Adult Safeguarding Bill 2017: Second Stage

Senator Colette Kelleher

I move: "That the Bill be now read a Second Time."

I am delighted to introduce the Adult Safeguarding Bill 2017. I welcome visitors from the National Safeguarding Committee, the Support and Advocacy Service for Older People, SAGE, and my sisters from the south in the Public Gallery who are here for this occasion. In many ways this Bill is greenfield site legislation that I hope will become an important piece of the architecture of our legislation on rights, care and protections of people. The Bill's goal is to provide safeguards from abuse or harm, in particular for those who may be unable to protect themselves. It can be thought of as Children’s First legislation for adults at risk. It is important to note that this legislation is for all adults because at some point or other in all of our lives we may be at risk of abuse or harm.

It is unfortunately true that many adults across the State are abused and harmed every day. This harm and abuse comes in many forms and from many quarters. Some of those who are abused and harmed have no voice of their own and no one to voice their concerns. Some are physically unable to reach out for help while others lack the capacity to do so. It is very likely that at some point in all of our lives we may be at risk of harm or abuse. It may not happen today or tomorrow but some day we may be the adult with dementia who is financially manipulated, or the person post stroke who can no longer speak, or a person with an intellectual disability who is taken advantage of, or the person whose adult son or daughter has turned their loving home into a personal prison. In yesterday's news reports we saw the horrific Armagh so-called house of horrors case where a vulnerable woman was abused for years on end. This legislation seeks to provide protection for people in these and many other situations. The 500,000 people aged 65 or over, people living in their own home, people living in institutions, people in nursing homes, people with mental ill health, people with autism and people with disabilities, both mental and physical, are particularly at risk of abuse and require robust safeguarding.

While we do not have comprehensive statistics on abuse and neglect, the data that exist paint a very bleak picture. The National Study of Elder Abuse and Neglect from 2010 estimated that 10,000 older people are mistreated or neglected each year, with 6,000 cases of financial abuse. That study also showed that for many people who are financially abused, their only income was their State pension. Given that the State rightly pays more than €7 billion in pension payments and more than €3 billion in illness, disability and carers' payments, the scale of financial abuse is potentially massive. Dr. Amanda Phelan of UCD estimates that 32,000 older people were abused in the past 12 months - a staggering figure. We know form international studies that people with dementia are especially prone to abuse in the community, with rates as high as 55%.

The need for a legislative provision to safeguard adults from harm and abuse has been highlighted several times by various bodies over the past six years beginning with a Law Reform Commission report in 2011. In 2014, RTE's "Prime Time Investigates" programme exposed high levels of abuse of adults at risk in Áras Attracta, Swinford, County Mayo. This investigation heightened awareness of abuse of adults nationally and the need for comprehensive action and reform. Following the RTE investigation, the HSE published its safeguarding policy, Safeguarding Vulnerable Persons at Risk of Abuse National Policy & Procedures. This safeguarding policy outlines a number of principles to promote the independence and rights of adults who are vulnerable and outlines the procedures to be followed if there are concerns of abuse or neglect of a vulnerable adult. The policy provides for a number of structures to be set up to support the safeguarding agenda. This includes the National Safeguarding Committee, on which I once served.

In July 2016, the Health Service Executive, HSE, published the independent review of the Áras Attracta case. This review called for the HSE safeguarding policy to be put on a statutory footing. It noted:

The HSE's safeguarding procedures are now being put in place and activated throughout Ireland. In order for these procedures to have teeth, however, they are required to be placed on a statutory basis. This would ensure that they are fully implemented.

Similarly, the Health Information and Quality Authority, HIQA, in its submission last year to the Oireachtas Select Committee on the Future of Healthcare noted:

We believe that now is the time to introduce safeguarding legislation to protect at risk adults from abuse and neglect. While national safeguarding protocols are in place following recent high-profile revelations of abuse, these do not go far enough to ensure the safety and rights of vulnerable people.

Last year the National Safeguarding Committee, chaired by Patricia Rickard-Clarke, formerly of the Law Reform Commission, published its strategic plan 2017-2021 which sets out a commitment to "initiate conversations with Government and Oireachtas Committees on the development of legislation to include adult safeguarding". In launching the report, Ms Justice Laffoy said there is a "significant gap in adult safeguarding". She also noted the need to "enshrine in law the rights of vulnerable people".

Safeguarding legislation has been also called for by a range of other stakeholders including non-governmental organisations, NGOs, academics, Oireachtas Members, including Deputy Mary Butler, front-line workers, concerned family members, people in the community and self-advocates. It is clear that the status quo is not working. The HSE policy does not go far enough. Staff working in this area have said they need powers to go with the responsibilities of the role and legislative backup to protect adults. There are also clear conflicts of interest. The HSE has too many roles, some of which are conflicting. It acts as the commissioner, funder and provider of services as well as police and protector. People with concerns often have nowhere else to go, no clear pathway, often resorting to the Committee of Public Accounts as whistleblowers as a last resort. That is why I have included an independent arm's length body in this Bill. In my consultations on the Bill I was alerted to many different cases of abuse. I was told about one older woman who was admitted to hospital for an extended period and could no longer pay her bills as normal at the post office. Instead she gave her bank details to a family member to pay her bills. When she examined her account after she left hospital, she found that someone had set up a range of direct debits to pay their own bills from her account. I was told about an elderly woman living with her son who had alcohol and addiction problems who was sometimes abusive but whom she loves, experiencing serious difficulties.

The Grace case, which we have dealt with in detail in recent weeks, highlights more than others why we need legislation like this. The case, which involved an adult with intellectual disabilities, highlighted systemic and systematic failures to act to prevent abuse, conflicts of interest, poor separation of duties and responsibilities, and a lack of clarity about what to do. With Grace, her life and her welfare fell through all the cracks in our current system. The proposed legislation is a framework to protect people like Grace with clear definitions of abuse and obligations on those who could and would have acted. It creates an arm's length, independent body to prevent and investigate cases of abuse and harm.

The goal of this Bill is to ensure cases like Grace, Áras Attracta or many others never happen again by changing culture and mindsets, with people recognising what abuse, harm and neglect are and having zero tolerance of them. It should act as a deterrent and put people off committing abusive acts, with sanctions for those who fail to act. It sets out clear pathways for action so that no one can say they did not know or did not know what to do.

To that end the Adult Safeguarding Bill 2017 does two main things. Part 3 provides for mandatory reporting by certain professionals and others where an adult has suffered abuse or harm, is suffering abuse or harm, or is at risk of suffering abuse or harm. Part 2 establishes a national adult safeguarding authority that will be required to respond effectively if significant concerns of abuse or harm are reported. The authority will have the power to investigate, including the power to enter. It will also have powers to direct the HSE and others to provide additional support or assistance if required. This was much emphasised by those working on the front line. It will also be able to appoint an independent advocate, a key protection especially endorsed by the self-advocates I met in preparing this Bill. It will also provide education, training and public awareness about what risk looks like and about adults at risk. It will promote standards in the safety and quality of services, provide guidance to State bodies and the Minister and provide information directly to adults at risk of abuse and harm via a helpline and website. This ability to self-refer is an important aspect of the Bill.

