A "defenceless" intellectually disabled orphaned girl was allegedly physically abused and severely neglected over years while living with a couple not related to her and who had no legal rights concerning her, the High Court has heard.
Serious concerns were also raised over possible sexual abuse of the girl, referred to in court as Amy, arising from her exhibiting sexualised behaviour as a child.
A local charity worker who visited the couple's home in the late 1990s when Amy was ten described it as "the worst situation" she had seen, the president of the High Court, Mr Justice Peter Kelly, noted.
The HSE is being sued over alleged failures over years to intervene to protect Amy, now in her early thirties.
A Garda investigation is separately underway into claims concerning the care provided by the couple.
Amy was made a ward of court in 2017 on the application of the HSE after a voluntary organisation providing care for her raised safeguarding concerns. She remains in full time care at a residential facility.
The HSE, which commissioned a review into her care by an independent review panel, got orders on Tuesday permitting the panel's report to be circulated to Tusla, the Garda, the State Claims Agency and two members of the girl's extended family.
Conor Dignam SC, for the HSE, said it was gravely concerned, when told last year of claims by Amy of physical abuse, it had no records concerning her. It has taken a range of safeguarding and other steps to identify any person who might be in a similar position and to learn from this case, he said.
Sara Moorhead SC, for Patricia Hickey, general solicitor for wards of court, said Amy's case involved an "extensive litany of failures" in which case conferences were called but serious concerns about physical and sexual abuse were not followed through.
The general solicitor, who is suing the HSE on behalf of Amy, wanted the report circulated because it showed, while some individuals tried very hard to help Amy, there were “system failures”.
The concern is about a view, if a person is in private care of some kind, nothing can be done to alleviate their situation, counsel said.
‘Private family matter’
The persistent view of the health board in this case was that guardianship was not a matter for it and was a “private family matter”.
Directing release of the report, Mr Justice Kelly said he hoped the report concerning this “small,defenceless child” will ensure such a situation “will never repeat itself in the case of any other unfortunate individual”.
The review has identified issues concerning delays in investigating child protection concerns, poor recording practices and failures by the relevant agencies to use statutory powers, he said.
There was “nothing to stop” the health boards, or the HSE, after it took over health board functions in 2005, to take action to protect Amy when she was a child, he said.
Earlier, he noted Amy was born in the late 1980s and her teenage mother died just before her second birthday. Amy was then raised for a time by her grandmother, without any formal care arrangement in place.
When the grandmother’s health deteriorated, Amy spent increasing time with the couple. When Amy was six, the couple were providing daily care and received payments from the grandmother.
When her grandmother died, Amy was aged eight and her grandmother left a will saying one of her daughters should be named Amy’s legal guardian.
Because the grandmother had no legal arrangement concerning Amy’s care, she had no legal authority to name a guardian so Amy was “left with noone having any legal responsibility for her until she was made a ward of court in 2017”, the judge said.
The couple took over Amy’s care without any formal legal arrangement and received various allowances concerning her.
The judge said, during this time, Amy spent some time at a residential care facility provided by a voluntary organisation.
The evidence was Amy enjoyed the breaks and sometimes showed reluctance to return to the couple.
Signs of severe neglect
The voluntary organisation had expressed concerns to the health board, the precursor of Tusla, and had ongoing concerns about the absence of any person who had legal care of Amy.
The records showed, during her childhood, Amy was showing signs of severe neglect, he said. She regularly missed school, had severe hygiene issues, regularly experienced urinary tract infections which were untreated and had unexplained marks, bruises and scratches.
There were also concerns she had displayed sexualised behaviour and was reluctant to go home after respite care.
None of this triggered a risk or child protection assessment in relation to the couple’s care of Amy, he said. The couple regularly refused to consent to assessments of Amy, he noted.
Earlier, Mr Dignam said, the HSE asked the independent review panel to report on what happened and to ensure the system learned from the case. The HSE has put in place various safeguarding and other measures, he added.
Ms Moorhead, for the general solicitor, said there is a “significant absence” of records concerning Amy and none until she was aged 12. Her file was closed just a month before she reached the age of majority, 18, and there were no records concerning her over a ten year period to 2017.
The review panel had said it was “extraordinary” Amy was with a voluntary care provider from 2009 on but there were no records available, counsel added.
