Alan Shatter (Dublin South, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise the issue, which has been somewhat truncated from the original matter submitted. My concern is with children known to be at risk and notified to the health board or HSE as being at risk who have lost their lives or children who have lost their lives having already found their way into the care system. On 19 February I asked the Minister of State with responsibility for children to detail the number of children who have died in the past ten years and who had been notified as being at risk. I was astonished to discover that not only did the Minister of State not know the numbers who had died but also it appears the HSE had not even bothered to collate them. The reply stated:

I have asked the Health Service Executive to gather the information requested and to forward this information to the Deputy. The Health Service Executive has advised, that due to the length of the period covered by the question it will of necessity take some time to compile as material will have to be retrieved from the archives.

I would have thought that circumstances in which children lost their lives, having been reported to a health board or the HSE to be at risk would have been properly recorded and the background detail would have been known and properly investigated. That does not seem to have been the case.

Some days after I received the reply to that parliamentary question, Carl O'Brien, the social affairs correspondent of The Irish Times, reported that:

A total of 20 children who were placed in the care of the State have died over a six-year period, new figures show.

Five young people died from drug overdoses, two from traffic accidents, two from assaults and two from suicide according to the Health Service Executive.

Carl O'Brien's source of information is not revealed and this information was apparently leaked to him. Where children taken into our care system lose their lives it should not be a matter of secrecy as to the circumstances in which they lost their lives or as to what action if any could have been taken by a health authority to provide them with protection. We have an excessive amount of secrecy and a total lack of transparency.

To her credit, in April 2007, the Ombudsman for Children recommended to the then Minister for Health and Children, who also happens to be the current Minister, that consideration be given to the establishment of a mechanism to review systematically child deaths in the State. A year ago she held a seminar on the issue. Two years after the recommendation was made by her it seems absolutely nothing has been done despite a decision of the European Court which imposes an obligation on all states to ensure deaths of children — particularly those who should have been taken into care or who were in care — are properly and independently investigated. This requires a sufficient element of public scrutiny for the investigation of its results to ensure accountability.

We are in the extraordinary position of knowing the names of some children taken into care who have lost their lives. There was the tragic case of Tracey Fay in respect of which the HSE received an internal report towards the end of 2008. Tracey Fay died of a fatal drugs overdose in 2002. It apparently took six years for the HSE to receive a review of what had occurred. It is reported that the review found that instead of providing her with stable accommodation, a local health authority provided a "chaotic" response, including 20 different bed and breakfasts, hospital beds, a bench in an accident and emergency unit and two different dedicated services. I do not know whether Tracey Fay's life could have been saved. I do not know how adequate or otherwise the child care interventions were. However, I know that in a democracy it is entirely unacceptable that it took six years to produce this report and the report is apparently a State secret. It has been at least three months since the HSE received it and, for all I know, with the HSE late 2008 could be any time between September and December 2008. The Tracey Fay report has not been published. The same applies to the tragic death of David Foley, who was found dead in a flat off Blackhall Place in Dublin's north inner city on Saturday, 10 September 2005. Three years earlier, he entered the care system as a 14-year old child. David Foley, like Tracy Fay, was totally failed by our child care system.

Pat Gallagher (Donegal South West, Fianna Fail)
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The Deputy should conclude.

Alan Shatter (Dublin South, Fine Gael)
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Apparently, there is some report into the death of David Foley but we do not know what it contains because it is suppressed.

Pat Gallagher (Donegal South West, Fianna Fail)
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The Deputy should make his concluding remarks.

Alan Shatter (Dublin South, Fine Gael)
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It is hidden somewhere on the shelves of the HSE. I do not even know if the Minister has received it.

In conclusion, we should have an independent review of the system for all children who die in care or who die after the HSE has been notified they are at risk. We should have transparency. Reports should be published. We should learn the essential lessons from these deaths to ensure the mistakes made are not repeated and other children do not lose their lives.

Pat Gallagher (Donegal South West, Fianna Fail)
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The Deputy is eating into the Minister of State's time.

