Oireachtas Joint and Select Committees

Tuesday, 10 May 2022

Joint Committee On Children, Equality, Disability, Integration And Youth

Foster Care Issues and the Loss of Positive Care Services: Engagement with Tusla

Mr. Bernard Gloster:

I thank the Chair and members of the committee for the invitation to appear before them. I am joined by my colleagues, who have already been introduced by the Chair.

Prior to addressing the two specific matters raised in the committee's invitation, I would like to briefly update the committee on a few key activities for the agency, although by no means all of them.

The agency will shortly publish the annual report in respect of 2021. In a year that saw the continued impact of the pandemic and the added major challenge of the cyberattack, the agency continued to provide increasing levels of services and responsiveness across a range of statutory functions. There were 73,069 referrals to our child protection and welfare service alone, which was a 5% increase on the figures for 2020. That is but one of several indicators of not only the demand for our services but also the complexity of the lives of many children and families. Our full activity report for 2021 will be available shortly and will, of course, be briefed to the committee.

The agency is well advanced in its three-pillar change programme regarding its practice, culture and structure. While there is no doubt there are many complex issues, historical and contemporaneous, to be responded to, there are also clear signs of steady and continuous improvements on several issues against the backdrop of the heightened concern of 2018 and 2019. The agency has had, since February, a new national management structure and six new regions, modelled broadly on the Sláintecare analysis. Each new region with its own chief officer will by the summer be established with significant devolved authority and responsibility to be achieved incrementally at local level. This will substantially improve the governance of the agency creating the right conditions within which many issues can be tackled.

Following discussion in 2020 and at the start of 2021, a sub-committee of the board of Tusla commissioned the executive to produce a plan for residential childcare. This area of care is not only extremely complex with an increasing demand but it is also resource intensive and the board required a plan to set out the approach for the coming years. I will refer to this later as it is directly relevant to the committee's invitation today.

The agency has a long-standing role in respect of separated children seeking international protection and many of those young people are in our care or supported in an aftercare context. Children presenting at the ports from war-torn countries, such as Somalia and Afghanistan, as well as those arriving through structured international programmes, are now an integral part of our work. The situation in Ukraine has seen an exponential growth in demand for these services and by 4 May, we had received 128 referrals resulting in 70 care admissions, with 50 remaining in care, from Ukraine alone. The agency also has dedicated resources linking all Tusla protection and support services available in each local authority area to the local inter-agency responses. We are working closely with our line Department and the Department of An Taoiseach to make the best possible contribution to the State response in what is a traumatic time for so many Ukrainian children and families. I am aware there has been reportage of an issue unfolding in respect of a large number of people arriving at Dublin Airport today. I will not be in a position to comment until I receive more information on that issue. I only heard about it as I was coming into the committee room.

The agency continued to function as an essential service throughout the phases of Covid-19. While there were many challenges working in this environment and maintaining a workforce, I record my thanks to all the staff of Tusla and our funded partners for ensuring the safety and support of so many over an unprecedented and demanding two years. The agency now has in place a proactive blended working policy and many new ways of working adopted during the restrictions on movement, although not all of them, have been adapted and used for future responses to need.

The agency is making solid progress on permanently securing its own ICT infrastructure and I anticipate by the autumn that we will be 90% independent and have our own security system of the latest standards in place. We are also this year developing a complete new replacement for the national childcare information system, NCIS, and this will make us unique internationally in having such an up-to-date national case management system for child protection and other critical services. As previously reported, there was data theft during the cyberattack which we are currently assessing and I anticipate that in the next few weeks we will communicate publicly our plans for appropriately and privately notifying individual people whose sensitive data were compromised.

Early years registration has been a concern of this committee for a number of years.The end of 2022 will see the next three-year cycle of registration for the majority of some 4,000 providers of these services. Our regulation service will this year, with the support of the Minister and the Department, ensure a slimmer and more user-friendly process which will be publicised in June, six months ahead of the registration date, giving providers the maximum time to achieve their continued approval.

The committee will be aware of the agency position on adoption legislation from the pre-legislative scrutiny stage in 2021. In anticipation of the final stages to commencement of the legislation, we have advanced planning and significant additional resources in recruitment to respond to this new context.

Turning to the matters raised in the committee's invitation to today's meeting, I want to make the following opening remarks. I will speak first to challenges facing foster carers and general foster care issues. The committee will be aware from my previous appearances of the significant role played by foster care in the overall response to children who, for a variety of reasons, cannot live at their own home for a period or indeed for all of childhood. Ireland is an international leader with a prevalence of alternative care placements being at more than 90% for foster care. It is equally the case that maintaining this has proved difficult in recent times. Tusla had 4,039 foster carers on the approved panel at the end of 2021, down from 4,324 in 2018. The proportion of this in the private sector offering is 542, having grown only by 39 in the same period, and this is very satisfactory from a dependency perspective.

