Minister of State Anne Rabbitte has called for clarity from An Garda Síochána on why they have asked for a review into prolonged sexual abuse at a Health Service Executive-run residential care centre in Donegal not to be published while they investigate matters.
Speaking to RTÉ's This Week programme, she also called for the gardaí to give timelines on when it can be published, and said that many families of residents at the centre would like to see the report published so they can bring some closure to it for themselves.
"By publishing the report I want to unveil that secrecy which makes the public very uncomfortable with, so we can understand how this failure happened and actually how to address the models of care," she said.
The review into the abuse at the Donegal care home states it continued due to a lack of HSE leadership, questionable care models and a difficult working environment.
The National Independent Review Panel (NIRP) was commissioned to examine 108 "occurrences of sexually inappropriate behaviours" by one resident, towards 18 other residents.
The alleged abuse happened at the Seán O'Hare unit in St Joseph’s Community Hospital in Stranolar - and later at the Ard Greíne Court complex.
While the review looks at the period between 2003 and 2018, it found that "earlier records suggest …[this] behaviour had been ongoing and known to managers of the service" prior to this time.
The first record incident of sexual assault by the man - known by the pseudonym of 'Brandon' - was on 28 January 1997. Three more incidents were recorded by the end of 2002.
From that time onwards, Brandon is said to have "engaged in a vast number of highly abusive and sexually intrusive behaviours".
Evidence in files reviewed by the NIRP suggests he "regularly targeted particular individuals who he pursued relentlessly".
The review panel says the abuse occurred due to a number of factors:
- The model of care, where residents were viewed as "patients" who were "ill" and in need of treatment.
- A difficult working environment meant many staff tried their best to "manage an ultimately unmanageable situation".
- There was a lack of external oversight and leadership from the HSE.
- A strategy of moving Brandon around only made things worse and while there was an abundance of policies and procedures, there was little evidence staff had been trained to use or implement them.
Ms Rabbitte said that from reading the report it is clear that the residents were let down, staff were let down, Brandon was let down and families were let down.
She said a number of staff in 2008 submitted a letter to the local HSE on the matter and she said that from reading the report her understanding that it continued comes down to the model of care.
"It was seen through the lens as a medical model so it would have been seen as an episode as opposed to the social care model would have seen it as behavioural incidents," she said. "So it was the model of care. And that is the content of the report I would like to see published. It clearly explains how this could happen."
She said it is important the report is produced to understand the overall context of it.
We need your consent to load this rte-player contentWe use rte-player to manage extra content that can set cookies on your device and collect data about your activity. Please review their details and accept them to load the content.Manage Preferences
Ms Rabbitte accepted that certain individuals failed in their duties and responsibilities, and she said following the publication of the report it would become very clear about " accountability".
"It is unfair for me to talk about that level of it without having it published as there is a garda investigation going on and I don't know the content."
The minister said she is happy with the content of the report and the privacy is being protected "but we cannot have secrecy at all. It needs to be fully published."
She expects the HSE to hold its staff to account for any of the failings and described how the families have been treated.
"The families are actually none the wiser as to what exactly content is contained within the report, how the system failed them, the lack of communication with them."
She said one family she met was unaware of the content of abuse their loved one had been subject to with no follow up.
Another family thought everything was finished and did not know there was a review taking place.
When asked how it happened that her department knew this information for two years and the families were not told until 2018 she admitted it is "unacceptable" but said at the same time there is a process that you would "trust the HSE to communicate, engage and reassure the families and let them be aware".
HSE Chief Executive Paul Reid said he wants "full transparency and openness" in addressing the abuse that happened at the residential care centre.
He said this should not have happened and admitted it was not addressed in a humane way.
He said the report is "distressing and almost stomach churning" and it is very clear what has happened.
He said if disciplinary processes have to be activated they will assess them and do this in "the proper manner".
Mr Reid said a number of supports have been put in place for the residents and families affected.
'Look Back' report
The review was commissioned after a 2018 'Look Back’ report into the abuses, by an external expert on behalf of the HSE.
There were no written reports regarding abuse of any named individuals after 2011 but there are reports to suggest Brandon was continuing to engage in inappropriate behaviour.
In the 15 year timeframe examined, the perpetrator was moved around the facility nine times. He moved to a private nursing home in May 2016 and died last year.
The review says there is no evidence that any families of abused residents were informed at the time of the assaults. Many of the families that met the review panel "were particularly keen that the report should not come into the public domain" because of "the shame and stigma associated with sexual abuse".
The review identifies four occasions of contact between the HSE and gardaí over the time period in question.
The first was in June 2011 when a staff member discussed the sexual assaults with a local officer. No evidence was found of any follow up on that report.
A staff member gave an "undocumented recollection" of having informed gardaí in March 2017, that the Look Back report was being compiled.
Gardaí were briefed on the findings and given a copy of that report in December 2018.
In April 2019, gardaí confirmed they were investigating allegations of abuse of "patients" and also the alleged withholding of information by staff employed by the HSE.
On Friday last, after the matter was first reported by the Irish Times, gardaí confirmed a file had been sent to the Director of Public Prosecutions.
The HSE says it has been asked by gardaí to delay the publication of the NIRP report while investigations continue.
An inspection by the Health Information and Quality Authority earlier this year found that the Ard Gréine Court was not compliant with regulations around protection of residents.
Inspectors found that "safeguarding risks to four vulnerable residents due to behaviours of concern previously displayed by one of their peers" were not documented in safeguarding plans.
They also found that recommendations from "an independent safeguarding investigation" had not been fully implemented.