Oireachtas Joint and Select Committees

Thursday, 25 September 2014

Joint Oireachtas Committee on Health and Children

Update on Child and Family Services: Child and Family Agency

11:10 am

Mr. Gordon Jeyes:

I thank the Chairman and members for giving us an opportunity to update the joint committee on the progress achieved by Tusla, the Child and Family Agency, in its first nine months. The Chairman has already introduced my colleagues who will respond in the event that there are any difficult questions. I intend to act out of character and keep my presentation brief. I have tried to highlight each of the issues in which members will be interested in order that they can question us further. Additional information has been made available in appendices.

Tusla was born on 1 January 2014. It is the first agency solely dedicated to the welfare, protection and nurture of Ireland’s children, particularly the most vulnerable. Among other things, this has greatly enhanced the transparency of taxpayer investment in services for vulnerable children and those in need of care and protection. A copy of our summary budget is included in appendix I which, among other things, illustrates how inflexible our budget is, an issue we may explore presently. The summary budget document is accompanied by details of our principal service activity and I have also included a summary of our business plan and progress to date. My colleagues will be pleased to update or clarify any matters arising in this regard. We have also provided an overview of monthly national performance activity as at July last.

It was essential that we established a body that is responsive and inclusive. In saying this, I note that much of the activity in the initial business plan has focused on ensuring we establish reliable routines. We are a start-up organisation in a difficult period for a country. Our focus, therefore, is on key elements of service to ensure we work efficiently and effectively. In addition, work has continued to reform and improves services, building on initiatives in family resource centres, educational welfare services and, specifically, on streamlining our service delivery and emphasising prevention, diversion and building on the strengths of families.

Tusla has been created in the demanding circumstances of increased requests for services, budget restrictions and recruitment constraint. In the face of austerity, it would be easy to be complacent, blame any inaction on limited resources and adopt the position that we are doing okay in the circumstances. We refuse to settle for such an approach. In the face of austerity, services are improving and have become more accountable and consistent across the country. Lessons from the past have been learned and we are providing an increasingly accountable, consistent and transparent service.

Appendix V is a summary of comments made in recent inspections carried out by the Health Information and Quality Authority, HIQA. These show increasing evidence of a service which is improving. While much has been done, much remains to be done. The comments also show an increased clarity of purpose, a sense that there is a plan and a determination to do the best for Ireland’s children. It is important to remember that children are not at risk because they are in the care of the State. Children are placed in the care of the State because they are at risk. It is also interesting to note two major concerns expressed by HIQA. On the first, the impact of maternity cover, following an agreement with trade unions, we are introducing a pool to cover maternity leave. Cover will be provided immediately as a consequence of Government investment. In response to a second concern raised by HIQA, colleagues in the Garda Síochána and Health Service Executive will have 24-7 access to information on children who are in the child protection notification system.

