RTÉ has done society a service by broadcasting harrowing scenes involving the physical and psychological abuse of persons with disabilities at a State-run care centre in Swinford, Co Mayo. As happened following the exposure of scandalous behaviour at Leas Cross nursing home some years ago, the Health Service Executive (HSE) has promised more effective inspection and enforcement regimes. But when Minister of State Kathleen Lynch is unable to say that similar abuses are not occurring elsewhere, what value has such an undertaking?
The real scandal involving the Aras Attracta centre lies in the failure of senior HSE management to respond to complaints from local people about quality of care and the treatment of residents there. Even before the sudden death of a patient in 2012 – a matter currently under Garda investigation – concerns were being raised. It took an unannounced inspection by the newly appointed Health Information and Quality Authority (Hiqa) to officially identify major shortcomings. Its inspectors found that residents were being left for up to 16 hours without food and their treatment was described as “distressing”. The HSE intervened and significant improvements were recorded.
Inspections would not have turned up the abuses recorded on camera. But their casual, almost routine, nature suggested an established culture involving the oppression and ill-treatment of residents. It reflected the kind of treatment meted out to vulnerable men, women and children in State and religious-run institutions during the last century. With plenty of evidence of traditional abuses to hand, the failure of management at Aras Attracta and within the HSE to respond adequately to local complaints; to monitor the behaviour of staff and impose strict discipline represented a lapse in their duty of care.
Abuse of power is an insidious thing. The systematic bullying and humiliation of individuals impacts on the perceptions and values of carers and the cared-for alike. Instances of intimidation and physical assaults at Aras Attracta were particularly egregious because those directly affected were not in a position to complain.
There are layers of responsibility in this case. Those identified as engaging in unacceptable behaviour towards their charges have been suspended, pending Garda and HSE investigations. But management at Aras Attracta, which failed to ensure staff discipline at Bungalow 3, has serious questions to answer. So has oversight management at the HSE. It is important that due process is followed in these matters, with explanations being carefully evaluated before judgements are made. In the meantime, however, the HSE will have to adopt a more assertive, caring approach if persons in its charge are to be protected from physical and psychological abuse.