Vol. 457 No. 4
10 Mrs. Geoghegan-Quinn asked the Minister for Health the number of allegations of child sexual abuse which are the subject of Garda and health board investigations at present, if he favours the mandatory reporting of such allegations; and if he will make a statement on the matter. [15498/95]
11 Ms O'Donnell asked the Minister for Health the Government policy on mandatory reporting of child abuse allegations as distinct from the recent procedure established between the Garda and health boards; the outcome of a study on mandatory reporting undertaken on the subject in his Department; the difficulties, if any, that are holding up the introduction of mandatory reporting; and if he will make a statement on the matter. [15648/95]
43 Ms O'Donnell asked the Minister for Health the Government policy on the mandatory reporting of child abuse allegations as distinct from the recent procedure established as between the Garda and health boards; the outcome of the study on mandatory reporting undertaken on the subject in his Department; the difficulties which are holding up the introduction of mandatory reporting; and if he will make a statement on the matter. [15514/95]
I propose to take Questions Nos. 10, 11 and 43 together.
I welcome this opportunity to make a statement to the House on the question of mandatory reporting of child abuse, particularly in view of the amount of attention that the topic has received in the media in recent weeks. Many of these reports have conveyed the impression that the introduction of mandatory reporting is the panacea for the problem of child abuse. This is not the case and, as I hope to explain the introduction of mandatory reporting is not without difficult and is not something that we should rush into without carefully examining its implications.
Mandatory reporting involves placing a legal obligation on designated professionals such as doctors, nurses, social workers, psychologists, probation officers and teachers to report cases of suspected child abuse to the authorities. In some jurisdictions the report must be made to the child protection services; in others reports go directly to the police. Some countries have made it a criminal offence for a mandated reporter to fail, without good cause, to make a report and generally reporters are granted immunity from legal proceedings in respect of reports which are made bona fide and with due care.
In 1990 the Law Reform Commission in its report on child sexual abuse recommended the introduction of a mandatory reporting law here. In the light of recent suggestions that professionals should be under an obligation to report the slightest hint or suspicion of abuse, it is important to point out that the Law Reform Commission recommended that the scope of mandatory reporting should be strictly defined. Its report set out in very precise detail the circumstances in which a duty to report would arise. The commission went on to say: "We recommend that the obligation to report should arise when the mandated reporter knows or has good reason to believe that child sexual abuse has occurred".
It is also worth mentioning that the commission did not consider that there should be a mandatory obligation on professionals to report a suspicion that a child may at some future time be subjected to abuse. Furthermore, the commission said that it would be wrong to place professionals under a legal duty to report unspecified abuse. They said that it should remain a matter of judgement in individual cases whether to report suspicion of non-specific abuse.
In the light of recent events, it is also worth noting that the commission's recommendation was that reports be made to the health boards. It did not envisage placing a duty on professionals to make reports to Garda, although it would be open to them to do so. I make these points to illustrate that what has been written and said about mandatory reporting in recent weeks bears litte relation to the type of system envisaged by the Law Reform Commission, following its in-depth study of the subject.
There was also a reference to the fact that the Kilkenny Incest Report recommended the introduction of mandatory reporting. In this context, it should be noted that that report favoured the mandatory reporting of all forms of child abuse to the health boards, which, in turn, would be under a legal obligation to notify all cases and suspicions to the Garda.
As the House is aware, earlier this year I introduced a new procedure for the notification of suspected cases of child abuse and neglect between health boards and the Garda. This procedure gives effect, on an administrative basis, to the recommendation relating to mandatory reporting in the Kilkenny Incest Report in so far as health board and Garda personnel are concerned. It is only fair to inform the House that some difficulties have already manifested themselves since the procedure was launched.
The first relates to pregnant girls aged under 17 who present at maternity hospitals. As the age of consent to sexual intercourse here is 17 years, by definition a criminal offence has been committed. The question that arises is whether doctors and other health professionals should report all such cases to the Garda so that the Garda can investigate the circumstances leading to the pregnancy and, if necessary, initiate a prosecution against the putative father. I am sure that many Deputies share my alarm at such a prospect and at the danger that young expectant mothers might delay seeking medical assistance if they knew that by so doing their boy friends, who themselves might be under age, could find themselves the subject of a Garda investigation.
