OPINION:Institutional care does not belong to a different era, as the Ryan report stated, as thousands of people with disabilities still live in such care, writes DEIRDRE CARROLL.
THREE WEEKS after the publication of the Commission to Inquire into Child Abuse Report (Ryan report), there has been little public outcry about the horrendous abuse of children with disabilities in institutions, nor has there been any mention that children and adults with disabilities remain in uninspected, unregulated services, paid for by the Irish taxpayer. Unfortunately, institutional care does not belong to a different era, as stated in the Ryan report, as thousands of people with a disability continue to live in institutional care, some in what can be described as Dickensian conditions.
Media coverage of this issue was limited to Inclusion Ireland and Emily Logan, Ombudsman for Children. Logan drew attention to the continuing failure of the Government, the Department of Health and Children and the HSE to provide for independent inspection of services where children with disabilities live. Inclusion Ireland has highlighted this failure since 2006. Figures published in 2005 showed that 374 children with disabilities were living in full-time residential care, with a further 500 receiving what is called “residential support services”, ie respite care, which may last for a few days a couple of times a year, or be a longer stay of weeks or months if needed.
The Ryan report highlighted the fact that children with intellectual disabilities and sensory impairments were especially vulnerable and were most at risk. Chapter 13 is devoted to special needs schools and residential services, and refers to a period from 1935 up to 1993. Fifty-eight witnesses gave evidence, and the majority (37) reported abuses in day and residential schools and services for intellectually disabled children. Chapter 5 deals specifically with a residential school for boys with special needs run by the Brothers of Charity in Cork. The commission refers to disturbing accounts of sexual abuse of vulnerable children by religious staff in this institution. The witnesses who spoke to the commission stated many former co-residents would not be able to give evidence, as they could not communicate independently.
In trying to explain why there has been little discussion of the abuse of disabled children, it is important to know many of the children went on to adult services run by the same religious organisations. Some witnesses sought reassurances from the commission that they would not be punished or “get into trouble” for attending the commission. As has already been stated, institutional care does not belong to a different era where disability services are concerned. Over 10,000 people with disabilities are currently receiving residential services. Many of these are living in excellent community-based services run by religious and lay service providers, but an estimated 4,000 are in places where there are more than 10 people living together. Neither community-based residential services nor the large institutions are subject to national objective standards or independent or unannounced inspection.
The Ryan report, in its recommendations, called for all services for children to be subject to regular inspection in respect of all aspects of their care. This is not happening for children or adults with disabilities today, one of Irish society’s most vulnerable groups.
The Government’s response will be that the Health Information and Quality Authority (HIQA) is advising on a set of national quality standards for services for children, which will include residential centres for children with disabilities. At present, the authority can inspect residential settings for children who have been placed in the care of the HSE by court orders. Children with disabilities are in receipt of services by reason of their disability, not a court order. Devising standards will take at least two years to complete, and if the experience of developing national standards for services for adults is anything to go by, we shall be told at the end that there is no money for implementation, and services will be asked to bring them in voluntarily. The Ryan report has taught us that this is not good enough.
Prompt action is needed. The Department of Health and Children should, without delay, prepare the necessary legislation to provide a legal basis for inspection and registration of residential centres for children with disabilities. They have known about this legal loophole since 2002. This could be done as an interim measure until the new standards are up and running.
For the thousands of disabled adults in residential services, we already have agreed national standards against which services can be measured. These standards were launched by the authority on May 11th – a little over a week before the Ryan report was published. In light of the horrors it described, these standards will be ignored at the State’s peril. It was said at the launch that it could cost up to €10 million to employ 50 inspectors. This money can, and should, be found. It should form part of the Government’s discussion with the Conference of Religious of Ireland.
Let us not fail children with disabilities in services today in the same way as we failed those who gave testimony to the commission. Let us also not forget that many of those mentioned in the Ryan report are now adults living out their days in unregulated services paid for by the Irish taxpayer.
Deirdre Carroll is chief executive of Inclusion Ireland