Dáil debates

Tuesday, 14 February 2012

Priority Questions

Health Service Staff

2:00 pm

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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Question 58: To ask the Minister for Children and Youth Affairs the number of additional social workers in place at the end of 2011 compared with the start of 2011; if there is a plan in place to deal with public sector retirements affecting social workers; if she will publish the plan; and if she will make a statement on the matter. [8297/12]

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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Question 60: To ask the Minister for Children and Youth Affairs the number of social workers that have retired or are due to retire at the end of February under the recent public sector retirement scheme; the total number of social workers that will then be in the State; and the way this number will enable her to fully resource the services needed to put the Children First guidelines on a statutory footing. [8083/12]

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 62: To ask the Minister for Children and Youth Affairs the number of social workers and employees in the Health Service Executive run residential care homes who will have retired by the end of February; her plans to replace these workers; and if she will make a statement on the matter. [8502/12]

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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I propose to take Questions Nos. 58, 60 and 62 together.

The Health Service Executive, HSE, compiles a monthly census of employment in the public health and social care sector. The latest data available is in respect of December 2011. It shows the total number of social workers employed in the HSE and in directly funded agencies at that time was 2,442 whole time equivalents, WTEs. The equivalent number for end 2010 was 2,432 WTEs, an increase of ten. The figure for the end of 2009 was 2,189. The figures indicate an increase of 253 WTEs over the period 2009 to 2011. These figures relate to all social workers employed, including in child welfare and protection services, mental health services and other health care settings including acute hospitals.

The HSE has also begun to compile a breakdown of staff working in particular care groups. It should be noted the classification of staff by care group is considered by the HSE and the Department to be provisional since the methodology is being refined and work is ongoing on the precise allocation of staff to the children and families area in the context of the planned establishment of the child and family support agency. Notwithstanding these caveats, the number of social workers employed in the children and families area increased by 37, or from 1,183 to 1,220, between December 2010 and December 2011. This information shows that the growth in social workers in the HSE last year is attributable to the increased numbers provided for child welfare and protection purposes. Provision was made for the recruitment of an additional 62 social workers to children and family services in 2011. The recruitment process in respect of these posts was completed in late 2011 and all posts have either been filled or accepted. I understand from the HSE that not all of the additional staff are reflected in the latest employment census returns owing to the time lag between candidates being offered positions and serving out notice with existing employers, and taking up duty and appearing in the employment census returns. To date some 25 individuals have taken up duty and others are due to come on stream in the coming weeks. In addition to recruitment for additional posts, typically in any year there are departures of social workers and other professionals when staff who are eligible to retire do so. However, the ending of the pension reduction grace period is contributing to a greater concentration of such retirements. The HSE's national service plan for this year acknowledged the uncertainty regarding the effect of individual retirement decisions and committed to detailed planning to proactively manage the impact on different services. Management preparation for these departures falls in the first instance to local managers and subsequently to HSE managers at regional and national level. Tonight the Cabinet sub-committee on health will be discussing a report on these changes and the work that is being done to manage them. In order to further strengthen management arrangements a formal transition team for the HSE has been established at national level. The Government and the Cabinet committee on health have also received direct briefings on the subject from the HSE.

My Department receives ongoing updates from the national director of children and families services, Gordon Jeyes, and his team. The latest information from the HSE indicates that approximately 45 social workers in children and family services have given notice of retirement. This figure is, of course, subject to change between now and the end of February and is being updated on an ongoing basis. The emerging position on residential care homes is that there will be minimal retirement of social care workers. This is influenced by the relatively young age profile of staff in these homes. The situation will be confirmed as we reach the end of February and I will write to Deputy Ó Caoláin if there is any change in the position.

The number of social workers retiring represents 3.7% of the overall number of social workers. In any given year a 1% to 2% turnover of staff would be expected. The immediate management of departures will draw upon the local flexibility available under the Croke Park agreement and the discretion available to the national director of children and families services to fill priority vacancies now and over the course of the year. In deploying available staff and filling vacancies, regard will be had to the relative workloads among social work teams and existing vacancies where they are a factor. The provision of additional social workers on foot of the Ryan report represents a significant staffing increase by any measure. It is important that decisions on the ongoing and flexible deployment of this increased total staffing resource are informed by the most up-to-date assessment of workloads and by flexibility on the part of staff in responding to priorities.

