Denis Naughten (Roscommon-South Leitrim, Independent)
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I thank the Minister for attending. As she recalls, she informed me at an Oireachtas committee meeting last July that the audit had been completed and that the report was being prepared, yet the report had been completed three months previously by the consultant, Ms Lynne Peyton. Frustratingly, Ms Peyton discussed the audit's conclusions at a conference in Belfast whereas it took 14 months for the HSE to publish the report.

Since 2005, there have been warnings about inadequate resources and calls for additional social workers in Roscommon to deal with child protection and neglect cases. It was a time of affluence and there appeared to be no shortage of money in some quarters, yet child protection referrals in Roscommon trebled between 2005 and 2009. The case in Waterford was roughly the same. The number of neglect cases increased fourfold, but it was 2010 before additional staff were recruited. At one point, Roscommon was said to be dangerously understaffed. In Castlerea, the staffing arrangement was described as unsafe. Social workers in Roscommon had an average caseload of approximately double the national recommended level at 35 versus 17.5. The National Standards Authority of Ireland, NSAI, threatened to withdraw registration unless staffing issues were addressed.

This situation was reflected to some extent in all three of the areas focused on in the report, showing a historical lack of suitably qualified social work staff and resources. In County Roscommon, 180 children have been on a waiting list for psychological services for two years. Nationally, the report highlighted inadequate provision of protection in the case of one in every five families in the neglect category. In County Roscommon, that figure was seven out of 30 families. Nationally, the audit identified 17 families as having been failed miserably by the State. It is important to remember that the audit only represents a small snapshot of the numbers throughout the country. That it took 20 to 30 referrals from a number of agencies for a social worker to be appointed is a damning indictment of the national services in terms of the level of priority they give to the issue of neglect.

Robert Troy (Longford-Westmeath, Fianna Fail)
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Unfortunately, we once again find ourselves discussing a report on the welfare of children and the inadequacy of the HSE's response. The most recent report cited cases in which up to 30 referrals had been made before the HSE took action. Is the Minister satisfied that a report that was finalised and given to the HSE in April 2012 took 14 months to be published? What happened to the promise of openness and transparency? Anyone listening to "Morning Ireland" yesterday would have had his or her confidence shattered. After five minutes of repeated questioning, a national specialist was unable to give an explanation for the delay in the report's publication.

Why was the report's publication delayed? When was the Minister made aware of the report's findings? I have continually raised the issue of the number of social workers, but the Minister has always maintained that she was satisfied with current levels. Given Ms Catherine Ghent's statement on RTE news yesterday that 17 social workers were looking after 670 cases, does the Minister remain satisfied?

The neglect of children continues to be a major concern despite being a common feature of previous reports, in particular the child death report. Have we learned nothing from these reports? What does it take for neglect to be recognised? HSE reports that clearly do not convey the severity of situations - words such as "dirty" and "unhygienic" do not adequately describe children with lice-ridden hair, beds saturated in urine, dog excrement on living room floors and mouldy food adhered to kitchen counters - are not good enough. It is a sickening and disgusting practice for a modern, progressive society. What immediate actions will the Minister take to renew confidence in a system that clearly continues to be deficient?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I welcome the publication by the HSE of the report entitled A Review of Practice and Audit of the Management of Cases of Neglect. The report was received by the Department of Children and Youth Affairs in May 2013 and was published on the HSE website two weeks ago.

The report follows the publication in October 2010 of the report of the Roscommon child care inquiry, which catalogued a number of concerns arising from the examination of the management of serious neglect in a family known to the HSE's child protection services. The findings of that inquiry raised the concern, as Deputy Naughten well knows, that this might not have been an isolated case and that there might be more widespread practice and governance issues in the management of cases of neglect in Roscommon and throughout the country. That report led to work on a national audit of neglect cases.

From the outset, it was the intention of the HSE that the neglect audit would comprise a number of phases. Therefore, the audit was not simply a one-off exercise, but constituted one element of a wider process to improve practice in respect of such cases throughout the country. For phase 1, which is the report in question, the HSE commissioned the services of Ms Lynne Peyton, an independent consultant in child protection, to complete an initial pilot audit of the Roscommon case. This pilot was extended to two other areas, those being, Waterford and Dublin south-east, was conducted in early 2012 and was worked on subsequent to completion. Since completion, the report has acted as an important working document informing preparations for the second and third parts of the process, namely, the workshops and training for staff and the national audit of neglect files that will follow on from this.

Last August, the attention of HSE social work staff was drawn to the ongoing and systemic impact of neglect as identified in the three audits. I welcome the report, from which we see that, in practice, neglect and the terrible damage that it can do to children has not been sufficiently identified. Given the fact that physical and sexual abuse cases have been responded to quickly, it may be a broader societal issue that neglect has not been taken as seriously. The Roscommon case has sensitised us to the situation, as has this initial audit. We need to do the rest of the work. An implementation plan to address the report's recommendations has been developed. I have details of that plan.

