When Pope Francis ascends the steps of his plane at Dublin airport on Sunday evening at the end of his 36-hour trip to Ireland, even he – the people’s pontiff, the champion of the poor – might feel a sense of relief on entering the cocoon of Aer Lingus’s business class.

He will leave a country in which the wounds of clerical abuse are still raw, and where visceral anger is building rather than fading. On Saturday, Francis again acknowledged a “grave scandal” and “repugnant crimes”. But the question for survivors and increasing numbers of the faithful is: what is he going to do about it?

Wave after wave of scandal concerning decades of abuse by priests and cover-up by bishops has crashed at the doors of the Vatican this year. The issue threatens to derail Francis’s papacy unless he can belatedly show that he does not just understand the scale and systemic nature of the problem but is willing to take concrete action to deal with it.

The past few weeks alone have seen the publication of a shocking grand jury report into clerical abuse and its concealment in Pennsylvania, the resignation as a cardinal of a former archbishop of Washington over alleged sexual assaults, a police raid on the Catholic church’s HQ in Chile, the sentencing of an Australian archbishop convicted of covering up child abuse, and a growing clamour from Irish survivors for the pope to take responsibility for these failings.

More scandals and revelations may be looming. Cardinal George Pell, the third-ranking official in the Vatican and an ally of Pope Francis, is facing legal proceedings in Australia relating to allegations of historic sexual offences. Early next year, the trial will begin in France of two cardinals on charges of concealing sexual abuse.

“This is a potential tipping point, not just for Francis’s papacy, but in the Catholic church writ large,” said John Allen, editor of the Catholic magazine Crux and a Vatican expert. “Ordinary Mass-going Catholics are saying that when this first blew up, and for a long time afterwards, they stuck with the church, because people in power were saying, ‘we understand how awful this is, it has to be fixed and we’re going to fix it’. What is punching Catholics in the gut right now is the thought that what they were told about the determination to get this sorted simply wasn’t real.”

Last week, six days after the publication of the damning Pennsylvania report, Francis issued a 2,000-word letter to the “people of God”, the world’s 1.3 billion followers of Roman Catholicism. “It is essential that we, as a church, be able to acknowledge and condemn, with sorrow and shame, the atrocities perpetrated by consecrated persons, clerics, and all those entrusted with the mission of watching over and caring for those most vulnerable. Let us beg forgiveness for our own sins and the sins of others,” he wrote.

The letter was not just about events in Pennsylvania, according to Greg Burke, the Vatican spokesman. “This is about Ireland, this is about the United States, and this is about Chile, but not only [those places].” Burke drew attention to the pope’s description of abuse as a crime as well as a sin.

Facebook Twitter Pinterest Cardinal George Pell arriving at court in Melbourne in May. Photograph: Stefan Postles/EPA

But for many survivors, it did not go far enough. Marie Collins, a survivor of sex abuse who resigned from a commission created by Pope Francis to tackle the issue, told the US’s National Catholic Reporter: “You can keep saying how terrible this is, and everybody knows that now ... Whether your intentions are good or not, what really matters is what you do. That’s the problem. History will judge Pope Francis on his actions, not his intentions.”

Some have suggested concrete proposals. Ending Clergy Abuse, which represents survivors in 18 countries, has put forward three: zero tolerance for abuse and complicity in abuse; a global public registry of clergy with substantiated allegations of sexual abuse; and obligatory reporting of child abuse allegations to civil authorities, with immediate excommunication for failing to do so.

Thomas Reese, a Jesuit priest and author, has gone further, saying the pope should establish a special office at the Vatican to investigate bishops, as recommended by the papal commission in 2015 but not enacted. If a bishop is found to have failed to protect children, he should be removed from office. In addition, said Reese, “the Vatican needs to report its part in this human tragedy. Who knew what, and when? What did they do?”

In his letter, Francis identified the need to challenge the “culture of clericalism” in the church in which priests and bishops are set apart from those in the pews in a deferential hierarchy. Clericalism “helps to perpetuate many of the evils that we are condemning today,” he wrote. His words are unlikely to be embraced by those in the Vatican and upper reaches of the church whose careers and lifestyles are sustained by such a culture. Some are already hostile to the pope’s desire for reform, and Francis’s enthusiasm for the laity over the clerics may reinforce the forces aligned against him in the Vatican.

Is the pope finally grasping the nettle of the scandal? “That’s an open question,” said Allen. “Ireland is arguably the country in the world most scarred by abuse, and if he comes here and doesn’t offer any concrete indication of how accountability will be delivered at long last, I think there will be an eruption.

“We will hear a deafening chorus of criticism and not just from the predictable quarters, but among reformers who have made the decision to stay inside the church and solve this problem. Some of them may decide it’s not worth it. They may break ranks and go public.

“And some grassroots Catholics who’ve been sticking it out – going to Mass, supporting the church financially – they may decide they’re just not going to do those things any more.”