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Dáil Éireann debate -
Thursday, 25 May 1995

Vol. 453 No. 5

Ceisteanna—Questions. Oral Answers. - Kilkenny Incest Investigation Report.

John O'Donoghue

Question:

9 Mr. O'Donoghue asked the Minister for Health the plans, if any, he has to implement the recommendations of the Kilkenny incest investigation report. [9450/95]

The central recommendation of the report of the Kilkenny incest investigation was that the necessary resources be made available to facilitate the implementation of all sections of the Child Care Act, 1991, particularly those provisions which relate to the care and protection of children who are being abused or neglected. In accordance with the commitment in the policy agreement A Government of Renewal, the remaining provisions of the Act will be implemented by the end of 1996. I am determined that this objective will be achieved and that the legislation in its entirety will be fully operational within the timeframe set by the Government.

The next phase in the implementation programme involves the commencement of Parts III to IV which deal respectively with the protection of children in emergencies, care proceedings and the powers and duties of health boards in relation to children in their care. It is my firm intention that these provisions will be implemented before the end of 1995. Their early introduction will greatly strengthen the powers of the health boards, the Garda and the courts to intervene on behalf of children who are in need of care and protection.

Parts III to VI contain the most complex provisions of the Act and must be brought into operation at the same time. Various sets of new regulations are required to give full effect to them. Extensive preparatory work is under way in my Department to facilitate the commencement of these provisions before the end of the year. Draft new foster care regulations and a new guide to standards in children's residential centres have been prepared and circualted for comment to the various interest groups, in accordance with a commitment given when the legislation was being processed through the Oireachtas. Further draft sets of regulations relating to the placement of children with relatives and in residential care are in the pipeline and will be circulated for comment before they are finalised.

When Parts III to VI of the Act have been brought into operation, arrangements will then be made for the commencement during 1996 of Part VII which deals with the supervision and inspection of pre-school services and Part VIII which relates to the registration of children's residential centres.

It has always been recognised that for the legislation to be effective, it must be backed up by a sustained programme of investment in the development of new child care services and family supports which are capable of responding to the needs of those whom the Act is designed to help. The implementation of Parts III to IV in particular have enormous resource implications. The various new initiatives, approved during 1993 and 1994 at an annual cost in the region of £20 million, were specifically aimed at preparing the health boards for the introduction of those Parts.

The Government is anxious to build on the progress that has so far been achieved in developing and expanding services and supports for children and families in disadvantaged circumstances. A sum of £10 million has been set aside this year to finance a further round of new child care developments which will again be targeted at strengthening further the capacity of the boards to meet the new demands about to be imposed on them. Details of these developments are currently being finalised by my Department in consultation with the health boards.

These allocations represent the largest ever investment of resources in the child care services and reflect the concern of the Government and the community in general that a comprehensive framework be put in place for the care and protection of vulnerable children.

The Kilkenny incest report also recommended that procedures for the identification, investigation and management of child abuse should be revised and that agreed Protocols should be put in place which clearly identify the roles and responsibilities of the relevant staff and provide for appropriate inter-programme collaboration within health boards.

At regional level, each of the health boards has reviewed its child protection procedures in the light of these recommendations and has taken specific measures to improve arrangements in this area. For example, the North Eastern Health Board recently launched a manual of child protection guidelines, intended to promote good practice by ensuring that child care professionals are provided with standardised guidelines on the detection and inter-agency management of child abuse. Similar procedures are currently being developed by the other health boards.

At national level, a new procedure for the notification of suspected cases of child abuse between the health boards and the Garda was recently launched. This procedure amends the child abuse guidelines issued by my Department in 1987 in relation to the interaction between health boards and the Garda in child protection matters. It clarifies the circumstances in which the health boards and the Garda are to notify suspected cases of child abuse to one another and gives guidance on the consultations that should take place following such a notification. A central feature of the procedure, which is in line with a key recommendation of the Kilkenny incest report, is a standardised notification system between the agencies. This is designed to facilitate a uniform approach to the notification of suspected child abuse on the part of health board and Garda personnel throughout the country. The document has been framed in a way that will facilitate the twin objectives of protecting the child and the full investigation of any alleged offence.