The Bill has a human rights focus and defines abuse and harm widely. These definitions are set out in Part 1. "Harm" includes assault and sexual and financial abuse. "Abuse" includes:

act, failure to act or neglect, which results in a breach of a person’s constitutional or legal rights, physical and mental health, dignity or general wellbeing, and may include ill-treatment, intimidation, humiliation, overmedication, withholding necessary medication, censoring communications, invasion or denial of privacy, or denial of access to visitors.

Passing this legislation will ensure we make good on our commitment to Article 16 of the UN Convention on the Rights of Persons with Disabilities which states:

States Parties shall take all appropriate legislative, administrative, social, educational and other measures to protect persons with disabilities, both within and outside the home, from all forms of exploitation, violence and abuse, including their gender-based aspects.

The proposed legislation is informed by the following principles: the promotion of individual physical, mental and emotional well-being; the right to assistance, support and an independent advocate; the right to protection from abuse and neglect; interventions in people's lives must be necessary and proportionate; and respect for people's autonomy in decisions and interventions that affect them. The Bill, I hope, strikes a balance between the right to autonomy and the right to protection from harm. I have been working on this Bill for nine months. In that time I have been advised and assisted by staff within the House and by more than 40 stakeholders from a wide range of backgrounds, including NGOs, academics, front-line workers, families and people who will receive additional protections if this legislation passes.

In particular I thank Patricia Rickard-Clarke, chairperson of the National Safeguarding Committee, for all her advice and guidance, and the self-advocates and individuals who for one reason or another would gain protections from this Bill and who informed the content and helped shape it. I also thank Dr. Sophia Carey from the Library and Research Service, Melissa English and David Hegarty from the Office of the Parliamentary Legal Adviser, the barrister we worked with, David Dodd, and of course Padraig Rice for his invaluable support with this Bill and other work. I also thank my colleagues in the Seanad for the political support I have received for the Bill, in particular, Senators Buttimer, Clifford-Lee, Higgins, Bacik, O'Donnell, Boyhan, Black, Dolan and Ruane who all signed the Bill, and others who expressed their support, including Senator Conway-Walsh. It is rare to see such levels of cross-party support and I sincerely thank everyone for that.

Finally, I thank the Minister for Health and his officials who have been very generous with their time and advice. I am encouraged by the Minister's support and commitment to progress the Bill. It is urgent legislation but I understand it is complex, involves several Departments and requires some more development to become a long-term piece of our rights and care architecture. I am grateful, therefore, for the Minister's suggestion that we take this Bill forward to a form of pre-legislative scrutiny and I ask for a commitment today that a version of adult safeguarding legislation will be enacted within a year. I ask fellow Senators to pass this Bill tonight to ensure we can progress it to the next required stage.

Senator John Dolan

I formally second the Bill. More than 100 years ago we gave asylum, in the best sense of the word, to people to protect them - people with mental health issues in the mental hospitals, people with other issues, the deaf and the dumb, as people were referred to, those who were blind, and those who were regarded as imbeciles. The cost of that protection was to be apart and sundered from the society they came from, to be forever outside. They were in a micro-community in those hospitals and other places. Just as in so many other areas such as communication, transport and medicine, there have been phenomenal changes over the past 100 or indeed 50 years. We put safeguards in place, develop mandatory standards, legislation and regulations, and we police them. Maybe we do not do that as well as we should but we have methods for doing that. There is data protection for people. Transport and vehicle standards and road and infrastructure standards have improved. In the medical area blood tests were not routine 30 or 40 years ago but they are now. We almost ask for the ones we want. In respect of blood transfusions approximately 30 years ago a Government precipitated a general election as a consequence of contaminated blood being provided by the State to people. We know the number of deaths that caused.

Now, more and more, people who have or who will have vulnerabilities live in the community. Those of us in the State are actively working to ensure people can move to or stay living in the community. We need a range of instruments to support them effectively.

I commend Senator Kelleher on bringing this Bill forward and I am honoured that she has asked me to second it. I want to make two pertinent points about Senator Kelleher. She has worked with the Cork Simon Community. She worked in the Cope Foundation for several years. She has worked in the Alzheimer Society of Ireland. Need we say more about someone who has felt, smelt and seen vulnerability in people, in our brothers and sisters? The other point I want to make relates to her general approach. She knows intimately the need for such legislation. She has clearly said this Bill is open to being improved and that she is open to it being improved. Having listened to and been close to people in vulnerable situations over many years, she has constructed this Bill and now she lays it before us all for further input into it and with the intention of approving it. I am asking every Member to engage with this reasonable, important and necessary legislative development to improve and pass it with the full support of the House. I can add my experience from across the gamut of disability and mental health issues for many years. I can say easily and in a relaxed way that this legislation is badly needed.

As a developed society, for the past quarter of a century, in particular, we have been forced to examine our own lapses in the provision of services and supports. I will not set out the litany, but we still have these lapses with us. We have seen our systems built too strongly on the twin pillars of trust and lack of ambition for people's lives. Consequently, we must know truly in our hearts that we need a body of safeguards. This Bill is an important element in this regard. It will also have a powerful and vital element in changing mindsets about people. That is crucial. Sometimes the measures will have to drag people to change their mindset, but I hope that will not always be the case. There is a good balance of carrot and stick in the Bill. Every person is vulnerable and everyone merits the dignity that the protection in the Bill would bring.

Another point is important. There is no group or class of people who are vulnerable adults or who are vulnerable by virtue of any category. Sadly, some people come into this world in a vulnerable situation and remain vulnerable for their lives, whatever the length. This Bill is about the universal condition of vulnerability. We have lessened vulnerability for some people in some components of their lives because of the actions we have taken, for example, the marriage equality legislation. Many instruments are needed, including this legislation. At some point in our lives, as individuals, we are all vulnerable. Let us consider the years of recession when we saw loss of jobs, homes and families. Other examples include marital break-up and life-changing illness or disability. When my nearest and dearest are vulnerable, I am vulnerable. Vulnerability can arise through neglect, mistreatment or the infliction of harm. It can come from being seen as a lesser person or a less valuable human being and can derive through age or other changed circumstances.

Some of us manage to muddle through with the support of empowering friends and contacts or with the love of other people who are close to us as well as the love of some people who we had thought were not close to us. Sadly, these natural supports are not always available to us. We are not always allied with supporters and advocates who can put manners on the relevant person or entities. That is why we need this legislation. This Bill is one of the necessary modern methods to be able to provide protection. It is needed so that people can live freely in the community. The ultimate prize is to have people being protected and safeguarded as and when necessary in order that they can have good lives in the community and so that they can thrive and flourish.

