Sarah Harte: Campaigners for accountability hit brick walls in Irish public life
Residents of the Owenacurra Centre in Midleton are facing a huge psychological burden of not knowing when the centre would be closed or where they would be living following this closure.
There are two basic things we ask of our public officials — that they avoid inefficiencies as much as possible and that they ensure some measure of transparency around their decisions.
The causal link between decisions and consequences has always been less than straightforward in the public sector, where the unwanted effects of policies can take time to materialise, but recently it feels like we haven’t been getting bang for our buck.
Last week the publication of inspection reports of Owenacurra Mental Health facility by the Mental Health Commission left the HSE with serious questions to answer.
The Owenacurra Mental Health Facility in Midleton, East Cork, received a 90% compliance rate in the inspection report. This should be good news, except it’s not, because the HSE is in the process of closing the centre, which will mean the further displacement of vulnerable residents to alternative locations in Cork City that have received lower marks in inspections.
The HSE is peddling what seems to be the false narrative that the service had to close because of concerns of the Mental Health Commission. It doesn’t stack up.
Local councillor Liam Quaide, an active campaigner in the bid to retain Owenacurra, (he resigned from the Green Party due to a lack of support from ministerial colleagues on the issue) said the inspection report further reinforced that there was no justification for closing the facility. The closure has received staunch opposition from within the community.
Other news reports, including one last Friday from RTÉ reporter Brian O'Connell, appear to raise the suspicion that the HSE is surreptitiously moving from the care in the community model for those with mental health difficulties back to the debunked 1980s idea of having patients or residents living in centralised institutions.
Meanwhile, back at Owenacurra, residents have lived with the huge psychological burden of not knowing when the centre would be closed or where they would be living following this closure. There were originally 20 residents in Owenacurra when, in 2021, the facility was earmarked for closure.
There are now six residents left, as the others have been moved elsewhere on what turns out to be spurious grounds.
The best way to synopsise what has happened at Owenacurra is to say that residents are being ripped from their homes at an unknown date to inferior facilities and are being detached from their communities, in a reversal of public health policy as to how we treat people with mental health difficulties. And yet there’s no transparency from the HSE on any of this.
Almost two weeks ago, the public accounts committee was examining financial governance issues at the University of Limerick (UL). Of particular concern was the 2018 purchase of land to build a city-centre campus in Limerick. The land was said to have been bought at an inflated price, so in this instance, financial accountability and the use of public funds come into question. University president, Professor Kerstin Mey, and colleagues appeared to duck and dive when asked questions by the PAC.
Independent TD for Wexford Verona Murphy, who was frustrated by what seemed to be a teeth-pulling operation, accused Prof Mey and UL colleagues of engaging in an “arse-covering exercise — full stop”. Semantically, Murphy’s words may be a little rough around the edges, but she had a valid point.
However, Verona Murphy also asked if the UL team had engaged in media training before appearing in front of the PAC. Professor Mey, in the most circuitous of ways, conceded that they had.
And in the wake of appearing, Prof Mey said that “it is also a fact that legal advice constrains us from discussing many of the shortcomings” in the acquisition.
To her credit, Prof Mey said after her appearance at the PAC that some of the criticism levelled at the institution was “completely fair”. And Prof Mey, and anyone else appearing before a public accounts committee, has a right to seek training and counsel before they give evidence.
Sometimes the PAC, high on their own supply, can feel out of control. They don’t have a right to trample all over somebody’s rights just because they’ve been appointed to a committee and because a person is obliged to appear in front of them.
However, they, and we as the public, have a right to some measure of answerability from those who appear. Unfortunately, the harsh reality is that appearing before the PAC doesn’t ultimately change the price of fish.
A recent eye-wateringly arrogant example from the playbook of some public officials who are required to answer questions about their actions was the botched secondment of former chief medical officer Dr Tony Holohan to a post at Trinity College Dublin. And unlike in Prof Mey’s case, there wasn’t the faintest hint of reproach in how this episode was handled on the part of any of the relevant parties. Quite the reverse.
An external report on the matter concluded that the funding commitments by the State towards supporting the public health strategy role to the tune of €2m annually “bypassed all of the accepted protocols for research funding” and were “arrived at” by Tony Holohan and Department of Health secretary general Robert Watt. When Watt appeared before the Oireachtas finance committee to account for his role, he was labelled “arrogantly dismissive”.
The ‘Tony goes to Trinity’ episode seemed to underscore the fact that some public officials, or indeed institutions, in receipt of large amounts of taxpayers’ money appear to deeply resent the temerity of the ‘little people’ questioning their decisions in the first place.
Trinity College did not instigate an internal inquiry into the failed secondment. While the Trinity board discussed the matter, it said it would not be commenting further. It speaks volumes about their attitude to the relationship between them and the citizens from whose pockets they receive significant funding.
It’s hard not to draw the conclusion that there seems to be a philosophy or culture among some high-ranking public officials or institutions in receipt of public loot that they don’t perceive themselves as remotely accountable.
When the internal controls of departments, organisations, universities, or agencies fail, you need some external controls. Ours amount to a brouhaha stirred up by the media, some inadequate statements released, followed by senior politicians saying that we should await the findings of the report, a report, and then nothing.
Witch-hunts are not useful, but there is a midpoint between looking for scapegoats and a legitimate search for answers and the rationales behind decisions so that lessons can be learned.
There is no price for failure in the public sector, and too often performance management seems entirely lacking.
Too little perceived ‘answerability’ for actions, omissions, decisions, policies, and expenditures and the public mood inevitably sours. Particularly when those who are called to account for themselves appear to give two fingers to the citizenry.
On election day, this leads to an inevitable change in government, but we’re left with the same bunch of public officials. The workings of modern bureaucracy have sometimes led to savage Myles na gCopaleen type humour, but when you’re talking about particularly vulnerable human beings, there is no Kafkaesque black comedy to be mined from the situation.
In the particular case of Owenacurra, answers are needed as to what has gone on and why, and whether more generally our national policy for mental health patients has been reversed in moving away from centralised institutional settings to community care.
At the very least, the Owenacurrra patients and their families deserve that.
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