Dáil Éireann Debate, Thursday - 6 July 2023
349. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to ensure that the best possible safeguards are in place to protect our friends and family in nursing homes since the establishment of the current Government; and if he will make a statement on the matter. [33325/23]
Amharc ar fhreagraSafeguarding adults who may be at risk of abuse, harm, and neglect by others in the context of their interactions with the health and social care sector, including in nursing homes, is a key objective of the Department of Health, every statutory body under its aegis and every relevant service that interacts with such adults.
In the health and social care sector, a framework of standards, policies and procedures for safeguarding adults who may be at risk of abuse, harm, neglect, and exploitation within the sector, including in nursing homes, is in place, and further measures are being developed to strengthen this framework.
Cross-sectoral legislative provisions relevant to adult safeguarding are also applied throughout the health and social care sector, including, for example, legislation on vetting and on the mandatory reporting to An Garda Síochána of information about the commission or suspected commission of certain offences against vulnerable adults or against children.
Existing governance measures
Key governance provisions currently in place include:
• The significant inspection and other regulatory powers of the Health Information and Quality Authority (HIQA) and the Mental Health Commission (MHC) in relation to the quality and safety of healthcare and social care provision generally (under the Health Act 2007 and the Mental Health Acts).
• The roles of health and social care professional regulatory bodies (including CORU, the Irish Medical Council, the Nursing and Midwifery Board of Ireland, the Dental Council of Ireland and the Pharmaceutical Society of Ireland) in relation to, inter alia, professional registration requirements and professional codes of conduct.
• Joint National Standards for Adult Safeguarding developed by HIQA and the MHC and approved by the Minister for Health, that apply to all regulated health and social care centres, including nursing homes.
Existing operational safeguarding measures
The existing framework also includes a range of operational structures and procedures, including in particular the HSE’s national operational adult safeguarding policy Safeguarding Vulnerable People at Risk of Abuse – Policy and Procedures (2014) , which is in place primarily in all HSE and HSE-funded social care settings.
The HSE has put in place a range of structures and processes to support and further develop its national operational adult safeguarding policy, including:
• A HSE National Safeguarding Office leading policy development and oversight.
• Clear guidelines set out in the existing policy for HSE and HSE-funded staff to follow in cases of suspected abuse or neglect of adults at risk (including a “zero tolerance” approach to abuse, meaning that abuse must be reported by staff in all instances).
• An adult safeguarding policy and procedures training programme, and a requirement that staff must attend training (the training is also accessible to non-HSE and HSE-funded services).
• Social work teams ("Safeguarding and Protection Teams") in each of the 9 HSE Community Healthcare Organisation areas.
• Over 2,000 designated safeguarding officers nominated by service providers and provided with additional training.
• Implementation planning for a revision by the HSE of its operational adult safeguarding policy which is expected to extend the policy beyond the social care pillar and to all HSE and HSE-funded services.
Policy and legislation development – health and social care sector
The Department of Health remains committed to ensuring that the best possible safeguards are in place to protect any of our service users who may be at risk of abuse, including such services users in any setting (including nursing homes) where health or social care services are provided to them.
Work to develop an overarching health and social care sector adult safeguarding policy, building on the robust structures already in place, is at an advanced stage and will be the subject of a public consultation planned for September 2023. The intention is that the policy will apply to all public, voluntary and private healthcare and social care settings.
Significant policy development work has been undertaken to date, including completion of the stakeholder consultation and primary evidence development phases of this major and complex policy project:
• A high-level inter-sectoral Steering Group was established to assist the Department in its development of the policy.
• The Department commissioned the Institute of Public Health (IPH) to undertake focus groups with cohorts of health and social care service users who may be affected by the national adult safeguarding policy for the health and social care sector, to ensure their voices are heard during policy development. A total of 12 focus groups were held, with 82 participants in 4 cohorts (including nursing home residents), between November 2019 and March 2020. The report was published in February 2021.
• The Department engaged with other key stakeholders in relation to the development of the national sectoral policy and the resulting output pack detailing stakeholders’ feedback is posted on the Department’s website.
• An independent international research evidence review to inform the policy for the sector was commissioned by the Department and published in February 2021.
• These reports, together with updates and related papers such as presentations to the Steering Group and discussion papers on the policy content, are published on the Department's website and can be accessed at www.gov.ie/en/publication/2861af-adult-safeguarding/.
The Department is now preparing for a public consultation in September and a costing study on a draft health sector policy on adult safeguarding, prior to submitting a costed draft policy to Government for its approval. Subject to Government approval of this national sectoral policy, legislation as required to underpin the approved policy will thereafter be prepared. The introduction of safeguarding legislation remains a priority for me.
