Years ago, on the RTÉ current affairs programme Questions and Answers, John Bowman asked me: "Breda O'Brien, why were the whistleblowers not believed?'
It was at the height of the scandals concerning the sexual abuse of children by members of the Catholic Church. The question has stuck in my mind ever since.
I thought about it again when reading Kitty Holland's account of the alleged sexual abuse of at least 18 intellectually disabled residents by another resident in Ard Gréine, Donegal, a facility managed by the Health Service Executive. According to an as yet unpublished investigation, the alleged abuser, who was given the pseudonym "Brandon", was engaging in public masturbation and sexual assault, including two alleged rapes.
It is unbelievable that this was allowed to continue from 2003 to 2016, with the full knowledge of staff and management.
Some people did try to stop the abuse. For example, in February 2008, six nurses wrote to management asking for a “satisfactory resolution” for “this very serious situation”.
Why did nothing happen in 2008? Or in 2011, when a psychiatrist warned that Brandon’s placement with vulnerable learning-disabled adults was completely wrong? Or again in 2011, when a nurse manager made a report to gardaí? Why did it take a whistleblower going to Thomas Pringle TD in 2016 before anything at all was done?
Yet vulnerability and powerlessness alone do not explain why whistleblowers are not believed. For that to happen, you need dysfunctional institutions
The same psychiatrist warned that failure to inform families about episodes of abuse could be construed as “collusion or complicity”, yet according to some of the families, they were not informed until 2018.
Abuse is most likely to happen when people are vulnerable or powerless. This current case is complicated by the fact that Brandon was also a vulnerable person. No assessments or attempts at education appear to have been undertaken with him.
Previous scandals concerned the children of the poor, who were not deemed to be “our” children. They concerned women stigmatised for becoming pregnant outside of marriage, or defenceless elderly people.
Yet vulnerability and powerlessness alone do not explain why whistleblowers are not believed. For that to happen, you need dysfunctional institutions.
One type of dysfunctional institution is vast and bureaucratic. The lived values of the organisation contradict the named values. Instead of encouraging openness, a culture of ass-covering and buck-passing prevails. Things happen slowly, or not at all.
One of the most unbelievable aspects of the Donegal scandal was the way people took refuge in the idea of a medical model
By the time something travels up the chain of command, all momentum is lost. These organisations tend to be filled with people rendered cynical by the difficulty of effecting any kind of real change.
Then there are less overtly cynical but still dysfunctional organisations where individuals identify with and want to protect their institutions from what they perceive as external attacks. This makes them reluctant to publicise things that reflect badly on those institutions.
At its worst, the Irish Catholic Church exhibited elements of both types. Slowly, painfully, and in a way that can never be deemed complete, the church has built a culture of safeguarding, mostly through the work of dedicated volunteers.
This cannot be said of the HSE. One of the most unbelievable aspects of the Donegal scandal was the way people took refuge in the idea of a medical model. Allegedly, according to this model residents were viewed as people in need of treatment, rather than operating from a social-care model that would take the whole person and their human rights into account.
This lacks all plausibility. How could anyone live through the early years of this century, when sexual abuse scandals were dissected for months on end, and still claim that it was the medical model of care that was at fault?
The implication of blaming a medical model is that these men with intellectual disabilities were left to suffer because they were not seen as fully human beings who would be traumatised and terrified by an abuser in their midst. But some nurses saw clearly what was happening.
Legislation, including vital adult safeguarding legislation, will not be enough
It is much more plausible that the HSE for decades had a culture that actively worked against accountability. After the Áras Attracta scandal in 2014, where residents with intellectual disabilities were physically abused by staff, Leigh Gath was appointed by the HSE to an office of confidential recipient. Confidential reports could be made to her about vulnerable and elderly adults.
In 2018, her report showed that HSE workers were fearful of reprisals, being discredited or disbelieved if they reported issues of concern. Her 2019/2020 report showed that while there had been improvements, of 320 reports, 282 concerns were still related to disability services, including older person services.
Gath has dealt with everything from a woman with a physical disability being obstructed in every way possible from receiving a replacement for an essential power wheelchair to allegations of peer-on-peer physical abuse.
While Gath does sterling work, no one person can effect a change of culture. Legislation, including vital adult safeguarding legislation, will not be enough either. We will still be here in 20 years’ time asking why whistleblowers are not believed unless a whole new set of positive unwritten behaviours are championed by those with the authority to enforce them.