The second area of difficulty relates to counselling services being provided by health boards to adults who have suffered sexual abuse as children. It is inevitable that in the course of such work, health board staff will become aware of the identities of at least some of the alleged perpetrators of such abuse. The question that arises is whether staff should pass this information on to the Garda even when the victim has made it clear that he or she does not wish to make an official complaint. If it were to be decided that health professionals were under such a duty, it could deter victims from coming forward for support and counselling.
Having said all this, I want to make it clear that I have an open mind on the question of the introduction of mandatory reporting here. I am anxious, however, that all the implications of such legislation, including the type of issues that I have just outlined, should be fully teased out. Towards this end, I have established an ad hoc group of officials drawn from the three Departments in which I have responsibilities — Health, Education and Justice — and I have instructed them to prepare a draft discussion paper before the end of this year. This paper will set out the main arguments for and against mandatory reporting. I intend that the paper will form the basis of wide-ranging consultations with professionals groups and other interested parties.
Before I conclude I want to deal with a specific query raised by Deputy Geoghegan-Quinn. My Department would not be aware on a day to day basis of the number of child abuse cases being investigated by health boards and the Garda. However, the scale of the problem can be gleaned from the fact that the number of reports of all forms of abuse and neglect received by the health boards is approaching 5,000 per year.
Given the publicly stated acceptance by professional bodies, teachers, doctors and the Church of mandatory reporting, will the Minister accept that he and his Department, rather than these professional bodies, are most concerned about the difficulties of mandatory reporting? Could he put in context the fact that on a recent television programme he urged the Church very strongly to get involved in mandatory reporting by bishops and parish priests and so on of child sexual abuse allegations while, at the same time in his Department, he is not pursuing with the same degree of urgency putting in place the guidelines and safeguards necessary for the introduction of mandatory reporting?
I would remind the Deputy that I was the one responsible last April for putting in place guidelines for the health boards and the Garda. At that time I said this was an administrative form of mandatory reporting and that if experience led me to the conclusion that there were still gaps or difficulties which we had not taken account of I would be the first to introduce changes. It is recognised from all that has been said that this is a very complex issue with which one must proceed to deal with a certain amount of caution. Nevertheless, I have instructed the officials in the three Departments for which I have responsibility to prepare a discussion paper as a matter of priority so that it will be ready before the end of the year. As my responsibilities relate to the Departments of Education, Justice and Health, I may have a certain advantage and greater overview which makes me more conscious of the problems in this area and of the necessity to adopt an overall approach which will take cognisance of some of the problems to which the Deputy referred.
In his statement the Minister said he has instructed his officials to prepare a draft discussion paper and I should like to know if he is aware that on 17 May 1994, 17 months ago, his predecessor stated in reply to a question from me that he had initiated a process for the drafting of a discussion paper in his Department. Will he explain what a discussion paper is? Is it pulled out of a hat in a Department whenever pressure arises as a result of a horrific tragedy or case? Is it studied by departmental officials or do other people participate in the discussion process?
Does the Minister accept that the 1987 guidelines, as updated by him last April, are not being adhered to and have failed to protect children at every opportunity? In this respect I would remind him of the Kelly Fitzgerald case, the west of Ireland farmer case, the Madonna House case, the Trudder House case, the raft of clerical abuse cases and the Drogheda Hospital case where the guidelines failed abysmally to protect children. Is the Minister happy to say to children, and to those who are concerned about children they believe are being abused, that a discussion document is being prepared in his Department, a document similar to the one referred to by his predecessor 17 months ago?
This question is going on too long.
Is the Minister proud of this action given the imperative in public policy to protect vulnerable children from abuse?
I accept that a certain amount of exaggeration is felt necessary at times in order to make a point. However, to describe the guidelines as an abysmal failure and to then paint a picture in the way the Deputy has done is unwarranted exaggeration. She asked if discussion papers were pulled out of a hat in Departments. This discussion paper has not been pulled out of a hat.
Is it the same discussion paper as that referred to by the then Minister, Deputy Howlin?
The Deputy made a long contribution——
The Minister should answer the question.
Will the Deputy please let me finish my reply. This is a very complex issue. In its conclusion the Law Reform Commission said that the law should be specific enough to discourage over reporting, whether by the over zealous or the defensive reporter while on the other hand it should be broad enough to facilitate the identification of children who are generally at risk and should be based on a definition of child sexual abuse which lays down a minimum rather than an optimum standard of care towards children. This makes it perfectly clear that one does not proceed to deal with this matter unless one has given it very careful consideration.
