State's direct provision just warehouses the vulnerable
Maybe the families and advocates of those with intellectual disabilities should be freer to make a choice about where their loved ones are cared for, says Brendan O'Connor
There are 8,000 Irish people living in direct provision centres. It costs an average of €112,500 to keep each of these people in those centres. Some of them are run by the HSE. Some of them are run by private contractors. 1,400 people live in HSE-run direct provision centres. Recently, Hiqa has been inspecting these centres to assess standards. They have been looking at things like whether residents' rights are being respected, and whether their healthcare and general welfare needs are being met. They have also been looking at general conditions and staffing. Of the HSE centres inspected, not one of them met the required standards. Yes that's right. None of them. Indeed, one third of the HSE centres inspected failed to meet any of the standards being inspected. So out of 75 HSE places inspected, 75 of them were substandard and 25 complied with no standard in any category whatsoever. They were literally doing nothing right according to Hiqa.
The picture isn't much better in general. When you include privately-run direct provision centres, which are all, remember, ultimately paid for by the HSE, by us, to the tune of nearly a billion a year, 93pc of the total are not up to standard. It's a fairly grim situation.
I should explain. Maybe you are wondering why Irish people are living in direct provision centres. The truth is, I don't know either. But effectively that is what many of the "homes" to which we consign adults with intellectual disabilities are. It basically amounts to direct provision, where human beings have no real autonomy over their fate, their care, their day. They are at the mercy of the state, or of wherever they end up. Many of them, of course, need to have all their decisions made for them and all their needs met by direct provision, but for others, more choice would probably make for more fulfilling lives, more humanity. But it is not generally possible in an institution where the needs of the staff, the routine and the collective prevail.