JOHN DEASY: 'Some people give out about the Committee of Public Accounts. On occasion, however, I think we can make a difference when it comes to public policy... Sometimes this place can be the cradle of parliamentary hyperbole. Words like "disgrace" and "outrage" flutter in the air like confetti. I think we can make a difference, and if we were able to do so in this area, I would be very pleased. The work we have put in has been worthwhile...'
PAC Meeting | Oct 8, 2015
Health Service Executive
Secretary General, Mr Jim Breslin called and examined
Deputy John Deasy: This is something you [chairman, John McGuinness] have brought up as well. I imagine you know what I am going to bring up. It relates to the foster home we have dealt with and the HSE's involvement. I thank Mr. Breslin for coming in and he is welcome.
Mr. Conal Devine was commissioned to undertake a report on everything surrounding the foster home located in the south east of the country where some serious allegations have been made. We are getting conflicting views with regard to the position of a Garda investigation in this regard. The Chairman was formally notified that there would not be any prosecutions in this case. That much has been repeated to several people.
As far as the Department is aware, what is the status of a Garda investigation? I am asking because those responsible in the HSE are using the excuse of an ongoing Garda investigation. They maintain it precludes them from releasing the report, even in redacted form. What is Mr. Breslin's understanding of it? Frankly, we are getting two stories.
Mr. Jim Breslin: My understanding is that when we have checked, it seems the process of determination on the part of the Garda has not concluded. The Chairman may have been informed differently. Obviously, we do not try to intervene in the process, but we have sought to check where the process is at. We have been told it has not concluded and this may relate to a number of lines of inquiry. That rings true with the line the HSE has given us, which is that the executive is precluded from publishing until it gets word from the Garda on the matter. That is the current situation, as we understand it.
Deputy John Deasy: Since we are at that juncture, I have another question. People have contacted the Garda and have directly asked the Garda whether there is an issue with publishing this report and the Garda have said "No." Some people are making the point to us that they do not believe there is an issue with the publication of this report. Can Mr. Breslin shine any light on that?
Jim Breslin: It is our intention to do so. I have written to the committee on the subject. The Minister has requested that we organise a senior counsel, Mr. Conor Dignam, to look into the matter. One particular aspect that the senior counsel has been asked to look into relates to the reasons the reports have not been published and whether these reasons are well grounded. An interim report is due back shortly from Mr. Dignam. We hope that will assist the Deputy in the question he is asking.
John Deasy: Mr. Breslin is getting to the kernel of what we have discussed in the committee. This report was commissioned using public money. The Department of Health funds the HSE budget. I have to ask a particular question but no one seems to know the answer. What is the natural course when it comes to a report like this? Public money has been used and spent to commission it. It has been lying somewhere for years now. What role does the Department have? Do we need to ask counsel every time to examine why a report has not been published? Does Mr. Breslin get to see this report once it is finished? Does the Minister get to see this report? Does the HSE keep it locked up? I am beginning to suspect that HSE is not releasing some of these reports because they would damage the organisation and some individuals and because the HSE is potentially protecting some individuals by not publishing.
Jim Breslin: If the issue of An Garda Síochána did not arise as a matter of routine, then it would as a matter of our request. Obviously, in such an instance, we would request and get these reports - I am confident of that. In the absence of that, with the-----
John Deasy: Mr. Breslin needs to request them. Is it correct?
Jim Breslin: Yes.
John Deasy: They do not arrive on Mr. Breslin's desk as a matter of course once they are finalised. Is that the case?
Jim Breslin: No, but in the vast majority of cases these matters are not only of concern to the HSE but also to the Minister or the Department. We get many reports in these scenarios. Situations could arise which are more local and are less obviously matters of public concern, but the HSE may take the view that they are worth looking into in any event. We would not necessarily get all of those. However, in such instances where we do not have An Garda Síochána's involvement, we would request the report. In this situation where we have done so, we have not been content to wait. We have agreed with the HSE that a senior counsel will review the reports. The Ministers have been at a disadvantage in the debate on the matter because they have not seen the reports - nor have I. However, they will have the benefit of a senior counsel having reviewed the report as well as a clear position from the senior counsel.
