The Data Protection Commission (DPC) has imposed a fine of €645,000 on the HSE for its failure to properly secure patient medical records.
The fine – which was widely reported last week – is a result of an inquiry the DPC began in May 2024, following two personal data breaches. The breaches were notified to the DPC in October and November 2023 after people gained unauthorised access to two derelict former psychiatric hospitals and found boxes of patient files in appalling condition, damaged by water, mould and animal droppings.
The commissioner ordered the HSE to audit the current conditions containing the records and “safely destroy any records containing personal data that are no longer needed”.
But though the personal data may no longer be needed, these records have value medically, legally and historically. And the imposition of a fine only removes further resources from the HSE, which already struggles with a lack of finances and expertise to properly take care of historic records under its care. What the HSE needs is not fines, but support and expert help in preserving historical records.
The issue goes back to the National Archives Act (1986), when the records of the health boards (and later the HSE) were not included. There is no legal requirement that it retains and transfers those records to the National Archives. It is not surprising these records became homeless once the institutions that generated them closed.
The records include the experiences of generations of patients treated in psychiatric hospitals, once the largest institutions of confinement in the State. In the 1950s, there were upwards of 20,000 patients confined on an annual basis. The rate of admission to psychiatric hospitals was the highest in the world, with 710 beds per 100,000 of the population. Without preserving institutional records, it is not possible to write a comprehensive history of the collective experience of mental healthcare in this country.
The recent Commission of Investigation into Mother and Baby Homes and Related Matters, which published its report in 2021, was built on the records preserved by religious orders and the State, as well as those generated by the Commission itself. The words of the women and children, who had been in the care of the religious orders and the State in these institutions, provided crucial oral testimonies on their experiences. When a decision was made to destroy those oral histories, there was outcry and a recovery process successfully implemented.
Yet once again, the answer to the question of what to do with sensitive historic records is to destroy them.
Unlike Mother and Baby Homes or Magdalene laundries, the State is solely responsible for the management of public psychiatric hospitals. The two hospitals at the heart of the recent fine – St Conal’s (formerly Letterkenny District Lunatic Asylum) and St Loman’s (formerly Mullingar District Lunatic Asylum) – were built in the 19th century during a period of massive State investment in healthcare and welfare. From the outset, they were charged with keeping safe the records of those admitted to their care, as well as the records of the institutions’ administration.
The history of inquiries into institutional care in this country in the past three decades reveals the extent to which confined populations were vulnerable to abuse and exploitation. The McAleese Report into Magdalene laundries found women were forced to work in return for housing and healthcare that was minimal at best. All that Remains, a recent RTÉ documentary with Niall Breslin, revealed that the psychiatric hospitals could also be subject to similar concerns. From a legal point of view, the only way the psychiatric hospitals can be fully understood is if the records are preserved.
Communities, former hospital staff, historians and archivists have worked to preserve similar records in Killarney, Monaghan and Grangegorman and these records are now housed in local and the National Archives. Those records, and the wealth of creative and historic projects that have emerged from them, offer an insight into what will be lost to the communities in Donegal and Westmeath, and to Ireland, if the recommendation of the Data Commissioner is followed.
Recently, the State has invested large sums recreating the lost archive of the Four Courts via the Virtual Record Treasury of Ireland Project. It has preserved the testimonies of all those who fought for the creation of an independent Irish State through the Military Service Pensions Collection. Those records reveal the cost of that conflict for many individuals, and the cost, in archival loss, for the long history of the country.
Psychiatric records offer something unique. Rather than tales of guerrilla warfare and the creation of the State, each one is a story of some of its more vulnerable citizens, and their individual losses and heartbreaks. Doireann Ní Ghríofa’s recent stunning novel, Said the Dead, explores records of Our Lady’s Psychiatric Hospital in Cork and demonstrates the immeasurable value of those records – both in facilitating creativity and fostering empathy. Those who were locked away deserve the respect they were often denied in life by having their personal histories protected. The destruction of those histories would be a further insult.
This is not simply about preserving more records for privileged historians – it is about whose histories we value and whose stories matter. It is about resourcing organisations whose histories are crucial in the lives of the ordinary citizens of the state.
What does it say about us that we invest millions in the history of the political nation while shredding patient files of those who lived and died behind the high walls of psychiatric institutions?
Dr Georgina Laragy is assistant professor in Public History and Cultural Heritage and Trinity College Dublin and Dr Aoife Bhreatnach is a writer and independent researcher