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Dáil Éireann debate -
Thursday, 26 May 1994

Vol. 443 No. 3

Ceisteanna—Questions. Oral Answers. - Child Care-Family Support Services.

Bernard J. Durkan

Question:

1 Mr. Durkan asked the Minister for Health whether he has satisfied himself, in view of events over the past five years, that adequate resources and sufficient staff are available to all of the health boards to facilitate the implementation of child care legislation with particular reference to the need for immediate action where it is clear that children are at risk; the current scale of contact with such families; the recommended scale of such contact; and if he will make a statement on the matter.

Liz McManus

Question:

5 Ms McManus asked the Minister for Health the number of sections of the Child Care Act, 1991, which have been brought into effect; the number which remain to be implemented; if a timetable has been set for the implementation of the remaining sections; and if he will make a statement on the matter.

Theresa Ahearn

Question:

11 Mrs. T. Ahearn asked the Minister for Health whether sufficient social workers/psychologists are available to meet requirements in respect of children at risk, with particular reference to sexual abuse; if he has satisfied himself that the health boards have sufficient staff to intervene, visit and counsel in such cases; and if he will make a statement on the matter.

Seán Barrett

Question:

25 Mr. Barrett asked the Minister for Health the degree to which the health services have identified various at risk families throughout the country; the extent to which the services are in touch with such families on an ongoing basis; the regularity of such contact; the number of sexual abuse cases identified in the course of such work; the number of cases in respect of which remedial action has been taken; and if he will make a statement on the matter.

Bernard J. Durkan

Question:

28 Mr. Durkan asked the Minister for Health whether he has satisfied himself as to the degree of availability of health board staff in respect of at risk families, with particular reference to children; the extent to which regular visits are made to such families in the event of identification of a problem; and if he will make a statement on the matter.

Alan M. Dukes

Question:

35 Mr. Dukes asked the Minister for Health if his attention has been drawn to the total number of cases of suspected incest which are currently known to health boards throughout the country; the number of such cases in respect of which action has been taken, action is pending or where action is deemed unnecessary; and if he will make a statement on the matter.

Frances Fitzgerald

Question:

162 Ms F. Fitzgerald asked the Minister for Health when the Child Care Act will be implemented in respect of ongoing care for young people up to the age of 18.

I propose to take Questions Nos. 1, 5, 11, 25, 28, 35 and 162 together.

Seventeen sections of the Child Care Act have been commenced to date, including most of the preventative and service-delivery provisions contained in Part II of the legislation. The provisions that are now in force apply to children up to the age of 18 years. The remaining 52 sections of the Act will be brought into operation by the end of 1996 in acordance with the timescale determined by the Government. I want to emphasise that this is the shortest possible period within which the legislation in its entirety can be implemented having regard to the scale of the infrastructure required to underpin the legislation.

As part of a structured programme for the implementation of the Act, priority is being accorded to the commencement of Parts III, IV, V and VI which deal respectively with the protection of children in emergencies, care proceedings and the duties and powers of health boards in relation to children in their care. These provisions will greatly strengthen the powers of the courts, the health boards and the gardaí to intervene effectively in relation to child abuse. The need for the early implementation of these key provisions was underlined in the report of the Kilkenny incest investigation. When this has been achieved, arrangements will then be made for the implementation of the other outstanding provisions, including Part VII, which deals with the supervision of pre-school services, and Part VIII, which deals with the registration of children's residential centres.

There is no need for me to remind the House of the fact that, for the Act to be effective, it must be properly resourced. It is absolutely essential that the necessary services, facilities and staffing required to underpin the legislation are put in place; otherwise it will fail the vulnerable children and families it is intended to assist. This Government will not be found wanting in that regard. Since we came into office, unprecedented levels of funding have been made available for the development of child care and family support services which will enable the health boards to carry out their various statutory responsibilities under the Act.

In 1993 a sum of £5 million was provided for new service developments in the child care area. The important new initiatives funded from this allocation include: more than 100 new posts of social worker and child care worker; Three new consultant staffed child and adolescent psychiatric services; 20 new posts in child psychology; the expansion of the home maker and home help services; the establishment of community mothers programmes in a number of health boards; increased financial support for pre-school services in disadvantaged areas, and 30 additional hostel places for homeless children.

This year an additional £15 million is available for child care. This will meet the full year costs of the various initiatives begun in 1993 and will enable a further round of new service developments to be launched during this year. The child care policy unit of my Department is currently finalising proposals for a package of major developments in each health board area. I intend to announce details of these developments in the next week.

These allocations represent the largest ever investment of resources in the child care area and demonstrate my determination, and that of my colleagues in Government, to ensure that this Act is not simply implemented on paper, but that there is a real and tangible improvement in the level and quality of services and supports to assist children and families in need.

Some of the provisions require new regulations to give full effect to them. In this context, I might mention that two working groups have been established under the aegis of the child care policy unit of my Department to prepare the initial drafts of the new foster care and residential care regulations. These groups include representatives of the health boards and the relevant interest groups as well as of my Department, and their work will help to expedite the competition of the preparatory work that has to be undertaken before the next segment of the legislation can be brought into operation.

In the development of services in the child welfare area, particular emphasis is being placed on strengthening the community based child protection teams. These multi-disciplinary teams play a key role in the identification, investigation and management of suspected cases of child abuse. I am committed to increasing the number of social workers, child care workers, child psychologists and other specialist professional staff in the community in order to enhance the capacity of the health boards to intervene effectively on behalf of children who are in need of care and protection.

I have already referred to the substantial number of new posts which I approved in 1993; I shall shortly be announcing the creation of a significant number of further posts.