Alan Shatter (Dublin South, Fine Gael)
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Finally, we should ensure we comply with our obligations under the European Convention on Human Rights. We have had so many debates in this State about the right to life of the unborn.

Pat Gallagher (Donegal South West, Fianna Fail)
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Will the Deputy——

Alan Shatter (Dublin South, Fine Gael)
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The right to life of the born — children who are taken into care — is asserted in the Constitution and in that convention, and it should be respected.

Pat Gallagher (Donegal South West, Fianna Fail)
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The Minister of State has just four minutes.

John Moloney (Laois-Offaly, Fianna Fail)
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I am taking this matter on behalf of the Minister for Health and Children, Deputy Mary Harney, who unfortunately cannot be present to respond.

The Health Service Executive is required under the Child Care Act 1991 to promote the welfare of children who are not receiving adequate care and protection. Where a child requires care or protection that he or she is unlikely to receive unless the child is taken into care, the Health Service Executive must take the child into its care and provide the most appropriate form of alternative care for that child.

With regard to statistics, there are over 5,300 children in the care of the HSE. Over 92% of these children are placed with foster families, with the remaining children placed in residential settings. During the period 2000 to date, there was a total of 21 deaths of children in the care of the HSE. The causes of death were as follows: three deaths by suicide; two deaths by assault; two deaths by road traffic accident; five drug-related deaths; and nine deaths from medical issues.

In regard to the other statistics sought by Deputy Shatter, the Health Service Executive is in the process of compiling the information requested. The Deputy will appreciate that due to the length of the period covered by the request, it will, of necessity, take some time to compile as material will have to be retrieved from the archives. However, every effort will be made to gather the data requested and to submit it to the Deputy within a reasonable timeframe.

The death of any child in care is a serious matter and requires careful and detailed consideration. Prior to the establishment of the HSE in 2005, individual health boards had procedures in place for dealing with deaths of children in care. I understand that as part of an ongoing process of standardisation the HSE is currently reviewing its procedures for dealing with deaths of children in its care, and a high level group in the HSE has been delegated to oversee the development of standard protocols for this area.

The Office of the Minister for Children and Youth Affairs is in regular contact with the Health Service Executive in regard to the status of any reviews, inquiries or investigations which are currently being undertaken on individual cases. I can assure the Deputy that the Department of Health and Children is monitoring and will continue to monitor the implementation of any recommendations arising from such reviews and inquiries. The Department will also continue to raise these matters at the regular meetings held between senior officials of the Health Service Executive and the Office of the Minister for Children and Youth Affairs on child welfare and protection issues.

The Office of the Minister for Children and Youth Affairs is participating in an initiative undertaken by the Office of the Ombudsman for Children regarding the possible establishment in this country of a child death review mechanism. A high level seminar was hosted by the Office of the Ombudsman for Children in April 2008. The items considered at the seminar included current practice in Ireland, the objectives of child death review, child death review methodologies and operational considerations.

The Office of the Ombudsman for Children has also recently prepared a child death review options paper. As well as providing the background to the process to date, the paper outlines human rights considerations, options around individual reviews of child death and relevant research. The paper notes that "international experience differs on the relative value of individual case review as opposed to an approach to child death which examines broader trends at a demographic level". The paper goes on to state, "it may be that in certain instances child deaths do not give rise to wider systemic concerns and reviewing them will therefore not enhance our understanding of what makes children vulnerable". In its conclusions, the paper states that the impetus for the initiative stems from the belief that the establishment of a system would lead to a deeper understanding of the factors which render children vulnerable. I understand that the Ombudsman for Children has written to the Chairman of the Joint Committee on Health and Children to inform it of developments in this regard and intends to share the options paper and other documentation with it in the near future.

In conclusion, I reiterate the Government's commitment to address the crucial challenge of protecting the most vulnerable members of our society. When families fail children for whatever reason, the children must be protected by society and the State, which is a complex and difficult task.