The HSE has apologised unreservedly, and has agreed to pay €440,000, to a severely intellectually disabled “voiceless” elderly woman following physical assault and mental abuse she suffered in a HSE residential home.

President of the High Court Mr Justice Peter Kelly on Thursday described the woman’s treatment at the hands of HSE personnel in the Áras Attracta facility in Co Mayo as “inhuman”. While the case made sad reading for the woman, it made shameful reading for the HSE, he said.

After the treatment of the woman came to light, as a result of an RTÉ Prime Time programme in late 2014, the HSE moved her. The improvement in her condition and circumstances since she has started to be treated “humanely and appropriately” has been “very substantial”, the judge said.

This indicated, if she was treated properly beforehand, she would, subject to the limitations of her disabilities, have had “a far better life and quality of life” than was visited upon her when the HSE was in charge of her care.

The woman, aged in her 70s, has been in health board or HSE care since her birth in an institution, has no known living family and is non-verbal with severe intellectual disabilities.

The RTÉ programme lead to the HSE applying to have the woman made a ward of court and that was done last year. The general solicitor for wards of court, Patricia Hickey, then initiated proceedings against the HSE on behalf of the woman over her treatment.

Among various claims, it was alleged the woman, a long-term resident of Áras Attracta, suffered physical and emotional abuse while in a unit there. It was claimed she was deprived of appropriate supports and stimuli and was physically deprived and abused.

The HSE admitted liability and the settlement came before court on Thursday for approval.

Micheál Ó Scanaill, for the HSE, said it wished to apologise “unreservedly” to the woman for the manner in which she was treated as was documented in the Prime Time programme of December 2014.

The settlement also included a €440,000 payment comprising €300,000 for general damages and aggravated damages, €100,000 for loss of disability allowance and €40,000 for cost of an independent advocate for the woman to monitor her care into the future.

Sworn undertakings

A HSE representative also gave sworn undertakings under which the woman will get additional care hours weekly and it will provide resources to ensure she can be taken on outings outside the Áras Attracta facility.

Seeking approval for the settlement, Sara Moorhead SC, for Ms Hickey, said this case arose from a “sad background” of institutional care since birth.

The RTÉ programme showed this “voiceless” woman being treated in a “physically violent and undignified manner”, which clearly caused her distress, and one of the most disturbing things was the “indifference to that distress”.

This woman had no one to represent her and therefore the HSE’s responsibility was “so much greater”, counsel said. Since she had been moved from the unit in question, there had been a dramatic improvement in her condition which only served to underline what was going on before.

The woman suffered from a digestive condition which was not diagnosed and treated until after an independent advocate became involved in 2014. It also used to be said that the woman liked being placed in the porch when in fact that was a form of punishment, counsel noted.

Experts who have assessed the woman are now delighted with the level of care she is getting but had made suggestions for some improvements, including additional resources and funding so she could go on outings. The HSE had said those would be provided.

Severe disability

In his ruling, the judge said the woman was born in an institution and has spent her entire life in institutions due to having a severe intellectual disability and other conditions.

She has been in the care of the HSE and its predecessors since her birth and was placed some years ago in Áras Attracta, he noted.

The RTÉ programme showed she had suffered “inhuman” treatment at the hands of HSE personnel involving physical assault and emotional abuse.

The judge praised Ms Hickey for the speed with which she took the proceedings and added it was to the credit of the HSE it did not attempt to deny liability for the treatment meted out to this “unfortunate” woman.

It goes without saying the woman is entitled to be compensated, the judge said. The legal system could sadly only provide financial compensation which was “no substitute” for what she has suffered but was the best the legal system could provide.

The damages are designed to compensate and the inclusion of aggravated damages indicates the court’s disapproval of the treatment of this “most vulnerable” woman.

The judge added he considered it was “crucially important” the woman has an independent advocate into the future to police the HSE undertakings as to her care.