Minister for Health (Deputy Simon Harris)

I thank Senator Kelleher for bringing forward this Bill today. The Government supports the principle of providing a legislative basis for the safeguarding of vulnerable adults. At a personal level, I welcome Senator Kelleher's efforts to progress legislation in this area. The Minister of State at the Department of Health, Deputy McGrath, was scheduled to take this debate on behalf of the Government, but I wanted to be here for the start of the debate to show my personal commitment to working with Senator Kelleher and all Senators on all sides of the House to try to make progress in this area.

The issues covered in Senator Kelleher's Bill are complex and broad, as the Senator has acknowledged. They extend far beyond the scope of the health sector alone or of any one Department. Strong collaboration and joined-up thinking will be required from a number of Departments and State agencies to ensure we provide the best legislative solution to safeguarding vulnerable adults across all services provided by the State.

Senator Kelleher knows these areas well and I am keen to extend my thanks to her. It is a particular pleasure to do so in front of her family, who have travelled to be with her this evening. I extend my thanks to Senator Kelleher not only for this substantial work, this Private Members' Bill, but also for the work she has put in over many years with vulnerable people, including her work with the Simon Community, the Cope Foundation and the Alzheimer Society of Ireland as well as on children's issues in the UK. I greatly value her expertise and input and I look forward to working with her on these matters.

The safety and protection of vulnerable people in the care of the State is paramount. A framework of policies and procedures is in place in Ireland for the safeguarding of vulnerable people at risk of abuse. I will outline some of these measures shortly, but it must be noted - this is important and represents a collective failing on the part of all of us - that there is no statutory framework underpinning these policies. I agree strongly that a legislative basis must be provided for this safeguarding.

The development of appropriate legislation is under consideration. This is a broad tranche of work that will involve an extensive scoping exercise across a number of different sectors to determine the precise nature of legislation involved. To this end, I sought the assistance of the Attorney General in liaising with the Law Reform Commission to conduct research in the area, as per the Law Reform Commission Act 1975. Consultation will also be required between relevant Departments. The most relevant Departments include the Department of Justice and Equality, the Department of Social Protection, my Department, the Department of Finance and the Department of Public Expenditure and Reform as well as others. We need to identify the current legislative gaps in the protection of vulnerable adults. Public consultation with stakeholders will be necessary as well to allow affected parties to express their views. It is important we hear their views and voice regarding improvements to the current system. By identifying the major legislative gaps and the preferred approach to addressing these issues in the context of the considerations of the Law Reform Commission on these matters, the Government will be in a position to determine the Departments most equipped to lead on the development of legislative solutions and the agency or agencies to be tasked with implementation. We know that implementation in this country is key. All of these processes will need to feed into the refinement of the Bill to promote adequately and effectively the safeguarding of adults at risk. That is the point we all want to get to as quickly as possible.

Before looking at some of the specific measures in the Bill, I will outline current policy and how it is being implemented. This is an important context to any debate on the matter. The Health Service Executive published its national safeguarding policy and procedures document, Safeguarding Vulnerable Persons at Risk of Abuse, in December 2014. The origins of this policy lie in the report, Protecting Our Future: Report of the Working Group on Elder Abuse, which was published in September 2002. Following the publication of that report, an elder abuse service was established by the HSE. In 2014, the last year for which figures were published, a total of 2,595 referrals were made to the service. This was an increase of 5% on referrals made in the previous year. Psychological abuse was the most frequently reported form of elder abuse at 28% of all complaints. This was followed by financial abuse, which accounted for 21%. The figure for self-neglect was 21% and the figure for physical abuse was 12%. A total of 66% of referrals in 2014 related to women. Of these, the majority were in the over 80 age category. That category accounted for 54% of cases. The referral rate was nearly four times greater in the over 80s when compared with the 65 to 79 years of age category. Public health nursing was the main referral source, amounting to 29% of referrals. This was followed by hospitals, which accounted for 14% of referrals, and family in the case of 13% of referrals.

There was a significant increase in the number of concerns that first originated from older people, from 19% in 2013 to 26% in 2014. This increase shows that more older people were referring and reporting abuse directly to the services.

The HSE has established a number of structures to implement its national safeguarding policy, including a national safeguarding office and a national safeguarding committee. Safeguarding and protection teams to deal with suspected abuse have also been established in each of the nine community health care organisation areas. These teams are managed and led by a principal social worker and staffed by social work team leaders and social workers. Staff training is ongoing, with a target to train a minimum of 17,000 staff in safeguarding during 2017. Over 900 existing care staff have been assigned as designated officers in service settings within the HSE's social care division to receive concerns or referrals of abuse.

The national safeguarding committee was formally established in December 2015 and includes multi-agency and inter-sectoral representation. The committee is independently chaired by Ms Patricia T. Rickard-Clarke. I welcome Ms Rickard-Clarke and her colleagues to the Seanad this evening and thank them for the huge body of work they have undertaken and note the important role it will have in inputting into any legislative solution. The committee has agreed terms of reference but its overarching remit is to support the development of a societal and organisational culture which promotes the rights of persons who may be vulnerable and safeguards them from abuse. Its remit extends beyond abuse of older people, those with mental health conditions or people with disabilities. Importantly, as both Senators Kelleher and Dolan have alluded to, the committee recognises that any vulnerable adult can be subject to abuse and that vulnerability can be a transient or permanent state depending on many influences. Any of us can become vulnerable at a certain point in our lives.

The national safeguarding committee published its strategic plan for the period 2017 to 2021 on 20 December 2016. One of the strategic objectives it identifies is the initiation of conversations with Government and the Oireachtas on the development of legislation on adult safeguarding. I welcome this. The work of the committee to date has confirmed that the scope of the issues relating to the safeguarding of vulnerable adults goes far beyond just the area of health and that a much broader, cross-sectoral approach is needed. Senator Kelleher served as a member of the committee on its formation. The involvement of the committee will be a key factor in the successful development of legislation. Perhaps the pre-legislative stage could provide an opportunity for further discussions and input from the national safeguarding committee directly to an Oireachtas committee.

Following Government approval in November 2015, I had the pleasure of launching the national patient safety office, NPSO, in December 2016. The aim of the office is to give policy direction and leadership in order to bring about improvements in patient safety to a health system that has been the subject of numerous investigative reports on patient safety incidents in recent years. The NPSO is developing a patient safety complaints and advocacy policy. This is in line with recent commitments to examining the complaints process as set out in the Health Act 2004 and associated regulation. The work has commenced with an examination of existing complaints models and systems internationally and a scoping exercise in respect of what exists in Ireland has been completed. The HSE’s Your Service, Your Say policy is currently being updated. In addition, patients can make complaints to the Ombudsman and to service and professional regulators.

