FERGUS FINLAY: Foster care scandal: Still an air of denial and defensiveness within the HSE

It matters because there is still an air of denial and defensiveness within the HSE about these issues, writes Fergus Finlay


Tony O'Brien, director general of the HSE, will appear before the PAC today to address the issue of abuse in foster care.

I wrote here last week about Grace, a woman abused while the State had responsibility for her care. It was this newspaper that had highlighted her story, and I wanted to call her Grace because she is someone who has lived a life innocent of any wrongdoing. I’m glad that Grace came to be recognised over the last week as a person, a citizen who had been wronged, and not as a label, a statistic or a number.

In that piece last week I wrote that “if I was health minister, I would (I hope) regard it as my paramount duty to find out what happened to Grace and how it happened. I hope I would demand that every scrap of paper relating to Grace’s treatment was delivered to my office, and I hope I wouldn’t rest until I got to the bottom of how this was allowed to happen to a defenceless fellow citizen”.

It seems that Leo Varadkar and Kathleen Lynch have done just that. There is going to be a full inquiry, as there must be. I have yet to see the terms of reference for the inquiry, but it is essential that they be all-encompassing. This may be our best chance in this generation to come to terms with what we must do if we are to treat vulnerable adults with the dignity too often robbed from them.

Why does this matter so much?

It matters because vulnerable people were terribly hurt, by vile abuse over many years, while they were the responsibility of staff who are still, for all we know, in positions of authority within the health board system. We need to know how those terrible decisions were made, how things were allowed to continue, whether or not grievous mistakes have been covered up.

It matters because the people who were hurt were entirely defenceless. We know some of the circumstances of Grace. But there are others. I have spoken to the family of another (let’s call her Fiona) who suffered terribly at the hands of this foster family while her own mother was seriously ill.

Both Fiona and Grace are now surrounded by love and care, and are living as independently as it’s possible for them to live. Both are women of enormous character and resilience, and both have people who have fought for them for years.

It matters because the details of what happened to Grace and Fiona, and up to 40 more people whose identities we don’t know, are contained in a report called the Resilience Report. There are more details of how decisions were made in relation to Grace in a report called the Devine Report. These reports, and the legal advice surrounding them, have so far cost a half-million euro to produce, yet we are not allowed to see them.

Without an inquiry we can’t be told, apparently, who made these terrible decisions and why, and whether they still have influence over people’s lives.

There are legitimate questions to be asked about how these reports were commissioned in the first place, but it’s more important to know how far-reaching they really were. My understanding is that the Resilience report is essentially a “desk-based” study, which relies on files to try to figure out how much people suffered and why they were left at risk. Files never tell a full story.

It matters because over the years, families have raised many concerns and have sought hard to establish what happened to their loved ones. There is evidence to suggest that these concerns were never taken seriously, and in some cases were simply dismissed. In fact I have seen evidence that families may have been threatened with legal consequences if they pursued allegations of abuse.

It matters because there are at least two other people who have behaved in a brave and honourable way to try to get to the bottom of what happened to Grace and Fiona and others. From inside and outside the HSE they have tried to protect and serve the interests of people without a voice of their own. Far from that being acknowledged, they have been badly treated and put under immense pressure. Their bravery and honesty needs to be acknowledged. They are due an apology.

It matters because there is still within the HSE an overwhelming air of defensiveness and denial about all this. After I wrote about Grace here last week, and subsequently did some radio interviews, I started getting some condescending texts from a senior HSE manager. “For clarification”, as he put it. I had said that all the families were due an apology, but surely I must know that all who could be reached had already received an apology, and that this had been made public by the HSE several times since last November.

I searched out the “apology letter”, and eventually found a pro-forma letter that had been issued to the families, which included the sentence “Also the HSE apologises for any failings identified and to those who received poor care when placed with this foster family”. How anyone would be expected to understand that this was an apology for decisions that allowed children to be grievously abused is inexplicable.

I suspect that Tony O’Brien, the head of the HSE, who has battled to change this kind of culture, might have been taken aback when he read the same letter. Maybe that’s why he told the RTÉ This Week programme that he was writing his own letter of apology.

But above all it matters because all this has to stop. There is a fundamental point at the heart of all this. People with an intellectual disability who depend on the State are just that — dependant. We think they have a right to protection and care. But in fact they might as well live in the Ireland so well described in the Ryan and other reports — an Ireland where people without any rights were casually abused with impunity.

We think they have rights because we have passed laws here which pretend to confer specific rights on people with a disability. Those laws are meaningless and insulting. They effectively perpetuate the situation that pertained when people with an intellectual disability depended exclusively on charity for services they needed.

An honest appraisal could only conclude that unless we are prepared to guarantee in our law that every person with an intellectual disability will have real legal rights, including the right of access to an independent advocate, abuse and neglect will always be possible. And when abuse is possible, especially when it can go on in the dark, it will always happen again.

After the Ryan Report into the abuse of children, then taoiseach Brian Cowen said that the only way to prevent abuse happening again was to make Ireland a model for the way we treat children. Perhaps, when a light has been shone on the neglect that has allowed this abuse, the time will have come when we finally agree to give people with an intellectual disability the rights they need to be full and equal citizens. What an achievement that could be for Grace and Fiona and other victims in this case.

It matters because there is still an air of denial and defensiveness within the HSE about these issues

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