Seanad Éireann díospóireacht -
Wednesday, 1 Nov 2006

Vol. 184 No. 24

Sexual Offences.

Ms Feeney

There have been three reported rapes and six sex attacks in Sligo since last July. Two weeks ago, a young woman claimed she was raped in the toilets of a nightclub in the early hours of the morning. She was out with a group of friends and having gone into the toilet, a man followed her in and subsequently into the cubicle where it is alleged he raped her. She presented at Sligo Garda station in a highly distressed state and accompanied by a friend. Two gardaí had to drive the young woman to Dublin for an examination as no doctor was available in Sligo on the night to see the alleged victim.

Sligo gardaí have informed me they use the services of a female general practitioner who is very generous with her time. However, on occasions, she can be on holiday or may not be working on a particular weekend. There are times when she is not available. Sligo gardaí then have no option but to travel to Dublin to the Rotunda Hospital. Sligo General Hospital has informed the Garda Síochána it has no role to play and that it would be preferable if the victims were not brought to its accident and emergency department. The Health Service Executive, HSE, has said it is a matter for the doctors of the town to deal with, yet Letterkenny General Hospital has a care unit which looks after alleged rape victims when they present, as has Mayo General Hospital in Castlebar. This is an ad hoc arrangement as there are no real guidelines in place and it depends on the goodwill of the medical personnel who are available to the hospital, but things work well.

The Sligo Weekender has reported recently that the Sligo Rape Crisis Centre has put in a strong plea for rape victims to be forensically examined by nurses where no doctors are available. I spoke to An Bord Altranais, the regulatory body for nursing. Under the Act, nurses are not covered to examine a patient forensically but the board is examining the possibility of expanding the role and practices of nursing. It is not aware of any forensic nursing course but it stated it would support the expansion of the nursing role and it would consider any proposal put forward.

It is time Sligo had a dedicated sexual assault treatment unit of its own, perhaps attached to Sligo General Hospital. This unit could cover Sligo, Leitrim, west Cavan, north Roscommon, south Donegal and east Mayo. In the meantime there should at least be a more modern, updated medical room in Sligo Garda station where young women could be seen and treated without being forced to undergo that terrible 150-mile journey to Dublin under such circumstances, especially when they are very upset, very distressed and have undergone that type of attack. Nobody should be subjected to this type of treatment in this day and age. I thank Sligo gardaí for delivering such a caring and sensitive service to young women who present having allegedly been raped.

Minister of State at the Department of Justice, Equality and Law Reform (Mr. Fahey)

I thank Senator Feeney for raising this matter on the Adjournment. I assure the Senator that I share her concerns in this matter. The trauma of having to undergo a medical examination following an allegation of rape should not be compounded by having to travel an excessive distance for that examination.

Along with my colleague, the Minister of State at the Department of Health and Children, Deputy Seán Power, I recently launched the national review of sexual assault treatment services. The Department of Health and Children, the Department of Justice, Equality and Law Reform and their relevant agencies, in particular the Health Service Executive and the national steering committee on violence against women, have a particular interest in and responsibility for improving facilities to meet the victims of this grossly abusive and harrowing crime.

The review identified a need for sexual assault treatment units, known as SATUs. By locating the site for carrying out tests in a unit separate from accident and emergency facilities or other usual first ports of call for treatment, the client is assured of privacy in an environment that is forensically suitable for the conducting of such examinations. The client is attended to by staff who are specialists and are sensitive to the many issues that may arise in the aftermath of such a trauma. The forensic clinical examination has unique features, with the medical practitioner required to perform a dual role in addressing the immediate needs and concerns of the victim and in acting as an agent of law enforcement in the collection of forensic evidence.

There are five SATUs in Ireland in five HSE regions, namely, the eastern, south eastern, southern, north western and midland regions. Many of the forensic clinical examiners are GPs in the local area. The review found that there has been an over-reliance on the limited number of doctors volunteering to be on call, increasing the risk that they would withdraw from providing their services to a SATU.

One viable solution to the problem of a steady supply of forensic clinical examiners, which has been identified in the review, would be the introduction of education and training for nurses to specialise in the area of forensic clinical examination. They would provide services to victims who present to SATUs and would provide expert witness testimony where a case subsequently went to court. Forensic nursing has already been introduced in a number of other jurisdictions. I am pleased to say that the Health Service Executive is already examining this recommendation with a view to establishing a pilot course for eligible nurses who would later be appointed as clinical nurse specialists in forensic clinical examination.

The findings of the review show that the responses experienced by victims of rape or sexual assault in Ireland depend on where they live. There is a particular difficulty in the west, with a combination of a lack of such facilities and the large distances to be covered, which led to the undesirable situation where the person referred to by the Senator had to be taken from Sligo to Dublin. The review recommended that two new sexual assault treatment units be established, one in the HSE western region and another in the HSE midlands region, so that the travel time for victims of sexual crime in these regions would be significantly reduced. I understand from the HSE that work has begun on establishing the recommended unit in Galway.

A key recommendation of the review is that the provision of services in existing and proposed new SATUs should be standardised. While all SATUs provide a consistently high standard of service to victims, some differences in approach were identified. Significant progress has been made in this area.

A multidisciplinary group from the school of nursing and midwifery in Letterkenny has devised a set of national guidelines on referral and forensic clinical examination in Ireland. These guidelines clearly set out the procedures to be adhered to in each SATU. The guidelines cover all aspects of the care, support and examination of treatment of victims from the moment the alleged crime is reported to the Garda Síochána. The practices at the Forensic State Laboratory are also set out. I am pleased to note that the new guidelines have now been printed and distributed to the relevant practitioners.

It is acknowledged that there is a need to develop a more comprehensive rape and sexual assault treatment service which is more easily accessible, provides appropriate privacy and is compassionate and empathetic to the victim while maintaining expertise and standards in service delivery. The implementation of the recommendations in the review requires the commitment from my Department and the Department of Health and Children and their relevant agencies.

I assure Senators that both Departments and their agencies are committed to implementation of the recommendations. From a health perspective the HSE, which was represented on the review committee, is responsible for the implementation of these recommendations. The Department of Health and Children has been in regular contact with the HSE during and since the completion of the report and is keen to see an early and full implementation of the report's recommendations so that an equitable and holistic service can be provided to those who have been injured and traumatised by the perpetrators of a truly appalling crime.

I reiterate that I share the Senator's unhappiness with the situation which she has outlined, and I assure her that the necessary steps are being taken by the HSE to establish a SATU in Galway which it is hoped will service the Sligo area in a more effective way than has been the case until now.

Ms Feeney

I thank the Minister of State and welcome the review. Given that Galway is a two-hour drive on a bad road from Sligo, it would be as well to travel to Dublin as the road is better. Where in the north west is the SATU unit? I welcome the pilot scheme to train nurses in forensic examination. Perhaps Sligo could be the pilot site for such training.

I thank the Minister of State for attending to take this Adjournment matter and for the information he has supplied. There is a need to move urgently. Perhaps the medical room at Sligo Garda station could be made more comfortable in order that women could be treated in their own town.

Mr. Fahey

The unit is located in Letterkenny General Hospital. As I said in my reply we are anxious to train clinical nurse managers to take over the role. The intention is that we will be in a position to appoint clinical nurse managers to various regional hospitals throughout the country and that will include Sligo.

Ms Feeney

Letterkenny General Hospital has refused to take victims from Sligo.