Michael Colreavy (Sligo-North Leitrim, Sinn Fein)
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Question 38: To ask the Minister for Children and Youth Affairs her plans to expand the resources available to the national review panel of deaths of children in care. [32524/11]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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In January 2010 HIQA published Guidance for the Health Service Executive for the Review of Serious Incidents including Deaths of Children in Care. The Guidance became operational from March 2010. The Guidance required the HSE to establish a panel of appropriately skilled professionals, both internal and external to the HSE, to review cases under specified criteria. According to the HIQA guidance the panel should have an independent chair and deputy chair and professionals from a range of disciplines appointed for their professional expertise. The subsequent establishment of this panel and its resources is a matter for the HSE.

In accordance with the HIQA Guidance the HSE last year established the National Review Panel for the purpose of undertaking these reviews. Dr. Helen Buckley, Senior Lecturer and Research Fellow at the School of Social Work and Social Policy, Trinity College Dublin was appointed as Chair. Dr. Bill Lockhart, retired CEO, Youth Justice Agency, Northern Ireland, was appointed as deputy Chair. There are twenty ordinary members on the panel, eighteen of whom are external to the HSE. In addition, a senior professional manager and a senior administrative manager were assigned to support the work of the Panel. While the National Review Panel has been established under the auspices of the HSE, it remains functionally independent, making findings of fact and producing reports that are objective and independent of the HSE.

The National Review Panel recently published its Annual Report for 2010. The report covers the period from March to December 2010. During this period 22 cases of death were notified and 8 serious incidents. Of the 22 deaths reported 6 of these were due to natural causes, 4 were drugs overdoses, 4 were as the result of suicide, 4 were due to road traffic accidents, 2 were homicide and 2 were as a result of accidents other than road traffic accidents.

Given the fact that this is a new process, it is unsurprising that the Review Panel have remarked on the nature of the process itself and challenges in operationalising the HIQA guidance. HIQA have already agreed to review the guidance and are engaging actively with the National Review Panel and the HSE Children and Family Services in this regard. These are matters which will be considered by HIQA in the first instance and by my officials in the context of related policy and legislative developments already in train.

The first Annual Report of the NRP is the subject of consideration by the HSE and I would expect that any measures falling directly to the HSE which are necessary to strengthen the effectiveness of the review process will be implemented.

Denis Naughten (Roscommon-South Leitrim, Fine Gael)
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Question 39: To ask the Minister for Children and Youth Affairs the progress made to date on implementing the recommendations in the report on the Roscommon child care case; and if she will make a statement on the matter. [32331/11]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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The Report into the Roscommon case was published by the HSE on 27th October 2010. Since its publication the HSE has given assurances that practice in assessing and responding to child welfare and protection concerns is being applied to the necessary standard across all regions. The HSE has already stated that it is committed to learning from this and other reports to ensure that services are strengthened to help protect children to the greatest extent possible.

In relation to the specific family case the management of the case was transferred to Mayo ISA in January 2011 and the monitoring and oversight role is undertaken by the HSE Regional Lead for Childcare. Child in Care Reviews on all the children have been undertaken and chaired by the Regional Lead.

The local Management Team in Roscommon is leading out on implementation of recommendations and monitoring and supporting the process. An external consultant has provided training across disciplines on working with neglect, gender issues attachment and supervision.

Nationally Workshops were convened to share the learning from the Roscommon Inquiry with specific focus on the Recommendations of that Enquiry. The Workshops had a multidisciplinary focus and a Practice Guidance Document, 'Back to Basics' as disseminated which documented key messages with accompanying guidance.

One of the Recommendations from the Inquiry was for a National Audit of Neglect Cases to be completed, commencing with Roscommon. An external consultant has completed a Review of Practice and Audit of the Management of Cases of Neglect in Roscommon, and has highlighted both strengths and challenges. It is envisaged that an executive summary will be published in the near future. Positive outcomes included:

- Well established multidisciplinary arrangements and organisational structures which facilitated teamwork and communication

- Initial assessments routinely completed

- An emphasis on direct work with children and young persons and commitment to listening to children and ensuring their voices were heard

The Review found that in a majority of the cases, staff and managers displayed a commitment to early assessment of need and provided a range of supports to assist children and families, resulting in improved parenting capacity and better outcomes for children. The Review concluded that the challenges involved are similar throughout Ireland and the United Kingdom including the need for more authoritative social work, senior managers reviewing and auditing files, national supervision policy implementation and establishing thresholds for legal intervention in cases.

