Seanad debates

Wednesday, 21 May 2008

HSE Child Welfare and Protection Services: Statements

 

1:00 pm

Photo of Barry AndrewsBarry Andrews (Dún Laoghaire, Fianna Fail)

Go raibh maith agat. I thank the Cathaoirleach for his kind remarks.

I welcome the opportunity this afternoon to discuss the important issue of child welfare and protection services, a subject of concern not alone to the Oireachtas but to society generally. Modern Ireland has seen a considerable rise in the profile of child welfare and protection issues in recent years. At the same time, we have more recently seen a period of major investment in child care and family support services to enable an appropriate response to child welfare concerns with more than €240 million in Government funding having been added to the annual investment in child care services since 1997.

The core principle underpinning these reforms and additional funding is to provide children and young people with the highest possible quality of care and to provide services to protect them as far as possible from all forms of harm. Since taking up office I have in all my contacts stressed the priority which both I and the Government place on the need to provide appropriate services to the most vulnerable young members of our society. In this regard, my aim is the provision of world-class child welfare and protection services for Ireland. I realise this goal will present many significant challenges in terms of resources and service reform. I look forward to addressing these challenges on behalf of our children.

A recent "Prime Time Investigates" programme highlighted many issues and created a much higher level of interest in this area. I welcome this and thank those responsible for producing the programme. The media has an important role to play in public affairs. The programme concerned contributed to our overall knowledge and created a forum for proper discussion on the issue. There are real issues to be addressed. I was troubled by the cases presented in the "Prime Time Investigates" programme. I am concerned that no child should suffer from problems with services. However, it is often the nature of our modern media to focus on negative aspects of a given topic. We must realise that within the short time available to broadcast a programme, the full picture can never be achieved.

Child welfare and protection in Ireland is primarily predicated on the Child Care Act 1991 and the Children Act 2001. The Child Care Act 1991 places a legal obligation on the Health Service Executive, HSE, to promote the welfare of children who are not receiving adequate care and attention. In implementing the Act, the primary emphasis must be on prevention and early intervention where possible and supporting children in their family situation in the community. Only in the case of serious problems as judged by social work professionals should alternative appropriate care services which place children outside of the home be provided. The Act allows for a child at serious risk to be taken into care on a voluntary basis or pursuant to a court order. Provisions for emergency situations where there is an immediate and serious risk to the health or welfare of the child are also included in the Act.

The Children Act 2001 for which the Department of Justice, Equality and Law Reform has main responsibility brings about a major reform in the law relating to juvenile justice and the protection of children and makes provision for non-offending out of control children and children whose actions, but for their age, would be a criminal offence. The focus of the Act is to minimise the need and duration of detention. A number of pilot programmes have been put in place to cater for children's needs in their own communities.

There also exists a range of policy and related documents in this area, including the National Children's Strategy, the Children First Guidelines, the UN Convention on the Rights of the Child and, most recently, the Agenda for Children's Services, the overarching policy document of the Office of the Minister for Children and Youth Affairs launched in December 2007. The agenda with its clear renewed emphasis on family support, coupled with reflective questions to enable service provider self evaluation, is part of the fundamental change now under way in respect of the formulation and delivery of Government policy in regard to children. It has been developed drawing on research and best practice at home and internationally. It requires an outcomes focus and integrated service delivery in line with the recommendations of the recent OECD report.

In this regard, it is worth noting that action has been taken on all key child welfare and protection related items in the National Children's Strategy with the pace of such action increasing significantly on virtually all fronts since the formation of the Office of the Minister for Children and Youth Affairs. In addition, there have been significant additional HSE-led actions such as the children services committees and the development of children's services plans under Towards 2016. These commitments are moving ahead in Dublin South, Dublin City, Limerick and Donegal and involve all public service providers in those areas.

I have been struck, in the short time since I took up my position, by the developments under the children services committees. I believe they are a model for the provision of excellent services across the statutory agencies. Members will be aware that there are in many areas of disadvantage various agencies trying to achieve the same end, namely, better outcomes for children. However, they often do not communicate or share information. We are bringing together for the first time the Garda Síochána, local authorities, VECs and schools in order to provide a strategy which will deliver better outcomes. Ultimately, I would like if the non-statutory agencies were involved. Developmental early intervention programmes jointly funded by Government and Atlantic Philanthropy are also being implemented.

