IT is difficult not to share the sense of severe disappointment held by the family of a Muckamore Abbey patient at the disclosure that the Department of Health does not believe a public inquiry should be held into appalling events in the psychiatric hospital.
An investigation of unprecedented scale, involving the PSNI and National Crime Agency, as well as reviews from within the health and social care system, centres on allegations that some staff in Muckamore physically and emotionally abused patients.
These men and women, it must be emphasised, are vulnerable people with severe learning disabilities.
To date, detectives have been dealing with 300 allegations of ill-treatment. More than 420,000 hours of CCTV footage is being examined.
These are clearly complicated matters which require patient and careful investigation, and the legal process must take its course.
Another priority, however, must be to re-establish public confidence in the health and social care system.
In this important regard, Muckamore is not an isolated case. It is the latest in a series of high-profile failings in the health service, including scandals surrounding hyponatraemia, the possible misdiagnosis of neurology patients and allegations of mistreatment of older people at Dunmurry Manor Care Home.
A thread running through these episodes appears to be an equivocal approach to the idea that health professionals, including management and administrators, should be quick to admit mistakes.
To the lay observer, it seems astonishing that those involved in the care of the sick and vulnerable might be anything less than candid when things go wrong in what are generally accepted to be highly difficult, pressurised and complex environments.
Nonetheless, frustration at the lack of transparency and openness encountered during the hyponatraemia inquiry led its chair, Mr Justice John O’Hara, to call for a duty of candour in health and social care.
The department of health, trusts and other bodies publicly agreed that such a culture change was necessary.
Against this background, the families of Muckamore patients and others are entitled to question their sincerity.
There are issues around whether the department has the legal authority and competence to initiate a public inquiry and shape its terms of reference.
Of course, a health minister would have the power to establish an inquiry; this is yet another area where the absence of Stormont is failing citizens.
The department says that a public inquiry would not be in the public interest, though it is unclear if it would change its mind were a minister to order one in the future.
For now, it should show the flexibility and courage to support the establishment of a public inquiry and set about restoring confidence in how our most vulnerable relatives, friends and neighbours are cared for.