When I issued the guidelines last April I said it probably would be necessary to look at them again and that is what I am doing as a result of experience in two cases. I assure the House that in terms of discussion papers etc. there will be no undue delay in dealing with this matter. While people in the professions and other fields have their own interests I regard the welfare and interests of the child as paramount and I will not allow anything to divert me from those considerations.
Will the Minister describe the staffing and structure of the child care division of the Department of Health? Does he intend to set up a proper child care inspectorate in the Department to investigate allegations of child sexual abuse and the non-investigation of same within health boards? Will he outline in clear terms, as opposed to employment numbers or new plans or initiatives, why a child who is sexually abused today is better cared for and better off than a child who was abused ten or 20 years ago?
There are questions on the Order Paper dealing with the issue of the inspectorate and I will deal with the matter when replying to them.
It is possible that we will not reach those questions.
The question of whether a child who is abused today is better off than a child who was abused ten or 20 years ago should not even be posed.
Why?
The situation has vastly improved from what it was even one or two years ago.
Give us an example.
For example, the provisions of the Child Care Act, introduced by the previous Administration in 1991, had not been implemented when we came into office last year——
They have not been implemented to date.
The timescale for the introduction of the provisions of that Act is ahead of schedule. The Government is committed to the implementation of certain sections of the Act before the end of the year and today week 44 sections will be brought into operation. We are also ahead of schedule in terms of the sections to be introduced before the end of next year. I have moved beyond that Act and into other areas which will better protect children against abuse and neglect in the community. I will make announcements in this regard in the not too distant future. While the implementation of the provisions of the Child Care Act is a considerable improvement in regard to children it is not all that I would like to see done and more action will be taken.
I asked the Minister to describe the current staffing and structure of the child care division in his Department.
I did not regard that as part of the question asked. The fact that the Child Care Act is being implemented so far ahead of the schedule laid down indicates that the necessary resources are being put into that section.
Does the Minister know the number of people working in that division?
Of course I do.
How many?
The Deputy should table a separate question.
I call Deputy O'Donnell.
That is a cop out by the Minister. It is the smallest division in his Department.
The Minister did not answer my question about whether this is the same discussion paper announced by the then Minister, Deputy Howlin, on 17 May 1994 or a new version of that paper.
This is my discussion paper——
So the Minister is starting all over again?
——which arises from the instructions I have given to my staff on this matter. I understand that the preparation of the discussion paper promised in 1994 was, to some extent, diverted by the concentration on the necessity of issuing the guidelines to which I referred. The discussion paper for which I am responsible is being given priority.
Why is it when discussing the enhancement of statutory mechanisms and other procedures to protect children, successive Ministers for Health have always pointed to the reasons things cannot be done, breaches of confidentiality, a reluctance to hold public officials in health boards liable for nonfeasance of their statutory duties and a raft of other reasons? All we have had since 1990 when the Law Reform Commission recommended mandatory reporting is a revamped version of the 1987 guidelines which constituted an abysmal failure to protect children.
I have many merits but I am not in a position to speak for successive Ministers for Health. To be fair I do not think any of them adopted that attitude. In recent years we have all been very concerned to do everything we possibly can to minimise and eliminate the abuse and neglect of children. I will take whatever action is required towards that end. I cannot be accountable for the delay since 1990 in implementing the Child Care Act, but since I was given these responsibilities ten months ago substantial progress has been made. The House may expect further substantial progress in the near future.
The Minister of State indicated that he intends to implement a further 44 sections of the Child Care Act. While this is welcome what extra organisational structures will be put in place? Will he confirm if the number of staff in the child care division in the Department of Health is fewer or more than ten?
The health boards have a major function in the implementation of the Child Care Act. I am not directly responsible for those working within them, but significant changes have been made. The Minister for Health has indicated that there will be further significant changes, particularly in the Eastern Health Board and I will consider these with great care. If the Deputy really wants an answer to the second part of her question — I do not know what she is trying to do——
I would like the Minister of State to confirm that the child care division is one of the smallest within the Department of Health and that he is asking too much of the staff working within it.
If that is the case, they are behaving very well. I have already emphasised that we are ahead of schedule in delivering on the commitments contained in the Programme for Government. If additional resources and personnel are required, they will be made available, but I am satisfied at this time that there are sufficient personnel and resources in the child care division to carry out the job they are expected to do.
We will take Questions Nos. 12 and 13 in ordinary question time.