The Adult Safeguarding Bill 2017, which we are debating this evening and which was published by Senator Kelleher, proposes the establishment of a national adult safeguarding authority with the objectives of promoting the safeguarding of adults at risk, and reducing the abuse and harm of adults at risk. The functions of the proposed authority would include: the undertaking of investigations where the authority believes on reasonable grounds that there is a risk of abuse or harm to an adult at risk; receiving reports from mandated persons under the legislation; promoting standards and providing information to adults at risk; and supervising compliance with duties imposed under the legislation. The Bill also includes measures to provide for: the provision of an independent advocate to an adult at risk who is the subject of an investigation; the appointment of authorised persons to conduct investigations and receive reports; and the imposition of a mandatory reporting obligation on a broad list of mandated persons. These issues will need to be thought through very carefully and I am glad the Senator has agreed that detailed pre-legislative scrutiny is the best forum in which we can iron out this detail and hear from all of the appropriate stakeholders.

I will now deal with some of the issues in the Bill and I do so to be helpful. I hope they are seen in the constructive manner in which they are meant. This is intended to spark the debate about how we can best progress the legislative underpinning of this important area.

A key element of the Bill is the establishment of a new authority to undertake investigations and receive reports from mandated persons. As a Government, we would prefer, as a general rule, to see new functions allocated to existing bodies, to avoid the large cost or, at times, extensive delays associated with the creation of an entirely new organisation. That is a matter that can be teased out further in the context of whether it is better to have a new authority or whether there is an existing authority that could fulfil that function, and the pros and cons of this.

In respect of the health service alone, consultation will be needed with the HSE and regulators such as the Mental Health Commission and HIQA. The remit of the proposed authority would be much wider than the existing HSE safeguarding and protection teams, the remit of which extends only to HSE and HSE-funded providers of disability and older people’s services, including private nursing homes. We need to establish how we ensure that we capture a broader range of responsibilities than those relating to the existing safeguarding and protection teams.

The proposed authority would have the power and duty to investigate allegations in relation to any adult who may be vulnerable wherever they may reside and regardless of their connection with statutory services. The relationship between the proposed authority, HIQA and the Mental Health Commission would also need to be clarified and discussed in further detail. In addition, consultation would be required with a broad range of stakeholders across the range of affected sectors to determine the best model prior to any final decision being made.

The HSE has an extensive staffing system in place for the protection of vulnerable adults at risk of abuse. There are in the region of 60 staff employed in safeguarding teams in the community health care organisations, which are managed and led by a principal social worker and staffed by social work team leaders and social workers. Extensive staff training is in place, as I have outlined, and over 900 designated officers have been appointed in service settings within the HSE’s social care division to receive concerns or referrals of abuse.

It would be important, at the pre-legislative stage, to ensure complete clarity between the roles of the proposed authority and those already in situ in the HSE, and to avoid overlap of functions, for example, in respect of training, publicity and the categories of authorised and mandated persons. In addition, under the functions of the proposed authority, there is a lack of statutory obligation for it to have regard to resources available to the HSE or any other public body with which it may have dealings. This is something that is included, for example, in section 8(2) of the Health Act 2007 whereby HIQA must have regard to the resources of the HSE in carrying out its functions. That matter would be worthy of discussion at committee.

Notwithstanding the issue of best practice, the proposals included in the Bill would need to be costed at a later stage. Any additional services would need to be costed in a detailed form and resourced properly, and details of this would need to be included in the Estimates and budgetary process that we need to go through in both Houses on an annual basis. Detailed scoping work would need to be carried out by all relevant Government Departments to cost these services so that we could have them in place when the time comes for Estimates and budgetary discussions.

The Bill, as drafted, relies heavily for the provision of independent advocates on the Assisted Decision-Making (Capacity) Act 2015. It is important to state that this Act is being commenced on a phased basis. New administrative processes and support measures, including the setting up of the decision support service within the Mental Health Commission, must be put in place before the substantive provisions of the Act come into force. A high-level steering group comprising senior officials from the Departments of Justice and Equality and Health and the Mental Health Commission is overseeing the establishment and commissioning of the decision support service and this work is ongoing. It is not possible to provide an exact timeline for the full implementation of that Act. That, again, is an example of the discussion that we would need to have including the Department of Justice and Equality. Pre-legislative scrutiny might provide that opportunity.

A substantial number of new powers and responsibilities are proposed in the Bill, including the proposed investigation process, the right of entry and inspection by an authorised person, the mandatory reporting by mandated persons and the schedule of persons to be specified as mandated. All of these matters will require careful legal consideration before their appropriateness can be determined. In outlining the issues that need to be teased out, I want to make clear that I am not dismissing the provisions in the Bill or undermining them in any way. Rather, I am seeking to provide a roadmap in respect of the issues we need to discuss at the pre-legislative stage. We need to hear from the relevant stakeholders and regulators - HIQA, the Mental Health Commission, the HSE, other Government Departments that have a role to play - and, most importantly, from the people we are trying to protect on these issues. These are some of the matters that will require further discussion and that is why I welcome the opportunity to do that at pre-legislative scrutiny stage. I do not see that as an effort to stall in any way what we all want to achieve, namely, the underpinning of the safeguarding of vulnerable adults on a statutory basis. I remain absolutely committed to working with Senator Kelleher in that regard.

I sincerely welcome the platform provided by this debate to put on record the Government’s position on the safeguarding of vulnerable adults in Ireland.

The safety and protection of vulnerable people in the care of the State is paramount. It is an area in which we have failed collectively time and again as a State. We clearly need to do something because what we have done to date has not been adequate, and we have seen many an example of that in recent weeks and months.

I agree that this protection should be and must be placed on a statutory basis in an appropriate way. My Department is committed to working with all other relevant Departments and stakeholders to put comprehensive and effective legislation in place. We need to have that broad consultation and we need to have the legal advice necessary to make sure we get this right in the interests of those whose needs we must prioritise.

I sincerely thank and congratulate Senator Kelleher on introducing this Bill. I look forward to working with her and colleagues in both Houses to ensure we progress the principle of what we are trying to advance to ensure that the most vulnerable in our society receive the protections that they require.

Senator Keith Swanick

I, too, commend Senator Kelleher on the effort she put into this Bill. It is fantastic. Fianna Fáil is happy to support and co-sponsor this Bill which aims to put additional protections in place to protect all adults from the possibility that at some stage in their lives they may be at risk of abuse or harm. I also welcome members of the Support and Advocacy Service for Older People, SAGE, and the National Safeguarding Committee as well as members of Senator Kelleher's family.

