Dr. Aoibhinn Walsh:

I completely agree that resource constraints that are national impact all children. Is it is about knowing the context as to when to configure resources around the additional needs and barriers of these children. For example, when children are referred to us we give them an hour with face-to-face interpreters, where possible. These children will come to us having been referred from an accident and emergency department where they may have presented at 3 a.m. with a parent to speaks with a dialect from Malawi, with rudimentary translation done by phone. At least the accident and emergency department staff know that they can try to address the immediate issue at hand and that there is a backup then to address the needs in a more holistic manner. From a health perspective, we need to know that the people engaging with these children know the questions to ask as well. There is a piece of training on this that we are trying to bring about more nationally through the Royal College of Physicians in Ireland, RCPI. It is really about knowing that we cannot do everything for every child all of the time but that if somebody meets a child and knows it is not within his or her remit, timeframe or skill set to be able to manage what can be such a complex level of need in the case of disputed minors, for example, or if a child clearly presents with significant educational needs and has not been linked in with the appropriate services, that person knows somewhere the child can go to, to be able to obtain services for those needs in a much more structured and cohesive fashion. This impacts on resource usage for other children if these children do not engage with hospital services and if they do not attend an appointment. For example, if there is an appointment for an MRI of the brain under general anaesthetic, this uses a huge amount of hospital resources in terms of specialists, equipment and reporting time. If the person has relocated, did not get the appointment time and does not attend, then all of that is gone. If such people had cancelled, if we knew they had been relocated and were able to book them back a month later, that appointment could then be given to another child. It impacts resource usage for every single child nationally.