HSE safeguarding structure needs ‘transformational change’, report finds

Review by independent safeguarding expert Jackie McIlroy was commissioned by HSE in wake of ‘Emily’ rape case

'Too often... there has been acceptance of poor-quality care, defensive practice, tolerance of abusive behaviours, putting organisational reputation above the needs of the individual and how the very institutions set up to care for people became instead unsafe environments.'
'Too often... there has been acceptance of poor-quality care, defensive practice, tolerance of abusive behaviours, putting organisational reputation above the needs of the individual and how the very institutions set up to care for people became instead unsafe environments.'

There is a need for “transformational change” in the Irish health system’s adult safeguarding infrastructure, an independent review has found.

The review was undertaken by independent safeguarding expert Jackie McIlroy and was commissioned by the Health Service Executive on foot of the rape of a care home resident by a staff member in 2020.

The man was jailed for 11 years. The woman is known by the pseudonym Emily and died in 2021.

The report, which was published on Thursday, is a “wider review” into the “procedures, structures and options for the future of safeguarding across all settings” in the HSE following an earlier review by Ms McIlroy of the Emily case.

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In her report, Ms McIlroy said she found “broad consensus” among those she engaged with that there was a need for “transformational change” in the way adult safeguarding was “delivered and the way the system is organised”.

Further 21 cases of suspected physical and sexual assault found at ‘Emily’ HSE care facilityOpens in new window ]

The report said the procedures currently in place were “outdated” and there remained a need for “cultural change to embed safe practice and promote an open environment where safeguarding concerns are taken seriously and abuse of any nature is not tolerated”.

“Too often the review heard that there has been acceptance of poor-quality care, defensive practice, tolerance of abusive behaviours, putting organisational reputation above the needs of the individual and how the very institutions set up to care for people became instead unsafe environments,” the report said.

High Court judge welcomes woman’s return to nursing home after removal by sonOpens in new window ]

The report recommended a “change programme” for adult safeguarding and protection, which should send “a strong message that safeguarding is everyone’s business, and that poor practice or tolerance of abuse is not acceptable”.

In a statement responding to the publication of the report, HSE chief executive Bernard Gloster said: “I wish to once again, on behalf of the HSE, offer my deepest apologies to Emily’s family for the trauma she and they endured while she was in our care.

HSE to investigate records of other residents in nursing home where staff member raped womanOpens in new window ]

“I have met with them on a number of occasions and conveyed directly to them how sorry I am on behalf of the HSE for how she was failed.

“I would also like to remind all commentators that, arising from the trial in this case, there is an order prohibiting the identification of Emily and of the nursing home concerned. These orders are important to protect the privacy of Emily’s family.”

Mr Gloster said the HSE had now commenced a process to “implement these recommendations and enable the development culture and practice across the HSE that places safeguarding at the centre of the services we provide”.

Colin Gleeson

Colin Gleeson

Colin Gleeson is an Irish Times reporter