Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 2: To ask the Minister for Children and Youth Affairs if her attention has been drawn to the recommendations set out in the most recent Health Information Quality Authority report of the Gleann Álainn Special Care Unit, County Cork; if she will publish an implementation plan for these recommendations; and the timeframe during which each of these recommendations will be fulfilled. [40760/11]

Charlie McConalogue (Donegal North East, Fianna Fail)
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Question 4: To ask the Minister for Children and Youth Affairs her plans for providing special care services for vulnerable children within the State in view of recent Health Information Quality Authority reports into the Gleann Álainn Special Care Unit and previous HIQA reports into Coovagh House and Ballydowd Special Care units; and if she will make a statement on the matter. [40763/11]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I propose to take Questions Nos. 2 and 4 together.

Young people in all care settings are deserving of the highest standard of care. Regrettably, this was not the case in Gleann Álainn. In view of the serious nature of the report, I have written to Mr. Gordon Jeyes, National Director of Children and Family Services, HSE, underlining my concerns as to the report's findings and asking him for details of the actions being taken immediately to ensure the standard of care in Gleann Álainn is improved to a safe and acceptable level in line with HIQA's recommendations.

I thank HIQA for its report. It was an unannounced inspection. I am very disturbed by the findings within the report. I have been informed that a range of measures are being taken to address the issues of concern highlighted by the inspection. An action plan has been developed to ensure that all issues identified are addressed. The Deputies will be pleased to hear that progress on the action plan is being measured on a daily basis and reported on fortnightly. Pending evidence of improvement in line with the action plan, the HSE has decided there will be no further admissions to Gleann Álainn. In addition, the HSE, at national level, is taking steps to improve overall management and governance of the special care unit and the high support services. This includes the important appointment, in recent months, of a national manager for the service. The HSE has also undertaken a review of the current model of care with reference to international best practice and the findings of this review will inform decisions on the future configuration of these services.

HIQA has indicated that it will carry out another full inspection of Gleann Álainn in January 2012. Progress on implementing the recommendations made will be assessed at that time and HIQA's findings will be communicated immediately to me. In fact, I have invited HIQA to come in as soon as that inspection has been completed to discuss with me the findings of the report following its return to Gleann Álainn in January. The ongoing work by HIQA is important in ensuring the provision of a high standard of care across the special care sector.

The HSE has a four-year plan to develop the national special care service. In January 2011, for the first time, the service came under a national director. From January 2012, there will be 20 places available nationally, with an additional 14 places to be added within the next period, bringing the total number to 34 places. The new places will be on the same campus as the two high support units - Monaghan and north Dublin. This plan will enable children detained in special care to move from a special care unit to a high support unit.

We have not really had such services and this is what is needed. If children are in special care, which is a particular sort of situation where their liberty is taken from them and where they need high support services, what is really important is that they are able to move on from those services to high support units and be reintegrated back into the community. That, certainly, is the plan in the future.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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As the two questions are being taken together, I presume the Leas-Cheann Comhairle is giving the additional time, including for the Minister.

Michael Kitt (Galway East, Fianna Fail)
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Indeed.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister's response was important and I hope we are not missing out on some of the detail.

I very much welcome the fact HIQA carried out this unannounced inspection in October last. I lay emphasis on the word "unannounced" because that is critical if we are to have the degree of oversight that is necessary to establish best standards and best practice in all situations.

I was disappointed with the HSE response which, in an effort to make excuses, stated that temporary management arrangements were place and that this had contributed to the situation in Gleann Álainn - an unfortunately named place in this situation. One must remember that the HIQA inspection was carried out within a week of reports being received on two of the residents having absconded having secured keys that belonged to one of the support staff. If that were a single incident, one might be able to wear the notion of temporary management arrangements, but there were 25 recorded incidents in the year preceding the inspection in October and a similar incident to that which gave rise to this unannounced inspection in October had taken place in September 2008. Had we temporary management arrangements in place then too? When does temporary management become an excuse? It is no excuse and no excuses are acceptable in this situation.

This is a facility that caters for up to seven girls. It is critical that we get it right in the interest of those girls who find themselves in this situation.

