This morning saw the publication of Safeguarding Ireland's comprehensive discussion paper on safeguarding vulnerable adults. It called for the establishment of an independent national adult safeguarding authority, a recommendation I fully support. The chairperson commented:

There needs to be a Statutory obligation on State bodies to do more than respond to crises. They also need to have accountability to take steps which prevent adult abuse and uphold people's rights.

It is a timely reminder for a number of reasons, as this week we debate the Assisted Decision-Making Capacity Bill and, disturbingly, over the weekend, we saw revealed in reports by Maeve Sheehan in the Sunday Independent, Kitty Holland in The Irish Times and Catherine Reilly in The Medical Independent further major concerns arising from the Brandon case in Donegal and the safeguarding issues it highlighted. The latest report, apparently delivered internally within the HSE, now contains allegations of rape going back to 1992. It is also revealed in correspondence between the HSE and HIQA, dated 7 March this year, that HIQA's deputy chief inspector of social services called for "The review of governance structures should not be limited to local... level but should also include the overall national governance and oversight structures used to identify and respond to issues that may arise...".

The Medical Independent revealed that a social care risk register for the safeguarding and protection team, SPT, dating from 2021, showed that risks related to staffing were ongoing. The SPT has been operating at 75% capacity since March 2020 due to staff redeployment. There was a risk of the SPT "not being able to continue to provide a cohesive service across CHO 1 if staffing falls any further due to leave or illness of remaining staff”. On 28 June 2021, another staffing risk was recorded, which was due for review on 3 July. It read:

Due to 50 per cent reduction in staff there is a significant risk that the safeguarding team may not be in a position to provide a cohesive service across CHO 1 [again]. We currently have no staff in Donegal and have lost 0.5 of our staff in Cavan/Monaghan.

This was all happening while I was being told by the HSE that everything was fine.

I do not believe these allegations are new to the HSE. They were part of what the whistleblower told me in 2016, they were part of what I brought to the HSE at that time, and were in the available HSE files at Ard Gréine Court. I believe they were suppressed by management within the HSE at all levels, right up to the very top, and only for the dogged determination of the whistleblower, these journalists, myself and, thankfully, the Minister of State at the Department of Health, Deputy Rabbitte, all this would have been conveniently swept under the carpet.

I am calling on the Government and the senior Minister finally to stand up to the HSE, to stop accepting mediocre management and lack of transparency and to get the Brandon report and other linked reports published in full, so we can confidently put in place the measures to ensure this never happens again.

I thank the Deputy for raising this important issue. I have not had an opportunity to see the report he referenced that was published today, but I can give an update on the initiatives-----

Nobody has seen it. That is the problem.

I was not aware that the Deputy was going to raise this specific issue, but I will update him on what the Government is planning to do at policy level. We can respond to the Deputy on a bilateral basis in more detail.

The Assisted Decision-Making (Capacity) Act 2015 does not extend to people who are involuntarily detained under the Mental Health Act 2001 or detained subject to an order under the Criminal Law (Insanity) Act 2006. The Attorney General's office has identified legal issues that need to be addressed before the 2015 Act can be extended, specifically around ensuring that detention orders continue to be valid in cases where all treatment is refused. The Government supports the extension of the principles and provisions of the Act and its 2022 amendment Bill to individuals whose treatment is regulated by Part 4 of the Mental Health Act. The Government will extend these provisions to this cohort of people through the mental health Bill, which is being drafted.

People accessing mental health services generally can avail of decision-making supports under the 2015 Act, including people receiving treatment on a voluntary basis in approved centres. The Act provides for the introduction of decision-making supports to help individuals with impaired decision-making abilities to make decisions about finances, healthcare and personal matters. The Act is not yet fully commenced. The Department of Children, Equality, Disability, Integration and Youth has prepared an amendment Bill, which is expected to pass through the Oireachtas this month. Its amendments will allow the Act to be fully commenced. Currently, the 2015 Act's provisions do not apply to people whose treatment is regulated under Part 4 of the Mental Health Act, those being, people who are involuntarily detained under that Act and people detained under the Criminal Law (Insanity) Act 2006.

On a parallel track, the Department of Health is progressing a mental health Bill based on the general scheme agreed by the Government last July. It is being drafted by the Office of the Parliamentary Counsel. The Minister of State, Deputy Butler, has put a considerable amount of work into it.

The Department of Health sought legal advice from the Attorney General's office. While the official advice has not been received, the Department has been informally told that, if the 2015 Act is amended so that its provisions fully apply to people detained under the Mental Health Act, there is a risk that, where such an individual refuses all treatment, the basis for his or her detention may become invalidated. The Attorney General's office has advised that further work is needed to safeguard against a situation arising in which people who pose a risk to others cannot be detained and treated where they refuse all treatment. The office has also advised that this policy work would be more appropriately addressed in the mental health Bill. That Bill will significantly update and overhaul existing mental health legislation, including provisions relating to consent to treatment under Part 4.