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‘Culture of victim blaming’ in HSE – Confidential Recipient

By Catherine Reilly - 23rd Jun 2024

Families feel that a “culture of victim blaming” arises when they raise concerns about practices in HSE/HSE-funded disability and older persons services, according to the Confidential Recipient.

In her 2022 annual report, Ms Gráinne Cunningham O’Brien also stated that on some occasions the HSE insists on the affected individual applying through Freedom of Information (FoI) to gain access to the report relating to the outcome of their complaint.

This is “most upsetting for adults who have a right to the report as it pertains to them and their complaint”, added Ms Cunningham O’Brien, who outlined that her office assists individuals to complete the FoI application.

“Families feel a culture of victim blaming emerges when they raise concerns and complaints. In particular concerns in relation to vulnerable adults being discharged from HSE services and families expressing dismay at the lack of appropriate service user care-planning and intervention to support them in the community,” according to Ms Cunningham O’Brien’s report.

Families who contact the office are “frustrated and feel there is nowhere else to turn”. Some of the issues raised include older adults having their home support package cancelled when they go for extended respite in a nursing home.

The office also receives anonymous concerns from staff in disability and older persons services. The concerns may relate to personal care, dignity, privacy, medication, diet, and staff engagement and management.

The purpose of the Confidential Recipient is to act as an independent confidential voice and advocate for adults with a disability and for older persons who receive a HSE-funded service. The role was created by the HSE in 2014 after the Áras Attracta scandal.

During 2022, the office received 109 formal concerns pertaining to disability, older persons, mental health, and primary care services. Thirty-three concerns related to care placement/planning and 25 to safeguarding.

In her report Ms Cunningham O’Brien, who succeeded Ms Leigh Gath in November 2022, stated there was a need to develop the role “to ensure that I can speak up and speak out for vulnerable adults in a meaningful manner”.

A HSE spokesperson said it is continually working to improve access to home support hours, appropriate respite, and residential support.

The spokesperson referred to a repositioning of the HSE complaints function which will “clarify” when a person needs to use FoI.

“The CEO is firmly of the view that this should not
be the means to obtain an outcome to a complaint,” they added.

The spokesperson said the Confidential Recipient was introduced at a “point in time” to provide a safe place for service users or others to express concerns if they felt they could not safely or confidently access other routes.

“Over time the role developed and so have additional structures, policies and procedures within the
HSE.  These include a significant growth in the national and local safeguarding offices, the National Independent Review Panel and a dedicated protected disclosures function.”

An independent review of HSE safeguarding operations by expert Ms Jackie McIlroy was published on 20 June.

According to the review: “The procedures that are currently in place are outdated and there remains 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.”

The recommendations from the review include embedding a safeguarding culture; increasing the visibility of safeguarding; supporting a strong change management process; and embedding a culture of learning and improvement.

The HSE stated it has commenced a process to implement these recommendations and enable a culture and practice “that places safeguarding at the centre of the services we provide”.

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