Whistle-blower says voiceless girl was left to suffer 20 years of hell
Disturbing claims persist of a cover-up of alleged sexual abuse in a foster home, writes Shane Phelan
There is nothing remarkable about the rural cottage where Rachel* (*name changed) lived for 20 years.
A small building, with no more than three bedrooms, anyone passing could never imagine the terrible secrets it is believed to hold.
Gardai investigated allegations of sexual abuse at the cottage, a former foster home, for many years. They recently discovered photographs there of a prepubescent Rachel.
In several of the images, she was in a state of undress.
For one of Rachel's social workers, who has long believed her client was violated in the most appalling way, the find was chilling. But for investigators, the photos, discovered in an album in the living room, are just another piece of inconclusive evidence to add to a wealth of suspicion.
Born with a severe intellectual disability and non-verbal, Rachel was placed in foster care by her mother soon after her birth and has had no contact with her since then.
In 1989, at the age of 11, she was sent to stay with a family in the cottage by the local health board. When she finally left the home in 2009, she had to have seven teeth removed under general anaesthetic because her oral hygiene had been completely neglected.
One of her social workers believes she was severely sexually abused over a prolonged period and may not have been the only victim.
She has claimed Rachel was never brought to a doctor and received no schooling.
Rachel was one of dozens of children with intellectual disabilities who stayed at the cottage, either as foster children or on respite breaks, for almost three decades.
A protected disclosure made by the social worker alleges criminal negligence by the former health board and the HSE, with recommendations to remove the girl from the home not acted upon.
Issues surrounding the care of Rachel and other intellectually disabled children have been subject to a number of Garda investigations and three HSE-commissioned reviews, which have seen external consultants and law firms paid in excess of €500,000.
However, the truth of what happened there has proved elusive. The HSE reviews remain unpublished and the Garda inquiries did not lead to anyone being charged.
A Fine Gael TD, John Deasy, has alleged an organised cover-up by certain health service staff, while Fianna Fail TD John McGuinness has been critical of the Garda investigation of the case.
While gardai insist that allegations were thoroughly investigated, many deeply troubling questions remain.
A dossier compiled by one of Rachel's social workers and submitted to the Dail Public Accounts Committee details an utterly shocking and inexplicable timeline of events.
A copy of the dossier has been seen by the Sunday Independent. We are not identifying the social worker as this could lead to the identification of Rachel.
The social worker was assigned to an adult Rachel in 2008, when she was still living in the cottage. She immediately became concerned that Rachel may have endured neglect, as well as physical, sexual and financial abuse, and began looking back through her client's files. What the social worker found in the files shocked her to the core.
The foster home at the centre of the allegations was located in an isolated area in the southeast and run by a couple who set up home there in the 1970s. Children were placed there by the health board and the Brothers of Charity, while some families used it privately.
According to the dossier, the Brothers of Charity ended its association with the foster home in the early 1990s after becoming aware the family had been dishonest about the number of children in their care. In 1992, concerns were expressed by a family about their daughter and an allegation of sexual abuse was made.
The complaint was dropped due to a threat of legal action by the foster family and the health board did not investigate the issue further.
In late 1995 or early in 1996, a further allegation of sexual abuse was made. According to the social worker, documentation from that period showed the health board decided, on the basis of information known to it, to cease placing children in the care of the family. Inexplicably, Rachel would remain there for a further 13 years.
While out of the home on a visit to a day service for people with intellectual disabilities, a 17-year-old Rachel was reported to be "wolfing down" her dinner, stealing food, stripping off her clothes, banging her head against the wall, screaming, and laughing uncontrollably. There was bruising on her body that her carers could not explain.
A report from the health board's area medical officer stated she weighed five stone.
The health board decided to end Rachel's foster care arrangement at the home.
This was appealed by the foster family, who petitioned the Department of Health.
Michael Noonan, the then minister for health, corresponded with the health board in 1996 about the case.
Although the health board decision to remove Rachel stood due to "serious protection concerns" and another placement had been found for her, she still remained with the foster family.
That summer, according to the dossier, a case conference was told the allegations had been "dealt with" and Rachel was to remain in the foster home. Rachel's social worker has spent the past five years trying to establish why the decision was made or who sanctioned it, with no success.
What she has been able to establish is that when the male foster carer passed away, the health board became aware of his death only six months later, raising serious questions about its level of engagement with the family.
In 2001, another social worker, who was working within the health board, attempted to remove Rachel from the foster home.
According to the dossier, this social worker was concerned Rachel may have suffered internal damage and that objects may have been inserted in her back passage.
She contacted Rachel's mother, who was living in the UK, seeking consent to have her removed, but did not inform her of the sexual-abuse concerns. Although consent was given, the health board relented to the wishes of the foster family and Rachel remained with them.
