Dáil debates

Thursday, 17 April 2008

Hospital Services

Child Protection Issues.

5:00 pm

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
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I thank the Acting Chairman for the opportunity to raise this issue. In the brief time available, I will only be able to touch on some of the issues that arise out of the publication of what is known as the McElwee review report. It is a damning indictment of Departments and State agencies in respect of their abysmal failure to comply with the Children First guidelines, which were specifically put in place to provide protection for children.

It is clear that there is no point in making a contribution if the Minister of State is not even listening to me. I am sure he has a prepared script for response but this procedure becomes even more futile if he is not listening. With the chance that he might reply to something I raise, I will continue.

A litany of failure has been set out in this report, which is one of many we have seen which illustrate the incapacity of the State and its agencies to ensure that the guidelines it put in place for child protection are properly complied with. We require explanations that are not provided by this report.

I will refer briefly to some matters contained in the report. It is clear that at an early stage the central authority for mutual assistance in criminal matters, based in the Department of Justice, Equality and Law Reform, received correspondence from the Dutch authorities informing it that Dr. A "sexually harassed American girls, two of them being 18 years old and one of them being 16 years old" in Amsterdam. An inquiry was made of the Department as to whether a prosecution could take place in Ireland. That was referred to the Director of Public Prosecutions who said it could not. Subsequently, the same section in the Department was requested in August 2005 to serve a summons on Dr. A for a court session that took place on 13 September 2005. Those court proceedings resulted in his conviction for a sexual offence.

It seems that although this was an Irish national who was engaged in sensitive work and indeed was undertaking research into child protection issues, it never occurred to the Minister for Justice, Equality and Law Reform, any official in his Department or any official who had received the original letter or the request to serve the summons to inquire into the outcome of that prosecution. The Department of Justice, Equality and Law Reform explains its failure to communicate anything to anybody after 2005 on the basis that it was not made aware of any detail of the conviction. There should be an obligation on the Department to inquire into the detail of the conviction and what occurred. If the Department had applied the Children First guidelines, it would have been required to ensure that if Dr. A was working in a position dealing with children, proper information was furnished. I want an explanation for the failure on the part of the Department and an assurance that in similar circumstances it will not behave similarly.

We then have what can only be described as a damning indictment of the Midland Health Board and the HSE midland area. The HSE midland area and the health board are the bodies which are primarily responsible for child protection. They have a statutory duty to protect children's welfare. At a very early stage in 2004, a top official in that health board was advised of the allegations made against Dr. A. Indeed, the outcome of the summons and the conviction were made known to him. Yet, incredibly, that health board continued to commission work from Dr. A into child protection issues and, amazingly, in the context of publishing one report, subsequently had the Minister of State at the Department of Community, Rural and Gaeltacht Affairs, Deputy Noel Ahern, present, presumably to give the Government imprimatur to his piece of research.

The report concludes:

Having regard to all of the facts available in respect of Dr. A's behaviour in Amsterdam in June 2004, the absence of any recorded risk assessment in respect of Dr. A, and the absence of any recorded "closure"of the Amsterdam incident for the Midland Health Board, it is inconceivable that an Officer of the Health Board would continue to make decisions to fund various projects involving Dr. A, particularly where they would involve young persons. The fact that at least one of those arrangements, incomplete and apparently entitled the Youth Resilience Project, was with Dr. A in a private capacity, and secured outside of any evident tendering or procurement procedures, raises serious concerns and requires further separate inquiry through the HSE's Internal Audit System.

It raises more than that. This reports lists a litany of failures on behalf of a number of officials of the Midland Health Board and the HSE. No one is held accountable for anything. I want to know whether anyone has resigned and whether the official known anonymously and euphemistically as MHB 1, who was at the centre of everything that occurred in the context of the total failure to abide by the Children First guidelines and the continued commissioning of Dr. A, despite information indicating that he was inappropriate to undertake research, is currently working in the HSE, in what capacity and whether his or her work has anything to do with children. Has he or she resigned?

The problem with this report is that it contains a litany of failure and the anonymity of departmental, health board and HSE officials is preserved. No one is held accountable. The truth is that no one, including this Government, cares. I ask the Minister to ensure that those issues are followed up and that the recommendation contained in this report that the Children First guidelines be given a statutory base be put in place. The report itself complains that where the guidelines are breached, there are no consequences. There should be consequences.

