We must call this Institutional Abuse for what it is – 11/12/14

RTÉ Investigations Unit: Inside Bungalow 3 (aired: 9/12/14), which covered the abuse of elderly people with intellectual disabilities in the Áras Attracta care home in Swinford, provoked what has become an all too familiar reaction from both the public and our elected representatives. For the public, we are once again left with a feeling of helpless anger. Anger that the most vulnerable in our society, who we believe should be cherished and protected, have in fact been suffering treatment which can only be described as torture. Our elected representatives were, as usual, very quick to issue statements telling us that this shouldn’t be happening. This sentiment seems without substance, as these declarations have been made countless times before in the face of previous, often recent, cases of sickening abuse coming to light.

The abuse of some of our society’s most vulnerable in Áras Attracta mirrors what has taken place in the mother and baby homes that were run by the religious orders. It mirrors what has taken place in some of our state run institutions for those with mental illnesses. It also mirrors that which was inflicted on pregnant women in our some of our state-run hospitals, resulting in unnecessary medical procedures such as the horrifying practice of symphysiotomy. All of these were, at the time, and still are, covered up by those responsible – the church, the doctors, and most damningly of all, the state.

This is not ancient history, either. Prime Time Investigates uncovered horrific abuse in the Leas Cross care facility in 2005, and the political establishment of the day announced that changes must be made. Yet here we are in 2014, witnessing abuse that is even more heinous and hearing the same responses from our government. So much of this problem stems from a political class that refuses to recognise that this goes beyond isolated incidents, and refuses to call the epidemic we have for what it is – systemic institutional abuse.

We can only move forward as a society and properly address this problem when we as a society, including our elected officials of past and present, accept our complicity in the continuation of this shocking abuse of the most vulnerable in our society. Our long established culture of covering scandals like this up, of handwringing after the event has been revealed and of taking inadequate steps to preserve the respect and dignity of the most vulnerable Irish citizens is something we are all aware of, and something that allows abusers to embed themselves within the institutions designed to protect the very people they prey upon.

The Young Greens are calling for an independent investigation into the abuse that has already occurred. However, to ensure such horrific events never happen again we believe that more needs to be done than simply treating this as an isolated incident. Radical action is needed to eradicate systemic abuse from our health system. The Young Greens firmly believes in finding practical solutions, undertaken at the lowest effective level, which we feel are not currently being investigated and implemented.

This year legislation protecting whistleblowers has been strengthened, but we say that current legislation on this issue does not do enough. Institutional abuse is an inherently cultural problem, and if a culture exists in an institution where inappropriate behaviour is not reported or stopped, then our legislation is effectively useless.

The first thing then that must be looked at is the point of entry to these work places. Who are we entrusting the care of our most vulnerable citizens to? Ideally, in the caring society that forms part of the Green vision a professional carer is well qualified, is vetted, is consistent in their duty and most importantly wants to help and empower the people they are caring for. In order for this to happen, a society needs to exist that recognises that the job of caring is one that is demanding, but hugely important on both an individual and societal level. It is a job that should be respected as one that enriches society to a far greater extent than it is now.

As it stands, that fundamental idea of caring is not respected in the increasingly profit-above-all society that Labour and Fine Gael are constructing. To see an example of the way caring is disrespected in our current society, one has only to look at how those who choose to care for their loved ones and forgo employment are treated. Their benefits have consistently been cut; especially by the current Government. Their sacrifice is treated by this government as selfish, a way of dodging work, as if caring for the vulnerable is harmful and the only thing that can benefit society is the creation of more profit for private enterprise. This is a destructive, narrow-minded and inhumane view of what our society should be and what our priorities should be. Fine Gael and Labour should be ashamed for furthering this and for making it increasingly difficult for people to provide care to those in need.

This is reflected in what the caring industry in general has been forced to become by this corporate-centric view – a largely privatised industry driven by profit, and one that strives to cut corners at every turn, creating worse conditions for those entrusted to its care in order to squeeze out marginally higher turnover. This is an industry which does not vet its workers, which even hires carers using Jobbridge and other unregulated government “job creation” schemes, which significantly undermines the importance of having fully qualified workers, who are invested in creating the best outcomes for those under their care – which should, of course, be the primary function of the caring industry.

