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18 July 2022 - IASW raises concerns regarding HSE safeguarding position

Concerns have been raised regarding an advertisement by the HSE for a Director of Nursing in Adult Safeguarding.

The Irish Association of Social Workers is among those that have said the position should not solely be open to medical personnel. [A copy of the letter dated 15th July 2022 from the IASW to Minister Rabbitte is available to download here]

Correspondence seen by RTÉ News also shows that the Minister with Responsibility for Disabilities wrote to the National Director of HSE Community Operations seeking clarification on the matter.

In January, Anne Rabbitte said it was clear there was a need to move away from a medical model of care, following the publication of the Brandon report.

The correspondence from the Ms Rabbitte to Yvonne O'Neill in the HSE dated 3 July about the advertised position appeared to reflect this view.

While the minister acknowledged that nursing played a vital role in the lives of adults at risk of abuse, she also pointed out that the National Independent Review Panel - which wrote the Brandon report - advised that moving from a medical model to a multidisciplinary approach was essential.

"Nurses solely leading nurses in their safeguarding practice does not, in the view of NIRP or myself, deliver best outcomes for adults at risk of abuse or neglect," she said.

The minister went on to ask a number of questions of Ms O’Neill, including an explanation of the expertise nurses had to deliver regarding leadership in adult safeguarding within their own profession.

The Irish Association of Social Workers has said it is surprising that while Social Workers, Speech and Language Therapists, Occupational Therapists and Psychologists will assess capacity alongside their nursing and medical colleagues under Assisted Decision-Making Legislation, they are excluded from applying for a safeguarding leadership role as now envisaged by the HSE.

Its Chairperson Vivian Geiran has said that the HSE appeared to be under the impression that only nurses could lead nurses in safeguarding practice, when he said the evidence suggested that opening nursing and all professions to holistic safeguarding leadership would deliver better outcomes for adults at risk.

It has noted that lessons need to be learned from the likes of the Brandon Report and what occurred at the care facility Áras Attracta, after RTÉ Investigates broadcast the documentary 'Inside Bungalow 3' in 2014.

Following a meeting of the Disability Matters Oireachtas Committee, the HSE responded to queries from Fine Gael TD Fergus O’Dowd regarding information he sought about the Brandon Report and Áras Attracta. The HSE said a programme of work was under way to implement the recommendations related to the service user Brandon. On Áras Attracta, it said that following the RTÉ programme, the HSE commenced an investigation.

It noted that in February 2016, following court proceedings, initiated by the PNA union, Ms Justice Murphy found that the HSE had acted in breach of its own procedures.

"In light of this ruling, a new investigation process, with an agreed Terms of Reference and membership, was initiated in 2016," it said.

The correspondence to Mr O’Dowd also confirmed that the independent investigation team had completed its investigation.

"The Final Reports in respect of 13 staff were provided to the HSE in June 2020 Arising from the Primetime recordings," it said.

It also confirmed to Mr O’Dowd that the costs to date based on staff costs, legal costs and Trust in Care investigation costs are €4,790,522.

Mr O’Dowd has described the details given to him by the HSE as extremely concerning and has called for the Áras Attracta report to be published in full.