The UN Committee Against Torture (UNCAT) will examine Ireland’s implementation of the UN Convention Against Torture and other Cruel, Inhuman and Degrading Treatment on 27th and 28th July. Ahead of Ireland’s examination, Sage, the support and advocacy service for vulnerable adults and older people, has referred issues of concern which amount to inhuman and degrading treatment for consideration by the Committee, and will present issues to the Committee in Geneva.
Identified from its work with older people over the past three years, Sage’s report highlights deprivation of liberty, the use of chemical restraint to manage behaviours, and the risk of a person being detained against their wishes in a care settings. Based on Sage’s experience, on the evidence of 8,000 reported cases of abuse to the HSE in 2016, and a Red C poll showing one in two adults in Ireland experienced abuse to a vulnerable person, the need for legislation to protect people from abuse, and legislation to prevent deprivation of liberty is recommended in the Sage’s report.
Sage raises issues on the unnecessary use of incontinence wear, and violations of dignity and privacy in unsuitable care settings, with the continued use of ‘Nightingale Wards’ – where people on occasions have to eat their dinner on one side of a curtain while someone uses a commode on the other. Highlighting that almost 5,000 people over 65 years old were resident in hospital in 2011, the State’s bias towards funding nursing home care, the impact of lack of home care or alternative models of care to meet individual’s wishes, Sage argues that these practices and lack of State action leads to inhuman and degrading treatment. Amongst Sage’s recommendations is that funding of the Nursing Home Support Scheme through the National Treatment Purchase Fund process should be open and transparent and ensure that all persons being funded by the State for nursing home care receive equitable services which reflect a person centred approach.
Sage is also highlighting to the UN Committee that Ireland has failed to commence the Assisted Decision-Making (Capacity) Act which was signed into law in 2015, and as a result has not ratified the UN Convention on the Rights of People with Disabilities. Ireland still operates a ward of court system under the Victorian era legislation Lunacy Regulations (Ireland), Act 1871. The wardship system for people deemed of “unsound mind” amounts to a complete denial of a vulnerable adult’s human rights. Nonetheless, from 2012 to 2015 there was a 36% increase in wardship applications, and Sage reports on the inappropriate use of the wardship process to enable the discharge of vulnerable older people from acute hospitals. Sage makes a recommendation to the State to not subject vulnerable wards of court to further degrading treatment by amending the current legislation to ensure an entitlement to representation in court, and to benefit from a decision-making supporter when they are being reviewed and released from wardship, which is required under the new legislation.
Under the UN Convention, the State is required to ensure that a person has the right to complain, to have their case promptly and impartially investigated by a competent authority, and that a victim obtains redress and has a right to fair and adequate compensation. For the State to meet its obligations Sage is calling for the expansion of the remit of the Office of the Ombudsman, and the inclusion of a process of investigation and redress in Safeguarding legislation.
A vulnerable person can face difficulties in making a complaint due to fear, isolation, dependency in an abusive situation, lack of information on how to make a complaint and lack of confidence in the system. In recognition of these difficulties, and to uphold a person’s right to have their voice heard and to make their own decisions, Sage is recommending that a statutory right to independent advocacy is included within legislation on Deprivation of Liberty, and on Safeguarding.