Tom Clonan (Independent)
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I thank the Minister of State for being here. I appreciate it very much. I know it is not only the day, but also the week, that is in it. I understand the pressure he is under.

This is a grave matter I wanted to raise with the Minister of State. I have been approached by a number of very senior therapists in the HSE West and North West region about something contrary to the Children First Act and the Criminal Justice (Withholding of Information on Offences against Children and Vulnerable Persons) Act. As part of and within the scope of their professional practice, they became aware of an individual who had disclosed watching images of child sexual abuse and to also having had sex with a minor, that is, he raped a child. This absolutely meets, and exceeds, the threshold for mandatory reporting as set down for all professionals involved in this area. However, a senior manager in the HSE West and North West region took it upon himself to indicate that nobody could make a mandatory disclosure to the authorities in relation to a risk to children except him. He abrogated this. He furthermore said that it was his view that what had been disclosed to this therapist and then discussed at the therapeutic multidisciplinary team meeting did not meet the threshold of mandatory reporting, which is completely and utterly incorrect. The people of Cavan, Roscommon, Donegal and Leitrim would be alarmed to know that a senior gatekeeper of information does not want disclosures of child sexual abuse and the rape of children to be disclosed, and that accelerates the risk to other children in that region. This is a very grave matter that requires immediate intervention.

There is another component to this. The therapists involved are extremely experienced. I have met them. They are people of absolute integrity and great empathy. They are the very best of us in terms of their public service. They were so concerned about this that they made a report to An Garda Síochána anyway, which is what they should have done and are mandated to do. They discharged their duties. They have since become the subject-----

Nicole Ryan (Sinn Fein)
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The disclosure is identifiable.

Tom Clonan (Independent)
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Apologies. There is now a pattern of retaliation and reprisal visited upon that team and the most senior of the therapists has had his role severely curtailed. There is this kind of reprisal for people who stand up to do the right thing.We are well aware of this pattern of reprisal and retaliation in the public service. That has a further danger because it sends a message to other professionals in the area that if they raise a concern, they are likely to be subject to hostile scrutiny. It really compounds what is already a toxic dynamic and makes it much worse. I hope that the Minister could intervene to make sure that person is restored immediately to their full duties and an assertion that the person could never promoted also needs to be clarified and withdrawn. This is one of the most qualified and experienced clinicians in their area. To be told they would never be promoted, having raised a concern around a risk of sexual abuse to children beggars belief. We wanted the Minister of State to make a statement on the matter and indicate what action can be taken.

Mary Butler (Waterford, Fianna Fail)
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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.

Tom Clonan (Independent)
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I thank the Minister of State. I am very reassured to hear that the CEO of the HSE, Mr. Gloster, shares the concerns of these three therapists. To look at this in the round, they were so concerned that they reached out to a public representative looking for help. My background is in researching systemic and systematic sexual violence in the Defence Forces. When reprisal is visited on the person who discloses such sexual abuse, the problem persists. That is why we have had 25 years of ongoing abuse of women in the Defence Forces, notwithstanding the original disclosures that were made. The harm is not reduced. That is my concern here. The Minister of State is alarmed at the manner in which this matter has been handled. It has not been dealt with properly. The most important thing here is the welfare of children. The ongoing reprisal against the senior therapist has to stop now because it will deter other people of integrity from coming forward if they fear reprisal and retaliation within the west and north west region.

Mary Butler (Waterford, Fianna Fail)
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As a Minister of State in the Department of Health, I take safeguarding incredibly seriously. I have to be frank. For too long we have had a culture of silence in relation to child abuse, with cover-ups facilitated by institutions and those in positions of power and authority. I do not say that lightly. We also know of the harm caused to people who have been victimised and abused in the care of the State and services funded by the State. This is not new and unfortunately it is not something we can say is fully behind us in the past either. Culture change takes time. From the very introduction of Children First, we set out a very clear message for everyone. If in doubt, report it. Do not expect somebody else will. Furthermore, we placed a legal obligation on people in certain positions working with children and vulnerable adults and in other positions of authority to report any concerns they may have to Tusla or An Garda Síochána. It is the responsibility of all Departments to ensure that all staff in their Departments and the relevant sectors and agencies under their remit of and funded by them are aware of and comply with the obligations under Children First guidance and relevant legislation to ensure that children and young people are kept safe while accessing services provided or funded by every Department. I am happy to talk to the Senator offline after this.