An indication of the in-year growth and loss rate of foster carers overall is in the context of 281 new approvals in 2021 and 208 cessations, leaving a net increase of just over 70. Tusla has targeted an improvement plan for foster care for the next three to five years which will be concluded in June. We have just completed the plan for residential care and in the autumn, we will conclude the third part, which is aftercare. Significant direct engagement has taken place with foster carers to listen to their experiences, issues and suggestions. Responding to many challenges, the next phase of improvement will focus on changes that will lead to continued improvement of foster care for children by also improving the support mechanisms for foster carers.

The agency is concerned that if we cannot maintain the high level of foster care as a model in the overall alternative care system, the outcomes for children will deteriorate and the attractiveness of fostering as an option will not keep pace with demand. Foster carers have reported satisfaction with our assessment process, the training provided and the role of the link worker. However, they have also described some of the key challenges they face, including turnover of social workers, difficulty accessing therapeutic services for children in their care, poor communication, delays in permanency planning, and failure to increase allowances in line with inflation. The Minister specifically raised foster carer improvements with the agency at a recent engagement and is anxious to support those improvements. I look forward to finalising and advancing these plans in the coming months.

I will move to the loss of services provided by Positive Care. Tusla has engaged in an updated procurement process since 2021 that is aimed at further ensuring the quality and appropriateness of private provision, both in residential and foster care. The purpose of the exercise is much more focused on quality, staffing and other compliances of service providers than it is on a competitive pricing process. I am aware of recent narrative, particularly since February of this year, on one private provider, Positive Care Ireland, PCI, which was unsuccessful in the third attempt at a rolling process. Tusla does not control either the external narrative or the commercial decisions of private companies, and some of the commentary has been concerning and created, more than once, a level of instability for children in the care of the provider and its many fine staff. The latest position advised to us by the company as of 5 May is its intention regarding the potential sale of its business and that it is at an advanced stage of same. However, should this materialise or not, it is and remains the position of Tusla that the least disruption possible to the children and to those caring for them is our sole objective.

I assure the committee that I am satisfied that all the processes that have been and continue to be utilised are appropriate and necessary. I further want to make it clear to the committee that there is no prejudiced view towards this individual provider being in or remaining in the market. The company is fully aware of the exact requirements it needs to fulfil to comply with a new contract from the current procurement process. It is a matter for it or any new commercial arrangement it makes to ensure it fulfils those requirements. I am more than satisfied that what has been required of it is neither unreasonable nor different from any other provider in the procurement process. In the final analysis of any such situation, and as I have previously advised another committee of the Oireachtas, there is a role for private provision across many parts of health and social care. However, if a service fails or ceases, the State ultimately must step in to do whatever is necessary to minimise the impact. This is not unique to children’s residential care. It is our hope the services currently provided by PCI will continue regardless of the provider, but always and only within the prescribed rules of such a sensitive service.

This scenario is one that arises in the wider debate about private provision in residential child care. I have previously indicated the concern of the agency that our level of dependency, rather than the existence of private provision, is a problem. At present we operate at a public to private ratio of approximately 40:60, that is to say, 40% public and 60% private. As I mentioned earlier in my statement, the board of Tusla requested a plan for the coming years and has recently approved a plan for residential care. In the plan, we aim to address the dependency to an achievable rather than an aspirational level, and we have targeted a 50:50 split in three years with desired reversal of the 40:60 split in five years. This will be achieved through increasing public provision as distinct from any intentional erosion of existing private provision, which has an important role. This is an important clarification considering some of the narrative that there is a correlation between this plan and decisions by the agency regarding PCI. I assure the committee this is not the case.

It is a fact that demand for residential care is likely to increase, regardless of any successes achieved in foster care. Therefore, to respond to this demand, increased public provision alongside existing levels of private provision will achieve the rebalance. The decisions of private enterprise to exit or enter the market are secondary to this. To demonstrate the detail of this plan, I am attaching for the committee a copy of the approved plan which we are working towards. It is my intention after this committee meeting to publish the plan on the Tusla website as chapter 1 of our alternative care improvement, noting, as mentioned earlier, that chapter 2 will be about foster care, and then chapter 3 will focus on aftercare where there are also many challenges to be addressed. All planned changes are based on the Tusla principle of the past two years, namely, continuous improvement.

I thank the Chair for the opportunity to make this opening statement and I am happy, as are my colleagues, to address any questions from members.

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