All of these initiatives are aimed at producing better integrated inter-agency service provision. They also seek to provide for earlier intervention via much more comprehensive interlocking service provision for children based on clear planning aimed at agreed outcomes in line with the move to family support initiatives.

The establishment in 2006 of the Office of the Minister for Children and Youth Affairs, then known as the Office of the Minister for Children, was key to realising the goal of bringing greater coherence to policy making for children. The purpose was to bring together the agencies responsible for the development of policy in areas that affect children. Child policy sections from the Departments of Health and Children, Education and Science and Justice, Equality and Law Reform came together to create a new policy environment of cross departmental co-operation.

The office also maintains a general strategic oversight of bodies with responsibility for developing and delivering children's services. This integration between policy areas is already having a significant impact on improving outcomes for our young people and children. It is enabling better planning and improved communications between those key areas that must work in co-operation. Those working in child policy areas recognise how important it is that the health, education and justice sectors work together in all sectors of children's services.

An integrated approach is the only way to deliver better services and ensure improved outcomes for our children. The setting up and operation of my office in respect of inter-agency, integrated service provision has been praised in the recent OECD report on the Irish public service. That is a credit to the people who work in that office, to my predecessor, Deputy Brendan Smith, and, before him, Deputy Brian Lenihan.

Child protection is a key part of the agenda in the office of the Minister for Children and Youth Affairs. An extensive programme of specialised residential provision for a small number of children and a range of other child welfare and family support services has been put in place in recent years. The HSE informs me that it has created over 300 new social work posts since the start of 2005.

Two days after the broadcast of the "Prime Time Investigates" programme I met with senior officials from the HSE to discuss, among other topics, the issues raised by that report. One of my primary concerns at this meeting was the issue of vulnerable children being placed on waiting lists for services. The HSE has assured me that in all cases where there is a serious and immediate risk to the health or welfare of a child, it responds immediately and takes appropriate action. All child abuse reports to social work departments are subject to a phased process of initial screening and assessment aimed at providing appropriate interventions. In addition, legislative mechanisms are in place to allow for responses from the Garda, such as, for example, the taking of children to safety in emergency situations.

I was informed also that a detailed consultation and reporting process is already underway to determine the current state of the waiting list issue. I expect a report detailing the outcome of this exercise before the end of June. In addition, I will chair regular meetings on child welfare and protection issues convened between senior officials of the HSE and my office.

In recent years there has been a rebalancing and readjustment of child welfare services towards early intervention and support for families in order to reduce the numbers of children who may become dependent on State care. This reflects the Government's policy of emphasising a preventive and supportive approach to child welfare. In many cases this is done in partnership with non-governmental agencies where the focus is on building capacity in vulnerable communities. This is in line with the principles of the Children Act 2001 regarding early intervention. Any parent or person with commonsense knows that early intervention is the key, particularly with children. If a child is neglected or abused this will eventually come to the attention of the State, most likely by way of criminality or truancy in the child' s later life, if services and welfare are not provided early enough.

A specific example of such community-based service development is the Springboard Family Support Programme, which is designed to improve the well-being of children and families in Ireland. All Springboard projects have a general strategy of being openly available to all families, parents and children in their communities, as well as a more specific strategy of working intensively with those who are most vulnerable. As with other family support programmes Springboard offers a range of interventions including individual work, group work, peer support, family work, advice and practical help. The HSE is committed to further development of the programme.

Another example of community-based family support services are the Youth Advocacy Programmes. Established on a pilot basis in 2002, these programmes provide supportive community-based alternatives for the care and protection of children most at risk. These programmes aim to maintain in their own homes young people who are at risk of out-of-home placement. There are currently five Youth Advocacy programmes in operation.

Increases in resources for child care and family support services have continued in recent years. In addition to the significant number of additional social work posts the HSE has created since 2005, funding of family support services has increased by 79% since 2003. This reflects the commitment of this Government and the HSE to the ongoing implementation of the National Children's Strategy and, most recently, the Agenda for Children's Services, already mentioned. Indeed, the HSE has made significant advances in many areas of children's services. A well-managed national approach is in operation, for example, dealing with the most needy children in HSE care, offering special care and high support.