This Bill's goal is to ensure cases like Grace, Áras Attracta, with which I would be very familiar in my area, and many others will never happen again. This Bill provides for mandatory reporting by certain professionals and others where an adult has suffered abuse or harm, is suffering abuse or harm or is at risk of suffering abuse or harm. It is important to identity what is meant by abuse and harm. Harm includes assault and sexual and financial abuse. Abuse includes acts, failure to act or neglect which results in a breach of a person's constitutional or legal rights, physical and mental health, dignity or general well-being and may include ill treatment, intimidation, humiliation, as we saw in the Áras Attracta programme, overmedication or undermedication, censoring communications, invasion or denial of privacy or denial of access to visitors. In 2014, the RTE "Prime Time Investigates" programme exposed the high levels of abuse of adults in the Áras Attracta setting in Swinford, County Mayo, with which I am very familiar. It heightened the awareness of abuse of adults nationally and solidified the need for comprehensive action and legislative reform. We were all shocked, and certainly I was, at the disgusting behaviour of health professionals on the night of that programme, and I was truly hurt and embarrassed as a health professional to witness what we did on that night. I hope we will never see the likes of it again.

The proposed legislation is informed by the following principles: the promotion of individual physical, mental and emotional well-being, and the right to assistance, support and an independent advocate. We might ask what is an independent advocate. It is important that a person speaks or writes in support or defence of a vulnerable person. That is what an advocate is. Other principles include the right to protection from abuse and neglect; interventions in people's lives must be necessary and appropriate; and there must be respect for people's autonomy in decisions and interventions affecting them.

It is also worth acknowledging that a great deal has been done in recent years. The Health Information and Quality Authority, HIQA, is now ten years old. The enactment of the Children First Act is another welcome development and improvement. Similarly, the passage of the Assisted Decision-Making (Capacity) Act is a further manifestation of improving standards. It is to be hoped we will soon see the passage of a disability (miscellaneous provisions) Bill to ratify the UN Convention on the Rights of Persons with Disabilities as a another positive step. I commend Senator Dolan on all his work in this regard and the Minister, Deputy Harris, on his commitment to reform.

With respect to the HSE's response to the Grace case, one of the most important and significant recommendations of the Conal Devine report was the provision and the implementation of a safeguarding policy for vulnerable adults. The HSE launched a national safeguarding policy for vulnerable adults in 2014, and while the safeguarding policy is currently not supported by legislation, it is a significant development in the protection of vulnerable adults, both those in residential services as well as those living at home. I would welcome that safeguarding being placed on a statutory basis.

I am delighted to lend my support and that of my party to this Bill. I once again commend Senator Kelleher on her hard work on it. Her efforts were Herculean.

Senator Victor Boyhan

I welcome the Minister to the House. I thank Senator Kelleher, in particular, for co-ordinating and drafting all the work that has gone into this Bill. It is being co-sponsored across parties. That is a measure of Senator Kelleher's broad support, the respect she holds in this House and her understanding of these very complex issues, and I acknowledge that. Previous speakers spoke about her past experience. From the very first day I met her here, she has been passionate about care. She has proven time and again that she has used her experience in this House very effectively in terms of legislation. This is a particular case in point, and it is important to note that.

There are 24 sections in this important Bill. When Senator Kelleher first came to me and asked if I would co-sign it, which I immediately agreed to do, she said it might not be perfect but it is a start. It is an exceptionally good start. It may need slight tweaking, and that is where we all come in. We are all working together for the one objective, which is ultimately the safeguarding of adults. I like the Senator's emphasis on all adults. As she clearly pointed out, we will all be vulnerable at some stage in our lives. That is the nature of life. There will be times when we will be vulnerable, weak and reliant. We will be dependent on other people to advocate for us and to defend our rights. That is a human response and a human need. I would like to think everyone would want to vindicate and support that safeguarding and protection of people.

The Minister and Senator Kelleher made the point, with which I agree, that this Bill has a strong human rights focus, and why would it not? This is about human rights and about respect for humanity and people. The Bill proposes the establishment of a national adult safeguarding authority with the objectives of promoting the safeguarding of adults at risk and reducing the abuse and harm of adults at risk, which will be some of the functions of that proposed authority. The proposals in the Bill are: to promote standards in the safety and quality of services provided for adults at risk, and that is what is envisaged in the national adult safeguarding authority; to undertake investigations where it believes, on reasonable grounds, there is a risk of abuse or harm of an adult at risk; to promote education, training and public awareness of the Act on matters concerning adults at risk; and to provide information to adults at risk in respect of abuse and harm they may be suffering.

We all know that abuse is very complex. It can be emotional, physical, financial, mental or sexual. There is a range of abuse, all of which is abuse, and there is no greater or lesser category of abuse. It is simply abuse. It is an appalling and shocking thing to happen to anyone and no one should have to suffer abuse. More important, however, people need to be empowered to respond and seek out help and support when they are the subject of abuse. That is important. It is also important to say that not all abuse happens in institutional care. We know people are abused in their family homes. We know family members abuse members of their family, be they young, middle-aged or old. That is the reality of it. We all know that from our casework. It is important that such work takes place.

Schedule 1 to the Bill reads, "The following classes of persons are specified as mandated persons for the purpose of this Act". It occurred to me as I read the list of mandated persons, which includes medical practitioners, social workers, probation officers, teachers and members of An Garda Síochána, that, sadly, I have read or heard of cases of abuse in every one of those categories. It has impacted on all those professions. Abuse knows no bounds, as we all know. That is an important point.

It is important the focus in the Bill is kept on the provision of person-centred support. It is important, with respect to the proposed national adult safeguarding authority, the establishment of which this Bill seeks to achieve, that it acts professionally and ethically, which is very important, and that we envisage and hope to empower people, either individually or collectively, which is very much needed, and that we protect and promote the rights of all adults.

We must always act with a duty of care to people. People need to be empowered and understand the implications of that. We need to ensure the wishes and the preferences of individuals are taken into account when dealing with abuse. Far too often, I have met people who were in an abusive situation who do not feel they have any power and are afraid. Their first port of call may be to the authority that they are complaining about. That is the reality of it. There are real issues for people in identifying an appropriate first port of call, particularly in a care situation. This is particularly so if they are vulnerable or do not have family to assist in dealing with whatever organisation it may be. It is important that we inform people of the scope of abuses and empower them to go on.

There are real issues in maintaining independence of service from service providers in terms of protecting people. This is a real issue, as is the area of maintaining confidentiality. We have seen many instances in the past few months of people who wanted and sought help and had elements of their confidentiality eroded or not respected. It is very important that we at all times deal with the person and his or her story. They need space, time, support and confidentiality. However, confidentiality cannot be used to close down investigations and open up issues.