I believe that the new procedure represents a significant step forward in achieving the closest possible co-ordination and co-operation between the health boards and the Garda, who are the two key players involved in the difficult area of child protection. The operation of the procedure will be evaluated on an ongoing basis and, if it emerges that it needs to be strengthened or extended, this will be done.

The Kilkenny report also recommended that there should be mandatory reporting of child abuse by designated professionals. The new notification procedure gives effect to this recommendation on an administrative basis in so far as health board personnel and the Garda are concerned. In the light of experience in the operation of the procedure by the two main players involved in child protection, it is intended to produce a discussion document on mandatory reporting as a basis for widespread consultations with the various interested parties.

In relation to the reporting of child abuse coming to the notice of general practitioners, the Medical Council has revised its guidelines on medical confidentiality as it relates to child abuse. This is in accordance with a recommendation of the Kilkenny report.

A Leas-Cheann Comhairle, this is a speech, not a reply to a parliamentary question.

Deputies will know that the Chair has no role in Ministers' replies.

It is unfair to members of the Opposition.

I thought it would be generally considered that this was a very important matter, particularly appropriate for answer at present. Therefore I wish to give the fullest possible reply to the House.

The recommendations in the report relating to the development of appropriate diagnostic, treatment and support services and facilities in each health board area for victims of child abuse and their families are being addressed in the context of the programme of investment in new child care services under the Child Care Act, 1991. A significant proportion of the additional funding made available for the implementation of the legislation has been used to improve and expand services in this area and to recruit additional psychiatrists, psychologists, social workers, nurses and other professional staff. Further progress will be made this year in developing these services.

In the area of prevention, the Kilkenny report recommended the extension of the "Stay Safe" child abuse prevention programme to all classes in primary schools. This important programme is currently being implemented in schools throughout the country with the active support of my Department, the Department of Education and the health boards.

My Department is also providing financial support to the Women's Aid organisation for the development of a Protocol for hospital personnel dealing with victims of domestic violence who are admitted to accident and emergency departments. Such a Protocol was also recommended by the Kilkenny report.

The report also contains proposals concerning the role of agencies outside the health services in relation to child abuse. Developments in response to these include the establishment by the Garda Síochána of a woman and child Unit to specialise and ensure an expertise in dealing with cases of child abuse. In addition, the recommendations relating to barring orders are being considered by my colleague, the Minister for Equality and Law Reform, in the context of a review of current legislation in this area. The implementation of the other recommendations in the report that relate to the health services will be pursued in the context of developing comprehensive and integrated structures and services for the care and protection of children.

The Minister of State is lucky that he is dealing with Deputies O'Donnell, Moffatt and myself rather than Deputy Gay Mitchell in giving a response of that length to one parliamentary question.

Is the Minister saying that, with regard to the new notification procedures, never again will circumstances arise in which health board officials investigating a case of child sexual abuse will wait up to nine months before notifying the Garda of such investigation? How many of the 62 outstanding provisions of the Child Care Act, 1991 have been implemented since 15 December 1994? Furthermore, does the Minister consider that the group established by the North Western Health Board this week to handle an inquiry into the horrific case of child sexual abuse will be, or can be, independent? For example, will all of the parties involved in the case be interviewed separately, including health board staff and general practitioners who may have been involved? When does the Minister expect a report from this group?

Would the Minister of State not consider it more appropriate, efficient and effective that an independent inspectorate be established by his Department to examine each of these cases of complaint in relation to child sexual abuse, its reportage, notification and handling so that the inspectorate could build up an expertise not necessarily available to all health boards?