In this regard I would like to place on record my appreciation for the work carried out by social work teams and their managers. These are hard working, dedicated people who must routinely deal with cases that are becoming ever more difficult, complex and intractable. They very often put themselves in harm's way.

I am aware that social work out-of-hours service proposals are currently under consideration by the HSE, my own office and the broader Department of Health and Children, to examine how this service can best be introduced nationwide. Notwithstanding this move towards a national approach, a number of out-of-hours service arrangements are in operation to part-cover this service around the country, in Dublin, for example, to deal with homelessness.

I should point out that not all services for children at risk must be provided by social workers. The HSE provides a multiplicity of services which can effectively address the needs of children at risk. Therapy, medical, nursing, psychological, community care and a very wide range of services benefiting children at risk are provided. In addition, non-governmental bodies provide key services for children and families at risk, on behalf of, or in tandem with, HSE services in areas such as residential care, foster care, community mentoring, family support schemes such as Springboard, Teen Parenting and Youth Advocacy, and in many other areas.

The latest information for children in care dates from March 2008. This shows that 5,362 children are in care. Of these, 406 are in residential care and 4,799 are in foster care. That latter figure is 88%, a higher percentage than in most other countries, and a great success. Other care arrangements are in place for 157 children, such as provision for remaining in the family home under care order. The identification of children at immediate and serious risk is, of course, a clinical decision, but professional social workers generally have no difficulty in perceiving what is an immediate and serious risk versus a less immediate risk. I would again emphasise that the HSE has stated that those at immediate serious risk are assessed and offered service.

The HSE has informed me that at the end of 2007, 90% of children in care have an allocated social worker and that social work services are available to all children in HSE care. It must also be made clear that child protection is the responsibility of everyone in society and particularly all public service providers including teachers and doctors. It is critical that everyone shoulders that responsibility.

The HSE service provision is guided by what it terms its "Children and Family Services Strategic Objectives". These seek to grant children the right to express views freely in all matters affecting them and to ensure that decision making in the planning and delivery of all children and family services is informed by an evaluated approach, based on empirical data from evidence-based research. The objectives also aim to re-orient supports and services so that they are fully integrated and easily accessible. They lay emphasis on prevention and early intervention, with a strong community based response. They further seek to ensure professional development and supervision to attract, retain and develop staff to support quality, child-centred service delivery.

The focus for development in the coming years is on preventive, community-based services which provide early intervention within a primary care context. The development of alternative care services will, over time, impact on the numbers of children in residential and foster care.

A differential model of service provision is also being considered by the HSE to respond to the needs of children at risk by directing them to protection or welfare and support services. This would counter the growing trend to classify large numbers of cases as child protection cases. International and Irish research indicates that in many situations cases can best be dealt with by way of welfare and care services which do not always require full-time social worker input to work well. My office and the HSE aim in this way to energise and involve communities in their own welfare and thereby effectively and validly reduce the later emergence of child protection issues.

The ongoing Child Care Information Project is initially implementing standard assessment and referral methods and thereafter moving on to better standardising national child protection procedures. This project, in tandem with other major standardisation projects such as the review of the Children First child protection guidelines, and the publication by HSE of its child protection framework, will work in synergy with the Knowledge Management Strategy for child welfare and protection, due to be completed in summer 2008. This will work to ensure availability of better information, improved communication and application of research findings to service provision, management evaluation and policy analysis. As these initiatives indicate, the HSE is well aware of the need to work from well-defined information and evidence; and not from uncorroborated anecdote. It is, however, essential that the evidence used is robust validated material.

While I am disturbed at any suffering by children I am confident that my office and the HSE can together ensure significantly improved and better integrated child welfare and protection services for all children who need such services. The work I have described shows how much is being done to realise this objective.

The development of robust, responsive and appropriate child welfare and protection services is a priority for both myself and this Government. The National Children's Strategy was published in 2000. Its vision was described thus:

An Ireland where children are respected as young citizens with a valued contribution to make and a voice of their own; where all children are cherished and supported by family and the wider society; where they enjoy a fulfilling childhood and realise their potential.

It is my intention to do everything I can to realise this aim.

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