The Government is "keen to see" the full Brandon report published but the HSE "has taken a view that this can't be done", Tánaiste Leo Varadkar has said.
Mr Varadkar told the Dáil that advice has been sought from the Attorney General to see whether the report could be published in full by the Minister of State for Disability Anne Rabbitte.
The Brandon report outlines prolonged sexual abuse of intellectually disabled residents at a HSE-run disability centre in Donegal.
Speaking to reporters on Thursday, HSE chief executive Paul Reid apologised to residents and families affected by the abuse.
“This has been one of the most repulsive reports that I have read and indeed one of the most gruesome reports I have had to read in my career,” he said.
Mr Reid said the HSE did not wish to publish the Brandon report in full because it did not want to “compromise” the scoping review into whether disciplinary action was required.
“The process is really important for us; we want to protect it for the future,” he said.
The executive summary of the report into prolonged sexual abuse of intellectually disabled residents at a HSE-run disability centre in Donegal was published on Thursday, despite the fact some affected families had yet to see it.
One woman, whose brother was one of the 18 intellectually disabled adults sexually assaulted in his home, said publication without ensuring families had seen the summary was “insensitive” and showed “a total disregard for families”.
A second family was told on Wednesday evening they would receive the report summary in the post on Thursday morning. They say Thursday’s post “has come and gone” and they hope to receive a hard copy on Friday.
The report was published on the HSE website at 12.30pm on Thursday.
The report, completed by the National Independent Review Panel (NIRP) in August 2020, finds that a former resident, given the pseudonym Brandon, perpetrated at least 108 sexual assaults on upwards of 18 intellectually disabled adults, most of them non-verbal, between 2003 and 2016.
In a statement to accompany the report, the HSE said on Thursday it would “like to apologise to residents and their families for the failings in care at a HSE residential and day care service for adults with intellectual disability in the North West.
"The HSE fully accepts the findings of the National Independent Review Panel (the Brandon Report).
“On receipt of the Report, the HSE acted immediately to seek assurance as to the current safety of the residents within the relevant service.
“The HSE’s primary concern is the current safety of residents. Regular safeguarding meetings take place within the service, which has undergone significant reforms in advancing the Community Healthcare Organisation’s strategy for disability services generally, and specifically in response to the report findings, building on ongoing improvements in that specific service prior to the report.
“The residents of the service and their families remain our priority. All those affected are, and have been, in receipt of a range of multidisciplinary supports. These supports continue to be provided locally, with oversight by senior HSE management at national level.”
The NIRP report says the “common strategy” to manage Brandon – to move him from ward to ward – “simply gave him access to a new cohort of clients whom he proceeded to assault until he was moved on again”.
None of the families was told about the abuse of their loved ones until December 2018, a decade after the abuse in some cases. While several have called for publication of the full report, the HSE has maintained its stance that it will publish only the executive summary.
‘The full truth’
Mr Varadkar was questioned about the report by Sinn Féin TD Pádraig Mac Lochlainn during Leader’s Questions in the Dáil on Thursday.
The Donegal TD said while the executive summary is detailed, it is “still not the full report”.
“The families and the Irish public need to know all of the facts. Why continue to drag this out? The families and the public deserve the full truth,” he said. “In order to properly protect our most vulnerable patients going forward, we need to learn from the mistakes here... There are continuing questions for the HSE here.”
Mr Varadkar said there were families who had been “deeply impacted and are deeply hurting”. “I think for anyone who’s read or listened to the reports of the issue, they’re going to be shocked and they’re going to be upset about what has happened,” he said.
“Certainly, when I read about it at first I was horrified that this could have happened and even felt disbelief that something like this could happen and continue to happen for a period of time.
“I think all of us our thoughts are in the first instance with the individuals and families affected. I can’t begin to imagine what they’ve been going through this morning and indeed in the years gone by.”
The Tánaiste said Ms Rabbitte was seeking advice from the Attorney General as to whether the full report could be published, and if not, at least in redacted form.
He said the HSE has confirmed that it had put support in place for affected families.
Mr Mac Lochlainn said it had taken “too long to get to this point” and that it had been “a long road and harrowing road for the families of those who suffered the most horrendous abuse”.
The report says Brandon’s assaults continued “unabated” and with the “full knowledge” of management.
Nursing staff tried repeatedly to stop the abuse, reporting it to management, it says. In 2011 a number of experts recommended Brandon’s contact with other residents be stopped and his victims’ families be told. The assaults, however, continued and families were not informed for several years.
Brandon was moved to Brentwood Manor, a private nursing home in Convoy, Co Donegal in May 2016 and died there last year.
The abuse came to light in 2016 when a whistleblower approached local independent TD, Thomas Pringle. He reported it to HSE management in the county and the then minister for disabilities, Finian McGrath. A look-back review, completed in 2018, led to the HSE commissioning the NIRP review.
Mr Reid said the report into the abuse outlined “an appalling set of failings in care at a HSE-run residential and day service for adults with intellectual disabilities in the north west.”
The events detailed in the report had “shocking consequences for many people,” he told reporters at the HSE weekly Covid briefing.
“The facts are very clear: vulnerable people were sexually abused while in our care. None of us can imagine the impact that this has had on the abused and indeed on their families,” he said.
“On behalf of the HSE I do want to apologise to those residents and the families. I just can’t imagine, we cannot cannot imagine the hurt that they had, and the pain, from seeing the details of this report. We are really truly sorry.”
Mr Reid said that the HSE still had concerns about the delivery of disability services within the health service and would be carrying out a national review into these services as a result.
“We need stronger levels of assurance,” he said.
Asked whether any HSE managers were still in place from Brandon’s time in care, Mr Reid said that the abuse took place over ”a long period of time.”
Many staff had retired or moved on or were working in other parts of the health service but .
”We are currently assessing a scoping exercise to understand if there are any disciplinary issues that need to be progressed,” he said.