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HSE in damage control mode to block full publication of Brandon report

The Brandon report is a harrowing read, however equally disturbing is the HSE’s response to the report, writes Sinead McGarry

AFTER months of delay, the HSE finally published the executive summary of the Brandon Report on December 16, the same day the Dáil adjourned for the Christmas break, preventing meaningful political discussion of what HSE chief Paul Reid described as “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”.

While it is unsurprising Reid is repulsed HSE staff and senior managers failed to prevent the known repeated sexual abuse of residents with intellectual disabilities; Reid’s determination to prevent the publication of the full Brandon report is equally predictable. 

Despite lip service about open disclosure and transparency when serious failures come to light, HSE management remains committed to a tried and tested formula: Damage control. 

This response prioritises the needs of the HSE over those the organisation is supposed to protect.

Information is delayed, withheld, or drip-fed, as the HSE waits for media and political interest to wane in whatever scandal has emerged.

 Endless processes serve to place time and distance between events and final reports, ultimately protecting HSE careers, as time elapses and findings are then contextualised as ‘historical’.

The HSE rationale for refusing to publish the full report remains flawed.

Paul Reid advises publication of the full report which contains harrowing and important details omitted in the summary, would compromise disciplinary proceedings — “a process which is really important to us” — and may also identify people who provided confidential information. 

Neither point stands up to scrutiny. 

Seven years after it commenced, we are still awaiting the conclusions of the equally important HSE internal disciplinary inquiry into the horrifying events of Áras Attracta, a timeframe which does not bode well for the proposed review in the Brandon case.

Most importantly, full publication of similar reports happens routinely elsewhere, including in Northern Ireland and the UK, without impacting upon criminal or disciplinary investigations, or compromising confidentiality. 

It is essential we ask why Reid, on an annual salary of €426,000, cannot deliver the same transparency in our health service.

Instead, we are fed a diet of “we have introduced new measures to address failings, nothing to see here”. The reality is there may be much more to see. 

Though asked twice on RTÉ news if he could provide assurance the events of Brandon were not happening in other HSE-run facilities, Reid pointedly failed to do so which immediately raises queries about what other scandals remain unknown to the public.

Instead, Reid said the HSE has introduced “dedicated safeguarding resources and procedures." 

We have some really good and strong processes for staff. 

This confidence is misplaced as these new processes failed even in the case of ‘Brandon’. 

By May 2016, when Brandon was moved to a nursing home, the HSE had introduced a new safeguarding policy and a local safeguarding social work team in Donegal.

Ignoring the new policy and multiple requests from their own social workers, the HSE still failed to develop a safeguarding plan for Brandon and residents in his new care setting for 18 months.

Reid has yet to explain why despite the horrors of Leas Cross, Áras Attracta, the Grace and Brandon case, HSE staff are not mandated to complete adult safeguarding training. 

A recent Department of Health report shows the public is unaware of the existence of the safeguarding social work teams, unsurprising as the HSE steadfastly refuses to promote them on a national basis. 

So we don’t insist HSE staff complete safeguarding training and we don’t tell the public how to report abuse to the HSE. 

On December 16, Paul Reid spoke on the national airwaves about the need to move to a rights-based culture in disability services, yet six days later he wrote to Minister Anne Rabbitte refusing to fully commit to protecting essential disability staff from redeployment. 

Does any of this sound like the work of an agency fully committed to protecting adults?

If the HSE succeeds, the lessons of the Brandon case will remain unlearned. 

The Irish Association of Social Workers has requested full publication as the report is likely to contain vital learning for social workers on missed opportunities to intervene and safeguard residents.

If professionals are prepared to welcome lessons in a transparent way in order to improve practice, why can’t our health service? 

Whose interests, apart from those of the HSE are served by keeping this report out of the public domain?

There is some reason for hope: Thomas Pringle has been an incredible voice for residents, families and Brandon himself and Minister Anne Rabbitte has been tenacious in her role as Minister of State for Disability. 

She has consistently challenged the HSE position, met families, and sought advice from the Attorney General around the publication of the report.

She has strong political backers in the Taoiseach, the Tánaiste, and Simon Coveney and it is vital this support continues if the Government truly wishes to change the HSE culture it is so often tasked with defending or explaining in the Dáil.

Health Minister Stephen Donnelly has been strangely absent from the discussions on the Brandon case; he also must step up and take the HSE to task with the same determination as Rabbitte. 

The Government and the entire political opposition must insist the HSE deliver the transparent culture Irish people want to see in their health service when failings arise. 

Anything less will result in more of the same.

It would be wrong to comment on the Brandon report without mentioning ‘Brandon’ himself. 

Referred to as an abuser, in truth, he was a man with intellectual disabilities who was equally as vulnerable as those he was permitted to harm. 

The HSE failed to protect his basic human dignity, failed to address his abusive behaviours, or provide the care he required.

The report which tells his story must be a watershed moment, a red line in the sand, one which dismantles defensive culture and forces the HSE to act with true transparency. 

Residents, families, citizens, politicians, advocacy groups, and organisations representing people who receive care, must unite and call for full publication of the report.

In the absence of this collective action, we are essentially telling people in care settings that we accept our health service can control and restrict information related to its own failings. 

Who among us would aspire to live in the care of such a service?

Sinead McGarry is a social worker

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