State, Deputy Kehoe, will be able to tell us and not pass the buck for the Minister for Health.
During the summer, Ms Evelyn Ring of the Irish Examiner wrote an excellent and informative article summarising many of the concerns about this issue. I compliment her and challenge other journalists to do the same and expose this heinous behaviour. Her article made clear that reports of alleged abuse of older people and persons with disabilities increased by almost 30% in the past year. We must ask ourselves why this is happening. We are told every day about the recovery and that we are coming out the dark recession when many families fell into awful situations. Many parents and grandparents tried their best to help out and they are still helping out. Why is this increasing at a time of supposed economic recovery? What is driving people to this distracted state in which they would abuse their elderly? It was also noted that 10,118 safeguarding concerns were raised with the HSE last year, a 28% increase from 2016, with the largest increase recorded for those aged 18 to 64. These are staggering and shocking figures that are a huge cause for concern. Of the concerns reported to the HSE's national safeguarding teams, 7,199 came from a service setting and 2,915 from the community. This is also staggering and a shocking indictment. RTÉ discussed this on Mary Wilson's programme and tonight on "Prime Time" it will have an exposé on something similar. I salute it for this.
An analysis of the reporting rate shows that it increases with age. Concerns about women are higher in all age categories but reporting increases threefold for men aged over 80. Some of the key findings of a recent report by the National Safeguarding Committee found that for persons aged under 65, physical abuse is the most significant category at 46%. Psychological abuse and financial abuse at 31% and 22% remain the most significant categories for those aged over 65. In cases of alleged financial abuse, a son or daughter accounted for 40% of cases for those aged over 65, with a further 24% involving another relative. This is shocking. It was specifically highlighted that training and public awareness increased the level of concerns notified to the HSE safeguarding service.
I do not want to give the impression that this issue is specific to Ireland. By and large, we are still a culture that cherishes our elderly and incidents of attacks upon them are still greeted with the absolute disgust and horror they merit. In the broader European context, we have the European strategy to combat elder abuse against older women. The EU understands abuse of the elderly as a human rights violation affecting a significant number of old people, among whom a high percentage are older women.
Violence against the elderly is a violation of Article 25 of the EU Charter of Fundamental Rights, which recognises and respects the right of the elderly to lead a life of dignity and independence and to participate in social and cultural life. There has been much discussion of rights in this House in recent years. These are very basic human rights which should be respected. A Eurobarometer special report on health and long-term care in the European Union highlighted that 47% of European citizens think that poor treatment, neglect and abuse of dependent older people are common in their country. That is a staggering figure. It is a shocking statistic which speaks to the pervasiveness of this issue. Women are also particularly vulnerable to abuse. Two thirds of Europeans aged 80 or more are women and more than a third of them suffer from Alzheimer’s disease or dementia, which makes them even more vulnerable to abuse.
It is clear that the issues addressed by the Bill are widespread and urgent. The specific intention of the Bill is to protect, on reasonable grounds, the financial autonomy of vulnerable persons, specifically elderly people who lack reasonable mental and physical capacity, to guard against financial abuse. We often hear of scary things happening relating to power of attorney and wards of court also. The Bill provides:
“elder abuse’’ may be defined as an intentional act that could reasonably be expected to result in physical or psychological injury to an elderly person;
‘‘financial abuse’’ means interfering with the financial autonomy and wellbeing of a vulnerable person, which involves a person knowingly by deception or intimidation, obtaining or using, or endeavouring to obtain or use an elderly person’s funds, assets or property with the intent to temporarily or permanently deprive the elderly person of the use, benefit or possession of the funds, assets or property, or to benefit someone other than the elderly person;
‘‘vulnerable person’’ means a person, other than a child, who—
(a) is suffering from a disorder of the mind, whether as a result of mental illness or age,
(b) is suffering from a physical impairment, whether as a result of injury, illness or age, or
(c) has a physical disability, which is of such a nature or degree—
(i) as to restrict the capacity of the person to guard himself or herself against harm by another person, or
(ii) that the person is incapable of adequately providing for his or her own health
I am entirely open to amending the Bill to remove any conflicts with existing legislation. My aim is not solely to try to do something in my capacity as a legislator but also to try to keep a national conversation going on this matter. I accept that it is a difficult and challenging issue to discuss. It would be easier to pretend that the problem is not as widespread as it is, but that would do nothing to help those most in need. If Members are not here to help such people, they have no right to be here in the first place. I note the basic goodwill on all sides of this House in terms of addressing this matter. All Members want to do what they can to advance remedies that work and are effective, but we need resources and more fully trained and professionally skilled people who can recognise, identify and engage with families or individuals who are experiencing these problems. It is up to us all to play our part and make this a country where the old are cherished and valued. As stated by Robert Greenleaf, “Where there is no community, trust, respect, ethical behaviour are difficult for the young to learn and for the old to maintain.”