'Gruesome' report into sexual abuse at HSE-run facilities outlines failure of staff to intervene

'Since I’ve taken up this role in 2019 this has been one of the most repulsive reports I’ve read,  and one of the most gruesome reports I’ve had to read in my career,' said HSE CEO Paul Reid. Picture: Leah Farrell/Photocall

Intellectually disabled adults suffered “sustained sexual abuse” by another resident at HSE-run facilities over at least 13 years and despite management knowing, “no effective action” was taken to stop “highly traumatic assaults”.

State failures to protect these vulnerable people are outlined in a summary of the "gruesome" National Independent Review Panel’s Brandon Report, about sexual abuse at a centre for adults with intellectual disabilities run by St Joseph’s Hospital in Stranorlar, Co Donegal.

Vulnerable residents were subjected to at least 108 sexual assaults between 2003 and 2016 by another resident given the pseudonym ‘Brandon’, the report said: 

It is clear from the evidence reviewed that this occurred with the full knowledge of staff and management.

To cope with the problem, Brandon was moved nine times in 15 years. This “simply created new opportunities for Brandon to abuse new victims,” the report found. Brandon was able to identify particularly vulnerable residents whom he pursued relentlessly.

His behaviour included breaking into residents’ rooms at night, touching residents' genitals, and masturbating publicly.

Although staff regularly reported incidents to the director of nursing at that time, little ever changed.

He was diagnosed with mild to moderate intellectual disability, bipolar affective disorder and frontal lobe syndrome, to which a senior forensic clinical psychologist directly attributed Brandon’s sexually inappropriate behaviour. Brandon died in a nursing home in April 2020. The report notes: 

Unfortunately at no time during Brandon’s 20 years in this service was a holistic assessment of his needs conducted or an alternative, more specialised placement considered for him.

An environment of powerlessness and fear existed both for residents at risk of assault and for staff who tried to report the abuse.

One staff member quoted in the report spoke of continuing fear to speak out and “a legacy of bullying where people were shouted down and sometimes bullied out of their jobs".  

This difficult working environment “undoubtedly contributed” to high levels of absenteeism and a reliance on agency staff which in itself contributed to Brandon’s ongoing mismanagement, the report found.

The report also found that a lack of external management oversight and leadership from the HSE allowed this situation to worsen.

Hiqa inspections carried out since July 2014 found serious deficiencies in the care provided to the residents including “significant risks to the safety and welfare of the residents in the centre”.

The scandal was eventually brought to light by the actions of a whistleblower who approached Independent TD Thomas Pringle who raised the issue in 2016.

The head of the HSE apologised to those impacted by the abuse.

“We are really truly sorry, the residents of the service and their families remain our priority,” Paul Reid said, addressing a press briefing today. 

Since I’ve taken up this role in 2019 this has been one of the most repulsive reports I’ve read, and one of the most gruesome reports I’ve had to read in my career. 

Mr Reid said work has already started to implement the recommendations in the report locally.

“We still have concerns relating to the delivery of disability services in this area, we need a stronger level of assurances,” he said.

Mr Reid also said “a scoping review” is underway to find out whether any staff in positions of responsibility during the time investigated are still working in the HSE in any capacity.

Despite the HSE’s apologies, not all families whose relatives' assaults featured in the report were given access to it in advance.

The Irish Times has reported that one family whose relative was sexually abused at the facility did not receive any copy of the report before it was published publicly on Thursday.

One women whose brother was sexually assaulted at the facility told the Irish Times that publication without ensuring families had seen the summary showed “a total disregard for families”.

The HSE said that “every effort was made to ensure all of the families affected were contacted and offered a copy of the report.”   

• If you are affected by any of the issues raised in this article, please click here for a list of support services.