John Deasy: Did Mr. Breslin say he has not seen the report?
Jim Breslin: No, I have not seen the report.
John Deasy: Why not?
Jim Breslin: Because of the investigations of An Garda Síochána.
John Deasy: Even Mr. Breslin has not seen the report because of the Garda. Mr. Breslin has characterised this as the routine way of doing business. Is that the case?
Jim Breslin: The routine way of business is that we would see them. It is unusual to have a Garda investigation as in this case.
John Deasy: Mr. Breslin is saying that he has contacted the Garda and he is satisfied that there are valid reasons for the report not being published at this stage and that those responsible for making that case are in the Garda. Is that correct?
Jim Breslin: We have contacted the gardaí. We have contacted the Department of Justice and Equality and the Department clarified that matters still needed to be concluded by the gardaí; they were not at an end point.
John Deasy: Until that occurs, do I take it that Mr. Breslin is not privy to that report?
Jim Breslin: Other than we have agreed with the HSE, and the HSE has facilitated access by the senior counsel to these reports. That will establish two very important things for us - one, whether the reasons for not publishing them to date well grounded; and, two, whether they are in a format that can be published.
John Deasy: I have a bit of a problem with this whole system. It comes back to public expenditure, even when one gets into redaction. If a report such as that comes back to Mr. Breslin, is it redacted? If Mr. Breslin finally gets that, does he get to see the unblemished report or does he get a redacted version? Does Mr. Breslin know?
Jim Breslin: It depends on the nature of the issues that are preventing its publication.
John Deasy: I have a bit of a problem with this now. This system really needs to change a little bit.
Jim Breslin: I agree.
John Deasy: A second set of eyes on the unredacted report is necessary when it comes to Mr. Breslin's office and the Minister.
Jim Breslin: That is why we put the senior counsel into this very situation.
John Deasy: I understand, but Mr. Breslin is telling me that even if the Department gets the report and wants to publish it, and Mr. Breslin is making it clear that his intent is to do that,-----
Jim Breslin: Yes.
John Deasy: -----Mr. Breslin might only get a redacted version of it.
Jim Breslin: I do not know, and not having seen the report, I do not know the issues of concern that might arise, but there potentially could be a situation where that might arise, or potentially not, and I do not want to prejudge that until the senior counsel reports.
John Deasy: I do not know Mr. Breslin very well but I will tell him why I have a problem with this. Social workers and people who have been around this for the past ten years have seen fragments of this report. They know that it is hard-hitting. They know it is a good report, and that is how they have characterised it to me. Mr. Breslin does not know; they do. A lot of people who are working in this area know exactly what has been written in that report and are very keen that it be made public, and they are very clear about their opinions as to why it is being held back.
I take everything Mr. Breslin said at face value. He stated that the Department of Justice and Equality and the Garda have made it clear that there are still issues that need to be dealt with. I am beginning to get worried, though, that the HSE sits on such reports and then redacts them, and it is in the public interest for that to change. A second set of eyes needs to be brought into this to make a decision on whether it is good public policy to continue that system.
As for some of the issues, I have never dealt with anything like it. I have been in politics since 1999 and I have never dealt with anything as serious and as disturbing as these allegations. I think Mr. Breslin gets my drift. I note the Chairman has been involved in this and we are on the same page when it comes to this.
Jim Breslin: I think it might be of interest to Deputy Deasy - it does not directly answer the concern he raises - that one of the other concerns of the committee in these discussions has been the selection of people to undertake the work and how a report gets commissioned. The Minister of State, Deputy Kathleen Lynch, has written to the HSE suggesting that there are already processes in place in acute care to ensure that nominations of people to undertake reviews are not done by the HSE; they are done by an external party.
