'Too many vulnerable groups hidden away from society' - health watchdog chief
Too many vulnerable groups, including the elderly and people with a disability, are hidden away from society without true regard for their rights, Phelim Quinn, the head of the country’s health watchdog warned today.
Legislation needs to be introduced to protect vulnerable adults who are receiving care in their own homes, he said.
All vulnerable people in our society, including the homeless, prisoners, migrants and asylum seekers in direct provision, have the right to access high-quality, safe health and social care services, said Mr Quinn, chief executive of the Health Information and Quality Authority (HIQA).
Three years into the regulation of disability services, his inspectors continue to find examples of institutionalised abuse, he told the National Federation of Voluntary Bodies.
Residents are at the mercy of outdated and outmoded services, he added.
He told the gathering that over the last 9 years, HIQA has established monitoring programmes in a range of Ireland’s health services.
They also regulate children’s social services and residential services for older people and people with a disability.
“In that time, HIQA has identified a substantial number of services that provide excellent person-centred, rights-based care.
“However, we have also had cause to highlight issues of abuse and exploitation within services, and in doing so, uncovered deficits as regards the policy and practice response to such circumstances.”
“Recently, as part of our annual business-planning process, we considered how we, as the State’s health and social care regulator, could ensure that services are safer and better for all. That conversation led us to reflect on some of the most vulnerable groups in receipt of services. Some of these services are already operating within a regulatory framework, but others are not! “
He said the introduction of regulation to the disability sector three years ago was a major step towards ensuring the provision of safe, effective care.
However, it was evident at the time that many residential centres were simply not ready for this change. Delays in implementing the policy of decongregation meant that a large number of services had systems in place that worked against the principles of safe, person-centred, integrated care.
Ireland still faces the challenge of outdated care facilities for older and dependent persons. The date for full environmental compliance in a number of HSE services was pushed out to 2021.
“HIQA is still regulating within a residential sector where a very significant number of adults and children with a disability are being accommodated in large congregated settings, which we all have to acknowledge will never reach full compliance with the national standards.
“Accommodating people in poor-quality environments and in cultures that are not compliant with modern standards could in itself be viewed as abusive.”
He warned the slow pace of progress in the development of models of true community-based, integrated care is a continuation of the idea that people with a disability in the care of the State, or of an organisation stemming from charitable or philanthropic backgrounds, are being looked after “well enough”.
“In fact, I believe that this approach perpetuates a situation whereby vulnerable groups are hidden away from society without true regard for their rights as citizens.
"This view is borne out by the outcomes of a number of our published inspection reports of disability services. As previously stated, in some instances, the culture and practices within a small number of these services could be interpreted as abusive. “