Seanad debates

Thursday, 21 March 2024

Nithe i dtosach suíonna - Commencement Matters

Childcare Services

9:30 am

Photo of Marie SherlockMarie Sherlock (Labour)
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I welcome the Minister. My question today relates to the State supports for the brilliant home visiting services that operate across many communities in Ireland. Across this country, approximately 170 people go into the homes of about 4,500 children each year and provide a vital parenting, learning and development support to parents and to children. Any of us with young children know the challenges of trying to figure out play, discipline and looking after the emotional needs of the parent and child. In households where there are additional challenges of disadvantage, poverty, domestic violence, homelessness, social isolation, special needs and other health issues, the early childhood visiting service has truly become a lifeline for many parents and their children. Oftentime the home visitor is the one trusted person from outside the home who is allowed in to help the parent navigate their way in life. Many of those home visitors are the bridge between public health nurses, Tusla, the maternity services and many other services. They often flag the need for access to other suppprts, particularly in the area of disability. In essence they are a vital part of the fabric of family supports in this country, they exist across about 40 sites in Ireland and yet those who are providing the service tell us that they can only really target about 1% of the eligible population, those who should be getting the service.

As I understand it Minister, there is there is no specific budget line for home visiting services within the Department of children, for the most part they are dependent on funding from Tusla and philanthropy and some from the HSE also. I believe the service in Kerry is the only service in the country that is fully State funded. We know that for the rest of the country, the Home Visiting Alliance tell us it is about 70% reliant on Tusla funding, 11% on HSE funding and 11% on philanthropy.

When I think about home visit services and the lack of recognition and, as I see it, respect for it, perhaps it is something to do with the unassuming way home visitors go about their work. Maybe the term 'home visitors' does not convery the sheer importance of the work that they do but to my mind it seems that this work is largely invisible to the State and that needs to change because home visiting is an essential part of the support network around families in this country. We know that in the heart of Dublin's north inner city, the early learning initiative is run out of the National College of Ireland and they do incredible work there under the stewardship of Dr. Josephine Bleach and her team, in terms of setting the standard for training and employing home visitors. They have become a national centre of excellence in providing outreach training to many of the sites around the country and indeed providing research on the little data that is available on home visiting services in the community.It is not sustainable, nor is it right, that to train and pay home visitors, they had to depend on philanthropy for up to 40% of their funding. This should be a State-funded service, full stop. We know from the 2023 feasibility study produced by the Home Visiting Alliance that there were a number of very clear recommendations to the State. Number one, on funding, is that it is not sufficiently funded at the moment. There needs to be a clear line of funding and it needs to be sustainable and multi-annual. Number two related to recognition. There is a significant issue with regard to professionalisation of the sector. The early learning initiative was providing FETAC level 5 training to those who wanted to become home visitors. Because of a change in the qualification system last year, we are now seeing that it is near impossible to get the requirements to meet those qualifications because it requires training within crèches as opposed to within the actual home visiting service. The last item relates to funding research within the sector.

The First 5 strategy sets out clearly that there needs to be a national approach to home visiting in this country. The First 5 strategy is a number of years old at this stage and we have yet to see that national approach. I want to hear from the Government its plans in this area.

Photo of Niall CollinsNiall Collins (Limerick County, Fianna Fail)
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I thank Senator Sherlock for raising this important issue and for offering the opportunity to respond.

Home visiting programmes provide support and guidance to expecting parents and parents of babies and young children. Home visiting is a prevention and early intervention strategy used to support parents to promote infant and child health, foster educational development and school readiness, and help prevent child abuse and neglect. Different models of home visiting exist. Home visiting programmes for parents of babies and young children are funded by the HSE and Tusla in some areas in Ireland. Programmes available in areas of Ireland include Preparing for Life, Lifestart, Parent Child Plus, Infant Mental Health and Community Mothers. The duration of each home visiting programme varies although most are provided for a period of two years or longer. The frequency of visits also varies from twice weekly to monthly visits.