Those working in these areas need proper training to ensure they adhere to guidelines the Government put in place to protect children. What training is currently taking place to ensure that people in positions of management in the HSE, the Departments of Justice, Equality and Law Reform, Education and Science, Health and Children and in other relevant Government agencies are not only aware of the Children First guidelines but understand their obligations to comply with them and are advised that there are consequences if they fail to do so?

Photo of Jimmy DevinsJimmy Devins (Sligo-North Leitrim, Fianna Fail)
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I thank Deputy Shatter for raising this issue and welcome the opportunity to respond on behalf of my colleague, Deputy Brendan Smith, Minister of State with responsibility for children, who is in Armagh at a North-South function and cannot attend the debate.

The Minister welcomes the publication by the Health Service Executive on 15 April 2008 of the review inquiry into child protection issues touching on or concerning Dr. A. When this issue came into the public domain in July 2007, the Minister instructed the HSE to carry out an immediate review of how the relevant authorities responded to an incident in Amsterdam involving Dr. A and his subsequent conviction in 2005. The Minister wishes to stress that the HSE report does not imply a general failure to operate the Children First guidelines across the public service, but only shows that in some instances the guidelines were not followed.

A key finding of the HSE review clearly states that Children First — the National Guidelines for the Protection and Welfare of Children, was not followed in at least some instances, once the situation concerning Dr. A's trip to Amsterdam came to light. The Minister welcomes the finding that if the guidelines had been followed, as stated in the report, then "timely and clear outcomes in a child protection context would have been achieved". This is a strong endorsement of the guidelines as they stand. The Minister believes, however, that lessons can be learned from this case. The review of Children First currently being undertaken by his office will carefully consider the recommendations of the report and take account of same in finalising the review, which is nearing completion. On the Minister's instruction a high level group has been established, comprising officials of the Office of the Minister for Children, the HSE, the Garda Síochána and the Departments of Justice, Equality and Law Reform and Education and Science. The group will meet as soon as possible to ensure that there is a fuller awareness of child protection policies, guidelines and procedures, and to explore how the current arrangements under Children First can be improved upon.

In the light of the publication of the review, there has been some commentary on the need to place Children First on a statutory basis. The Minister believes the conclusions of the review to be a clear vindication of the existing child protection guidelines. Co-operation between the HSE and State agencies has been improved upon since the incident in 2004. It can be argued that a statutory route could be problematic, as it might place extensive administrative burdens on relevant bodies and organisations and actually slow up the notification process.

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
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Complete nonsense.

Photo of Jimmy DevinsJimmy Devins (Sligo-North Leitrim, Fianna Fail)
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In some jurisdictions where a statutory arrangement is in place, there is anecdotal and indeed research evidence that such problems have been encountered.

Photo of Alan ShatterAlan Shatter (Dublin South, Fine Gael)
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Instead, the guidelines are entirely ignored.

Photo of Jimmy DevinsJimmy Devins (Sligo-North Leitrim, Fianna Fail)
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The consideration of putting the Children First guidelines on a statutory basis will be taken account of in the review which is nearing completion in the Office of the Minister for Children. This is a complex area which has been the subject of serious consideration by previous Ministers with responsibility for children. Any such decision could not be taken lightly as there is international evidence that such an approach has both positive and negative consequences associated with it. What is important now is to ensure that Children First, as it currently operates, is as effective and robust as possible in facilitating child protection.

Training and education, together with good recruitment and child protection policies in line with Children First, in all relevant agencies is most important in ensuring child protection, and the HSE has undertaken in its response to this report to address these issues, particularly training and education. The report has been referred to the HSE's human resources directorate to determine what, if any, implications there are under the HSE's human resources policies, and the Minister welcomes that. In addition to the meeting between the Office of the Minister for Children and relevant stakeholders, the finalisation of the review of Children First, which commenced after the Ferns Report, is an ideal opportunity to ensure that the guidelines are updated and improved as appropriate in the light of the Dr. A inquiry. It is important to note that the Children First guidelines, although not on a statutory basis, are Government approved guidelines which bring with them very clear responsibilities for those who become aware of child protection issues.

The Dáil adjourned at 5.25 p.m. until 2.30 p.m. on Tuesday, 22 April 2008.