John Deasy: Unfortunately, the external parties in some cases are people who were former HSE employees.
Jim Breslin: This is the point I am coming to. Deputy Lynch has written to the HSE to say that the selection process around that could benefit from it being more independent. In particular, the HSE's attention has been drawn to a practice that has developed, and one that I am very aware of, in the child welfare area where an external party to the HSE, somebody of objective standing who stands apart from the HSE - a professor in a university, not an employee of the HSE - selects from a panel of people who might undertake the review.
There is the occasion where members of that panel have worked in the HSE because that is by far the biggest provider of health services but a studied eye is given to the composition of the panel, to ensure that it has clear independent status to it. We think this is an area, and the HSE is working with us and the Department of Children and Youth Affairs to try to develop a methodology that in the future would not lead to the kind of the concerns that members at the committee here have expressed, and we will have that.
John Deasy: Mr. Breslin is making me feel a bit better now. We have been dealing with this for the past year. We have been dealing with the methodology, the panels and the independence of these reports and reviews.
That is news. That is something we have not heard previously. We put a lot of work into this with regard to the independence of these reviews. Mr. Breslin states that the Minister in question, the Minister of State, Deputy Kathleen Lynch, has written to the HSE stressing that the reports should be more independent. Is it a bit more concrete than that? Does she have a proposal that she sent to the HSE or is it merely a request?
Jim Breslin: She sent a proposal to them and the Department has followed up with a series of meetings with the HSE, who can see the merit in this because it does not do anybody any good, and the Department of Children and Youth Affairs. Indeed, she has met with people involved in the panel in the children area to try to get the methodologies right as we implement something similar in this space.
John Deasy: The families involved in the foster home and those who have been in contact with us will take something from that. If the system is changed because of this issue, the raising of it and our continual contact with the HSE and the Minister in question, that is useful.
I am glad I asked Mr. Breslin the question and thank him for the response. I would like it if the clerk to the committee, without saying anything, could correspond or communicate with Mr. Breslin's office so that we could get a copy of those proposals so that we can take a look at them. We made some definite recommendations in this area but if Mr. Breslin can give us that information, we would like to take a look at that.
Jim Breslin: No problem. In my correspondence with the clerk to the committee, I undertook to keep the committee informed on progress on the work of the senior counsel, and I will do that. I will not wait for a request from the committee on that. I will do that as we get developments.
John Deasy: I thank Mr. Breslin.
Chairman: We can welcome what might happen in the future on the lines of what Mr. Breslin described, some of which comes out of recommendations made by this committee. I am happy with that.
What I am deeply concerned about is the fact that the health boards, dating back to their time, and therefore the Department of Health, failed a high number of vulnerable young adults in this State, and probably continues to do that in this case. Within the organisation of the health services, someone knows what happened in relation to this. It did not go unnoticed. A senior social worker and an independent organisation felt strongly enough about it to make a protected disclosure on a number of different occasions, and felt so strong about it that they raised it at a restricted public meeting of employees with the HSE.
It also was raised here. Deputy Deasy and I raised it, and I made a disclosure to Pearse St. Garda station. This is what annoys me about it. Some employees of the health board at that time must have known about this and that was said by the whistleblower in greater detail. I have not heard from the HSE or from the Department of Health to say they have identified the various persons who engaged with this issue at that time.
I want to put this on record because of what Mr. Breslin said. I was asked to attend a meeting in the Garda station some months ago where I was told that the evidence had been presented to the DDP and that no action would be taken. Mr. Breslin states that he is waiting on the Garda report or the Garda is dealing with it, and I have been told that the Garda has dealt with it. They either have or they have not dealt with it. In my opinion, someone is covering up or playing games, and we need to come clean on all of this issue, not only in the interest of accountability, transparency and all of those words that are used nowadays, but in the interest of the families concerned.