Additional information not given on the floor of the House.

My Department is informed that the contingency arrangements in place at local and regional level will provide for redeployment within and across social work teams to areas of greatest need, priority focus on child protection, delivery of an accessible system for managing referrals and restructuring and consolidation of specialist teams such as fostering or adoption, having regard to the potential to expand their geographic remit and respond to reductions in demand.

Since decisions on the filling of vacancies must have regard to the need to meet budgetary targets it is important to note that the Government has increased the HSE's children and families budget by €21 million or 4% this year. The HSE national service plan also provides for an increase in the total number of staff employed in children and family services compared to last year. This contrasts with a reduction of €14 million or 2.3% in the budgetary provision for children and families in 2011 under the previous Government. It reflects the determination by Government to lead the improvement of child welfare and protection services. It provides significant additional flexibility in managing service pressures and reforming services to make them more effective. Notwithstanding the additional financial provision made by the Government, I do not wish to minimise the financial and service challenges facing the HSE in 2012. The financial difficulties facing the country are such as to require acceleration of reform across all areas of the public service. Reform is a central element of the change programme for child and family services, including the establishment of a new and dedicated children and family support agency. However, the Government's delivery of an increased budget for child welfare and protection services at a time of financial reductions generally is testament to our commitment to resourcing the comprehensive reform process which is underway.

The consistent implementation of the Children First guidance, which I launched last year, across all sectors working with children is a high priority for the Government. In this context I have established an interdepartmental committee to oversee progress in implementing the guidance across the Government. The revised guidance, together with the introduction of legislation, are designed to heighten societal awareness of the importance of safeguarding children. One of the key challenges for the HSE is the need to ensure that its services are rebalanced with an emphasis on primary prevention and family support for child welfare cases and interventions, including assessment of current risk, where child protection concerns are evident.

The HSE, as the statutory body responsible for promoting the welfare of children, already has in place a network of personnel to provide training, information and advice on the implementation of Children First. The HSE is currently providing a programme of information and training on the new guidance across the country. This includes the publication of its child protection and welfare practice handbook. A recent audit of Children First implementation has found that as of December 2011, 94% of all social workers have received and were aware of the new guidance and practice requirements. Children First is not new policy; it has been in place for over ten years and has guided the practice of those working with children over the period. In the case of the HSE and An Garda Síochána, the two statutory agencies with particular responsibilities for the assessment and investigation of child welfare and protection concerns, Children First forms an integral part of their existing operations and practices. In addition, the significant increase in the number of social workers since 2009 is of considerable assistance to the HSE in driving forward the process of implementation. I do not anticipate that the retirements this month will materially affect the capacity of the HSE to implement the Children First guidance when it is placed on a statutory footing.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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I remind the Minister of comments she made while in opposition. On 4 November 2009 she stated in the Seanad:

It is, therefore, disturbing to read about the report from the HSE in The Irish Times today that the number of children in care who have a social worker has fallen by 7% this year. It makes a mockery of the recommendations made in the Ryan report if we do not have these services in place to deal with children in need of protection and care.

Since she came to office I have asked the Minister about the recruitment of social workers on a number of occasions. In November 2011 she said: "It is quite an achievement on the part of the HSE to have delivered 200 social workers, with 60 to be in place by the end of December and a further ten in January." On 17 November the Minister advised me that by end of 2011 an additional 60 social workers would be in place, all of which would be new and extra posts.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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A question, please.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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The Minister is now telling me that what was in place at the end of last year was ten more than were in place at the start of the year. Although in opposition in 2009 the Minister claimed it was a mockery not to implement the recommendations of the Ryan report, she failed to have those 60 social workers by the end of last year. In addition, 71 social workers are retiring under the HSE retirement programme. The Minister is now saying that it will be up to the HSE national director of children and family services, Gordon Jeyes, to decide which of those should be replaced.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I must call the Minister and will come back to the Deputy.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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That is not good enough. What is the transition team doing and when was it appointed? What is the status of the Minister's commitment to appoint a further ten social workers in January? Where will she find the additional 71? Of the 60 social workers supposed to be in place by the end of last year, how many are in place-----

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I call the Minister

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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-----as opposed to being in some form of negotiation of contract?

