THE RYAN report into the abuse of children in religious-run institutions made for shocking reading last year. It illustrated in the most graphic terms how an imbalance of power and lack of oversight can place vulnerable children at risk of horrendous abuse. The Government and religious congregations rightly accepted their failures and pledged to take steps to ensure it could never happen again.
Yet, the State continues to preside over a care system which places some of the most vulnerable in society – people with intellectual disabilities – at a similar risk of abuse. Research shows that people with mental impairments are at a significantly higher risk of mistreatment than the general community. However, residential homes for 8,000 people with intellectual disabilities are not subject to any form of independent inspection or regulation.
Against this backdrop, new figures show that hundreds of complaints have been made to health authorities in recent years on issues ranging from poor communication, unacceptable living conditions to alleged cases of abuse or mistreatment. The complaints also raise wider questions such as how robust are the Health Service Executive’s official complaints procedures and whether those found to have abused or mistreated staff have been dealt with appropriately.
For almost a decade there have been discussions at government level about introducing mandatory care standards and inspections. The Health Information and Quality Authority (Hiqa) – which inspects nursing homes and children’s homes – has put together detailed proposals on how such residential standards would operate.
When the Government last considered the issue a year ago, Minister of State for Disability John Moloney said the State did not have the funds to introduce them. Instead, he said, care standards would be brought in on a voluntary basis by service providers. This is not acceptable.
The minimum we owe our citizens is that while in State-funded care they are provided with sufficient safeguards to protect their health and welfare. It has become possible to do much harm to disabled people because they are not visible in society. The old institutions which took them out of society played up the mythology of protecting vulnerable people from the harsh reality of the world. In reality, this segregation has allowed society to treat people with disabilities as second-class citizens where they are stripped of their rights and dignity.
We know not all residential services are the same. Some do excellent work in promoting the rights of the disabled and involving them in the community. But wherever vulnerable people are in care, an imbalance of power exists between those detained and those in charge of their wellbeing. In the absence of robust care standards or frequent inspections, people with disabilities will continue to remain at an unacceptable risk of abuse, mistreatment or neglect. Surely we have learned that much from the past?