During my time in the Seanad, I have had to make representations on a number of cases of alleged abuse in institutions of this State. I have been bitterly disappointed by the lack of engagement. I have been bitterly disappointed that people who have alleged they are suffering abuse have not had the support of the agencies and authorities that should support them. I put that on the record of this House. I am pursuing one or two issues at a very senior level, which is the appropriate place. There will come a time when I will have to push out further. I do not think that is good enough. To go back to people who are suffering and tell them there is a process which takes a long time is no good for people in that terrible situation. We need competence, compassion, care, understanding and support for people.

I encourage everyone to support this Bill. The Minister has talked about pre-legislative scrutiny. The time is now. It is time for us to act, not delay this Bill. If there is to be pre-legislative scrutiny, which I understand and recognise is important, we do not want delay. We accept and acknowledge it needs to happen. We accept and acknowledge that people are being abused in institutions of this State. We know the record.

I pay particular tribute to RTE and the media - print, radio and television - because they have opened up the window and beamed terrible stories into our homes. It is important.

I want to hear when the next Stage of this proposed legislation which will give a statutory basis to protecting and safeguarding people will be. I thank the proposer and all those who co-signed the Bill.

Senator Colm Burke

I welcome the Minister of State to the House. I thank Senator Kelleher for bringing forward this Bill. It is quite comprehensive and a lot of work has gone into it. I pay tribute to the Senator and the people who helped her because it is a very carefully drafted document, not something that was drafted in a very short period of time. A lot of thought has gone into it.

It is very important that we provide the level of safeguard and security proposed by the Bill, particularly as it is now very relevant. While we might initially think the Bill will concern people with disabilities, there has been a huge demographic change in this country and we have more and more older people who will benefit from it. The age profile in the country is going to change quite dramatically. We also have more and more people living on their own whose families have left the country, meaning the level of family support that was there in the past may not be there in years to come. That is something to keep in mind. This Bill is very important from that point of view. The Bill clearly sets up mechanisms for dealing with those situations and providing safeguards such as setting up the national adult safeguarding authority, the functions of which are set out in the Bill. The Bill is well thought-out in that respect.

One of the Bills I have brought into this House was in regard to professional home carers. There is currently no regulation of those who are providing home care. That is an area that needs to be dealt with. There are 32 organisations providing home care services but they are not really covered by legislation. There is an understanding between the HSE and these organisations but there is no statutory regulation in place. That is something which this legislation covers also. It would be worth looking at Senator Kelleher's Bill along with the Bill I brought forward in regard to home care because there is not adequate legislation in place to deal with this area.

There is an issue about legislation that is in place but not being implemented. An example of this is the role of disability officers in local authorities. I have spoken to a number of different local authorities, each of which has a different interpretation of the role of the disability officer. I raised this issue because I came across a family whose child had intellectual and physical disabilities. I have mentioned this before in this House. The family needed major changes to their house in order to look after their child. Six years later, nothing had been done by the local authority. When I contacted the disability officer, the response was that it is not the disability officer's job to advocate for that child. The disability officer saw the role as being to provide access to public buildings, not to advocate for people with disabilities. That interpretation is wrong. When I rang the National Disability Authority, it had a totally different interpretation. It is an issue that is quite easy to check out. The Minister of State could write to every local authority, setting out the role of the disability officer, and examine whether there is legislation in place which is not being implemented. I believe there is. I have asked the National Disability Authority to write to each local authority and update them on the role of the disability officer. When I rang one local authority, its disability officer had got two things done that year at a cost of €8,000. That was the only work the officer did during the year as disability officer because this person also had responsibilities for other areas in the local authority. That is a very simple issue to rectify. It is grand to bring in legislation and have it in place but then we must ensure it is used effectively.

This is very welcome legislation because it opens up the discussion about the responsibilities and duties of individuals and statutory and local authorities. We need to see if they are being used effectively. If one takes the case of the child with major intellectual and physical disability, I had to take that all the way to the Office of the Ombudsman for Children before I got the local authority to do the necessary work on the house for the family. It is important that legislation which is brought in is followed up on.

At section 12 of this Bill, the role of the independent advocate is clearly set out. That is extremely important because there are situations where an adult may be living with his or her parents but the parents are unable to adequately put forward their concerns. This could be someone with a disability. That is also extremely important.

I welcome this legislation. It opens up the entire discussion. I agree with other Senators that it is important that the legislation is not parked for another three or four years before being dealt with. We must bring forward comprehensive legislation to deal with all of this area and also the issue of home care and home care providers.

Senator Máire Devine

I welcome the Minister to the House. I welcome visitors and stakeholders, particularly Senator Kelleher's sister. I am sure they all worked with Senator Kelleher for nine months - a gestation period - hoping to get this Bill through, so well done to them. This Bill is about five things - awareness, understanding, procedure, good practice and mandatory reporting. The Bill will bring awareness and urgency regarding all adults in vulnerable situations. Vulnerability is fluid. We can all be vulnerable at different stages of our lives. It is not just for those who may have additional needs, although it will primarily offer them the protection they deserve. It is for the protection of anyone who may find themselves vulnerable to abuse. It is to be welcomed that this House and society are addressing this and putting it on the record that there are vulnerable adults. It could be any one of us and it is an issue that is serious and deserves legislative support.

Recalling my own experiences in nursing in the community here and in Belfast, I have come across a lot of at-risk or neglected individuals. I had a duty of care and I could report abuse because I could go to my own regulatory body to do so. However, I have met ordinary care workers who still ring me to seek advice. They are very concerned, particularly when dealing with an older person or a person with a disability in the home setting. They are terrified and do not know where to go. It is to be hoped this Bill will give them the lead and responsibility they need. It will bring an understanding to those in the community and care sectors, who are currently at a loss as to how to manage situations involving adults and abuse.

Many people in the community and care sectors are in no man's land if they are suspicious or if there are allegations or actual cases of abuse towards adults. There is no clear understanding about where to turn to, what the worker is responsible for and the most appropriate way to respond. This Bill clears up a lot of this confusion. Given Senator Kelleher's background in community work, for this legislation to come from the ground and the Senator's own experience and go through this House first is great news and is to be welcomed. We as legislators must listen to those who have first-hand experience. Perhaps if those in power had listened sooner, we would have had this legislation earlier and avoided many of the recent controversies in the news. My colleagues continually tried to report abuse in Áras Attracta 15 years ago. They were not listened to and, as Senator Swanick said, it was our other colleagues who were perpetrating this abuse. It took an RTE programme to blow it out of the water, so to speak, and get it into the public domain.

I welcome this Bill which will introduce clear procedures and outline key responsibilities for agencies in dealing with vulnerable adults. Having awareness, understanding and a protocol results in good practice. I commend Senator Kelleher on moving beyond the indignation felt by all of us about the recent stories of Grace, Mary et al and formulating this Bill, which puts key measures in place to ensure these types of atrocities are not seen again. This is why Sinn Féin is happy to co-sign this Bill. We believe it will bring positive change to this Republic.