Michael Kitt (Galway East, Fianna Fail)
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I thank Deputy Ó Caoláin.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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In my question, I asked particularly if the Minister will publish an implementation plan. That is critically important. It is not only about the issues highlighted by HIQA and that there have been repeat abscondments. There are also reports that some of the girls in the facility fear others because of bullying and intimidation. The capacity to contend with difficult circumstances that present themselves will vary. At all times, we must be able to ensure that children in such circumstances can live without fear of any kind. I am particularly interested to know the Minister's plans and whether she will publish them.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I can only agree with most of the Deputy's points. What happened is unacceptable, as is the standard of management in the unit. However, the report found evidence of good relationships and warmth between the staff and children. The children told inspectors that their being placed in the unit was of benefit to them. They stated they had built positive relationships with individual members of the staff team. While we should not lose sight of that, we should certainly not underestimate in any way the seriousness of what has happened and the need to address it.

I have a lot of detail on the actions that are being taken to improve circumstances, including allowing for more immediate access to a psychologist for the children; very detailed management actions; new management in the centre; much more national oversight; the assignment of a senior manager to undertake the role of quality improvement and an implementation manager; reducing the number of young people being placed in the centre; and an independent review to investigate the incident with the keys and the absconding of the young people. Very detailed oversight is sought at present, which is absolutely correct.

If it helps the Deputy regarding the implementation plan, I will send him a detailed note on what is happening. When I receive the report from HIQA in January, I will be very happy to share it with the Deputies.

Charlie McConalogue (Donegal North East, Fianna Fail)
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Unfortunately, the events in the report by HIQA into Gleann Álainn are not isolated. The report is consistent with other HIQA reports into the State's other two special care units. Just last week, HIQA published the report on Gleann Álainn finding it in a state of crisis. HIQA declared Ballydowd special care unit unfit for purpose in 2009. The HSE committed to closing it down, yet it remains open due to the increase in the number of children requiring access to special care units over the past year. HIQA found that Coovagh House in Limerick was in a state of crisis. What is the position in the State's special care units? The position is stark and, unfortunately, is a very poor reflection on how the State is dealing with vulnerable children. The record has not been good.

As a result of the passage of the Child Care (Amendment) Bill earlier this year, it is likely that pressures on the special care units and the number of people needing to access them will increase. Has there been an assessment by the Department of the likely increase in numbers? While I totally understand the need to be able to move on to high support units, I believe there will always be, unfortunately, a requirement for strong special care units and an effective service. Does the Minister intend to continue sending children abroad to gain access to special care units and services? How many children will be in this category in the coming year? It is not acceptable.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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It is unfortunate that the previous Government neglected special care. There is a great deal of work to be done to address the deficits I have inherited; that is the reality. I am determined to address the deficits, however, because the needy group of young people in question deserves the very best the State can offer.

A recommendation was made to close the unit in Ballydowd. I visited the unit and the decision was reversed. Considerable improvements have been made in the unit, which currently has nine children. HIQA has inspected it recently and this will result in many improvements and good standards.

Gleann Álainn has five children. Therefore, 14 children are in the care of the State. That is the maximum number of places at present. We need approximately 34 places. There will be another five when Coovagh House reopens in January 2012. While there should not be a waiting list for special care, there is. This cannot be dealt with overnight.

A number of children are abroad in care placements. The number supplied to the Deputy previously, 31, is incorrect. The correct number, which I gave to the Deputy, was 15. This has risen to 17. Of those, eight are in a secure care placement under court order. The rest are in need of care.

The shortage of places in Ireland must be addressed, and I have outlined how this will be done. Some of the children in question require very specialist placement. We simply do not have the sorts of therapeutic inpatient units that some of the children need given their range of sexual, behavioural and developmental problems. This is being dealt with.

It is reported that many of the children are doing extremely well in their placements. Eight of the 17 children abroad are in secure care placements and the others are in care placements. The total is 17, not 31. There are 14 places in Ireland at present but there is a need for approximately 34. An assessment has been carried out and there is a national plan to move towards 34 places. I am working on that and will be paying special attention to ensuring we have those places for children in Ireland. There will probably be a need for some placements in the near future for children with very specialist needs whom we simply do not have the resources to cater for.

Unfortunately, over the past ten years of the Celtic tiger, inpatient facilities were not made available for young people with mental health difficulties. They should have been. We are witnessing the deficit in this area and it affects children negatively.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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May I ask another question on this important matter?

Michael Kitt (Galway East, Fianna Fail)
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We have greatly exceeded the time allowed.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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If the Deputy would like to communicate with me on the matter, I will respond to him.