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mistake upon mistake

Litany of errors by child services saw woman's claims of serious sexual abuse 'lost' for over three years

The HSE’s child and family services, the precursor to Tusla, also repeatedly sent details of the case to a series of incorrect addresses.

shutterstock_312380828 Shutterstock / Torwaistudio Shutterstock / Torwaistudio / Torwaistudio

THE HSE ‘LOST’ a disclosure of alleged serious physical, sexual, and mental abuse by a woman against her father for more than three years.

A series of errors in the handling of this case, revealed today by TheJournal.ie, spanned nearly six years and has led to multiple apologies from both the HSE and child and family agency Tusla.

Over the course of nearly six years from October 2010, the HSE:

  • ‘Misfiled’ the original retrospective disclosure of abuse for over three years
  • Informed the woman in question that an initial delay of nine months in inviting her to meet was a result of that disclosure being missing
  • Took 15 months to process the complaint towards an investigation
  • Sent sensitive details regarding the case on at least three occasions to two incorrect addresses, one of which was on the same street as the woman in question

It subsequently emerged that the original copy of the retrospective disclosure made by the woman, ‘Mary’ (not her real name), had been ‘misfiled’ and ‘inadvertently attached’ to an unconnected Garda notification. This led to an ‘unreserved’ apology from child and family agency Tusla, one of many concerning this case.

In processing the initial allegations, the HSE’s child and family arm (the precursor to Tusla) directed correspondence detailing sensitive aspects of the case meant for the woman in question to two wrong addresses on at least three separate occasions.

“My life was made hell through this,” Mary told TheJournal.ie. “My life was already hell with confronting what had happened, and then to have the disclosure of such sensitive things dealt with the way it was just made it a hundred times worse.”

This case is one of many which is being considered by Ombudsman Peter Tyndall as part of a systemic investigation into the way complaints are handled by Tusla. That report is currently being drafted and is expected to be published in the coming weeks, a spokesperson confirmed to TheJournal.ie.

Grab1 Correspondence concerning the missing disclosure, sent in January 2014

Click here to view a larger image

The manner in which the case was dealt with by the HSE bears resemblance to the recent farrago surrounding an error in how Tusla dealt with a complaint against Garda Sergeant Maurice McCabe which saw an erroneous accusation of sexual assault against him kept on file by the child and family agency for nearly two years after it had been found to be false.

October 2010 – initial disclosure is ‘misfiled’

The retrospective disclosure regarding this case was made in October 2010 by Mary, who lives in the midlands.

It concerned accusations of serious sexual and physical abuse against her father covering a period of 15 years between the late 1970s and the early 1990s.

No response, bar an official acknowledgement of the initial letter, was given to her for at least seven months following her initial contact. Tusla, which was set up in January 2014, subsequently apologised for this “avoidable delay” which it said resulted from an “administrative error” which saw the disclosure misfiled.

Grab2 Correspondence apologising to Mary in July 2011, sent to an incorrect address on the same road on which she lived

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After repeat attempts by Mary to contact a social worker (whom she had been informed would be handling her case) went unanswered, a meeting was finally agreed between the two for June 2011, but not before that meeting was cancelled by the HSE worker three times at short notice.

At the eventual meeting, Mary noted that the social worker “clearly had no idea who I was or what my case related to”.

“They told me that the original copy of my disclosure had gone missing which was why the case had been delayed,” she told TheJournal.ie.

July 2011 – Sensitive information sent to wrong address

That original copy was subsequently located in November 2013, three years after the initial complaint – it had been ‘misfiled’ and ‘inadvertently attached’ to an unconnected Garda notification. The social worker in question, who has since been promoted, “apologised unreservedly” for this error in January 2014.

Following that meeting in June 2011, Mary never saw that social worker in person again.

File Photo HSE Grace Reports RollingNews.ie RollingNews.ie

The social worker did send an acknowledgement letter regarding the meeting, which contained specific, sensitive information regarding the abuse allegations; however this letter was sent to a wrong address on the same street that Mary was then living on. This particular letter also apologised for the “oversight” which saw the meeting delayed for nine months.