One element of the Bill is vitally important, namely, the provision set out in section 12 which outlines the need for an independent advocate to assist and support should they be requested. The reality is that independent advocacy would aid many different elements in our society, for example, in respect of the mental health tribunals about which I am conducting research. This morning's meeting of the Oireachtas Joint Committee on Children and Youth Affairs involved a discussion about advocacy for children in need. The rationale for the provision of advocacy is clear. It ensures fairness, dignity and support for the vulnerable person regardless of ability or situation. It is vitally important. We look at the great work of the Irish Advocacy Network.

I note that we have a few small changes to make around definitions in the Bill. It is nothing major. The changes would add to already solid legislation. I am sure people will agree that the stronger we make this Bill with regard to definitions and remit, the better. Sinn Féin hopes Senator Kelleher will welcome the small changes in an enabling capacity on Committee Stage.

In light of all the recent dark controversies regarding adults who were abused and left unprotected, I am at least partially comforted by the idea that cases will never be allowed to happen again. This legislation will play an important role in this regard. Over recent months, based on my experience in the Seanad and committees, I believe we are entering an age of modernisation or enlightenment. So many Bills and motions are going through that seek to protect the vulnerable. We are beginning to recognise the need to mind each other and to care for and embrace those who do not have a strong voice at different stages of their lives. I have no doubt that support will be given throughout this House and I again commend Senator Kelleher.

Senator Frances Black

I commend Senator Kelleher on introducing this Bill and all those who have supported it. I wholeheartedly welcome this legislation because we all know that some of the most heinous crimes committed in this country target the vulnerable. I believe this legislation tackles the abuse of vulnerable adults and will lead to equality of treatment of all people.

Abuse of the vulnerable can take many forms. It can be sexual as in the Grace and Mary cases. It can be neglect. It can be physical and psychological abuse in the case of the Áras Attracta scandal. A society should be judged on how it treats its most vulnerable, and all safeguards must be implemented to ensure the proper treatment of vulnerable adults. Some vulnerable adults may not even be aware of their abuse. I believe that special education programmes could be made available to vulnerable adults so that they understand when they are being abused and have the language and opportunity to report this. The exploitation of the elderly by unscrupulous people in getting them to withdraw cash to pay for unnecessary property repairs and renovations is another example of vulnerable adults being abused. Bank employees could be educated to recognise this type of exploitation and to ensure any large cash withdrawals for this type of work are replaced by bank drafts payable to the contractor. With all the questions that have recently come to light about the integrity of the Garda Síochána and its inaccurate reporting of issues, I think it is necessary to examine the practice of Garda questioning of vulnerable adults. The appointment of an independent advocate should address this issue.

I see the need for this legislation on a weekly basis through my work with the RISE Foundation. We offer support for family members impacted by the alcohol and drug misuse of a loved one. Family members who have a loved one in addiction often struggle with shame, stress and anxiety. They are terrified to ask for help because of the risk of being judged by society, especially when they are living under the threat of violence from drug gangs because of drug debts accumulated by their loved ones. Recently, I worked with two elderly women whose sons were in addiction, both living in rural communities. One of them who lives in an isolated area on her own had extremely threatening drug dealers call to her house. She was terrified. Another incident involved one woman having a photograph of her six year old grandchild sent to her with a note asking for huge amounts of money that she did not have. She ended up going to the credit union but still lives in fear. I believe these vulnerable women will benefit from the support available through this legislation.

Vulnerability can occur at many times in an adult's life and can be as a result of health, financial or other difficulties. When people are in this state, they are often easy targets for exploitation. People with health difficulties can be forced by family members or others to sign over property or assets against their will. This Bill will protect these vulnerable people. People who find themselves in financial difficulties can often be preyed upon by people who can exploit their weaknesses and get them to sign up to high interest loans. These people need to know their rights.

Some elderly people have to end their days in nursing homes when their families are unable to give them the care they require. This is a very difficult decision for any family. This Bill will safeguard the rights of these vulnerable adults to be treated with the respect and dignity they deserve and will also give peace of mind to the family who can have confidence that the homes are properly monitored.

Another group of people in society who are vulnerable is that comprising adults with intellectual disabilities. The recent case of a young woman being left in foster care despite allegations of sexual abuse highlights the gaps in services in our country and I am of the view that the introduction of this legislation will go a long way to address these.

I welcome the legislation. I commend Senator Kelleher and all involved for the great work they have done.

Senator Michael McDowell

I, too, welcome this Bill. I commend Senator Kelleher and all her colleagues in this House and those outside it who have helped her with this initiative.

Sometimes, when we see a proposal to establish a new statutory body, we can query whether it might be easy to propose and difficult to oppose. In respect of this issue however, I think we now have sufficient experience to judge that adults who are at risk really do not have the protective system that we accord to children by means of the Ombudsman for Children or similar bodies. The adults in question really are an isolated group of people. They depend on agencies such as HIQA and so on to pick up indications of their potential abuse. There is a very strong case for, first, enshrining in law an obligation on mandated people to do something about any information in their possession relating to an adult at risk in order to safeguard them from harm and, second, setting up a mechanism for something to be done about any information that they impart on foot of their mandated duty, and for steps to be taken to protect adults at risk.

We all know, increasingly now, of cases of adults - not merely in care institutions, but sometimes in the care of their families - who are abused and subjected to humiliating treatment and a lifetime of misery. Part of the background in which those kind of things can occur is the absence of a national policy and a national mechanism for dealing with such cases.

I do not want to add to the troubles of An Garda Síochána, but I was struck by the recent figures, which were mentioned in last weekend's edition of The Sunday Times, relating to the differential in domestic abuse reportage in this part of Ireland compared to Northern Ireland. I fully understand why that may have been the case. It may have been a legacy of a previous time, when what went on within a home belonged within that home, the family was to be respected as an institution and gardaí were disinclined to become involved, even in cases of domestic violence. Whatever the reason, this differential is wholly unacceptable.

The disinclination to become involved and the inclination to avoid becoming involved in messy situations where it would be difficult, for example, to sustain the necessary ingredients to a criminal investigation, form part of a background in which we find that people are left vulnerable and without any real help. I just mentioned the psychology that would lead gardaí to stand away from domestic violence. Even if one tries to understand that psychology, which I do not think we should try to do anymore, it probably indicates a national characteristic to avert our eyes and not become involved, not be seen as busybodies, not make reports and not risk offending people or creating misunderstanding. This leaves vulnerable people with no real assistance or hope of an end to their suffering at all.

Having said that, I really do believe that this legislation is a very valuable starting point. I am delighted that it has such cross-party support. I know that the Department of Public Expenditure and Reform will probably have a fit when it sees the Bill because it will ask who is going to fund all this. Words are cheap. Apologies are cheap. Commissions of investigation are not cheap but they are a great way of doing nothing while other people give one time to work out where one stands on issues. This Bill puts it up to us, as parliamentarians, to consider whether we will do something for adults at risk. It is a worthwhile Bill. It should pass Second Stage and be accepted by the Government. I await the Minister of State's response to it.

