Maire Devine (Sinn Fein) | Oireachtas source

I welcome the Minister of State at the Department of Health, Deputy Helen McEntee. It is good to have the correct Minister of State in the House. It is not the case that Senator Pádraig Mac Lochlainn was shooting the messenger because this issue affects all Senators.

The issue I raise is the care of children outside the State. A small number of children need special care which cannot be provided here and are sent abroad to avail of a broader range of treatment options, supports and interventions. In the past two years six children were sent abroad for this reason. However, records are not held for other years. Data must be collected nationally for future reference and use. Of the six children sent abroad, three were sent to the St. Andrew's facility in Northampton in England. I do not know where the other three were sent, but perhaps the Minister of State might provide that information. The lack of facilities for children who require them means that some children are sent abroad where they do not have access to family, friends and someone who will fight their corner. These disturbed and vulnerable children do not have a voice abroad and are in a dire position. The cost of placing three children in facilities abroad for one year is €1 million.

A few weeks ago Channel 4 broadcast a "Dispatches" documentary, "Under Lock and Key", which painted a damning picture of disgraceful conditions at the St. Andrew's facility. It found that children were held in an institution that did not meet their needs, make them better or keep them safe. The facility is operated by one of the largest and wealthiest health care charities in Britain. Serious concerns arising from the "Dispatches" programme include that patients were subject to restraint, seclusion and frequent sedation. An inspection by the Quality Care Commission, the British equivalent of the Health Information and Quality Authority in this jurisdiction, noted the use of a technique known as prone restraint. This face-down method of restraining a person, with which I am familiar, is widely used across all wards in the St. Andrew's facility which caters for young children aged between 11 and 18 years. The use of prone restraint has been banned here because it compromises respiratory function and has caused deaths in the past. If someone sits on a person and restrains him or her in a prone position, it cuts off his or her airways.

In a six-month period between 2015 and 2016 prone restraint was used 600 times in child and adolescent wards. One 15 year old patient remained mainly in segregation for 22 months in a room with very little natural daylight.Four patients died within seven months of each other in one ward between October 2010 and May 2010. All of those patients had been prescribed the drug clozapine, which has been lauded as the new wonder drug for schizophrenia in particular, but it is also what we consider quite a dirty drug, having too many side effects and needing constant monitoring.

It is a damning report of a health-care facility to which we send some of our most vulnerable and disturbed children. What is our oversight? Tusla claimed that St. Andrew's was highly regulated. Do we have any input or impact there? Do we carry out cross-balance checks to ensure our children are safe over there when they are all alone?