Home visiting services are developed in an ad hoc manner in Ireland, driven by local needs, resources and priorities rather than informed by a national approach. At present, some areas of the country have no home visiting programme available while other areas provide universal access or targeted access to a home visiting programme. The First 5 strategy for babies, young children and their families includes an action to agree an approach to home visiting services across a continuum of need, building on the current public health nurse home visitation programme and having regard to Irish evidence on the implementation of prevention and early intervention initiatives.

The Minister, Deputy O'Gorman's Department has undertaken a national review of home visiting services in Ireland, which is due to be completed in quarter 2 of this year. The project was undertaken by the centre for mental health and community research based in the National University of Ireland, Maynooth. The study examines the resources, activity levels, geographical coverage and outcomes associated with home visiting programmes in Ireland. It considers evidence of the effectiveness and implementation of home visiting programmes in Ireland and across the world. Researchers shadowed home visitors and consulted parents to explore the demand and preferences for different types of home visiting services. Researchers also consulted key stakeholders to identify, assess and agree options for a standardised approach in Ireland to home visiting service provision.

Most of the Tusla budget that is used to fund home visiting programmes is from Tusla's general allocation from the Minister, Deputy O'Gorman's Department, which is commissioned, as appropriate, at the local area level. However, up to €10 million has been ring-fenced for home visiting programmes between 2024 and 2029.

The Government published an action plan for survivors and former residents of mother and baby and county home institutions on 16 November 2021. The aim of the action plan is to support the implementation of the 22 commitments made by the Government in January 2021 to respond to the priority needs and concerns of those who spent time in these institutions. Under action 18, the children's fund, the Government has committed to honour the memory of the children who died in mother and baby homes through the creation of a specific fund which supports children who experience disadvantage in the present day. It is proposed that the children's fund will be used to support the establishment of a new national home visiting programme within Tusla. Accordingly, over the next five years, Tusla will receive up to €10 million in funding to develop this programme. The aim of the national home visiting programme will be to co-ordinate, provide direction, and collate evidence and data to inform the future development of the sustainable national home visiting service. The focus initially will be on Traveller parents and lone parents, as per the instruction of the expert panel established by the Department of Children, Equality, Disability, Integration and Youth, which provides advice on how the children's fund might most effectively be used. Specifically, in 2024, funding will be used to recruit a national home visiting manager and a data and information officer for the programme. The setting up of the Tusla national home visiting programme will allow for an increased number of children and families to benefit from such a service.

Photo of Marie SherlockMarie Sherlock (Labour)
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I welcome the establishment of the national home visiting programme. I am struck, however, by the fact the research into home visiting services was commissioned in 2022 and was supposed to be completed in 2023. We hear now it is going to be completed this year. There is only one year left of this Government. I very much hope the outcomes from that research will be acted upon this year.

I am concerned about the full understanding within the Department about home visiting. The Minister of State talked at the start of his response about home visiting services and the current public health nurse home visitation programme. They are entirely separate from what I am talking about here. Home visiting services are not provided by public health nurses. They are home visitors. It is a completely distinct service.

I welcome all supports to those who were in mother and baby and county home institutions, but that is not relevant to what we are talking about here. It is a pity the Department is purposely confusing supports to the families we are talking about.

Photo of Niall CollinsNiall Collins (Limerick County, Fianna Fail)
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Home visiting programmes are recognised as having positive outcomes for families who receive them. The intention of the Minister, Deputy O'Gorman's Department with the additional funding from the children's fund is that an increased number of children and families will benefit from such a service. As mentioned earlier, Traveller and lone parent families will initially be targeted. Based on the evidence gathered, a co-ordinated and prioritised national approach can then be implemented with a view to expanding access to regions and cohorts that currently do not have access to home visiting services. This funding will have a real positive impact for children and families who are vulnerable and experience disadvantage in Ireland. Additionally, families can avail of universal and targeted parenting support programmes available in their areas, provided by Tusla, the HSE and their partners in the community and voluntary sectors. All of these services are aimed at supporting parents and carers to be more confident and capable in their parenting role, helping to achieve the best outcomes for children and families.