Even before Tuam revelations, mother and baby homes were causing concern

Routine references are made to the records potentially containing “legal and criminal issues”.

As this newspaper revealed in 2015, the level of concern among the staff examining the records was revealed in an internal note of a teleconference in October 2012 with then assistant director of children and family service Phil Garland and then head of the medical intelligence unit Davida De La Harpe.

That note recommended that an “early warning” letter be written for the attention of the national director of the HSE’s quality and patient safety division, Philip Crowley, suggesting “that this goes all the way up to the minister”.

“It is more important to send this up to the minister as soon as possible: with a view to an inter-departmental committee and a fully fledged, fully resourced forensic investigation and State inquiry,” concludes the note.

However, that never happened. In fact, nothing happened until Catherine Corless forced a State inquiry into the matter.

So what did exactly did the HSE know in 2012 and why were they looking at the Tuam and Bessborough Mother and Baby Homes?

This story is inextricably linked to yet another inquiry into another scandal. This time it’s the Magdalene Laundries.

In 2012, the HSE was undertaking an enormous trawl of its records as part of the examination of the State’s role in the Magdalene Laundries under the McAleese inquiry.

The McAleese Committee had requested that the HSE records relating to the 10 Magdalene Laundries be examined by the HSE.

However, according to records obtained by the Irish Examiner, permission was granted to include two Mother and Baby Homes in this trawl — Bessborough in Cork and Tuam in Galway. This decision was “based on potential pathways references by the advocacy group Justice For Magdalenes (JFM)”.

Prof Jim Smith of Boston College and JFM group had written to the chairperson of the inquiry, then Senator Martin McAleese on February 21, 2012, outlining a circular he had discovered relating to a 1948 Government survey which revealed “disturbing” infant death rates in excess of 50% at the Tuam Mother and Baby Home.

Within eight months, HSE staff in Cork and Galway had turned up all manner of concerns in relation to both Bessborough and Tuam — issues which were so serious that they rivaled if not surpassed those being found in relation to the Magdalene Laundries.

In August, clear evidence of transfers of women from the Tuam home to the Galway Magdalene Laundry was being reported by a social worker examining the Tuam archive. However, included in this information was information on infant deaths.

By October, a fuller examination of the Tuam archive was beginning to case consternation and led to the internal note mentioned above.

The note, revealed by the Irish Examiner in 2015, was prepared by Dr Declan McKeown — consultant public health physician and medical epidemiologist of the medical intelligence unit in the HSE — and relayed the details of a teleconference with then assistant director of children and family service Phil Garland, who was co-ordinating the HSE project for the McAleese Committee and then head of the medical intelligence unit Davida De La Harpe.

The note relays the concerns raised by the principal social worker for adoption in HSE West who had found “a large archive of photographs, documentation and correspondence relating to children sent for adoption to the USA” and “documentation in relation to discharges and admissions to psychiatric institutions in the Western area”.

It notes there were letters from the Tuam mother and baby home to parents asking for money for the upkeep of their children and notes that the duration of stay for children may have been prolonged by the order for financial reasons.

It also uncovered letters to parents asking for money for the upkeep of some children that had already been discharged or had died.

The social worker, “working in her own time and on her own dollar”, had compiled a list of “up to 1,000 names”, but said it was “not clear yet whether all of these relate to the ongoing examination of the Magdalene system, or whether they relate to the adoption of children by parents, possibly in the USA”.

At that point, the social worker was assembling a filing system “to enable her to link names to letters and to payments”.

“This may prove to be a scandal that dwarfs other, more recent issues with the Church and State, because of the very emotive sensitivities around adoption of babies, with or without the will of the mother.

“A concern is that, if there is evidence of trafficking babies, that it must have been facilitated by doctors, social workers etc, and a number of these health professionals may still be working in the system.”

The report ends with a recommendation that, due to the gravity of what was being found in relation to the Tuam home, an “early warning” letter be written for the attention of the national director of the HSE’s quality and patient safety division, Philip Crowley, suggesting “that this goes all the way up to the minister”.

“It is more important to send this up to the minister as soon as possible: with a view to an inter-departmental committee and a fully fledged, fully resourced forensic investigation and State inquiry,” concludes the note.

In tandem with this, in September 2012, a 20-page report had been prepared on Bessborough. It revealed that the HSE was in possession of a death register maintained by the Order that ran the institution between 1934 and 1953.

The report outlined that the almost 500 deaths recorded in this period were “shocking” and “a cause for serious consternation”.

The report goes on to express concerns that death certificates may have been falsified so children could be “brokered into clandestine adoption arrangements, both foreign and domestic” — a possibility the HSE report said had “dire implications for the Church and State”.