Three days prior to the wrong address being used in writing to Mary, a report filed by the same social worker did in fact detail her correct address. On all this correspondence, Mary’s name is misspelled. A copy of that report had also been requested by her. It was never sent (all of this correspondence, including that which had been misaddressed, was finally received by Mary when she requested it of yet another social worker in August 2012).

In the wake of this meeting Mary heard nothing from the HSE until she made contact with it personally requesting an update. In dealing with this further complaint, a senior manager in the HSE’s child and family section sent two responses, both again containing sensitive information relevant to her case, in October 2011, both of them to another incorrect address (in this case, the address didn’t even exist and the letters were returned to sender undelivered). The manager acknowledged this “clerical error” in December 2011 and again “sincerely apologised” for the “unacceptable standard of response”.

December 2011 – investigation begins

At this time, roughly 15 months after the initial disclosure was made, another social worker met with Mary with a view to kickstarting an investigation into her claims of abuse. The HSE had already been “satisfied that there were existing child protection and safety and welfare concerns that required immediate and ongoing response” following the delayed screening of the initial disclosure.

90405707_90405707 Former Tusla CEO Gordon Jeyes, pictured with Minister for Justice Frances Fitzgerald in January 2016 Sam Boal / Rollingnews.ie Sam Boal / Rollingnews.ie / Rollingnews.ie

Such a meeting would be held in advance of the same social worker meeting with members of Mary’s family. This person subsequently, in early 2014, asked Mary for the notes she had compiled from their meeting, to facilitate the Garda investigation which had been instigated, saying that their own had been lost. When Mary refused this request, the social worker later claimed that they had not taken any notes of the meeting, nor had they taken any notes from any of the subsequent interviews with Mary’s family. Assuming this is the case, such practice is in direct contradiction of Tusla’s own child protection guidelines.

Over the following four months, Mary repeatedly requested of the senior manager at the HSE the reason as to the delay in the progress of its investigation (in February 2012 she submitted a specific complaint under the HSE’s ‘Your Service Your Say’ portal regarding the initial nine-month delay before she was met by a social worker, and also the fact no report of that meeting was given to her despite assurances to the contrary). The responses from this manager at the time repeatedly refer to their ‘regretting terribly any distress you have been caused”.

May 2012 – Child services director apologises, gives personal ‘assurances’

With months passing without an update and the case appearing to have hit a standstill, Mary eventually contacted Gordon Jeyes (then national director of children and family services at the HSE, and subsequently to become Tusla’s first CEO) seeking a meeting. This occurred in May 2012.

In the aftermath Jeyes expressed his “sincerest regret and apology” that Mary’s experience had resulted in “further distress during such a difficult time in your life”. He likewise committed “to learn from your regrettable experiences so that they will not be repeated going forward” and gave “assurances that I will pursue the matter further”.

Gordon Jeyes left Tusla in May 2016. TheJournal.ie has asked him for comment in relation to this matter.

In the aftermath of this meeting the case ground to a halt once more. This led to Mary engaging the services of both the Data Protection Commissioner (in May 2013, concerning the posting of sensitive information to the wrong address on repeat occasions, and the loss of her disclosure) and the Ombudsman (in June 2014, with regard to the Mary’s grievances as to how her case had been handled in general).

In response to a query from TheJournal.ie, a spokesperson for the DPC said that the Commissioner “does not comment on individual investigations carried out by this office”.

Any alleged breach of the Data Protection Acts involving sensitive personal data is considered serious and is investigated by the DPC.

When asked whether the DPC has dealt with many other data protection failures by state bodies involving the disclosure of abuse, the spokesperson responded that “this office does compile records in the manner requested in (this) query”.

The Garda investigation into Mary’s claims was eventually dropped in early 2014 due to a lack of evidence.

In December 2015 Mary discovered, via health regulator CORU, that the person who eventually investigated her complaint and who interviewed her family was not registered with the regulator as a social worker at the time of the interview.

