Charity CEO's resignation shows up the State's failure to provide essential services

Shock departure highlights again the need for the State to take direct responsibility for our most vulnerable citizens

Patrick Relihan — pictured in 2016 at the launch of a golf classic fundraiser — has suddenly resigned as CEO of Matt Talbot Adolescent Services, which has worked with troubled teens. Picture: Gerard McCarthy

The sudden resignation of the chief executive of a prominent charity doing vital work should give pause for thought on how health services are provided in this country.

Organisations such as Matt Talbot Adolescent Services (MTAS), from which Patrick Relihan has resigned, are left to fill gaps in the State’s provision.

In a properly-functioning State, all services would be provided by the State. Instead, elements of provision are farmed out to organisations which operate on a not-for-profit basis.

Quite often, these charities had their origin in efforts by a religious order or diocese to do some good in what was a poor country. So it was with the Matt Talbot Adolescent Services, set up in Cork over 20 years ago to treat teenagers who have addiction problems.

Cara Lodge in Enniskeane, Co Cork, the only such residential centre for teens and young adults with addiction and related problems, closed last October. Now Patrick Relihan has resigned as CEO of MTAS.

This is vital work that can contribute to making a difference for young people who have often received a raw deal from fate. Intervention during teenage years has been proven to help some escape the spiral that in adulthood can lead to violence, crime, imprisonment, and all the attendant fallout that comes with addiction to drugs or alcohol.

On the face of it, this is exactly the kind of service the State should be providing — but instead, the HSE funds a large part of the organisation’s budget and remains at arm’s length. 

Thus the oversight of charities such as MTAS is done by volunteers rather than professionals, the staff isn’t paid on agreed State wages, and the specifics of governance are a matter for the organisation.

What could possibly go wrong?

Plenty, in the case of MTAS. 

Resigning with immediate effect, as Mr Relihan has done, is unusual in any walk of life, not to mind the charity sector. His departure comes in the midst of a financial audit by the HSE, which gives around €1.2m to MTAS annually.

Until this year, the organisation treated more than 200 teenagers and young adults annually for addiction and related problems. The service includes daycare centres in Cork City and a residential centre, Cara Lodge, in Enniskeane, West Cork — the only centre of its kind in the country.

Last October, Cara Lodge ceased operation. A joint statement from the HSE and MTAS at the time noted that “there has been a significant reduction in referrals from the HSE/Cork Kerry Community healthcare to MTAS residential services” over the last five years.

“Any reduction in the referrals of children to residential services is to be welcomed, as from a clinical point of view removing a young person from their home environment for treatment is the least preferable option and should always be seen as a last resort.”

More places needed for troubled teens

Those who work in the area claim that there is a need for more, not fewer, residential places for teenagers with addiction problems — but the shutting down of Cara Lodge has to be seen in light of the problems that have been besetting MTAS rather than any reflection on addiction among young people.

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In recent years there have been continual internal ructions within the organisation which has resulted in a slew of protected disclosures being made.

These disclosures included allegations of financial mismanagement, safety concerns for clients, clinical mismanagement and bullying.

The disclosures were all investigated. No adverse findings against any individual have ever been published or notified to the disclosers.

Disclosures and investigation

Tusla did inspect the Cara Lodge facility on foot of a complaint and, in February 2019, the child and family agency ruled that no more teenagers should be admitted due to a number of management issues.

The ruling was later modified to allow the continued admittance of clients after a number of assurances were given. There have been two out-of-court settlements with former staff, one of whom was suspended on full pay for four years.

In 2019, the HSE commissioned a review into MTAS’s operation but then refused to publish the final result. The reason for not doing so, according to a statement issued to the Irish Examiner last year was that the HSE manager in charge “was not satisfied that the terms of reference of the review were fully adhered to and decided not to pursue the review any further”.

Could it be that the reviewers found stuff that was unpalatable to the HSE? 

Audit of Matt Talbot Adolescent Services

Then, last February, the HSE began a financial audit of the MTAS which is ongoing.

Now the CEO has left. Over the years, dedicated professionals in the areas of social care and addiction have worked for the organisation, trying to make a difference. A number of those to whom the Irish Examiner has spoken say that their dedication did not receive anything approaching due recognition.

It remains to be seen whether there is now a future for the organisation.

The real scandal, however, is that a vital health service for a vulnerable group has to be provided by a charity yet again, because the State refuses to take responsibility for it.