A HSE-funded settlement package worth €6.3 million has been approved by the president of the High Court for a woman with serious intellectual disabilities known as Grace in respect of her mistreatment while in the care of the State.
Mr Justice Peter Kelly described her treatment as a “scandal”.
The package includes punitive damages to reflect what the HSE accepted were very serious failings in the care of the “literally voiceless” woman who was entrusted to its care as a young child until aged in her early 30s.
The judge said Grace’s treatment over 20 years was “not just shocking, but a scandal”, particularly as it continued into the 21st century, and involved “abdication” of responsibility by health board and State agencies.
Grace was placed with a foster family in the southeast in 1989 but, while a health board decision was made in 1996 that she and other children be removed from them following an allegation a child was sexually abused, evidence of physical abuse and neglect of Grace as well as suggestions of sexual abuse, she, the most vulnerable child, was left there for another 13 years until 2009.
It remains a “mystery” why the decision to remove her, against which the foster family made representations to the Minister for Health, was not acted upon and was later reversed by a three-person health board committee, he said.
Were it not that a commission of investigation had been set up, he would have insisted on answers to many questions, including what “extraordinary” hold the foster family had over the health board committee which led to Grace being left with the family in the teeth of professional and social work advice.
He hoped the commission would “get to the bottom of this”.
Despite recommendations by lawyers years ago that Grace be made a ward of court, that was not proceeded with due to fears the court would ask questions about her care, he noted. Rather than face that, the “unfortunate and voiceless” Grace was left where she was.
Sad figure
When removed in 2009 from the foster family, Grace “cut a sad figure” in a “wretched” state, frail, dirty and unkempt, with health problems due to a poor diet and psychosis. Her only possession was a child’s toy which she held onto “for dear life” and to which she still clings but her condition has greatly improved since, he was pleased to note.
He paid warm tribute to two social workers who were the “catalyst for change”, saying the particular advocacy and dedication of one of those led to enormous improvements in Grace’s care and also praised the lawyers who acted for her.
He was approving a settlement of an action brought on behalf of Grace, now a ward of court, by a solicitor appointed by the court “as the committee” to represent her personal and financial interests.
While money is no compensation for what Grace suffered, it is “the best the law can do” and will ensure she is properly looked after into the future, he said. It was about trying to right the wrongs done to her while in the care of a State agency.
The funds will be paid into court and the package provides that Grace will retain her medical card, get funds equivalent to her lost disability allowance and be appropriately housed and receive all necessary therapies and supports. The future care costs are estimated at €4.3 million.
Given the HSE’s handling of Grace’s care in the past, the judge sought, and got, sworn undertakings from a HSE official in court it would abide by the terms of the settlement.
Apology
Through its counsel David Nowlan SC, the HSE apologised to Grace in court for its failings. The apology said the care she received while with the foster family fell “far short” of the compassionate, caring and personalised support to which she was entitled.
The HSE’s failings included inadequate monitoring and oversight, and inadequate action to move Grace after significant concerns were raised, it said. It had taken steps locally and nationally for continued improvements, standards and safe care.
Sara Moorhead SC, for the committee representing the interests of Grace, said, when she got involved in this case: “I genuinely could not believe this was the 21st century in terms of what we were dealing with”.
For years, everyone appeared to “run away” from Grace in relation to her needs and this was “perhaps one of the saddest cases” concerning abdication of responsibility for a very vulnerable, “literally voiceless”, person.
One of the tragedies was, because this was a “modern case” and many professionals were able to identify what Grace needed after her mother entrusted her to the HSE in the 1970s with a view to adoption, Grace never got the care that would have provided her with a much better life. She had only the HSE to look out for her as her family were not in contact with her.
From when Grace was about 10, it was identified, given her disabilities, she needed to be in a group care environment rather than foster care but that did not happen and for unexplained reasons she was put with the foster family.
This was a case where, in some ways, no money can compensate and “no one will ever know what went on for 20 years in that home”. There was very limited interaction between the HSE and the foster family for years and Grace lived in dreadful conditions, was very isolated, had ragged clothes and the food given to her led to bowel and other health problems.
Apart from concerns about sexual abuse, there was a “basic want of care”.
Lack of rationale
While there was contact between the family and politicians after the 1996 decision that Grace be removed from them, her side could find “no professional rationale” for the later reversal of the 1996 decision. The irony was Grace, the “most vulnerable” of the children in the family’s care, was the only one left with them.
It seemed “some class of pressure” was brought to bear and there was also a financial imperative for the foster family to keep Grace whose disability benefit was signed for weekly by another person.
It was only about 2007 when Grace’s mother called to ask about her welfare that “fairly derisory” attempts began to change the situation. In 2009, “panic” set in, leading to Grace being “spirited away” overnight from the foster home which had a “catastrophic” effect on her including psychosis.
She has improved immeasurably since and loves animals and the sea, counsel said.
