Elizabeth Mulhare is preparing for her eighth winter in a house unsuitable for her needs as a cerebral palsy sufferer, says Health Correspondent Catherine Shanahan
Elizabeth Mulhare lives in a three-bedroom bungalow on the outskirts of Fermoy town which she can access via the front door but not the back.
A step leading from the kitchen to the back garden is not wheelchair accessible and Elizabeth is confined to a wheelchair.
The 30-year-old has cerebral palsy and “highly complex medical needs including significant abdominal problems”, as outlined by her GP in a letter seen by the Irish Examiner. He writes that she requires “acute medical intervention on a frequent basis”.
Elizabeth underwent bowel surgery in 2015 and has a permanent colostomy bag. She attends the Stoma Clinic in Cork University Hospital (CUH), 43km away. She usually travels in her mother Barbara’s car which has been adapted with a swivel seat. The transfer to the car is tricky as the drive is sloped.
Elizabeth is entirely dependent on her 56-year-old mother, Barbara, for washing, dressing, and toileting.
She is hoisted for all transfers. A free-standing hoist is used for chair to bed transfers. For wheelchair to shower chair transfers, she is hoisted onto a freeway recliner in the living room, and from there, wheeled into the bathroom.
An occupational therapist (OT) who assessed the suitability of the property at 4 Lios Óir, Pike Rd, last August, on behalf of Cork County Council, said in her report that Elizabeth’s bedroom is “unsuitable for needs due to size” with limited circulation space for using the hoist to complete transfers.
The OT also noted staining on the walls and ceilings in the hall and bedroom, which Barbara puts down to dampness and resulting mould.
The OT found limited circulation space in the bathroom for turning the shower chair, with a lip into the bathroom which she said was identified as a concern.
She noted door saddles — not conducive to wheelchair use — and “visible markings” on the internal doors caused by Elizabeth’s wheelchair, which just about fits through.
She also found that rear access — via the kitchen door — was “not accessible to Elizabeth”. Elizabeth eats in the kitchen.
It was the third report by an OT examining the suitability of the property for someone with Elizabeth’s needs.
The first, compiled in September 2011, the year Elizabeth and her mother moved in, found the property met Elizabeth’s immediate housing needs. It recommended adaptations to the bathroom which were subsequently carried out.
The second OT report was produced in 2014. It was determined that the house set-up was no longer suitable for Elizabeth’s needs. Recommendations included further adaptations to the prop- erty — or re-housing Elizabeth.
The findings of the first two reports are referred to in a report by a third OT, which the Irish Examiner has seen.
The third report, obtained by Barbara from Cork County Council following a Freedom of Information request, was on foot of an assessment by an OT in August 2018, after Barbara had brought judicial review proceedings against the Council in the hope of being re-housed, ideally closer to Cork city, as Elizabeth has frequent appointments at CUH. The legal challenges were unsuccessful.
In May 2017, Ms Justice Marie Baker said in the High Court it would be an “impermissible breach” of the constitutional separation of powers between the legislature and judiciary for the court to order Cork County Council to give Elizabeth Mulhare and her mother with more suitable housing.
Nor could the court declare they should get greater priority on the council’s housing list of some 7,480 approved applicants, including 557 with needs based on physical disability.
The Mulhares essentially wanted to be considered outside the statutory scheme for housing allocation and the Judge held there was no statutory basis entitling them to be housed in a particular house in a particular area..
As reported in the Irish Examiner at the time, the court heard Cork County Council’s top two housing list priorities are those living in dangerous accommodation and the homeless. Those with disabilities are the sixth priority.
The court heard the Council had offered to renovate the house in Fermoy to address Elizabeth’s needs but had said it had no other suitable accommodation and had to keep in mind the needs of all its tenants.
While the the Council can disregard its own order of priority for those who need accommodation due to “specified exceptional circumstances”, the court had no power to interfere with its choice or assess how it manages its housing stock, Judge Baker said.
She also rejected arguments the failure to provide a more appropriate house breached the Mulhares’ private and family life rights under Article 8 of the European Convention on Human Rights.
In July 2018, the Court of Appeal unanimously dismissed the Mulhare’s appeal of the High Court decision.
Mr Justice Michael Peart, with whom Ms Justice Elizabeth Dunne and Mr Justice Gerard Hogan, agreed, said he shared the High Court’s sympathy for the position the applicants found themselves in and believed it was of the “utmost importance” for the health and welfare of both that they live in better conditions.
However, the council must perform its statutory functions in accordance with the housing list priorities and the management of a council’s housing stock is very much a matter for the housing authorities concerned in the first instance, “not for the courts”, he said.
The courts cannot intervene unless a “clear error” is established in the decision making process and no such error had been established, he ruled.
This coming winter will mark the Mulhares’ eighth winter at 4 Lios Óir. The condition of the house has not improved since the Irish Examiner first highlighted the case in March 2015.
Barbara says her daughter’s health has deteriorated since they moved to Fermoy. She says “everyone is agreed” that they need to be nearer to CUH.
Their GP is in agreement. He writes that they are “currently residing in very poor living accommodation in Fermoy with no support network”.
“The family’s resources are stretched with trying to cope with the associated logistical difficulties in managing this situation, including transportation, as this patient is wheelchair bound,” he said.
The most recent OT report says “in consideration of Elizabeth’s needs, there are two options available” — modifications to her Fermoy home,or relocation to a different property, specifically “an accessible property in greater proximity of Cork city”.
The OT comes down in favour of the second option.
“Based on a holistic view of Elizabeth’s functional, medical, social and environmental needs, this appears to be the more appropriate option for Elizabeth,” the OT concludes.
In 2015, when the Irish Examiner contacted Cork County Council to ask why Elizabeth had been housed in a home not fully adapted to her needs, we received the following response: “The council is aware of issues relating to the condition of the property at 4 Lisore, Pike Rd, Fermoy, and is working closely with representatives of the tenant with a view to resolving the issues in a timely and satisfactory manner.”
More than four years later, the Irish Examiner contacted the council again in relation to the suitability of the property the Mulhares’ are living in — asking if it was dangerous to house someone in a wheelchair in a property that cannot be exited through the back door in the event of fire.
We also asked why an engineer’s report - which Barbara claims was compiled after an engineer allegedly visited their home in March 2019 — was deemed not to exist when she requested it under Freedom of Information.
The council gave a single-line response: “Cork County Council does not comment on individual cases.”
This was not the protocol the council followed when the Irish Examiner asked about the Mulhares’ situation four years ago.
The response at that time was: “The council is aware of issues relating to the condition of the property at 4 Lios Óir, Pike Road, Fermoy, and is working closely with representatives of the tenant with a view to resolving the issues in a timely and satisfactory manner.”
The Irish Examiner asked the council how it was able to comment on an individual case in 2015 but cannot now.
The council replied: “In line with current GDPR [general data protection regulation] legislation, Cork County Council does not comment on individual cases.”
The problem of unsuitable accommodation for Elizabeth has not been resolved in a timely or satisfactory manner. She continues to reside in a house that her GP and two occupational therapists believe is unsuitable for her. The Court of Appeal said it was of the “utmost importance” for the health and welfare of both Elizabeth and her mother that they live in better conditions.
“We’re going into our eighth winter here now and I fear for her,” Barbara says. “She could have a turn at any time. It’s a living nightmare, and it has to stop.”