Letter to the Editor: People or systems? Which are vulnerable?

Letter to the Editor: People or systems? Which are vulnerable?

Before I start let me be clear... I actually agree completely with the approach taken to manage Covid-19 so far. Given the circumstances.

However, I also think it is fair and reasonable to discuss the term vulnerable persons. Language has power. It is now timely to ask the question: Is it the people or is it the systems that are vulnerable?

The term ‘vulnerable persons’ diminishes the lives, dignity, value and human rights of many people.

The main reason for the early lockdown was our under-resourced health system. And rightly so in the circumstances. But if a suite of community supports had been in place, our approach might have been different.

For example, the lack of step down facilities for people ready to be discharged from acute hospital settings; the lack of investment in or availability of rehabilitation services; inadequate home care packages to facilitate older people to stay living in their own homes; no universal right of access or grants for Personal Assistants; insufficient supports or recognition of the role of home carers.

If these systems were in place people would not be vulnerable.

Congregated settings are particularly vulnerable systems. Key ones are nursing homes, direct provision centres, the Irish prison system, mental health institutions and residential care settings where nearly 3,000 disabled people with high support needs live. But being vulnerable does not have to mean being silent, without opinions or rights.

The fact that there are so many private, voluntary and charitable organisations delivering services for a wide diversity of the population indicates that the Irish State abdicated itself of responsibility.

We really need to ask ourselves if fundraising so charities can deliver essential health and social services is right? Many of these organisations are part or wholly funded by the State to deliver key services but with the minimum of oversight, few in-depth reviews of the quality or value of the services delivered.

Over 640,000 persons in Ireland (13.5% of the population) are disabled by environments, attitudes, bureaucratic systems, and rapidly changing technology.

The reality is that many disabled people lack appropriate or sufficient health, housing, independent living and personal assistance supports.

The care of 28,000 older people living in nursing homes has not been proportionate to their needs, adequately planned for or catered for.

Moving forward we need sustainable solutions for a new way of living.

This demands real user participation in the design, delivery, leadership and evaluation of systems and services by the people living in them or using them.

It is time to consider the impact psychologically and otherwise of the use of the term of vulnerable persons.

We need to have a conversation about how we can enable those of us with support needs to stay safe, while living a fulfilled life without being hidden away.

The medicalised control of people who are deemed vulnerable, who have so far been excluded from having their own voices heard about how they can be supported, even if that means with extra supports, is a conversation we need to have as we figure out how to live with the impact of Covid-19.

It is time to discuss who or what is vulnerable.

- Jacqui Browne

Fenit,

Co Kerry

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