It is worth noting that the HSE was making such allegations after examining the mother and baby home’s own records.

The report notes that the records reveal a culture “where women and babies were considered little more than a commodity for trade amongst religious orders” and that they were “provided with little more than the basic care and provision afforded to that of any individual convicted of crimes against the State”.

It also highlights the “intricacies of Bessborough’s accounting practices”, and that “detailed financial records and accounts were not handed over to the HSE by the Sacred Heart Order”.

We also learn of the nuns’ “preoccupation with material assets” and “preoccupation with materialism, wealth, and social status”, and that the women provided “a steady stream of free labour and servitude”. The nuns also received “financial remuneration” for the children of these women.

With regard to the money made by the order both via adoption and by making natural mothers pay for their care, the report specifically states that “further investigation is warranted into these practices”.

This report was seen by both the Department of Health and the Department of Children and Youth Affairs.

Given the level of concerns surrounding what was being found in relation to both institutions, Dr McKeown began work on a briefing paper on the situation for Mr Crowley. This was also forwarded to the then national director of children and family services at the HSE, Gordon Jeyes on October 19, 2012.

In one of the drafts of this paper, marked “strictly confidential”, Dr McKeown states that the records show that one child was sent to a US couple in 1957 in return for a cash payment.

“Some of the records are well kept, however, and show that in one case of an infant being sent to a family in Louisiana in 1957, a sum of approximately €50 was paid to the order by both the adoptive parents and by the natural (birth) parents,” he wrote.

Under the Adoption Act 1952, it was illegal for an “adopter, parent or guardian of a child” to receive any payment shall not receive or agree to receive any payment in return for the adoption of a child. The exceptions to this under the Act were payments made for the maintenance of a child and payments to solicitors for professional services.

Dr McKeown also said that the adoption records contained in the archive showed clear examples of multiple illegal adoptions which were not processed by the Adoption Board — then the regulatory body for adoption at the time.

“The adoption records are scanty, but a number of records do exist which appear not to have gone through the Adoption Board. Processing an adoption through the Adoption Board would have been the accepted practice at the time.

Dr McKeown also revealed that letters from “senior Church figures requesting the nuns to identify babies for adoption to the USA” — indicating that the Catholic Church hierarchy was also directing this practice.

“In one case, the child of a named woman is suggested for transfer to American adoptive parents,” states the briefing paper. Dr McKeown concludes this draft by stressing the need for the issues raised in Bessborough and Tuam to be investigated further.

“The archives need to be examined for clinical, accounting and ethical irregularities, of which there are numerous clues in the material already uncovered.

“Additionally, there may be legal or criminal issues underlying the documentation, and it is critical that these potentials are outruled as soon as possible, given the increased public interest in the issue of adoption practice in Ireland, particularly in the 1950s,” he wrote.

None of these concerns appear in the final HSE submission to the McAleese Committee which was only concerned with the institutions in so far as referrals from to and from Magdalene Laundries.

In a cover letter attached to a draft of the HSE report sent to principal officer at the DCYA and member of the McAleese Committee Denis O’Sullivan on November 1, 2012, Dr McKeown states that that “adoption, birth and registration and the recording of infant mortality” in relation to the mother and baby homes were issues that may require “deeper investigation” and had been referred to Mr Crowley.

As a result, they would “no longer form part of the core investigation into the Magdalene system”.

Six days later, Mr O’Sullivan emailed Gordon Jeyes on November 7, 2012, to advise that any issues around mother and baby homes were outside the remit of the McAleese Committee.

Material included beyond that is beyond the scope of our work — eg, the scope does not extend to an examination of other places of refuge eg mother and baby homes, other than in the context of referrals from Magdalene laundries.

"If there are separate and validated findings of concern emerging from such additional research, obviously they should be communicated by HSE and through a separate process."

The previous month, Nuala Ní Mhuircheartaigh of the McAleese Committee had emailed then HSE assistant national director of child and family services Phil Garland acknowledging the Bessborough report, but stating it was “heavily focused on broad narrative and context rather than fact”.

Given the very real facts that were contained in both reports on Tuam and Bessborough, it’s unclear where the HSE investigation went from here, if anywhere. Were any of the concerns reported to the gardaí? Why wasn’t the minister informed?

The HSE declined to answer any of these questions stating it was providing all relevant information and documentation to the Mother and Baby Homes Commission.

The Report of the Inter-Departmental Group on Mother and Baby Homes, published by the Department of Children and Youth Affairs in July 2014, also failed to mention any of these concerns.

At that point, Tuam Mother and Baby Home was when it was making headlines around the world.