Some of those young adults may have continued through their lives being affected by what happened. I have read some of the reports and, quite frankly, in my time in the public arena I have never read anything so horrifying. Both the reports and the verbal explanations given to me by the social workers are horrifying. That is what disturbed me most about this. We had an exchange here with the HSE on this matter and I must say that its arrogance and stonewalling on the occasion in question was breathtaking. A bit of truth and a bit of effort would really change things around here and would also the circumstances of the people affected. In light of what I have been told and in view of the fact that the Department of Health, at some stage in its history, employed people who were directly responsible in this area, there is an onus on the Department to conduct some sort of investigation into both itself and the individuals concerned. It should not be held back by the report or the information to the effect that there is a Garda report. The witness can say that I told him there were no prosecutions to happen. That is what I was told. I will leave it at that but I could not leave it at the exchange with Deputy Deasy because so much has happened since.
Jim Breslin: I am happy to do this. I do not want this to be an ongoing issue. The purpose of commissioning the senior counsel is to get us to a point where we can put whatever we can into the public domain. One of the key issues the senior counsel is to examine is whether this concept of not publishing the report is well grounded. That finding will answer at least part of the question that the Chairman has posed. Officials at the Department and Ministers have met some of the people who have concern and local knowledge of this issue and everybody's concern is shared here. This is not something where we lack concern on this issue.
Chairman: Did Mr. Breslin meet the officials within the health system who, at that time, were to the fore of the care of vulnerable young adults?
Jim Breslin: In this instance?
Jim Breslin: We have met certain people who have made themselves available to us. The process of commissioning the senior counsel is to look at the two reviews that were conducted to see whether they were adequate in who they met and how they went about their job but we have not met everybody who was working on this.
Chairman: Given Mr. Breslin's exchange here this morning and how upfront he has been on some of the questions that we have asked, which is a little bit different than what we usually get here, I think he should ask them. I think he should seek the names of the individuals who were at the forefront of this at that time and determine whether they have all been questioned or made a contribution to the investigation. Quite frankly, it does Mr. Breslin, the committee, and the Garda no good to say that such a serious issue has not been brought to a conclusion one way or the other...
John Deasy: Can we stay on this point for one second? I want to reiterate one thing. Mr. Breslin has made it clear that the process involving the choosing of the individuals who do these reports will now change which will end potential conflicts of interest that have arisen in the past. Very clearly, that is what we have seen and that is good and the people involved in this will be pleased with that.
I have to return to the reports that are commissioned using public money and the way they are treated once they are completed. I think Mr. Breslin's office, on the basis of good public policy, needs to take a look at redaction and the circulation of those reports and, in my opinion, the continual suppression of these reports within the HSE. I could make a good argument that, for the public good, that system can no longer continue. I think Mr. Breslin needs to provide a second set of eyes or a different system or proposal to the HSE. I think, as a matter of good public policy, that needs to be considered at this point.
Jim Breslin: I will say two things on that. I speak with some knowledge of the children's area because that was my former posting. The approach that is taken there is that the reports are published. The important thing in the terms of reference when something is set up is that the person who is doing the inquiry is told that the report will be published. If they go off and do the report and then one decides whether to publish it or not, one gets into redaction terrain, so it is important that we set up a process that is for the publication of reports.
John Deasy: Okay.
Jim Breslin: We can look at taking on board the concerns that the Deputy has expressed on that in as many cases as we can.
John Deasy: Perhaps I am repeating myself but some people give out about the Committee of Public Accounts. On occasion, however, I think we can make a difference when it comes to public policy. I will take at face value what has been said about reports and changing that system. I am pleased that we are coming to a conclusion on a couple of these issues. Sometimes this place can be the cradle of parliamentary hyperbole. Words like "disgrace" and "outrage" flutter in the air like confetti. I think we can make a difference, and if we were able to do so in this area, I would be very pleased. The work we have put in has been worthwhile, so I will follow up on this.