A Government pledge for unannounced visits to inspect residential services for people with an intellectual disability must be implemented, writes Deirdre Carroll

 A few weeks ago I was contacted by family members about their brother who is now in his sixties. He has a moderate level of intellectual disability and has episodes of violent and disturbed behaviour, which have made it very difficult for his family to find him a suitable place in a disability service.

He also has been the victim of sexual assault by another service user in the past but the family were told nothing could be done about it. After many years of living in unsuitable and inappropriate services, including episodes in psychiatric hospitals, he finally found somewhere to live which both he and his family liked.

He has lived there for a number of years but recently due to a new outburst of violent behaviour was moved to another unit where his lifestyle is more restricted.  His family first contacted me twelve years ago when similar problems had occurred. I was interested to know what had happened in the intervening years. It emerged that some years ago this man told his family about incidents of appalling sexual and physical abuse he had experienced as a young boy at a residential school for boys with disabilities.

As a young boy he had been assessed with a mild level of intellectual disability and was falling behind in his local school. His parents were advised it was in his best interest to send him to a special residential school. He left school aged 16 sixteen, illiterate with a moderate level of disability, disturbed and with violent behaviour and a hatred of authority. His family never knew of the reason for such behaviour until his disclosures a few years ago. His loving parents died not understanding why their son acted in such a frightening way, but worst of all he has been condemned to living a half life of great torment through no fault of his own.     

The Ryan Report identified children with a learning disability and sensory impairments as especially vulnerable and most at risk. A separate chapter in the report is devoted to a residential school for boys with special needs run by the Brothers of Charity in  Lota, Cork where young boys with mild to moderate intellectual disability were subjected to the most horrific acts of sexual abuse.  The Ryan Report made twenty recommendations.

Shortly after its publication the Government issued a statement making it very clear that it accepted each recommendation and was committed to their implementation. Minister Barry Andrews was asked to draw up an implementation plan for Government. Individuals, victim support groups and agencies involved with children, including Inclusion Ireland, were invited to make submissions to the Office of Children and Youth Affairs. It is a credit to the work of his Office that the plan was launched at a press conference on the 22nd of July.  

There was a general welcome for the plan and for the Minister’s press release in which he committed the Government to giving the highest priority to the care of children. While accepting the genuine commitment of Mr. Andrews, Inclusion Ireland is concerned about the lack of urgency surrounding the implementation of one of the key recommendations of the Ryan Report: the need for independent and unannounced inspection of children’s residential services. There is a noted absence of such inspections of services for children with disabilities. 

The implementation plan states that there are approximately 150 centres offering residential care or respite care to children with disabilities and notes that these children are not in the care of the State although they are cared for by the State - a legal nicety which has prevented them from being inspected under the Child Care Act of 1991. At present, privately run residential services for children without disabilities are inspected by the HSE, and the Social Services Inspectorate (SSI) of the Health Information and Quality Authority (HIQA) inspects HSE run residential centres. The Health Act 2007, when finally enacted will give the SSI the statutory powers to undertake all inspections.

 The action to be taken around inspection of services for children with disabilities described in the implementation plan, states that the Health Act 2007 will be commenced to allow for the independent registration and inspection of all residential centres and respite services for children with a disability by December 2010. This means that for another sixteen months at a minimum, children in these services will continue to lack the protection of visits by experienced inspectors. Furthermore there is no guarantee that in December 2010 such inspections will commence.

The new standards for residential disability services for thousands of   adults with intellectual and physical disabilities, which was launched in May, have been put on the long finger as the Department of Health says there is no money to implement them in the foreseeable future. This is despite the overwhelming evidence pointing to the need for inspection against approved standards.    Surely some sense of urgency around independent inspection of residential services for children with disabilities is not too much to expect from Minister Andrews? The Minister should have instructed the HSE and the SSI to commence immediately inspections of centres where children with disabilities live while awaiting the full enactment of the 2007 Health Act in December 2010. Such action would have sent out the right message that the Minister and Government is serious about this plan.     

Minister Andrews says there will be no peace for the survivors of abuse unless we live up to the ambitions set out in the recommendations of the Ryan Report. The man described above is not a survivor of abuse, as his brother correctly reminded me, he is still a victim. The State failed to protect him as a vulnerable child and   continues to fail him as a vulnerable adult. It is time for Minster Andrews and his fellow Health Ministers Mary Harney and John Moloney, to lead the way by injecting a sense of urgency around the implementation of independent inspection of children’s and adult services.  

Deirdre Carroll is chief executive of Inclusion Ireland, the national association for people with an intellectual disability