Tommy Broughan (Dublin North East, Labour)
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To ask the Minister for Children and Youth Affairs in line with the requirements of the judgement in the case of Health Service Executive v WR (Neutral Citation (2007) IEHC 459) that the HSE would, among other things, undertake to conduct a process of identifying need for special care and high support by December 2007 and that it would produce a report on an annual basis in July of each year dealing with the manner in which the needs of young persons at risk were being fulfilled in the provision of these services, if annual reports of this kind have been published by the HSE; and if so, the locations at which copies may be obtained; and if such reports have not been published, the reasons for non-publication. [6996/13]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Special care involves the detention of a child for his or her own welfare and protection in a special care unit with on-site educational and therapeutic supports.

Special care units provide secure residential services to children and young people who are in need of specialised targeted intervention. Children are detained in special care if their behaviour is deemed to pose a risk to themselves. The detention by order of the High Court of a child in a special care unit is considered as a last resort and is intended to be for as short a time as possible. Such detention is resorted to when other forms of residential or community care are considered to be unsuitable. Special care units are inspected annually by HIQA pursuant to section 69 of the Child Care Act 1991 and the inspection reports are published. I note that I have just signed a letter for Deputy Thomas Broughan on a question he put down last week on the number of children who are receiving care abroad. He will receive the letter today.

The Deputy refers to the judgment in the case of Health Service Executive v. WR (2007) IEHC 459. I understand the judge in the case was complimentary of the HSE on the manner in which cases were being dealt with and the offer of the HSE to produce an annual report on these matters was not taken up by the court. I emphasise that since the delivery of that judgment, the ongoing procedures for dealing with special care applications to the High Court have evolved. All cases in which the inherent jurisdiction of the High Court has been invoked to effect special care placements are now listed for mention before the court on a monthly basis. Deputy Caoimhghín Ó Caoláin asked a priority question on this topic previously and I am happy to confirm to the House that there are no children on the waiting list currently. Any child in need of special care is receiving it. In circumstances in which each case comes before the High Court every month, the need for an annual report has been obviated.

The HSE produces an annual review-of-adequacy report pursuant to section 8 of the Child Care Act 1991. The report includes a particular chapter on special care. There is ongoing examination by both HIQA and the HSE. A great deal of work has been done by HIQA examining standards in the three special care units and there have been significant and necessary improvements in recent times.

Tommy Broughan (Dublin North East, Labour)
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I thank the Minister of State for her reply and the information she provided. What is the current capacity of Ballydowd, Gleann Alainn and Coovagh special care units? How many children can they cater for and how many staff do they have? While it is welcome that there is no waiting list and that the problems identified in 2007 by the High Court appear to have been ameliorated, how many children pass through the special care units each year? How many children passed through the units in 2011 and 2012 for example? I note Gordon Jeyes's point on the use of agency staff. The children in these units have very challenging behavioural issues and there was an issue in 2007 and onwards about agency staff. I note that Jennifer Hough in the Irish Examiner made a particular study of Gleann Alainn and reported publicly on a number of occasions about some of the things that had happened there. I have seen a recent estimate that there are approximately 104 staff across the three centres. Can we take it that agency staff are no longer used and that all staff are qualified?

The Minister of State referred to HSE v. WR and said that annual reports are provided by HIQA now. Is the Minister of State happy with that or would she have preferred that reports would have been compiled for the High Court?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I am satisfied with the HIQA standards inspection that takes place now. There are three designated special care units in the State which are operated by the HSE subject to a single national governance arrangement. As of this year, we have adopted a national governance approach to special care which was needed. There is a unit in Ballydowd in Dublin which has a capacity of ten beds and is fully occupied. There is another unit in Gleann Alainn in Cork with a capacity of four beds where three children are currently placed. The third unit is at Coovagh whose three beds are fully occupied.

Deputy Thomas Broughan asked about the numbers in special care, which is a very tiny proportion of all children in care. Approximately 0.4% of children in care are in special care which equated in 2011 to 38 children. These are children with very special needs who require careful therapeutic help. They return to the High Court every month for very careful supervision. Providing this type of special care for children with such special needs is very demanding. Deputy Thomas Broughan is right to point to the supports staff need. I am not in a position to answer him on the issue of agency staff today but can communicate with him on it.

Tommy Broughan (Dublin North East, Labour)
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Or unqualified staff.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I will revert to the Deputy on the staffing issues he raised. I do not have the information with me. HIQA has raised the issue of staff support in its inspection reports. The HSE has done a lot of work to ensure that staff have the support and supervision they need. Gordon Jeyes has led the national approach to special care and taken a particular interest in the matter to ensure that we move to greater consistency in standards. The issues identified in previous HIQA reports, which were serious, are being addressed. The most recent report I have on one of the centres shows that more and more of HIQA's recommendations are being implemented.

Tommy Broughan (Dublin North East, Labour)
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Is there more the Minister of State has to do to ensure that there is a substantive legislative basis in this area in addition to the Child Care (Amendment) Act 2011? Are the national special care admission and discharge criteria used by social workers to assess children known to the Minister of State and in the public domain? The Minister of State mentioned children who have been referred to special care units in Scotland and Sweden. Are there children who are abroad at the moment and what kind of resources has the State spent on their care? Did the Minister of State ask for additional resources in the 2013 budget to deal with the critical needs of these children?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I was pleased to be able to maintain the budget in the face of huge difficulties nationally. The budget for the new child and family support agency was slightly increased in fact. It was very important to have that stability.

There are approximately ten children receiving services abroad. This care tends to be very expensive as the Deputy knows. I have given him the details in reply to the question he asked. These are highly specialised placements for children with behavioural and sexual difficulties. The cost per month varies from €26,000 per month to $10,400 per month at the facility in Nebraska where one child is placed. We are still using some services abroad. I would like to examine whether we have the capacity to deliver these services domestically to the small number of children who need them. The services are not available currently. Under High Court supervision, the decision has been taken in relation to a small number of children to place them abroad.