In May 2015, she learned from the Ombudsman that the manner in which her complaint was processed had been acknowledged by Tusla as “being not acceptable”. A Tusla representative likewise acknowledged that the sending of sensitive information to incorrect addresses on repeat occasions “was regrettable”.

Regarding the alleged loss of notes by the person who eventually investigated the complaint, the principal social worker who investigated following the intervention of the Ombudsman concluded that “no minutes (of the initial meeting) had been taken”. The Ombudsman concluded that it “would have been remiss” of any social worker to fail to keep minutes of a meeting concerning a complaint of serious abuse.

Both Tusla’s Child Protection and Welfare Handbook and CORU’s Code of Professional Conduct and Ethics for Social Workers make it clear that adequate, accurate note-taking is a pre-requisite for all meetings between Tusla employees and those alleging abuse.

“They’ve made my life hell”

Today, more than six years after her initial disclosure, Mary is keen, more than anything, that what happened to her “cannot happen to anyone else”.

Tusla's headquarters in Dublin's South Quarter Sam Boal / Rollingnews.ie Sam Boal / Rollingnews.ie / Rollingnews.ie

“These are people who we trust to fight our corner, that they will take statements of the most sensitive nature, that they will protect them and keep them safe. That they will hear your pain and anguish and distress, and your vulnerability,” she said.

A source of particular anguish to her is the dispute over the notes, or lack thereof, taken by the social worker Mary met in December 2011, and who subsequently interviewed her family.

“This person interviewed me and my family members and never documented any of those interviews,” she says. “Then I heard that they had taken no notes at all, and soon after that the case was dropped.”

I was absolutely devastated.
They couldn’t even get the basics right, when surely taking notes is one of the fundamental aspects of their job.

She says that at no time did anyone from either the HSE or Tusla contact her voluntarily to apologise for her treatment: “I always had to contact them to make a complaint.”

“One of those I dealt with, in 2012, told me that I was being ‘overly-sensitive’, that I needed to ‘get over it and move on with it’. How can you say that? This is my life. You’re just making a mockery of it.”

“You expect these people at the most basic level to just do their jobs, even if nothing was to come of it at least you would know in your heart that they did everything they could to protect you and those around you,” she says.

In my case not one of them did their job with the basics of human decency – all they did was try to ignore the situation rather than deal with it. I will never trust a social worker again.
They should be ashamed by the way they treated my case. My abuse may have happened 25 years ago but it will sit with me for the rest of my life. So will the way they handled my case.

Reaction

In the aftermath of Mary contacting the Ombudsman, matters moved relatively quickly.

In May 2015 a Tusla service director acknowledged, via an Ombudsman intermediary, that the delay which occurred in 2011 before an investigation was begun constituted “an avoidable omission and would not be considered acceptable”. They added that as a result “changes were made in local administrative practices” in order to prevent a recurrence of such an issue.

They added, as previously mentioned, that it was “regrettable that correspondence was sent to the incorrect address”.

The director concluded by apologising to Mary once more, and said that a separate apology was being prepared by Tusla’s Director of Quality. Later that month her initial disclosure was returned to her – more than four-and-a-half years after it was initially lodged.

In April 2016 the Ombudsman confirmed to Mary that her case would be used as part of the social work investigation into Tusla’s procedures for dealing with complaints.

Tusla itself confirmed in August 2016 that it is “currently undertaking a full review of all cases awaiting allocation including retrospective abuse cases”.

In response to a query from TheJournal.ie in relation to this article Tusla said that it “does not comment on individual cases” in a statement.

“This is to protect the children and families with whom we work. We are currently working with the office of the Ombudsman in relation to their investigation into how Tusla manages complaints and will implement the recommendations made,” the statement said.

Reviews and quality assurance checks by external bodies allow us to continuously improve and enhance our services to ultimately improve the lives of the children and families with whom we work.

Read: Remains of young children and babies found in sewage chambers at Tuam mother and baby home

Read: ‘Admin error’ that led to McCabe allegations was not reported as HSE data protection breach

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