Caring in our society, therefore, is a job which is undervalued, underpaid and ultimately not respected. This directly results in people who are wholly unsuitable to the work of caring, as seen in the Prime Time investigates program, being placed in roles that they should never have been allowed to do in the first place. This also results in the many workers who excel in their jobs and who genuinely do their best for those in their care not being recognised for their good work. Is it unexpected that they do not feel safe in whistleblowing?

The problems then are manifold and interconnected. Firstly, the problem of underfunding results in the underpayment of carers, which has the secondary effect of our brightest and best leaving Ireland to work elsewhere. This then leads to a situation in which those who are unsuitable for the job are the only ones willing to do it and once in these positions these vulnerable workers feel unsafe in reporting abuses when they see them, out of a lack of either experience or job security. The fact that caring services are underfunded is not a new one and has been pointed out countless times, therefore when abuses happen which can be directly linked to underfunding, it is disingenuous for elected officials to say that they are unaware that these problems exist.

Why has underfunding systemically occurred? The harsh truth is that for Fine Gael, Labour and Fianna Fail, appealing to a middle-class, middle-aged demographic, talking about the complex, ugly problems we have in providing care for the most vulnerable in society is not seen as a vote-winning strategy. What the parties perceive as vote winning is to talk about cutting taxes for the rich, or to talk about ‘job creation’, even if they are underpaid Jobsbridge jobs which in this case are actively harming those in care.  Most of the state’s most valuable services are losing out to this disgraceful tide of populism.

The second part of the problem, and one that our government has clear power to address, but have not done so, is the complete lack of oversight and effective regulation. It’s not enough to call for another retrospective investigation. It’s not enough to limit ourselves to this one specific incident and to go back to thinking that this abuse isn’t happening systemically, until the next Primetime special gives the Irish public and their representatives a wake-up call.

The Young Greens agree that an investigation is necessary, but we would suggest further measures to deal with the cultural problems in the caring industry. Carers need to be vetted, well qualified and well paid. It must be recognised that as workers, carers must be cared for as well. A worker secure in their position is much more likely to voice their concerns when they see abuse happening, and is better equipped to perform their job to the best of their ability. An abusive worker, such as those featured on Primetime, must be made fully aware that they will be caught and that they will be punished severely for the harm that they have inflicted.

How do we achieve this? A simple and effective strategy would be to change the way that inspections are carried out. Inspections need to be unannounced and undercover, as suggested by HSE head Tony O’ Brien. What is equally important is that those reports must then be acted on – something an understaffed and underfunded HSE and HIQA have struggled to do. A report condemning certain behaviours which is not acted on, and there are many of them, can be easily ignored by those engaged in abusive practice. Workers in the care industry must also be provided with a greater level of CPD (Continuing Professional Development) and training. We must ensure that workers are fully equipped to provide a high standard of care that is an enriching and empowering experience for the most vulnerable in society.

The footage filmed at Áras Attracta made for heart-wrenching and sickening viewing. Politicians are quick to condemn but they are not so quick to accept responsibility for their past inaction, or to use their position of power to help in a meaningful way. Condemning is easy, curing is another matter. The Young Greens accept that the state that we were a part of has a responsibility. We don’t want to merely issue yet another statement on it; we want to ensure this does not happen again. We want a society where every person is valued for their humanity and what their personhood contributes to society. We do not want a society that sees our most vulnerable members as economic and social burdens, as the current government seems determined to view them. As seen from the treatment of people with disabilities, the elderly, people who are homeless, the unemployed or asylum seekers.

People with disabilities have been patronised, disempowered and actively abused by the Irish State for too long. The system of care for people with disabilities must be based on user experience, empowerment and facilitating everyone to participate fully in society in a way that’s autonomous and enriching. The Young Greens call on the Government to start implementing disability law similar to laws enacted in the British Columbia district in Canada and create the legal framework required for Assisted Decision Making; a decision making process centred around enhancing the autonomy of the person with a disability. The Assisted Decision Making (Capacity) Bill 2013 is a step in the right direction, but in its current form it does not go far enough and it is doubtful that the current government would actually invest the resources necessary into a system of assisted decision making; even though increasing the autonomy and giving a stronger voice to people with disabilities would do a lot to counter the existing culture of abuse towards them. We should be addressing the cause and preventing abuse happening, rather than doing nothing and then reacting in shock over and over again.

Lorna Bogue – Chair of the Young Greens