Sir, – Pat Leahy rightly asserts the need for a systematic approach to lessons learned from our response to the Covid pandemic (“Ireland has had three books on Covid but still no inquiry. What’s going on?”, Opinion & Analysis, September 23rd).
Individuals stories can be informative, but not if these are only the partial stories of a few. Rather a Covid review allowing for multiple truths, conflicting accounts and identification of things we can do better next time is both a moral imperative and a necessity, not only to be better prepared in the future, but to make our services work better right now!
As the HSE clinical lead for disability services during the pandemic, while I feel we did many things well, some things we did not do well, and it would be unforgiveable not to learn from both.
Did the subsidiarity of disability services help our response? Disability services are a patchwork of HSE and (mostly) voluntary or independent organisations (Section 38s and 39s) which are more autonomous than those services run directly by HSE staff.
In the early days of the pandemic the HSE wanted to restrict online meetings and consultations to platforms that were fully secure. Some organisations – wisely in my view – ignored this and provided services and supports through less secure but more widely available platforms. What can we learn from this?
Also, early in the pandemic disability services proved guidance for practitioners on how to conduct remote assessments. Some practitioners were very enthusiastic about this and others quite resistant to it.
For some service users, digitisation opened doors and for others it shut them.
What can we learn from this to support more effective hybrid provision of services?
Given the higher rates of Covid deaths in institutionalised settings, should this not spur us on right now to allocate more resources to speeding deinstitutionalisation of the 1,800 people with disabilities still living in congregated settings? What does it say about our society if we choose to ignore our lesson here?
Furthermore, some things have changed since the pandemic, and these have very important implications for our citizens. During the pandemic some adults with disabilities living at home were denied access to vaccination, because their parents or guardians decided against it on their behalf. With the commencement of the Assisted Decision Making (Capacity) Act earlier this year, such a decision can no longer be made in this way and the State is legally obliged to provide all individuals with reduced capacity with assistance in their decision making. But just how would we do this if vaccinators can’t get past the front door?
The greatest learning for “the system” will come from what those in positions of power don’t know. All our experiences are only partial, the telling of multiple truths is necessary for us to know better how to respond to future pandemics or national emergencies.
Framed well, a Covid review can authenticate collective efforts and collective suffering, but continually delayed it festers suspicion and cynicism, undermining political and clinical leadership, our preparedness as a society and the need to let our citizens tell their stories. – Yours, etc,
Professor of Psychology
and Social Inclusion,
& Learning Institute,