The question tabled was a very broad one, necessitating a comprehensive reply——

——of ten minutes.

There were at least five questions included in the Deputy's supplementaries which I will do my best to answer. Deputy Geoghegan-Quinn asked whether I can give the House an assurance that never again will certain things happen. The reply is no. I do not think any Minister should give assurances of that kind. Nonetheless I am satisfied that the guidelines drawn up over a period, issued jointly by me and the Garda, will be effective. I have also stressed that if, over a period of time, they do not prove to be effective, we will have no difficulty in re-examining them. I must take this opportunity of paying tribute to the Garda for the manner in which they have co-operated in this extremely sensitive matter, one we all hope will continue to be handled sensitively.

The Deputy asked how many of the recommendations of the Kilkenny incest report are outstanding. I have heard a number of figures bandied about in relation to how many of them have been implemented. There has been what I would consider creative accounting in calculating the number of implemented to date. There are in the region of 22 substantive recommendations in that report, but there are also subsidiary ones. The guidelines issued jointly by the Department of Health and the Garda covered ten of the subsidiary recommendations contained in that report. I hope that answers that part of the question.

How many still await implementation?

Very few await complete implementation.

The Minister must know how many.

The great majority of them have either been implemented, or are in the course of implementation, but there are a couple that must await other developments before being implemented. It depends largely on the implementation of the Child Care Act and I have spelled out the position in that regard. The inquiry into the terrible and well publicised case in the west has been set up and I have nothing further to state in that regard. It was made clear that the inquiry will be completed within weeks. The independent inspectorate, in relation to which a question was put to Deputy Noonan and referred to me, is one of a number of suggestions being considered in the Department and it has much to recommend it. As far as the Government is concerned the implementation, as quickly as possible, of the Child Care Act is the main goal.

The Minister went into great detail on the additional resources required. Will he agree that not all recommendations cost money? No amount of resources can compensate for failure of accountable management systems. Will the Minister agree, in view of the last three disasters in our health boards — the Kilkenny incest case in the South-Eastern Health Board area, the Kelly Fitzgerald case in the Western Health Board area and the present case in the west which comes under the North-Western Board — that it is time to introduce answerability for health boards? These cases clearly indicate culpability and failure of management and inter-agency co-operation, which is unacceptable. Will the Minister also agree, if we are to delegate responsibility to health boards for child protection services there must be accountability — for example, has any member of a health board, a social worker or other person dealing with these matters, who has failed in their duty ever been fired?

I agree with the necessity for accountability. I have been very well aware from an early stage that full implementation of the Child Care Act depends to a large extent on the way health boards operate its provisions. I have spoken to some health boards about this matter and I intend to speak to the remaining health boards in the near future. I hope I do not have to point out their great responsibility under the Act but I will emphasise it anyway. I do not wish to add further to certain matters which are currently under investigation.

On the independent inspectorate, as Deputy Currie is also Minister of State at the Department of Justice I urge him to follow the example of the Garda. When all these cases came to light the Garda discovered it could not operate on a Garda division basis in the inspection and investigation of these cases and it very quickly set up a domestic violence unit in Harcourt Square to build up the expertise necessary and feed it to each division. Does the Minister agree that to overcome the problems experienced day in and day out in each health board area with child sexual abuse and domestic violence the immediate establishment of a national inspectorate is necessary? That would ensure the expertise required is available and that whatever investigation takes place is carried out independently by experts?

I have paid tribute to the Garda for the work it has done in regard to the joint guidelines. I also pay tribute to the Garda on the matter raised by the Deputy as a result of her experience in the Department of Justice. I have an advantage in that I am Minister of State at the Departments of Justice, Education and Health and I can take a wider view because I exercise a co-ordinating role. While I have considered with great interest the suggestion made by the Deputy on the inspectorate I am also considering other ways in which this necessary job may be achieved. The Deputy can rest assured that sufficient weight is being given and will continue to be given to her suggestions.

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