Phil Prendergast (Labour)

I also congratulate the Minister of State and wish him every success in his difficult portfolio. I am sure if there is any help we can give him, we would not be remiss in doing so.

The areas of welfare and protection services for children are wide and varied. They range from catering to the very basic needs that must be met for all children to ensuring the health, safety and welfare of those children whose care rests with the State. One of the areas of major concern to me is that of the plight of adolescents in need of urgent psychiatric assessment and care. The HSE recently responded to a parliamentary question on the appalling lack of available beds for such adolescents, with a promise of 18 further beds being brought into service over the course of the remainder of 2008. It also pledged that of the 3,598 children currently awaiting assessment, 70% will be seen within 12 months. Today, there are only 12 beds available in Ireland for the treatment of these children and the HSE seems to consider that sanctioning a further 18 beds will be tantamount to waving a magic wand which will almost immediately solve the problem.

While I am aware that the majority of those on the waiting list will not need inpatient care, I find it difficult to believe that the provision of these extra beds, a drop in the ocean compared to the overall number of beds in service under the HSE, will have the desired effect. In the meantime families are at their wits' end, some of whom I know, who cannot leave their children out of their sight for fear of them self-harming or attempting suicide. This is a very real problem, particularly when one knows somebody in this situation. The case of the person I know has been flagged as urgent and all that goes with that, but a bed has still not been made available for this individual. This is an immediate problem that has a detrimental effect on many people's lives — many more people than the lives of the family concerned — and it must be prioritised with real targets and realisable goals set.

Another issue that needs to be investigated as a matter of importance is the provision of a child psychology service and the waiting lists associated with this service. I have been contacted by a number of clients whose children have been referred for psychological assessment by their general practitioners. One case in particular stands out, where a six year old child, suffering from severe psychological problems, was referred by her general practitioner 18 months ago to the local psychology department in South Tipperary General Hospital. At the time her mother was informed that she could expect to have her child seen and assessed within six to 12 months. When no appointment was received some months later, the mother again contacted the Department to be told that the waiting period had extended to 18 months and she could now expect an appointment at some stage in that timeframe. Last week she received a letter from the psychology department stating that the waiting list is now running at two years and so it had to be temporarily closed. The current plan is to offer those on the waiting list a one-off appointment, which would allow the professionals to redirect the client appropriately. No doubt following this one-off assessment, this child will be placed on yet another waiting list.

My impression is that this deterioration in this service coincides closely with the HSE staff embargo because it is having an effect across such a range of services. It is difficult for the Minister of State in his brief to prioritise which service is more needy and depending on whom he is representing at a time, each case would merit that it should be given sufficient resources to meet its needs. Staff are being lost through various routes and are simply not being replaced, as is the case in so many other services managed by the HSE. On consultation with other health professionals employed elsewhere in Ireland, I am aware that this is not an isolated case — other waiting lists have also been closed temporarily for some time with no sign of being re-opened. Only emergency referrals are seen at short notice and the chances of the existing waiting lists being cleared in any timely fashion seems remote.

Once again vital frontline services have been eroded and children's welfare put at risk because the HSE cannot manage its budget adequately. Early intervention is so important in many of these cases to minimise anti-social behaviour in later years, and it is a false economy to curtail such services in the interest of offsetting vital funds against budget overruns.

I remember working in a paediatric unit as an innocent student nurse when I thought that if babies got sick, they were treated, got well and were sent home. I recall an infant having a skeletal survey when admitted because of various aspects of bruising. This baby was only ten weeks old and it had 11 fractures at various stages of healing. I remember being very upset about that. The baby was put immediately on an at-risk register and taken into foster care because the services at that time would have dealt with such a case in a timely fashion. I do not know what the outcome was for that child, but I am sure the child had a better outcome than we can expect for children in similar circumstances today.

Previous speakers expressed concern about a welfare and protection issue that has been vigorously highlighted in the media relating to the HSE's management of the care and ultimate disappearance of an astonishing number of immigrant children. Despite numerous media discussions around the issue in recent months, we have yet to receive a satisfactory explanation from the HSE. I am horrified about this issue. I cannot conceive how 388 children — the figure may now be more than 400 — in the care of the HSE have simply vanished over the past seven years. It seems that the majority of those missing are immigrant children who arrived in Ireland without parents and were taken into care for their own protection. We know now that these children were frequently housed in inadequately supervised HSE accommodation, where there are no on-site child care workers. While the HSE is responsible for the safety and care of such vulnerable children, it is imperative that the essential structures and services are put in place to ensure that these children cannot be exploited in any way while under our protection. The statistic in this regard is horrifying.

When a child tragically went missing in Portugal, the search for her knew no borders. It was highlighted on every news channel and every man, woman and child in Europe knew that this had happened within 24 hours. Yet here in Ireland all these children went missing and we did not hear a word about it. This is bordering on the criminal, if only for the fact that broadcasting these children's photographs and statistics might have resulted in their being identified by the public and returned to safety.

While I welcome the Criminal Law (Human Trafficking) Act, which will come into force in June, outlawing the trafficking of children for any purpose, it will be impossible to implement the letter of this law if we cannot initially provide a truly safe haven and adequate supervision for these children who come to Ireland in uncertain circumstances.

I would like to highlight an area that I previously raised with Professor Drumm. Every child is entitled to a developmental check-up to ensure that he or she is meeting his or her milestones and also to pick up potential health or physical problems he or she may have. The optimum time for the developmental check-up to be carried out is at nine months, but in recent times many children were not being called until they were two or three years old, which for some children was too late to deal with deficits, perhaps in hearing or other behavioural problems, that could have been addressed if they were picked up at the optimum time for the check-up.

The HSE recently introduced measures to address this backlog, resulting in children being called to be seen by a public health nurse at between nine and 11 months old. I ask the Minister of State to ensure that the present staffing embargo will not negatively impact on the new measures, and that children will continue to be seen at nine months old in accordance with best practice and recognised standards of care.

A recommendation in one of the reports into the death of a young child was that a trained children's nurse should be on duty in all accident and emergency departments in the interests of prompt diagnosis of children with potential problems, a issue I raised on this morning's Order of Business. While recommendations in any report are always difficult to implement, if there is a paediatric unit in a hospital we should go some way towards ensuring a system is in place that the some degree of the necessary expertise will be available to assess a child over whom there is a query about their condition in the interests of ensuring best practice. With the best will in the world, one will always get co-operation and, as would be said in a hospital setting, such intervention amounts to fire-fighting techniques. Staff are more than willing to help in a situation where they can prevent greater problems later on.

The Minister of State has a very difficult brief. He referred to many initiatives, which I welcome. I compliment him on the way he dealt with the media the morning after the "Prime Time Investigates" programme. While I am not casting aspersions on any of the previous holders of his office, I believe we have someone in charge who will fully engage with personnel to ensure the best possible outcome for our children because they are worth it.