Liam Twomey (Fine Gael)

I second the motion. When considering what happened in this case we should not focus on the family involved but on how it points to what is happening in the health service. As somebody who is involved in the health service, I am under no illusions about what is happening. There are numerous families with issues involving neglect, physical and emotional abuse and possibly even cases of sexual abuse. We are inclined to react faster when the latter come to light because of its serious nature but sometimes we are inclined to drag our heels with cases of emotional neglect. There is a focus on trying to work with the families. There can be problems with drug and alcohol abuse as well as the sheer inability of some parents to look after themselves and their children. These are not just isolated cases. There are thousands of children in those circumstances at present.

This mirrors what is happening in the rest of the health service. We manage our health and social services as if we were in a war. We are fire fighting with these services but we allow some matters to fall through the cracks. What is considered good procedure and good policy are not implemented because everybody is under pressure and stressed out or they cannot cope with what they are doing. The first impression one gets from the report is that many of the social workers and front-line staff are not talking to each other. One must ask why that is happening. Is it because the procedures are just a mess or is it that all the individuals on the front line are just too busy and stressed out to do things right? Then a disastrous situation such as Monageer occurs, there is a report about it and recommendations are made, but nothing significantly changes.

The circumstances of any disaster or crisis such as this, involving children, that has occurred in this country in the past few years are similar throughout, regardless of whether it happens in Roscommon or County Wexford. I have never seen a Minister who has responsibility for these issues crack the whip and insist on changing things in a way that will work. It does not happen. We do not have 24-hour social worker cover. Social work is a different job from what I do as a doctor or from what a garda does. Regardless of whether it was a priest, myself or a garda who called to that house, we are not trained nor do we have the legal responsibility to deal with what was happening in that house that night. It would have to have been a social worker.

I cannot say whether we would have saved the lives of that family. However, if the social worker service is in place and is running efficiently, we will save the lives of the next family in a similar situation. That is the way we must think in this regard. The 24-hour cover must be put in place in a way that will work properly. There must also be communication between the different services. It is clear from the report that people did not bother finding out what the personnel in Donegal were thinking. People did not care what the general practitioner thought, as long as the boxes were ticked. The "attempted to make contact" box was ticked and then it was forgotten. That is the situation.

In some respects, there are many policies and bureaucracy in place that make this worse. The issue of consent is one. Let us be realistic about this. Consent can be a barrier in these cases. I have no wish to trample on the rights of individuals but it can be very difficult to get individuals who require the help of the social services to this degree to fill out forms so one can send a copy of the form to Dublin, from where it can be forwarded to Donegal to get the reports sent back. We need to be a little more sensible in how we run our services. The files should automatically move with the patient so if somebody who is a recognised official from the social work services in Wexford and has the required authority rings up for a form, it is sent to them. Nobody looks for these files for some Saturday morning reading over a cup of coffee. If the right official in Wexford makes contact with a reasonable official in Donegal, that will protect the confidentiality of the clients and family involved. Instead, we bog ourselves down with unnecessary bureaucracy because we think we are protecting the family. Look where that got us. It cost the lives of every one in that family.

The Minister should show that type of leadership and make changes. There is too much glibness. The Government is growing tired. I cannot say that for the Minister of State present, Deputy Trevor Sargent, because he is new to the Government but the incumbents that preceded it appear to have grown tired. The Minister for Health and Children, Deputy Mary Harney, when push came to shove, said at a health committee that she would publish this report. Has anybody seen it? Has anybody heard the Minister say she would publish it? No. Once she had done her soundbite for the media, that was that. This is the problem. We do not have a Minister who says: "Good God, I cannot let this happen again."

I foresee what is happening in the social services today being the basis for the next commission on abuse in 20 years. The same type of dead-hand complacency and carelessness about what is happening is present across the upper levels of the system. Just as was the case 20 years ago, some of us who were not in positions of authority would have heard about what was happening. However, I am sure the Minister will have seen from the commission report that there were reports to the Department of Education and to other people in authority who could have done something about what happened in those institutions long before they were dealt with. We now see the same type of devil-may-care attitude at the upper echelons of health service management.

That is why I compare it to a wartime situation. In such situations, things are chaotic. That is what is happening on the front line of social services at present, but it is the time these people need direction from the top. I know the social workers and public health nurses who are involved in these cases, and they are doing their best. They send their recommendations to what is called their back office but things get lost or fade away somewhere between there and the people who make the decisions. The result is crises such as this across the services.

We must spend money on the 24-hour social worker service and we will probably have to spend money on beefing up some front-line services. There should be a focus on leadership. We constantly talk about leadership, taking responsibility, doing the job and not pandering to special interests fearful of what might happen. Being very realistic about what we can achieve, we can get this thing sorted out. I do not believe we will solve all the problems. However, when something happens I hate reading reports that glaringly state the cock-ups that happen could have been prevented or at least minimised. That is what I would like to see happen.