Then, according to the dossier, nothing happened for six years. No one from the health board or the HSE visited Rachel, and her case file lay dormant in a cabinet until August 2007 when her mother rang to enquire about her wellbeing. At that point, the HSE requested that a local disability organisation hold a residential bed open for her, at a cost of €120,000 per annum. However, she still wasn't moved.
Concerns were raised by the author of the dossier after Rachel turned up for a day-service appointment in August 2008 with a black eye.
The following March, she was found to have bruising on her breast and thigh. She was brought to a sexual-assault treatment unit but became distressed and would not cooperate with an examination.
The dossier claims gardai did not fully investigate these incidents.
Finally, in July 2009, Rachel was taken from the home after her mother was informed of the bruising and demanded she be removed.
At this point, the social worker and a colleague say they contacted the HSE expressing fears for other children who had been in the foster home. But they were not happy that the HSE was taking the matter seriously enough and contacted the Department of Health.
"We felt the actions being taken at the time were nothing short of a cover-up and sought for all the issues to be addressed through an independent inquiry," the social worker wrote in the dossier.
Bizarrely, the email sent to the department, expressing these concerns, was forwarded for a response directly to the local HSE office and managers about whom the claims had been made. The social workers believed this had left them open to civil liability, so they felt compelled to make a protected disclosure under the provisions of the Health Act.
"Had we not made a protected disclosure, it is clear the HSE would not have investigated this case at all," she wrote in the dossier .
A consultancy firm run by former IMO industrial relations director, Conal Devine, was tasked by the HSE to examine Rachel's case.
According to the dossier, while the review was ongoing, two HSE officials central to events moved to another state agency.
Mr Devine's company completed its report, which cost €124,797, in 2012. The findings have yet to be published. However, it is understood one of the recommendations was for a review of the cases of everyone else who was placed at the foster home.
It appeared that 20 years after an initial allegation of abuse was made, the HSE still did not know exactly who it, and the agencies it funded, had put through the home.
Another firm, Resilience Ireland, was commissioned to do a "look-back" review, and it identified 40 historical placements. This review cost €30,060. The same firm was then asked by the HSE to do a full review, involving direct contact with all of the families involved. Its lead consultants for this project were former health service staff, Ger Crowley and Tom O'Dwyer.
A report was delivered in April at an estimated cost of around €149,000. It has yet to be published.
According to the dossier, some of the families interviewed were confused by the process and did not know who they had spoken to. Rachel's social worker also expressed concern about the fact that former health service staff were potentially investigating the failings of ex-colleagues.
While there is no suggestion the consultancy firm did not carry out its duties correctly, the Public Account Committee issued a report recommending the HSE cease the practice of hiring former staff to conduct sensitive investigations into systemic failings.
Health minister Leo Varadkar decided last month that a senior counsel was to be appointed to examine how the reviews were procured and the approach taken in conducting them.
Contacted by the Sunday Independent about her dossier, the social worker said she had made the disclosures because she feared there was no appetite for accountability within the HSE or the Department of Health. "There have been endless inquiries and reviews resulting in huge profits for solicitors and management consultants with no discernible benefit for clients, no accountability and no apology," she said.
"We need to know who made decisions in this case and where those decisions were fundamentally wrong, or where it is found that people put the interests of the HSE above the safety and welfare of vulnerable adults and children, those responsible should be held accountable and prosecuted."
For its part, the HSE said it intends to publish the reports once given clearance by the gardai and the Office of Wards of Court. In a statement, it said it was not waiting for the publication of the reports to implement their findings.
The HSE said it was satisfied the reviews had been "carried out with integrity by individuals with the appropriate skills and experience to manage an investigation of such a sensitive and important nature". However, it declined to say whether any staff had been sanctioned over failings in the care of Rachel or other children.
Garda sources have also defended the force's handing of the allegations about the foster home. They insisted there had been several investigations into abuse claims over the years and five separate files had gone to the DPP.
The passage of time, the death of one of the main parties, and the inability of most of the former residents to communicate proved to be massive hurdles, a senior source said. While the naked photos of Rachel may have been suspicious, they were not pornographic in nature and dated from "a more innocent time". Detectives did not considered them to be sinister.
Gardai rejected claims by Mr McGuinness that specialist interviewers were not brought in to speak to former residents. A senior source said this had happened "where appropriate".
For now, it appears that if anything did happen during all those years in the cottage, it remains locked in minds of severely mentally disabled individuals.
What is clear is that Rachel will never recover. She suffered huge psychological trauma after being removed from the home, culminating in bouts of psychosis.
She now requires a health worker to be with her at all times and is on a combination of psychiatric medicines.
This is likely to be the case for the rest of her life.
* Rachel's name has been changed to protect her identity