“What we’re dealing with here effectively is invisible citizens in our system and that is fundamentally intolerable in a democracy” – Professor Gerard Quinn, Director, Centre for Disability Law & Policy, NUI Galway.

‘RTÉ Investigates-Lost in Care’ - In this report Aoife Hegarty and producer David Doran reveal how the HSE failed to properly protect hundreds of adults with intellectual disabilities. In many cases the HSE had never even had a file on the clients in question and in some cases the files that did exist were little more than a single page.

Last year RTÉ Investigates revealed how a young woman with profound intellectual disabilities – now known by the pseudonym ‘Grace’ – was left in a care setting in Waterford for almost 20 years despite a succession of sexual abuse allegations.

When failures in the ‘Grace’ case came to light, two case reviews were commissioned by the HSE – one in 2012 and a second in 2015 – but both reviews remain unpublished. Following sustained public pressure, the Government announced earlier this year that the entire matter would be subject to a statutory Commission of Investigation. But just how broad will the Commission’s investigation be?

An unpublished internal HSE report leaked to RTÉ Investigates suggests that some of the failures indentified in the ‘Grace’ case did not happen in isolation. This Report catalogues a series of similar concerns, showing how in the same region of the country as Grace, hundreds of adults with intellectual disabilities were repeatedly failed by the State’s care services.

The report, which dates from 2013, was written by a senior social worker and examined 1080 files spanning a 30 year period. The report describes a system in “disarray”. It identifies a number of “key concerns”, including that:

The Health Service Executive has little or no knowledge about most of the clients in the adult intellectual disability services that it funds.

The social work service for adults with intellectual disabilities has been and still is very inadequately resourced.

Intellectually disabled adults have been left at serious risk of abuse including sexual abuse because concerns have not been properly identified and acted upon by the health board or HSE.

The report reveals that there were almost 200 adults with intellectual disabilities for whom case files did not exist. Other files had not been updated in over 25 years and consisted of nothing more than a single sheet of paper with the author referring to some as a “complete mystery”.

In one particular case a lack of information and communication meant that a vulnerable woman was being regularly returned, unsupervised, to her family home, despite it being known that the woman was sexually abused in childhood by a family member. The home visits were to be supervised but the HSE worker who accompanied the woman had no knowledge of the abuse or of the need to supervise the visits.

In another case a client had been placed with a service some 17 years earlier and hadn’t been visited by the health board or HSE in the intervening years. The client’s files contained “very little information” despite the placement costing “€88,000” annually.

And another case referred to a man with Down Syndrome who spent his whole life in residential care, yet when the report’s author and this colleague visited him, they were “the first official people” to have done so in 16 years.

In a statement to RTÉ, the HSE said that of the 1080 disability files reviewed “47 priority cases” were highlighted for follow up. 

It says the care and safety needs of all the cases highlighted are being met - there are “no current safeguarding issues” -

And a range of service improvements have been put in place to “safeguard vulnerable adults from neglect or abuse”.