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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The Ryan report recommended an additional 270 workers. The agreement was that 260 would have been recruited by the end of last year. I am very pleased to say that I have lived up to that commitment. We have 260 social workers recruited, with another ten due to be recruited this year. That is what the implementation group has been working on and is what the Ryan report stated we needed. That has been agreed. I believe the Deputy came into the House a number of times and said we had gone backwards in terms of social worker numbers - we have not. He also doubted whether the budget would be in place for the 60 social workers. The budget has been agreed. The additional 60 social workers, at a very difficult time, have been recruited. The Ryan report recommendation has been met in full. Some 25 of those 60 social workers have already taken up their jobs. The rest, as the Deputy will understand, are giving in notice and have said they will join in coming weeks. It is very fortunate that I got the funding to recruit those 60 social workers because as the Deputy says, approximately 45 social workers representing 3.7% of the complement have indicated that they will retire. I have looked at where those individuals are and I am pleased that they are spread around the country and not in any one particular place. For example, 13 are in HSE south, eight in HSE Dublin north-east and so forth. I can give the Deputy those numbers if he would like to have them.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I call Deputy Boyd Barrett and then Deputy Ó Caoláin. Three questions are being taken together.

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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It is difficult to get my head around the answer the Minister has given. If I understand her correctly, at the beginning of last year, there were 2,342 social workers and at the end of 2011 there were ten more. That is a net increase of ten but 71 will retire at the end of February, representing a reduction in the number of social workers. I am unsure whether the 60 that have been recruited and to which the Minister referred are in addition to the final 2010 figure.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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Yes.

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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Okay. If one adds the increase of ten to the 60, that makes 70. However, with 71 to retire in February, that is a net decrease of one social worker. How on earth can the Minister claim this is meeting the recommendations of the Ryan report? More important, how can this possibly provide the required social work resources to meet the Children First guidelines which the Minister has committed to putting on a statutory footing? Peter McVerry has said that to bring us up to the number of social workers in Northern Ireland, which is by no means a beacon in this regard, we would need an extra 1,200 social workers. There seems to be no movement at all under the Minister's watch in terms of the net number of social workers available, although we need more.

Is there some massaging of the figures going on in terms of moving social workers from primary care teams and community preventative programmes into child protection? This seems utterly self-defeating and, ultimately, it will be more costly. Preventative social work should not lose out at the expense of social work further down the line. Clearly, prevention is even better than dealing with problems when they emerge.

There has been a failure to provide extra social work resources but we do not simply need more social workers. Once assessments are carried out we need a range of other resources which do not seem to be provided for in the budget in any way, including child care workers, family support workers, psychologists, occupational therapists and speech and language therapists. Where are the budget commitments to provide these resources? They will be necessary to put substance to the Children First guidelines and the Minister has stated she will put them on a statutory footing.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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I reject Deputy Boyd Barrett's interpretation and I will give my reasons. For a start, there were 37 extra social workers working in child and family services during 2011. An additional 60 social workers have been recruited. As Minister I have ensured that the monetary provision for child and family services went up by €21 million or 4% this year compared to the previous budget. The previous Government reduced funding in this area by €14 million. I succeeded in maintaining the funding in a difficult situation and secured an increase of €21 million or 4%. I reject what Deputy Boyd Barrett stated about there being fewer resources in this area.

Clearly, the situation regarding the recruitment of social workers and how they are deployed has been impacted by the difficult financial situation in which the HSE finds itself. I have stated again and again that the legacy I have inherited is completely unsatisfactory as is the way social work services have been run within the HSE. It is so unsatisfactory that I cannot compare work with like work throughout the country because the data has not been collected for previous years. The legacy is a complete failure to manage these services in the way they should have been managed and a failure to give the data we need to plan for them properly. However, this is being dealt with and this is why there is a strong programme of reform in this area, led by Gordon Jeyes, with a focus on priority cases coming to the duty teams. This is being managed by him and his team. We are gathering more data so that we can plan better. Just as important, we are reforming these services so that we will deliver them in a new place away from the HSE in a new child and family support agency.