As regards the detailed arrangements for pursuing allegations of child abuse, the procedures followed by the health boards are in accordance with the guidelines issued by my Department in 1987. All the boards are taking steps to improve existing arrangements for the reporting and management of child abuse, with particular importance being attached to co-operation and co-ordination between the hospital and community care services of each health board. This is being done in response to a recommendation in the report of the Kilkenny incest investigation.

The detailed information sought by Deputies Durkan and Dukes is not readily available in my Department However, in recent years there has been a dramatic increase in the number of suspected cases of child abuse, particularly sexual abuse, reported to health boards. The boards now deal with some 4,000 new cases of child abuse annually. For example, in the latest year for which full details are available — the number of reports was more than 3,800 of which some 1,500 cases were confirmed, including more than 500 cases of child sexual abuse.

Considerable progress has been made in the last 12 months in building up child care and family support services and in strengthening the capacity of the health services to respond to the needs of deprived children, particularly those who are not receiving adequate care and protection. At the same time, I accept that much more remains to be done in this area. It is my firm intention that the momentum of the past 12 months will be sustained and that all necessary arrangements will be put in place to ensure, in so far as is humanly possible, that children are protected from abuse.

Will the Minister agree that there are glaring gaps in the services so far as the protection and care of children is concerned, which have been highlighted in the past number of years? Notwithstanding the lengthy and helpful reply he has read out to the House, those gaps will remain because, even where a problem has been identified, there appears to be difficulties in follow-up procedures. Will the Minister assure the House that follow-up procedures will not be found wanting in the future?

I accept the report of the Kilkenny incest investigation which highlighted a number of deficiencies in the support services for vulnerable families. I brought these proposals to the Government who accepted them. We are working on proposals to implement the provisions of the Child Care Act in full in the timeframe I outlined and the Government has provided me with the necessary resources to achieve that objective.

I have established a child care policy unit in my Department whose specific objective is to implement all the initiatives I have outlined, to work in co-operation with child care units in the health boards and ensure we attain the desired objective of a proper infrastructure of support for families and vulnerable children as soon as possible.

I am sure no one would doubt the Minister's intentions in this regard but I am concerned about the delivery of services. It is approximately one year since the report of the Kilkenny incest investigation was published. Has the Minister received a breakdown of health board requirements in respect of resources, staffing, funding, etc., to meet the provisions of the Child Care Act? Has he planned precisely how he intends to meet these requirements?

A section of the Child Care Act provides that children will be catered for up to the age of 18 years. Will the Minister guarantee these provisions are in place? I note he is quick to nod his head. I have evidence of a girl who was allegedly sexually abused since the age of seven. Through her teacher she approached the health board when she was 17 but was told that because she was over 16 years the service she required could not be provided. Are all health boards providing services for all children up to the age of 18?

Section 5 of the Act which deals with accommodation was implemented relatively early. It was reported last week that there are still children under the age of 16 years in bed and breakfast accommodation. Will the Minister indicate why that is the case?

Brevity should be the keynote to our proceedings.

I appreciate that. Children are living in inappropriate bed and breakfast accommodation. Is it a case that only the Western Health Board has complied with section 5 of the Act?

I outlined the framework within which we are working in what I thought was a comprehensive reply. Those sections of the legislation which are in force relate to children up to the age of 18. If the Deputy wishes me to examine a particular case, I will be pleased to do so. Other sections of the Act will come into force next year and 1996.

I am aware there are homeless children on the streets. The Government is very concerned about that. It is hoped to deal with the problem by way of the infrastructural build up of resources and personnel I have outlined. I said on many occasions that I could implement all sections of the Act by statutory instrument by applying my signature but I will not do that until I am confident that the infrastructure in terms of places, supports and personnel are in place. That is my determination in the time frame I have outlined.

Is the Minister satisfied that he has identified the reasons for a lack of a follow-up procedure in a number of cases in the past few years? Will that problem be addressed in his proposals?

Every case is considered on its merits. Unfortunately, now and again horrific cases of child abuse arise. I treat each case as a serious matter to be investigated in its own right and we learn from them. I said previously that no matter what resources are available, neither I nor anyone else could guarantee that no child will be abused in the future. It is my determination that, as far as possible, the support mechanisms will be in place to ensure the follow-up of every case of child abuse reported to the health services which needs monitoring or support and that every family recognised as being vulnerable will receive the resources and support it needs.

More than half the time available to us for the disposal of priority questions is now exhausted.

In response to my earlier question the Minister said he would not implement sections of the Act unless he could guarantee they could be delivered. Is this not what is happening in relation to section 5 which deals with accommodation? The Minister has not provided the spaces and, if anything the problem is worsening, particularly in the Eastern Health Board region. Young children are staying in bed and breakfast accommodation which the Minister acknowledges is inappropriate accommodation. Is he not doing what he has undertaken not to do?

I do not regard bed and breakfast accommodation as suitable for children. The problem of homelessness is not confined to Dublin, nor is it confined to Ireland. Youth homelessness is a new phenomenon that needs to be addressed. It is a more serious problem than simply providing accommodation. We need to analyse why children are on the streets. Sometimes they are driven from their homes by violence or abuse. We need to put in place the support mechanisms to support families so that children will not have to resort to taking to the streets or looking for accommodation provided by a local authority or a health board. I am determined to put this mechanism in place.

Meanwhile the children will have to stay in bed and breakfast accommodation.

We have made historic, unprecedented progress during the last 12 months and I am determined to maintain that momentum.

Will the Minister give an undertaking that where medical evidence indicates that a child has been sexually abused the child will automatically and immediately be moved into a place of safety?

I could not give such a guarantee. Each decision is made by a professional assessment team involving medical assessors and psychological assessors. Their best judgement will determine the best practice in each case.

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