Thomas Pringle (Donegal, Independent)
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I thank the Minister of State for taking this Topical Issue. It is refreshing to have the Minister of State responsible take an issue when it arises. She has dealt with this issue all throughout the process and I thank her for that.

I first raised the issue of the Brandon report in a Topical Issue in the convention centre in July 2021. At that time, the Ceann Comhairle said on the conclusion of the debate: "Any members of the public watching these proceedings will wonder if they live in a democracy or an autocracy when a State agency can deliberately and protractedly frustrate the efforts of a Minister of State to get information about a fundamentally serious matter."

Since that time, she has tried to get the HSE in Donegal, and, I contend, nationally, to be accountable for the failings to service users in Donegal at Ard na Gréine and, indeed, to Brandon himself as well.

Families, unfortunately, have been kept waiting too. The whole way the families have been treated has been terrible and it leaves a stain on all of us. Whether we can ever achieve answers for them is debatable at this stage. The HSE has prevented the closure of Ard na Gréine and the decongregation of the setting as the solution to end the problem. However, how much decongregation has actually happened in Ard na Gréine? Perhaps the Minister of State can address that in her response as well. My information is that nothing has happened there and that is shocking. It calls into question the HSE commitment to making things right even at this stage. Sadly, I do not believe there has ever been an acceptance by the HSE that what happened was wrong and it would make sure that it would not happen again. The fact that decongregation has not happened proves that.

The Minister of State has worked on the issue and has tried to get the system, that is, the HSE, to deal with the issue and treat the families with the respect that they deserve. It seems it comes down once again to saving money on behalf of the HSE and the most important people, who are the service users, are being left behind. Unfortunately, it is over a year since the Minister of State said she would be in a position to publish a review of the system in CHO 1, which she hoped would make possible learning from the mistakes of the past possible by looking at what works and what does not work in the system and whether the system is now robust. Recently, some people have offered a chance to participate at this late stage and maybe give feedback to the reviewer. I know they have not been contacted or spoken to during the process, which is not good enough.

While the purpose of this process might be to look at what is currently in place, surely we need to know about the failings of the system as well. In order to see what works, surely it is necessary to understand what did not work. There is also the issue of the HSE nationally, which is not addressing this process at all. There is no doubt that Brandon and service users were failed by the HSE locally in Donegal but I believe we were all failed by the HSE nationally. It participated in a cover up and only looked to protect itself as an organisation. It is only by all of us admitting where things were done wrong before that we can aim to correct mistakes in the future. The least that victims like Brandon and their families can hope is that this will not happen to another family. Sadly, I am not sure that will be the case the way that things have gone.

Anne Rabbitte (Galway East, Fianna Fail)
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I would like to thank the Deputy for raising this matter. I agree with him. For context, we are discussing this since May 2021. I am advised that the then chief officer of HSE community healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo established an independently chaired strategic working group, SWG, in line with objective 5 of the HSE corporate plan 2021-2024, which is to "work to reimagine disability services, to be the most responsive, person-centred model achievable with greater flexibility and choice for the service user."

The SWG was also tasked with the implementation of service reviews including those in the national independent review panel's Brandon report, which included two recommendations. Recommendation one was the establishment of a strategic working group tasked with developing a new vision for disability services in this area in line with national policy and this working group should be charged with re-designing disability services in this area and developing a road map for achieving this new vision. Recommendation two was that this strategic working group should design services based on a social and human rights-based model of service provision for people with disability.

Nationally, HSE community operations established a safety risk management oversight team, SRMT, to oversee the work of this group. The national SRMT was chaired by the then HSE's chief operations officer. The independent chair of the SWG reported to the chief officer for the CHO, who, in turn, reported to the national SRMT. The SWG progressed two key strands of work, namely service improvement and service redesign. The new vision for disability services was reflected in the service redesign strand for disability services in the CHO. The vision is in line with national policy, based on a social and human rights model of service provision for people with a disability.