This is a challenging environment. I agree with what Deputy Boyd Barrett says about the challenging environment and the numbers of families who find themselves under pressure. Issues of drug and alcohol addiction are seriously impacting on families and there is an increase in the number of children coming into care because of these problems.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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There is more than anecdotal evidence that social workers across the child care area are hugely challenged by the volume of cases and information presenting. This is something we must recognise, not only in terms of the current situation but in terms of the situation likely to present following the enactment of various legislation to which the Minister and the Government are committed, which will require human resourcing in order to address the issues properly. Has the Minister had the opportunity to address her concerns with regard to the need evidenced on the ground with the Minister for Public Expenditure and Reform, Deputy Brendan Howlin? Has she taken the opportunity to engage with him and to outline the importance of addressing this issue?

The Minister mentioned that a small number, in terms of the number of social workers and employees across the HSE-run residential care homes, are due to leave. She is not able to give me the precise information today but has promised to forward it in the future. Why is the HSE unable to give us that information at this time? The Minister was able to tell us that 45 social workers are to go from children and family services, 3.7% of the number of social workers, and I presume these are these are from outside of the residential setting. Why is the information on the residential setting not available to us? The numbers the Minister has flagged in her response are not a response to the exodus by retirees. Has she a contingency plan in place in her Department to address this further exodus of workers before the end of this month?

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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I have asked for the information with regard to the residential care settings and the information to date is that one person who is not on the care side is leaving that sector. That is the information to date. If this changes in the coming weeks, I will communicate directly with the Deputy on it. Based on the current figures, only one person is retiring. I believe this is largely influenced by the age profile of the workforce in residential care, which tends to be younger. This is encouraging with regard to the challenges in that area.

The Deputy raised the broader point of the demands in this area. Of course, I have had discussions with the Minister for Expenditure and Reform, particularly before and after the budget. The Government is very aware of the challenges. In meeting those challenges, we must also look at reform and at how we have been delivering some of the services. I have already outlined the plans to establish the new child and family service support agency. We must also look at areas like those raised by the Deputy. For example, we should look at how the guardian ad litem service is being run. This was included in legislation without a management plan and without clear criteria. It has developed in an ad hoc manner and needs to be examined. The cost of residential care and how it is provided must be examined and work is under way on that.

We cannot just say that more money will solve the issues. I accept resources are important to meet the needs of children and families but we must also look at reforming certain areas that cost significant money and look at the priorities in the different areas. We must also look to the voluntary sector providing child and family support services and must examine how this sector engages with the HSE in meeting the priorities as they present. I assure the Deputy that is being done within the HSE. The situation is challenging and the issues will not be solved over night. However, the Department, the HSE and the new agency will address the issues raised by the Deputy. This is a demanding time in terms of the demands on the services, given the legacy and the work that has not been done in a range of areas.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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May I put a brief supplementary question?

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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We are running over time, but I will allow each of the Deputies put a brief supplementary question.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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To recap, the Minister stated today that the 60 social workers who the Dáil was told last year were to be recruited as part of the Ryan report recommendations were not required as the levels recommended by the report had been reached because the Minister would go back as far as 2009. That begs the question of what was the point of recruiting those social workers in the first place. They were being recruited to bring compliance with the Ryan report recommendations but only ten were in place by the end of last year. That is totally inconsistent with the Minister's approach of letting social workers retire from the HSE.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Thank you, Deputy.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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I was very disappointed to hear the Minister minimising the impact of those retirements by saying they would be spread across the country.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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This is Question Time.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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At the same time we are supposed to be putting an effort into raising the numbers.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Thank you. I call Deputy Boyd Barrett.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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The Minister has not responded on how those places will be filled.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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She will be given an opportunity to do so. We are way over time on this question.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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I would like an answer.

