Mary Butler (Waterford, Fianna Fail)

I thank the Senator for raising this really important matter. I apologise for being late. I was in the Dáil. I arranged cover in the Dáil because I wanted to take this matter personally. I did not want to pass it to someone else. The Senator will appreciate that none of the Government, my Department, the HSE or I can comment on the individual case. However, the HSE does, as a matter of routine, investigate any allegations of the nature made in this case and notifies all appropriate agencies and individuals. I want to take the opportunity to set out my absolute intolerance of any inaction on safeguarding and reporting of safeguarding. Safeguarding is everyone's business. I have said that for so many years in relation to mental health, dementia, and older people. No one cannot turn their back on safeguarding. As professionals, I expect everyone working in our health and social care services to not only fulfil their legal obligations, but to act urgently out of concern for the welfare of any child or vulnerable person who may be at risk.

I understand that HSE West and North West is progressing an independent external review under the HSE Incident Management Framework 2020 relating to a counselling service in the north west. This review was initiated following concerns raised in relation to children first mandatory reporting, as the Senator said. The HSE advises that it is engaging with staff directly in this process in line with the incident management framework. I have been advised that while the HSE has been actively working on this issue from the outset, the formal review process took longer than anticipated to commence owing to its complexity. I am not happy with that, the fact that it took longer than anticipated to commence. The issues raised are too serious. Once this review is completed, the HSE will take any required actions to ensure that the findings and recommendations are implemented in full.

Under the Children First Act 2015, there are specific legal obligations for certain staff known as mandated persons to report certain information relating to harm of a child to Tusla, known as mandatory reporting. The Children First Act is supported by the Children First National Guidance for the Protection and Welfare of Children 2017, and the HSE child protection and welfare policy, which sets out the roles, responsibilities and procedures assigned to ensure the effective management of child protection and welfare concerns in the HSE. The HSE is very clear on the obligations of mandated persons. All staff are regularly made aware of the policy and the obligations on mandated staff to report their concerns to Tusla and-or An Garda Síochána.

One aspect of the existing HSE child protection and welfare policy indicates that staff should inform their line manager when a concern arises. The purpose of this is for communication; consultation when a staff member is unsure of their concern, and for the line manager to ensure that the child protection and welfare reporting procedure is followed correctly. The HSE have advised my Department that it is not intended to be a screening of a concern or a barrier to reporting. This is the real nub of it. The HSE policy clearly states that when there is disagreement about the threshold of concern "either party can seek further consultation with Tusla. If you remain concerned, you should report this concern to Tusla and/or An Garda Síochána.".. The policy also states that a mandated person "cannot delegate their own responsibility to report".

The HSE has advised my Department that after the relevant therapists wrote to the CEO of the HSE in October 2024 on this matter, the CEO wrote to the health region stating - this is really important - that there should be no line management screening of mandated reporting by individual professionals and suggested that the therapists be advised immediately that they are free to contact Tusla directly. The relevant staff were advised of this. I will come back in my next response to the Senator.