A Review of Progress following Audit was undertaken after three months and again this had many positive outcomes.

Achievements included:

- The recommendations of the Inquiry Report and the Review of Practice and Management of Neglect are being implemented via an Interdisciplinary Child Care Steering group.

- A monthly child care meeting chaired by the General Manager considers specific developments within the Child Care Service, including budgetary and resourcing issues, waiting lists and individual cases which require to be notified to senior management.

- Family Support Services have been streamlined to include a single point of entry and is being realigned with new social work boundaries.

Revised management structures have been put in place in Child Care Services in Roscommon and 5 additional social work posts were allocated to Roscommon in 2010. A further 3 additional posts have been allocated in Roscommon and will be appointed as soon as the recruitment pause is lifted. This is envisaged to be late 2011. The recent advertisement of the Children and Family Integrated Service Areas Managers who will soon be appointed will also further strengthen the management structure in the region.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 40: To ask the Minister for Children and Youth Affairs the facilities outside of this State to which children in care with specific behaviour difficulties are sent; and if she has considered developing a facility within this State. [32503/11]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Under the Child Care Act, 1991, the Health Service Executive has a duty to promote the welfare of children who are not receiving adequate care or protection. In discharging this function the HSE has in place a network of special care and high support facilities for children with specialised care needs. Beyond that, the HSE is on occasion, required to make arrangements for the placement of children in care facilities outside of the State to allow for access to therapeutic services not available in this country. This is done on as infrequent a basis as possible and only where such placement is considered to be in the best interest of the child. These children most commonly have severe behaviour difficulties, in some cases as a result of injury or accident or in others due to their childhood experiences.

Where children are placed abroad they remain in the care of the State and they have an allocated social worker who visits them in their placement. They also have a Care Plan and this is reviewed within the statutory framework. All units in which children are placed are subject to the regulatory and inspection framework of that jurisdiction and the HSE makes itself aware of any reports prior to placing a child abroad.

I am advised by the HSE that there were 15 children in placements outside the jurisdiction in 2010. The following facilities for overseas placements have been used by the HSE - Friends Therapeutic Community Trust, Fresh Start, Eden Priory Grove, Southlands, Coxlease, St Lukes Hospital Group, Alderwasley Hall School, Keys Childcare Led, Five Rivers, Quay Foyer, Redbank Treatment Centre, Watling House, Kibble and Jennifer House in the UK; Betterkeys, Camphill Community and Care in Northern Ireland and Boystown, Nebraska, USA.

I should emphasise that the referral of persons abroad for specialised therapeutic interventions is an established feature within our health and social care system and decisions in each case are made in the best interests of the individual. Some children have specialised needs, many of these are met by directly provided services or services commissioned by the HSE within Ireland. For a small number of children their needs are best met in specialised care settings abroad, primarily in the UK, which can provide an individually tailored mix of care and therapeutic interventions. The level of requirement for these services is closely monitored by the National Director and my officials. The establishment of the new Child and Family Support Agency will provide a further opportunity to review the development and configuration of the range of specialised residential provision in Ireland.

Peadar Tóibín (Meath West, Sinn Fein)
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Question 42: To ask the Minister for Children and Youth Affairs her plans to address the high numbers of children who are placed in the care of the State due to financial difficulties of their families rather than risk. [32508/11]

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Under the Child Care Act 1991 children should, in the first instance, be supported to remain with their families. Children should only be taken into care where the HSE has identified abuse or the risk of abuse, including neglect than cannot be prevented or resolved without the child being received into care.

My officials had a recent meeting with the Department of Social Protection at which this matter was discussed. It was agreed that there should not be any cases in which children enter the care system due to financial need rather than cases of abuse or the risk of abuse. If any such cases are identified by the HSE, my officials will work with the Department of Social Protection and the HSE to ensure that children are only received into care on the basis of risk to their safety and welfare that cannot be alleviated by financial support alone.