Let Tristan’s legacy be better service

ON THE steps of the High Court this week, Angela Neiland somehow managed to be a composed, courageous and compelling advocate for the son she lost four years ago.

Tristan Neiland died in January 2013 at the Angel’s Quest Carmona Services facility in south Dublin run by St John of God.

He was placed there to give Angela, her husband Andrew and their other children a weekend of respite from the round-theclock monitoring Tristan needed.

Prone to seizures, he was a little boy who required immediate intervention when such episodes occurred, and Angela usually slept beside him to ensure this happened.

When she entrusted him to the care of others, she made this explicitly clear.

He needed to be connected at all times to a vital signs monitor, and physically checked at least every 15 minutes.

This did not happen. His oxygen saturation monitor was not applied to Tristan, while a less effective baby monitor was placed in the corridor outside his room.

Shockingly, following his death staff tried to claim that Angela had not made them aware of his need for an oxygen saturation monitor.

And far from being checked every 15 minutes, he hadn’t been seen for 56 minutes when he was found dead.

A report into the failings in Tristan’s care also found that evidence given to investigators was very likely falsified.

That devastating report was delivered to the board of St John of God in November 2013. Yet just two weeks later, as later revealed exclusively by this newspaper, clandestine bonus payments of millions of euro were shared by 14 of the agency’s bosses in breach of the HSE salary cap in place at the time.

Angela Neiland’s grief has been compounded by all of these things – the false and obscene accusation that she somehow bore part of the responsibility for her son’s death, and the lack of monitoring that could so easily have seen him leave the centre as healthy and full of vitality as when he entered it.

But there is a broader context. The Neiland family diligently cared for their son and brother, but when they needed a break, they had to entrust him not to the care of the State but to an agency funded by the State.

This devolution of services has been a hallmark of successive governments, which have farmed out care for children, and mental and other health services.

This is no way to run what should be the minimum requirement of any mature society – a reliable, dependable and completely accountable public health service we can trust.

In a moving and disturbing interview today, Angela Neiland hopes that by speaking out, services will improve. We have just two words to add. They must.