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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Will the Minister clarify that under her watch, after retirements at the end of February, we are talking about a net increase of one social worker, according to her figures? This is against a background of children waiting 18 months for psychological assessment or six months to have hearing assessed, for example. In order to implement the Children First guidelines, we are going to need many more resources. Is it the case that the delay in putting the Children First guidelines on a statutory footing results from the Minister's awareness of "challenging circumstances" or "legacy issues" meaning that resources are not being put in? Therefore, the Government and the Minister could end up exposed to legal action if the guidelines are put on a statutory footing but we fail to put in place the necessary resources to implement them. Is that the reason for the delay?

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I have just one point. In the Minister's first response to this group of questions, she used the term "fortunately, not all in the one place" in referring to the exodus of personnel.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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Yes.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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That would worry me, although I can see how the Minister might look at it. Where is the fortunate aspect unless there is an intent not to ensure replacement? If these personnel were in one or a small number of locations, it would create an immediate crisis. Will the Minister assure us on the floor of the House that because these personnel are going in ones and twos in a range of areas across the country, it will not afford her an opportunity to ignore the need for replacement, given the enormity of the workload that each and every one of these social workers must take?

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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Deputy McConalogue seems almost disappointed that funding has been put in place for the 60 social workers who have been recruited and are ready to start. I do not understand the Deputy's point.

Photo of Charlie McConalogueCharlie McConalogue (Donegal North East, Fianna Fail)
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I am disappointed they are not in place.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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The 262 people have been recruited, with the vast majority of them in place. A number of them are due to begin work in the next couple of weeks. I will provide the child and family social work numbers for Deputy Boyd Barrett. It is important to maintain numbers in the current climate, as the Deputy will appreciate. In 2010 there were 1,183 workers and in 2011 there were 1,220 - an increase of 37 on the previous year in child and family services. That does not take account of those in the batch of 60 who will start. I have given the following statistics before but total social worker numbers have gone from 2,189 in 2009 to 2,431 in 2010 to 2,441 in 2011.

The point was made as to whether social workers were moving from different areas but that decision must be made at a management level. I will give an example regarding adoption, where there is less demand and fewer people to be assessed. A number of social workers were involved in that process and some must move from that area to deal with highly pressurised areas, including child protection. There will have to be redeployment and flexibilities under the Croke Park agreement must be utilised in order to meet the challenges.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It will not be from community services.

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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That is a management decision locally. It relates to how to best use the resources that are there. I agree that community social worker and social workers in primary care are very important as well. At a time of huge demands in the child protection area, it is clear that we have to make decisions. Local managers are making decisions about the best use of the social workers who are in place.

I would like to make a point about the implementation of Children First. The guidelines have been in place for ten years. People are respecting them. By the end of December 2011, some 94% of social workers had been involved in discussions and training about the new Children First guidelines. The HSE is coping with the referrals that are being made, albeit in a very difficult environment of increased pressures. Clearly, I would like more resources to be devoted to this area. I am pleased to have managed to get the kind of increase I have secured. Unquestionably, many demands are being made on the services at present. These guidelines have been in place for some time. People have been working towards them for ten years. I do not doubt that those who are concerned about a child who needs care and protection, or who genuinely and in good faith feel that a child could be sexually or physically abused or neglected, are making referrals at the moment. It is about managing the resources that are available as best we can. As the economic situation improves, we will have to ensure more resources are devoted to this area. In the meantime, we have to reform the services as well.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I asked the Minister about her use of the word "fortunately". Will she respond to my worries and concerns that she will not actually follow this-----

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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I think the point I was making was clear. I was saying that 45 people were not leaving from a particular part of the service. It was in that context that I used the word in question. The local managers in each area will deal proportionately with the numbers that have left from that area and will come up with the necessary plans to deal with the situation.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Will they all be replaced?

Photo of Frances FitzgeraldFrances Fitzgerald (Dublin Mid West, Fine Gael)
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Where it is a priority for them to be replaced, that decision will be made by the local and regional management. Ultimately, it will be a matter for the director, Gordon Jeyes. It will depend on the resources that are available.