AS a boy growing up in 1960s Belfast, Gabriel Scally remembers Muckamore Abbey Hospital a "very happy, friendly place".
His father, Dr Brian Scally, was the lead consultant psychiatrist at the Co Antrim facility and he has fond memories of accompanying him for call-outs when the "rural" hospital had its own farm, workshops, staff chalets and even its own cinema.
"At that time there was always a doctor there every night and I visited the place very often. It was set up as a very modern, advanced therapeutic community and that's why it was placed outside Belfast," he said.
"It was meant to be a model community in which people with learning disabilities could live happy, fulfilled lives."
When he went to Queen's University to study medicine, the undergraduate and his classmates visited Muckamore in the 1980s as part of their training into learning disability.
The medic's links to to the hospital continued until the early 1990s when he had a top role at the former Eastern Health Board - the organisation that managed the facility - and when an overhaul that saw patients discharged into the community to live supported, independent lives began.
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During the first conversation I had with Professor Scally in the autumn of 2018, months after revelations of alleged abuse of vulnerable Muckamore patients by nursing staff were reported in The Irish News, he expressed his shock and questioned how authorities were dealing with it.
He had been involved in the probe into the Winterbourne View scandal in Gloucestershire, which led to six care workers being jailed for abuse of vulnerable adults in 2012.
"I found the abuse that went on in Winterbourne View extraordinarily disturbing. It resulted in a large number of convictions and the closure of the facility. It was horrific," he said.
"So you can imagine how disturbing I found it after Winterbourne that it now looked like these sort of things were going on - but on an even bigger scale - in Muckamore Abbey Hospital.
"I was also very concerned that the learning from Winterboure View and other incidents didn’t seem to have any effect and that something as bad or even worse could happen in Muckamore Abbey."
While based in England as a leading public health doctor for the past 20 years, his close ties to the north's health service continued with his involvement in a damning public inquiry into the hyponatraemia-related deaths of five children.
Acting as an "expert advisor" to inquiry chief Sir John O'Hara, the watershed report found that four of the children's deaths were preventable and concluded that parents were "deliberately misled" about catastrophic failings in their children's care.
Moved by concerns expressed by Muckamore families about the handling of the crisis and their calls for an inquiry, Prof Scally last summer wrote to most senior official at the Department of Health, permanent secretary Richard Pengelly, and offered to lead an independent probe.
"I’d already had significant involvement in the hyponatraemia inquiry. I was well aware of the real problems that existed in the health service in Northern Ireland," he told The Irish News.
"So I was extremely disturbed at that sort of extraordinarily bad management and leadership and treatment of patients was potentially going on in an institution full of vulnerable people - I think that's one of the key things, that the patients in Muckamore are almost uniquely vulnerable."
At the time he sent his letter to Mr Pengelly, Professor Scally was half-way through a major investigation into a cervical cancer screening controversy in the Republic.
His discovery of "top to bottom failings" led to a state apology by Taoiseach Leo Varadkar and radical changes to the system.
Comparing the responses to problems in healthcare on either side of the border, he said it was "like chalk and cheese".
"In terms of the how Irish government responded to the CervicalCheck inquiry, that is light years away from the response in the north for example to the hyponatraemia inquiry – and the lack of progress that has been made in really getting to the bottom of the Muckamore Abbey problems which clearly go back some years now."
Prof Scally's letter to Mr Pengelly, seen by The Irish News, details his involvement in government commissioned investigations as well as his personal connection to Muckamore.
It outlines how he had been following the publicity around the Muckamore allegations and noted "some degree of similarity" with Winterbourne View.
"If you are minded to establish an independent inquiry you will be considering options for who might conduct such an inquiry," he wrote.
"I have a personal commitment to the well-being of people with learning disabilities, this undoubtedly being linked to my father having been a consultant psychiatrist and a former Medical Superintendent in Muckamore Abbey until the mid-1980s.
"It is because of this personal commitment that I am taking the unusual step of making you aware that I would be willing to discuss my involvement in an inquiry, if this is of interest.”
While Mr Pengelly thanked him for his offer, he replied that a decision to establish a "public inquiry" is "one for a minister to take".
The civil servant also referred to the ongoing police investigation into Muckamore, stating: "This has priority over a public inquiry which - if initiated - would in all likelihood need to be paused to allow the PSNI work to conclude."
Mr Pengelly, who was the most powerful person in the north’s health service in the absence of a minister, added in his August correspondence that he felt Professor Scally’s personal link to Muckamore through his father could be an issue.
Dr Brian Scally retired almost 40 years ago.
The permanent secretary wrote: “I would... like to thank you for offering your services to any future inquiry and I will certainly bring this to the attention of any incoming minister to inform their decision on the way forward.
"That said, the potential conflict of interest associated with your father’s employment in Muckamore Abbey Hospital would firstly need to be considered carefully."
Rejecting any suggestion that his father's former job would impact on his ability to be impartial, Prof Scally expressed his "disappointment" at the response.
"It’s very simple for me really. I feel very strongly that a proper, impartial inquiry is required. I think a knowledge and a background or a connection with services for people with a learning disability and with Muckamore Abbey is not a disadvantage but an advantage," he said.
"From a personal point of view, I'm extraordinarily committed to making sure that the maximum amount of learning is taken out of this terrible situation so that nothing like it ever happens again and that care and support available to patients and their families really is beyond question, and also, that the governance mechanisms for the future are up to the job of safeguarding the patients.
"If I can be accused of anything, it’s being far too committed about those sort of things."
The leading doctor also insisted that an inquiry could go ahead - and not impact on the PSNI probe.
Detectives have indicated that 1,500 suspected crimes have been identified in just one ward in Muckamore over a six-month period in 2017, in the biggest case of its kind in the north. There have been six arrests to date.
"There are many, many matters that require close scrutiny that go far beyond the incidents that police will be investigating. I see no reason why an inquiry could not be set up," Prof Scally said.
"The model I would recommend is that the inquiry should be set up under an independent chair who would have the support of the families. Should the person carrying out that inquiry require further legal powers then there should be a commitment from the minister that he would provide those powers if needed - in order to compel witnesses and to ensure access to all relevant documentation, which is always a major issue.”
Last December, the medic met with some families of patients affected by the abuse allegations. He urged them to "keep pushing for answers".
"We need to start taking the patient voice seriously. We're not doing that," he told The Irish News.
"As long as the health service's instinct is to cover up, play down things that have gone wrong, it will really make patients and relatives angry and resentful. Incidents will continue to occur and recur, as has happened in Muckamore. So you have to change that whole culture."
