Taoiseach, make this the best little country in the world for people with disabilities

My take on the abuse in Aras Attracta as detailed by the RTE Investigations Unit in Irish Independent on 11 December 2014.

The HSE reacted promptly and with apparent gravity to the abuse in Aras Attracta, exposed by RTE’s ‘Prime Time’ programme, once it was made aware of it.

The nine staff directly involved in the abuse were “put off duty” on a without-prejudice basis pending investigation, the matter was referred to An Garda Siochana and HIQA and “an independent chairman” was appointed to carry out a thorough investigation into Bungalow 3 in Aras Attracta.

Another review has been commissioned of the other Aras Attracta units, and a “system-wide programme of measures to ensure quality and safety” of all 908 residential centres for people with disabilities will be led by HSE National Director of Social Care, Pat Healy.

Health Minister Leo Varadkar said the abuse exposed was “vile, inexcusable, intolerable”, and supported the actions undertaken by the HSE.

HSE chief Tony O’Brien wrote to all HSE staff last Monday, saying that “the footage portrays practices, behaviours and attitudes which are not simply acceptable… and should not and will not be tolerated” and that they left him feeling “utterly disappointed and betrayed”.

Speaking to Sean O’Rourke yesterday, Mr O’Brien said he was “devastated… there was no excusing it, it was humanity at its worst”.

While the condemnation of the abusive behaviour of the staff in Aras Attracta by Mr O’Brien and Mr Varadkar is very important, their words and actions do not go far enough to address the bigger issues on hand.

First of all, it is not credible for the HSE to commission the investigation and review into Bungalow 3 and Aras Attracta. Not matter how independent the appointed chairmen are, they are commissioned by the HSE to investigate facilities run and funded by HSE. We saw the lasting benefit of independent (not statutory) investigations into both Leas Cross and Savita Halappanavar. For credibility, the review and investigation into Aras Attracta must also be independent.

Secondly, the HSE, with government-wide support, must act upon its own recommendations to move the 3,700 people with disabilities who still live in large residential settings out into the community. The 2011 report ‘Time to Move on from Congregated Settings’ is busy gathering dust, while thousands of people with intellectual and physical disabilities are left to age in large institutions.

The 2011 Programme for Government promised to introduce personalised budgets for people with disabilities. Moving people out of large residential settings and empowering them with personalised budgets would significantly contribute to a better quality of life for people with disabilities, as they or their next of kin would be making decisions about the type of care they receive.

While there has been much condemnation of the abuse of the residents in Bungalow 3 in Aras Attracta, people with disabilities are dehumanised all over the country, denied stimulation, daily activities, dignity and respect. The most basic human rights, such as being called by your own name and dressed in your own clothes, are being denied to people with disabilities every day.

HIQA is being much criticised for not picking up on the abuse exposed on ‘Prime Time’. Yet, HIQA did not go into Bungalow 3. It has only been inspecting residential units for children and adults with disabilities for under a year, so far having visited 800 of the 1,300 units.

HIQA’s inspection reports highlight many denials of the most basic human rights of people with disabilities. And as more inspections are carried out, more horrors will be exposed. But that’s the point of inspection regimes, they can never be expected to catch the behaviour laid bare on Monday’s programme.

These will only be addressed through a combination of a sustained, effective inspection regime, when residents, staff and family members blow the whistle and when there are good advocacy programmes in place. Aras Attracta makes a very strong case for more and better advocacy services for people with disabilities and any other citizens who may not be able to advocate for themselves. Legislation has been passed to empower independent advocates to visit residential settings but this needs to be instigated and the advocacy services need to be adequately resourced to act on behalf of people with disabilities.

Enda Kenny, how about trying to make Ireland the best little country in the world to be a person with a disability? Taoiseach, if you were serious about this, you would set up an independent investigation into the abuse exposed in Aras Attracta.

You would resource and implement the ‘Congregated Settings’ report so that people with disabilities can live in homes in the community and are not in hidden away in large residential settings.

You would act upon your own commitment to move towards personalised budgets for people with disabilities so that they and their next of kin can decide how best to spend the €1.5bn currently allocated to disability services.

You would resource and empower the advocates of people with disabilities so that those with the most profound disabilities do not remain silenced.

Finally, you would sign Ireland up to the 2007 UN Convention of People with Disabilities, long promised but not yet delivered. We remain one of the few countries in the world not to have signed this.

Positive change in public policy in Ireland is often triggered by cataclysmic events. The ‘Prime Time’ investigation into Leas Cross led to the regulation and inspection of all public and private nursing homes. The death of Savita Halappanavar has put patient safety and quality of care at the forefront of health policy. The expose of abuse in Aras Attracta can be such a turning point event.

Taoiseach, this is your chance to remedy the cruelty perpetrated upon Ivy McGinty, Mary Garvan and Mary Maloney in a state-run care home in your own backyard. Please use it.