The report is well worth reading in detail, as it identifies improvements, changes in practice and instances of more attention being paid to neglect. It is important that these aspects are recognised. I will provide a number of examples of some of the changes that have occurred. In Roscommon, there have been developments with respect to the implementation of monthly child care meetings chaired by the general manager, a restructuring of social work teams and the streamlining of family support services to include a single point of entry for referrals. This is important. In addition, more than 50 staff in all of the relevant disciplines - Deputy Naughten mentioned psychology - have participated in training on the identification of neglect. One of the points the report repeatedly made was that it was critical for all disciplines - doctors, social workers and public health nurses - to take neglect more seriously than had been the case traditionally and to realise the damage that it does to children.

In Dublin south east the social work department has been restructured and the new arrangements are working more effectively. There has been a blitz on the waiting list there and unallocated cases have been significantly reduced. There are quite a number of other points concerning each area, which are identified in the report. I want to reassure both Deputies that there has been a follow-up implementation plan.

The audit found that parental alcohol misuse was a factor in 62% of families in the overall sample. It states that family dysfunction, which ended up with the kind of neglect that both Deputies have described so graphically, was often associated with chronic alcohol and drug abuse. The audit also found that domestic violence was a key issue, parental mental health issues featured in two thirds of the Dublin cases, and standards of hygiene and physical conditions were unacceptable in more than half the cases.

There is a need to identify neglect at an earlier stage and intervene more effectively. The report makes the point that many children were left in family settings for too long. That is a similar finding to the report on child deaths. The new national approach to managing social work cases involves more streamlined procedures, a national risk-assessment and national standards. It will make a huge difference to the disturbing findings that were outlined in this report.

In addition, we are currently undertaking the recruitment of new social workers. Some 84 were recruited recently and the recruitment of a further 90 is under way.

Denis Naughten (Roscommon-South Leitrim, Independent)
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We owe it to the children at the centre of the Roscommon case to ensure that their courage and bravery is recognised. No other family should be failed by the State again to the extent that they were.

When will the national audit of neglect files commence? What steps are being taken to develop a national training programme, which was identified in this report, not just within child care services but also in An Garda Síochána, the courts system and the Judiciary? Will a review of other neglect cases take place in light of the inadequate protections that are in place? I refer specifically to Roscommon. Based on the number of neglect files in Roscommon, 50 more families are potentially under threat in circumstances similar to the seven identified in this audit. Will a full audit of all the files take place now?

Robert Troy (Longford-Westmeath, Fianna Fail)
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Having read this and other reports, we are aware that alcohol and drug abuse is one of the main factors in child care and welfare issues. Is the Minister happy that this report, which was finalised over 14 months ago, only came to her Department in May this year? Did the Minister receive notification of the report before May?

Given that her Department is hiring additional social workers, I take it that the Minister is no longer satisfied with the current staffing levels. She says that 80 new social workers are being employed with a further 90 coming on stream, but when will they come on stream? Will they be deployed to the relevant areas that are so badly in need of them?

What is being done to ensure that this area is being prioritised? It was clear that children were being neglected and nothing was being done about it. What immediate actions will the Minister take to ensure that in instances where the HSE is aware of neglect concerning child protection and welfare issues, but is not doing its job, a safety net will be put in place to protect children's welfare?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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There is at least a 30 year legacy concerning Ireland not dealing as effectively as it should have with vulnerable children. My Department's goal is to ensure that children do not fall through the cracks. That is why we are changing the way these services are being delivered. We are developing a focused management team and national leadership which was not there before. I would point out that during the previous ten years, as Deputy Naughten rightly observed, these children were being dealt with like this during the so-called Celtic tiger period. We must now focus on ensuring that these children and their families get the kind of services they have not received previously.

The development of the new child and family agency, together with a more structured approach with national standards and greater risk assessment at an earlier stage, will ensure that children will receive a much better service. The recruitment of social workers is an important part of that. The 270 social worker posts, which were recommended by the Ryan report to bring social work teams to an appropriate level, have been recruited. We do have high levels of maternity leave and some sick leave, but recruitment is going on as we speak. Some 84 social workers have been recruited which has to make a difference to the quality of work that is being done.

Major efforts are being made by front-line staff. Training has already started and there is a new awareness of neglect as a result of this report. The work that is being done in each area will make a difference to standards. Each area will commence a review and audit of all child neglect cases. This phase will be implemented in line with the recommendations of the Roscommon report. It will also use the methodology applied to complete the national audit of child neglect cases, which will commence in August 2013.

A lot of work has already been done by the HSE as a result of this report. It complements the work the HSE is doing nationally to ensure that we have services that are fit for purpose and which will meet children's needs. As the report outlined, their needs were clearly not met hitherto.