Deliver the safeguards to protect most vulnerableAdded on August 17, 2012
Fri, Aug 17, 2012
While there are encouraging signs of draft standards being introduced, promises have been made and broken in the past
THREE YEARS on and the findings of the Ryan report haven’t lost their capacity to shock.
The sheer scale and longevity of the torment inflicted on defenceless children – more than 800 known abusers in over 200 State-funded institutions during a period of 35 years – makes clear this was systematic abuse rather than anything accidental. Between 1936 and 1970, 170,000 children were consigned to the 50 or so industrial schools.
But why did this abuse happen?
It wasn’t because the nuns and brothers who ran these schools were monsters. They were girls and boys from good families, the ones whose parents aspired that one day they might enter a religious order.
In so far as it’s possible to explain why abuse took place, we know of some key reasons: a huge imbalance of power and a lack of rigorous oversight.
Perpetrators abused children because they could. Poor, defenceless children were in no position to question the actions of their masters. In addition, the system of inspection by the Department of Education was fundamentally flawed and incapable of being effective.
It would be reassuring to think that we have moved on. There is, after all, much talk these days of safeguarding young people, protecting the rights of the most vulnerable and expressions of regret over past failures.
The truth is, we haven’t really moved on all that much. Today more than 10,000 vulnerable people with disabilities – including 650 children – are living in State-funded residential centres that are not subject to mandatory care standards or independent inspections.
This is despite evidence which consistently shows that children with learning disabilities face a much higher risk of abuse or mistreatment than the general population.
They are far from family. They may not understand what’s happening to them. Even if a family member suspects something, many fear retribution or losing a residential placement.
In a landmark study of more than 50,000 school-age children in the US in 2000, researchers Sullivan and Knutson found that children with disabilities were 3.4 times more likely to be physically, emotionally or sexually abused compared with other children. Deaf and hard-of-hearing children had twice the risk for neglect and emotional abuse, and almost four times the risk for physical abuse. Children with speech and language difficulties had five times the risk for neglect and physical abuse, and three times the risk for sexual abuse.
The Health Service Executive does not release details of individual complaints. But we know that about 500 official concerns over care were recorded over a period of more than two years, from 2007 to March 2009. They ranged from issues over lack of communication and poor living conditions to allegations of abuse, assault or mistreatment.
In one case of alleged physical assault at a centre in Co Cork, a staff member was removed from the area where the resident was based following an investigation by a complaints officer.
In another, an abuse allegation in Co Leitrim prompted investigations by social workers and the Garda Síochána.
Often, the records did not show the outcomes of any investigation. For example, in Co Mayo an allegation of abuse against a staff member was investigated. While it was agreed to ensure that care standards would be improved, it did not show if there were any consequences for the staff member.
There is one proven way of helping to prevent abuse or mistreatment: independent inspections and careful policing of standards.
Yet, unlike any other form of residential care in this State, homes for people with disabilities are not subject to independent inspection.
No one in government can say they haven’t been warned about this. Groups such as Inclusion Ireland – the umbrella group for people with intellectual disabilities – has been calling for these measures for some 17 years now. There are a host of official reports commissioned by State agencies that have also raised concerns over the lack of safeguards: the McCoy report into Brothers of Charity Services in Galway in 2009; the Irish Human Rights Commission’s inquiry in 2010; the Commission to Inquire into Child Abuse in 2010.
And for a decade there has been talk at government level of introducing mandatory care standards and inspections. The Health Information and Quality Authority (Hiqa), which inspects nursing homes and children’s homes, has put together a document on how residential standards would operate.
There are some encouraging signs of movement on the horizon. Minister of State for Disability Kathleen Lynch says draft standards have been produced by Hiqa which will be placed on a statutory footing, possibly midway through next year.
The only problem is these kinds of promises have been made before, only to be broken. In 2009 the previous government was poised to introduce inspections – only for the then minister of state with responsibility for disability, John Moloney, to say he did not have the funds to introduce them.
Many disability service providers also want standards or inspections. The National Federation of Voluntary Bodies, which represents about 60 organisations, has said its members are fully supportive of inspections. The majority of its members have some form of voluntary standards in place already.
Standards and inspections aren’t a magic wand that will banish ill-treatment for good. For example, Hiqa is still forced to close down nursing homes providing substandard care. But they do provide a crucial safeguard. As well as helping to detect abuse, inspections can also provide constructive feedback to those who deliver services.
The next few months will reveal much. After all the rhetoric, it will show whether the Government is really committed to doing everything in its power to protect the most vulnerable.
At the end of the day, wherever vulnerable people reside, there is an imbalance of power between residents and staff in charge. In the absence of robust care standards or frequent inspections, residential homes will remain fertile ground for potential abuse, mistreatment or neglect.
Carl O’Brien is Chief Reporter
© 2012 The Irish Times