A range of key service improvements and service redesign actions have been undertaken over the period May 2021 to October 2024. Due to the progress made on the actions set out under the service improvement and service redesign strands, the national HSE SRMT decided that it had completed its work in September 2023.

In addition, it was assured that the CHO's disability services self advocacy strategy and sustainability plan would continue to ensure the implementation of the vision for disability services. As such, the governance and oversight responsibility for disability services in the CHO was transferred to the chief officer. It was decided that the independently chaired SWG would continue to operate with a review to take place in quarter 4 of 2024 to coincide with the roll out of the new HSE health region and integrated health area structures under Sláintecare.

The CHO disability services self-advocacy strategy, which has an accompanying implementation plan, was launched in December 2023.

The self-advocacy strategy considers the barriers that individuals face when advocating for themselves and sets out the future direction for enabling the participation of adults with disabilities using the service through effective self-advocacy. Self-advocacy groups and networks are increasingly being established throughout all areas of disability services. Earlier this year I requested that Colm Lehane, independent chair of the strategic working group tasked with the development of a new vision for disability services in the community healthcare area for Cavan, Donegal, Leitrim, Monaghan and Sligo, prepare a high-level report for me on disability services in the area. The primary objective of this report is to provide an independent and objective assessment of safeguarding structures and processes in place in the CHO. In the context of the Brandon report, this report will address whether the recommendations outlined in the report and associated reports - of which there are a lot - have been implemented by the HSE in CHO 1. I expect the final report in due course.

Thomas Pringle (Donegal, Independent)
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There is a lot of high-level gobbledegook in that response - SRMTs reporting to chief officers and stuff like that - but the reality is that while the outcome of the Brandon report was supposed to be the decongregation of the facility where Brandon lived, it has not been. I have been dealing with this since about 2016. That it has not been decongregated yet is down to HSE management not doing its job and not doing what it is supposed to do. Many people believe decongregation will resolve the issues in relation to Brandon. I have spoken to some people involved and working in this, and they believe that too. I really do not know and, unfortunately, there is nothing in the response to give me encouragement it will happen.

A service was closed in the north of County Donegal on foot of a High Court report and it was not explained to family members what was happening. The service users who were resident there are severely disabled and I do not know whether they would fully understand but it was not explained to family members. They have been moved out due to a damning HIQA report on the building. It related to the facilities rather than any safeguarding issues, as I understand it. I want to make that clear but it is symbolic of the fact things are not changing. People are not being talked to, as far as I can see. The decongregation has not happened because the HSE is not working at it. That is a problem. Will the Minister of State's report say that when it comes out? This report was supposed to be published well over a year ago and it still has not come out. That is a problem. This is ongoing and we will see repeats of this as well.

Anne Rabbitte (Galway East, Fianna Fail)
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I acknowledge the advocacy and voice for the most vulnerable the Deputy has continued to provide in Donegal since-----

Thomas Pringle (Donegal, Independent)
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I would rather not be continuing with it.

Anne Rabbitte (Galway East, Fianna Fail)
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I know. I will give the Deputy the commitment tonight that I will talk to Mr. Lehane to see exactly how close we are to completion of it. I certainly would like to bring it to complete closure before this Dáil finishes up. I see it as one of the pieces in relation to safeguarding. I and the Minister of State beside me, Deputy Carroll MacNeill, talk a lot about safeguarding. There is a culture piece I want to see addressed. I want to see advocacy addressed and the voices of the individuals heard. I want to see that management chains have changed and that the investment that has gone in has led to a clear understanding of safeguarding and protocols. We do not need more legislation or rules; we want a clear understanding that the culture of those tasked day to day with looking after the most vulnerable is understood and delivered upon and that the families are respected and are part and parcel of whatever progress is made.

I give the commitment I will talk to Mr. Lehane tomorrow. I know it is independent; I am stepping outside that independence and will ask how close we are to completion so I can lay that report before the Dáil. I am conscious the national independent review panel, NIRP, report was never published. Many other reports were started but not finished. Let me bring the one I looked for before the House. Whatever flaws are in it, let it be published. I think people have a right to know.