Frances Fitzgerald (Dublin Mid West, Fine Gael) | Oireachtas source

I welcome the publication by the HSE of the report entitled A Review of Practice and Audit of the Management of Cases of Neglect. The report was received by the Department of Children and Youth Affairs in May 2013 and was published on the HSE website two weeks ago.

The report follows the publication in October 2010 of the report of the Roscommon child care inquiry, which catalogued a number of concerns arising from the examination of the management of serious neglect in a family known to the HSE's child protection services. The findings of that inquiry raised the concern, as Deputy Naughten well knows, that this might not have been an isolated case and that there might be more widespread practice and governance issues in the management of cases of neglect in Roscommon and throughout the country. That report led to work on a national audit of neglect cases.

From the outset, it was the intention of the HSE that the neglect audit would comprise a number of phases. Therefore, the audit was not simply a one-off exercise, but constituted one element of a wider process to improve practice in respect of such cases throughout the country. For phase 1, which is the report in question, the HSE commissioned the services of Ms Lynne Peyton, an independent consultant in child protection, to complete an initial pilot audit of the Roscommon case. This pilot was extended to two other areas, those being, Waterford and Dublin south-east, was conducted in early 2012 and was worked on subsequent to completion. Since completion, the report has acted as an important working document informing preparations for the second and third parts of the process, namely, the workshops and training for staff and the national audit of neglect files that will follow on from this.

Last August, the attention of HSE social work staff was drawn to the ongoing and systemic impact of neglect as identified in the three audits. I welcome the report, from which we see that, in practice, neglect and the terrible damage that it can do to children has not been sufficiently identified. Given the fact that physical and sexual abuse cases have been responded to quickly, it may be a broader societal issue that neglect has not been taken as seriously. The Roscommon case has sensitised us to the situation, as has this initial audit. We need to do the rest of the work. An implementation plan to address the report's recommendations has been developed. I have details of that plan.

The report is well worth reading in detail, as it identifies improvements, changes in practice and instances of more attention being paid to neglect. It is important that these aspects are recognised. I will provide a number of examples of some of the changes that have occurred. In Roscommon, there have been developments with respect to the implementation of monthly child care meetings chaired by the general manager, a restructuring of social work teams and the streamlining of family support services to include a single point of entry for referrals. This is important. In addition, more than 50 staff in all of the relevant disciplines - Deputy Naughten mentioned psychology - have participated in training on the identification of neglect. One of the points the report repeatedly made was that it was critical for all disciplines - doctors, social workers and public health nurses - to take neglect more seriously than had been the case traditionally and to realise the damage that it does to children.

In Dublin south east the social work department has been restructured and the new arrangements are working more effectively. There has been a blitz on the waiting list there and unallocated cases have been significantly reduced. There are quite a number of other points concerning each area, which are identified in the report. I want to reassure both Deputies that there has been a follow-up implementation plan.

The audit found that parental alcohol misuse was a factor in 62% of families in the overall sample. It states that family dysfunction, which ended up with the kind of neglect that both Deputies have described so graphically, was often associated with chronic alcohol and drug abuse. The audit also found that domestic violence was a key issue, parental mental health issues featured in two thirds of the Dublin cases, and standards of hygiene and physical conditions were unacceptable in more than half the cases.

There is a need to identify neglect at an earlier stage and intervene more effectively. The report makes the point that many children were left in family settings for too long. That is a similar finding to the report on child deaths. The new national approach to managing social work cases involves more streamlined procedures, a national risk-assessment and national standards. It will make a huge difference to the disturbing findings that were outlined in this report.

In addition, we are currently undertaking the recruitment of new social workers. Some 84 were recruited recently and the recruitment of a further 90 is under way.

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