Senator Lynn Ruane

I had not planned on speaking but as I was listening to everyone's contributions, I could not help thinking back over so many of the faces and the cases of adult abuse I have witnessed over the years. Although we have uncovered some of the most extreme cases, there are many cases that are so subtle and so carefully manipulated that we will never be able to pinpoint that they are happening.

I remember one woman who was living in a homeless service and who had managed to get away from her family. Her sons and her husband had been constantly sexually abusing and raping her. When she found refuge in a city centre hostel, that family continued, every week, to find her at her local post office, to further beat her up and to take her weekly money so that she would be left begging on the streets. That was obviously an awful situation, but I learned as I worked longer in the homeless service that it was not an isolated case of family members finding a vulnerable adult wherever they had found refuge and continuing the abuse.

There was another woman who lived in her home in the Dublin 12 community. Her son came every week and did the same. He would take her money and leave. She would be left begging outside the shops within her own community because she did not have access to her own social welfare money. The issue of financial abuse of older people is huge. How do we unearth that it is happening within families? How do we even get there? It is quite scary to think that we might never be able to fully protect vulnerable people.

Another case comes to mind. My father died four years ago this week. He obviously had quite a young family. He was quite old when I was born, so he was in the fortunate position of having a young daughter who did not really listen to the advice of the medical profession and kept insisting on more. I unearthed so many different illnesses that he had and that the medical professionals tried to say he did not have. I had no medical background but I fought for years to get a proper diagnosis for my father. I refused to believe their diagnoses and it turned out in the end that I was right. There was one thing that stood out to me throughout my father's illness. He had dementia. I remember going to the hospital one day - I will not name the hospital because I have an ongoing back-and-forth with it - and my father sang. He found refuge in song. Every time he felt uncomfortable or scared of a situation because of hallucinations caused by his Lewy body disease, he would sing. The one thing he could remember, and which took him back to that moment of safety, were the words of a song. We sang every day until the day he died and I taught him songs, even right up to those of Paolo Nutini. He was still learning until the day he died.

I remember going up to the hospital one day. I experienced a lot of things that no older person should have to endure. I witnessed him being left in his own urine, being left without his catheter and having to fight for things. Medical treatment - operations that he should have had - were withheld. The doctors tried to make out that he was too old or unfit for them. One of the things that hurt me most when I went up there related to the question of medication.

One day he was completely out of it and I asked the nurse: "Why is my Dad so out of it? Why is he sedated?" He was never distressed, violent or a problem. As he had become immobile, he was never a flight risk. He had never tried to run out of the hospital. When the nurse gave me her answer, it was as if it was normal; I could not believe the culture that had been created in the health service was to provide medication. She said to me, "Your Dad was singing all night." I could not believe the health service had decided to over-medicate to shut my father up because he had been singing to get through the night, the fact that he was not in his own home or bed, or the fact that he might have been hallucinating. What I had taught him to do every time he felt he was hallucinating was to sing and they had sedated him for doing so. He was not the only person to whom it was happening. There are family members who do not realise their older relatives are being medicated unnecessarily. It is an attack on their agency, autonomy and human rights.

There is also the withholding of medication. I worked in hostels and remember witnessing a worker withholding HIV medication from someone to try to curb their behaviour because it was chaotic. They withheld vital medication to try to stop them from behaving in that manner. It was scary and so sad to see. The Bill is important on many levels. We have far to go in protecting vulnerable persons. The withholding of medication is an abuse of human rights. I look forward to seeing how the Bill can be improved and made stronger. I thank Senator Colette Kelleher. I did not realise until today how many areas it touched. It was only when everyone started to talk I realised it was so far-reaching. Other Senators have given it their support. I look forward to it being enacted and implemented, I hope within the next 12 months, but even 12 months is too long as how many more older people will be abused in that time?

Senator Colette Kelleher

Goodness me, it will be hard to capture it all in five minutes. I will come to what the Minister of State said at the end of my contribution.

There was a fantastic endorsement by Senator John Dolan. Last night we received a briefing and one of the points Mervyn Taylor of Sage made was that instead of expressing indignation, which we all express and are good at here - I am getting even better at it - we should introduce legislation. It is about learning lessons such as the painful lesson we learned from the situation involving the Irish Blood Transfusion Service. The Bill is about all of the lessons we have learned and all of the situations we have come across in our working lives, including those when we acted and those when we failed to act. It is about ensuring we understand what abuse is and know what to do when we see it, including how to stop it. I really appreciate what Senator John Dolan said.

Senator Colm Burke said the Bill had been carefully drafted and opened up an important discussion. If we have done nothing else, we have opened up a serious and important discussion about vulnerable adults and how we live our lives. Many years ago, when I was a community worker in Finglas, nobody had heard of the sexual abuse of children. It was an accidental injury. Now we know that it happens. In the same way, we are transforming our understanding of a problem, the scale of which we do not fully appreciate.

I thank Senator Keith Swanick for endorsing and co-signing the Bill and sharing not only the shame felt at what had happened in Áras Attracta but also the view that we should try to do something about it, including highlighting the importance of independent advocates.

Senator Victor Boyhan talked about the legislation empowering us to respond by providing for clear pathways. He also said there should not be an undue delay in bringing it forward.

Senator Máire Devine talked about the elements of awareness, understanding procedures, good practice, mandatory reporting and the need for clarity when abuse was noted. I would welcome suggestions for improvements. The Bill is a good starting point, but it needs more work.

I appreciate Senator Frances Black's concrete examples of vulnerable persons, including those living in isolated rural communities, being subject to abuse, including from dealers at the door. Senator Lynn Ruane spoke eloquently about her father in referring to the the under-use and overuse of medication, both of which are equally wrong.

There was also a great endorsement by Senator Michael McDowell, a lawyer, and I was scared. There are a lot of them here.

Senator Lynn Ruane

Especially when it is Senator Michael McDowell.

Minister of State at the Department of Health (Deputy Finian McGrath)

He is not that scary. I remember the time when he was a Minister.

Senator Colette Kelleher

I am not a lawyer; I did not have enough points to do law and did social studies instead. I was helped greatly by and received support from Ms Patricia Rickard-Clarke and Senator Colm Burke also. I believe we have only seen the tip of the iceberg in what is going on in homes and institutions. This is about not being drowned by what will come through. There is a need for a clear pathway because we can do better for adults, as we have done for children.

I hope I have recognised all of the contributions made. I really appreciate the fact that there is cross-party support for the Bill which I will not let languish. It might go for pre-legislative scrutiny, but it will not stay with the committee because we need to bring it back as the matter is urgent.

Seanad Éireann debate -
Wednesday, 5 Apr 2017