Good intentions are no defence when placed against a record of providing "unsafe and chaotic services" for people with autism. Following 18 months of inspections and consistently ignored recommendations, the Health Information and Quality Authority (Hiqa) was forced to take control of three residential homes run by the Irish Society for Autism. It is another blow to confidence in the charities sector.
Health safety inspectors found staff at one centre had been given no guidance in the administration of anti-psychotic and sedative medication while at others there had been failures to address deficiencies, inadequate staff training and a shortage of funding.
In the absence of remedial action and improved standards of care, Hiqa moved to cancel their registration. At that stage, the Health Service Executive sent in qualified personnel to maintain services. It was a late – and reluctant – admission by the HSE of its responsibility for the care of these citizens.
The State developed an excessive reliance on a religious-run voluntary sector involving education and health in its formative years. As the number of religious vocations waned and demand for services grew, however, the not-for-profit, voluntary sector moved to fill the gap.
Inadequate regulation and oversight by government agencies facilitated the growth of financial misconduct in some cases. In recent years this has led to public scandal. There have been instances too of poor service provision and mismanagement. This very large, fragmented sector is now in urgent need of policing, reform and rationalisation.
The HSE has been eager to farm out services to the not-for-profit sector that it should provide itself, according to a former executive with that organisation Jacky Jones. She believed mainstream services "didn't want to bother about the people involved".
That is an indictment not just of the HSE but of successive governments and society. A tendency to segregate, mistreat or ignore older people; the physically unwell and the mentally challenged is deeply entrenched and quietly accepted by the public.