Ms Mary Flaherty:

There were many interesting points and one could go in 100 different directions. I will refer to some of the specifics. On phase one and phase two, there is much work to be done in phase one. Those of us who work day-to-day around the country with cases such as abuse cases will be aware that in different parts of the country there are completely different procedures. One need only re-examine the statistics in any year from the HSE where "the review of adequacy" is the phrase it uses. One should look at the number of reports of abuse of all kinds and the attrition, through the point of being confirmed or unconfirmed, in one area versus another. One should look at whether it would be strange that one part of the country should have figures that are completely aligned. There is a real job of work there with the existing employed social workers - the staff who are clearly within the remit of the agency where there would be no argument.

I accept there are complex issues, for example, around public health nurses. I mentioned Child and Adolescent Mental Health Services, CAMHS. CAMHS, if it refuses to provide sexual abuse services in the context in which I work, does not treat them as a mental health issue and unless one is suicidal or is self-harming, one has a mental health issue to be resolved. Once that is resolved, one may still have issues around one's sexual abuse that one has not worked through, and in some parts of the country, a therapist or a psychologist might continue with him or her. In many parts of the country, it is excluded. There is a great deal of standardisation to be done. Even in the case of child deaths, if, for example, one brings in the child and adolescent mental health specialists, often it is the mental health specialist working with parents who are the ones who need to be alert to child death dangers. Those areas will be difficult and I do not envy the job of negotiating all of these matters.

In the short term, there is a great deal of work which has already begun in standardising the cohort of staff working clearly within the agency's remit, and ensuring that in every part of the country this is a warning sign that we act on and move in this way.

In regard to what I would regard as a good outcome, the beginning of a plan has been developed. CARI has been involved in its evolution but my concern about the plan for child sexual abuse services, therapeutic or otherwise, is that an attempt is being made to develop them on an expenditure-neutral basis. I think this will be impossible to achieve in the context of a service that is in its infancy. If one takes the model for the adult counselling agency, which celebrated its tenth anniversary last year, I am concerned about the suggestion that we can roll out a service that would be in any way adequate to the needs of children. They will not be equivalent because the number of adults is limited and children have a specific timeframe. The numbers will not be huge but we should, at a minimum, be able to offer a specialist therapy service to children at least as good as the one we say they need when they turn 18 if they have been victims of abuse. Why is a similar service not to be provided while they are under 18? Children should be able to access a specialised therapy service to cope with abuse. While abuse may occur at any age from two to 18 years, early therapeutic intervention would avoid the need for extensive mental health services and further trauma and abuse in later years, both within the family and over the generations. I invite the committee to keep an eye on that issue. In regard to other preventative work, Ferns five is trying to develop services for abusers because that is also a preventative measure.