Failure to share information is often quoted as a weakness when children are let down by the child protection system. A consistent approach to child protection is essential. Information will be shared. In addition, emergency place-of-safety arrangements are working well and now will be augmented by a duty out-of-hours system. Communication has improved, and through newsletters, website and training, best practice is identified and shared and practice improved.
Other specific improvements in 2014 include a full review of domestic sexual and gender-based violence services because this is the first time all of those services would be under the one authority - there was a set of funders within the previous health service arrangements. A roadmap is being developed for these services so that the pernicious effects of domestic violence are everybody's responsibility and specialised services for responding to sexual violence are enhanced. In addition, family support and family resource centres have been integrated within our working at local level and new synergies have been created within our local area pathways. Teams around the child and the family have been created and are increasingly effective - the meitheal. Information is a key requirement in child protection and we are setting up the national child care information system, which is in the last stages of user-acceptance testing. On improvements, finally, educational welfare is a constituent part of the service delivery and as the committee will see later, we view education as a key component in improving young people's life chances and opportunities. Work continues to improve attendance, participation and retention and align these functions to other agency work. School attendance guidelines have been developed to underpin this and work continues on the assessment of and support for education in places other than recognised schools, including at home.
We must act, first, with accountability, across the country. As I speak to partners, including the courts system, it is clear that there is a straight line of management and lines of accountability. National policy is discussed, best practice identified and consistency increased. Staff are clear about their responsibilities and held to that, and we produce monthly information relating to HR, finance and service delivery.
To enhance accountability further, we need to review the funding distribution which can look inconsistent and to develop local partnerships within children services committees. We have a joint protocol for services with primary care, health and well-being, mental health and services for children affected by disability, but that needs to be strengthened. Children suffer where there are gaps. As part of the aspiration to be a responsive service, there is a need to learn more from those who complain and for us to do better in responding within agreed timeframes. We are improving, but have more to do. Mechanisms need to be developed in order that the services Tusla shares with the HSE are accountable and recognise Tusla as an independent agency with separate legal status.
The service delivery framework is being rolled out across the country. Areas have developed multidisciplinary teams around the child emphasising early intervention and partnership working. Most teams now have a dedicated front door, duty and intake service with response times greatly reduced, and continuity of service enhanced. Children First arrangements have been strengthened through the child welfare and protection handbook and we have just issued additional guidance relating to the difficult area of section 3 cases where the alleged abuse is extra-familial. An alternative care handbook, also sharing best Irish practice, has been finalised and will be published shortly, and strong aftercare arrangements are being consolidated. Early years inspection now runs on a national basis, and the workforce has been enhanced and there is a guarantee of a full inspection at least every three years. Within the early years inspectorate, a system of registration is being implemented to replace the previous practice of notification and in partnership with others, because we do not have sole responsibility here, the emphasis is on child development as well as ensuring a safe environment.
For adoption services, which we now run on a national basis, within the limited resources, we are making progress on the difficult backlogs of information and tracing and record management.
There has been considerable progress in special care and, as befits a multidisciplinary agency, evidence of that is included, as appendix VI of the presentation, following the newly released junior and leaving certificate results achieved by some of Ireland's most vulnerable children. These are at-risk children who have been taken into our care on a secure basis because of the way in which they were leading their life. Through careful nurture and partnership work with education, they have achieved junior certificate results and, perhaps more importantly, leave care with a good attitude to education and learning. Nearly 98% of six to 16 year old children in care and nearly 90% of 17 year old children in care are in full-time education; both figures represent an increase. An extremely impressive 60% of young people who have left care are in full-time third level education. Some 56%, or 474, of young persons over 18 years are still living in State-sponsored and commissioned arrangements with their excellent foster carers. The equivalent figure in England, where care arrangements stop at age 16, is 3%. Further development is required to build on this strength, finalising national aftercare standards, foster care support and commissioning arrangements.
In the face of a dynamic and well-planned reform agenda, there are four particular challenges that inhibit the more effective development of Ireland's aspiration for a full range of services for children. The first is a sustainable budget. Current budget pressures prevent staffing services reaching full complement and that inhibits service effectiveness despite strong and effective arrangements to prioritise the most important and the most urgent. Any analysis of HIQA and Ombudsman reports note that the concerns relate to resource or recruitment deficits. My point in raising this is that all budgets have consequences. We will deliver services for the taxpayer for the resource available.
Cost-effective support in partnership with HSE is also important. Tusla would support going further than merely shared services, but to the development of an internal market, so that services relating to finance, HR, estates, ICT and other support are provided on a cost-effective basis and are responsive to a different range of customers. As reform is completed, Tusla, the community health trusts, hospital trusts and others should each have a shareholding in support services and a monetary value should be given to each shareholding with a view to enhancing the customer experience. For Tusla, a relatively small State body compared with the HSE, to have a shared service only with the HSE is not a balanced partnership and is difficult to operate.
There can be little doubt that the current time and money spent on legal matters is neither sustainable nor in children's and parents' best interests. Tusla has embarked on a comprehensive and ongoing process of reform. Significant attention has been given to increasing our credibility in providing evidence and enable effective and timely judicial decisions. Training has been increased and new court reporting forms for social work colleagues introduced.
There is detailed oversight of legal budgets since we took it over on 1 January, with a significant reduction in those authorised to engage legal services. Further reforms are required to move towards greater use of mediation, reform of the important guardian ad litemsystem and a further review of the way in which we use legal services.
We need to see regulation and registration for the guardians ad litem.

The practice of representation of guardians ad litemat both solicitor and counsel level raises questions regarding the use of legal representation in court by expert witnesses who are there to support the court's work.
There is a need to development mediation services and processes. Increasingly legalistic proceedings at District Court level can result in significant delays as points of law are considered. Repeated short-term care orders are not conducive to providing stability for children. Often, paradoxically, they are not fair to parents.
From my experience, having worked in children's services in three jurisdictions, services for children are all too often organised within lines of professional demarcation rather than the needs of children. This is not in the best interests of children. Children’s education, health and welfare needs are intensely inter-related. Consequently, effective multi-agency work is crucial and requires scrutiny, support and insistence.
The common theme in all of the serious case reviews of the past ten years has been a lack of joined-up strategy and integrated implementation. There is a new joint protocol between key HSE services, primary care, services for children affected by disability and mental health issues and the Child and Family Agency. This protocol needs to be strengthened and great care must be taken to ensure that parallel reforms remain complementary. If reforms are not synchronised, there is a danger of reinforcing significant service gaps. In such territory, tragedy can occur.
I was going to leave a blank conclusion, because I felt that was more a matter for the committee, but I will add this. We are realistic and recognise that the pace of reform has been inhibited by the dictates of austerity. The fragility of the agency, having been born in such difficult circumstances, is a consequence of its establishment at a time of severe restrictions on the public purse. Despite all the pressures, there is enthusiasm, commitment and initiative. There is a plan.Staff deserve great credit for what has been achieved and I thank the Chairman for his opening remarks in that regard. The issue now is to complete the task, support the commitment and ensure that reform is consolidated and sustained.