Perhaps the most chilling aspect of Tuesday's Prime Time programme on Áras Attracta was the casual and routine nature of the abuse meted out to vulnerable residents.
The kicking, hitting, pinching, prodding and dragging was performed by staff without any sign of anger or any other strong emotion. Some of the mistreatment was clearly considered great sport.
All the while, other staff sit by, idly fiddling with phones, doing paperwork or, on one occasion, smoking a cigarette.
It seems clear the abuse was part of the culture in the centre’s Bungalow 3, hardly meriting a flicker of attention, let alone a disapproving word.
All-Irish staff
And whereas a previous
Prime Time
exposé of malpractice in Dublin creches featured young, poorly paid staff misbehaving as they tried to cope, the scenes from Áras Attracta show older, clearly experienced staff – all of them Irish – roughhousing the residents to whom they owe a duty of care.
It's the kind of behaviour we imagine happens in orphanages in harsher climes, not in a modern State-run home in Ireland.
This didn’t come out of nowhere. For up to four years, local whistleblowers have been voicing their concerns about what was going on in Áras Attracta. The sudden death of a patient in 2012 is currently being investigated by the Garda. The centre was one of the first to be inspected by the Health Information and Quality Authority (Hiqa) when it assumed responsibility for monitoring centres for people with intellectual disabilities just over a year ago.
That unannounced inspection, in February, revealed major shortcomings. Residents were left up to 16 hours without food, and inspectors described their treatment as distressing.
However, a subsequent inspection in May found significant improvements. As far as Hiqa is concerned, the HSE is now implementing the action plan it promised.
Hiqa after Leas Cross
Hiqa owes its existence to a 2005 scandal uncovered using undercover journalism, in the Leas Cross nursing home.
The agency has won many plaudits for its investigations, but regulation can be cumbersome and expensive. Even when inspections are unannounced, it is difficult to gather direct evidence of wrongdoing. Hiqa inspection reports are typically couched in bureaucratic language, and the process offers offending institutions many chances to improve themselves.
Last July, The Irish Times looked at almost 200 inspection reports into disability centres and found less than 2 per cent complied fully with regulations. Just three of 190 centres were found to be fully compliant; one in five failed to comply with any regulations.
There is clearly a serious problem here. Yet the ultimate sanction of closure is rarely used, particularly in the case of State-run homes, because there may be nowhere else to accommodate residents.
As so often in the health service, lack of resources has been put forward as one reason for the problems in Áras Attracta. It is said that cutbacks in funding closed some units, making conditions difficult for residents and staff.
This argument will cut little ice with anyone who saw the shocking television footage. There was little to indicate that staff were stressed or overworked. And even if this were the case, it would never excuse their actions.
