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Dáil Éireann debate -
Thursday, 13 May 1999

Vol. 504 No. 6

Adjournment Debate. - Hospital Admissions.

I thank the Minister for Health and Children for attending the House to take this matter on the Adjournment. Last Tuesday a very worrying report was launched by the organisation Children in Hospital, Ireland. The study it commissioned shows that half the children admitted to hospitals are admitted to adult wards where they are exposed to sights and sounds which can have a traumatic impact on them and the effects of which can have lasting consequences on their future wellbeing.

Although most of us generally assume it is accepted practice that parents are with their children during their time in hospital, extraordinarily the study shows that four hospitals will only allow parents to visit at certain times. The period immediately before and after surgery can be the most stressful time for children. At such times they need their parents to be with them. The study found that many hospitals actually discourage parents from being with their children at this very vulnerable time.

Children in adult wards are deprived of the benefits of child and family centred care where facilities and staff are focused on their needs and where the general organisation of the hospital routine is in line with what children need, not necessarily in line with staff or adult patient requirements.

We should all be grateful for the service provided by Children in Hospital, Ireland, a group that has raised the issue of addressing the needs of children in hospital. Sadly, many such children are in hospital for long periods of time and their needs for emotional support, education and recreation should be catered for. In addition, the children require other practical support, including visitors in situations where parents may be living some distance from the hospital. Very good work is being done by Children in Hospital, Ireland, and that has been added to by the research the group commissioned, which has just been published.

It is unfortunate that the political response at governmental level has been very weak. There was scant attendance by politicians at the launch of the research findings, even though many people were invited. When they got a slot on "Morning Ireland" neither the Minister nor a representative was prepared to appear and respond to the valid issues they raised.

It is now 40 years since the Platt report on the welfare of children in hospitals was published. That report suggested a framework for how children in hospital could be cared for appropriately in a manner which encompassed all their needs and which recognised the necessity for involving the family in caring for children in hospital. Central to the proposal of that report is the recommendation that children should be nursed with other children and not adults. Since the publication of that report in 1959, international and national expert opinion has steadfastly supported and endorsed that view. However, those who work with children in hospital are very concerned that their needs are not being met and the research produced by Children In Hospital, Ireland, attempts to quantify the scale of the problem.

That group makes a number of recommendations to the Minister and hopes for a respond in the near future. The Minister declined to respond this week, which is one of the reasons I raised this matter on the Adjournment. There is much talk of the ill-treatment of children in the past in various institutions and we should bear in mind that our record in the treatment of children at present is not one we can be proud of. Too often the needs of children are relegated to the bottom of the agenda and we seem to take the view that children are somehow less than full citizens and therefore do not have the same rights as adults. For that reason we should pay particular atten tion to a group of children which is particularly vulnerable – children in hospital.

I know this group has contacted the Minister. It has articulated its concerns and has sent a copy of its research to the Minister. It wants the rights of children to be cared for with other children and other adolescents to be recognised by the Minister. It wants recognised children's rights to parental and family support as well as the right to adequate facilities.

The basic right of children in hospital is that they do not have to wait too long and the Minister should tackle the waiting lists. He should be prepared to go through the research commissioned by this group and to give an undertaking to address their concerns as a matter of urgency.

I thank Children in Hospital, Ireland for preparing "Children being cared for in adult wards”, of which the Department of Health and Children received a copy yesterday. My Department supports the work carried out by this association and to that end has resourced a number of its initiatives in recent years. I have also attended some of its functions.

I note from the report that Children in Hospital, Ireland, considered those up to the age of 18 as children, while I understand that the specialty of paediatrics generally refers to children up to the age of 14 or so. This would suggest that there are a considerable number of definitional issues which require clarification and I am sure the association will assist me with this matter.

In addition, there are often other factors to be taken into consideration in this whole area which can be lost in a simple statistical analysis. For example, the accommodation of adolescents aged between 17 and 18 in a paediatric facility may on occasion be more inappropriate than treating this group of patients in an adult ward.

I would, however, support the suggestion that in all circumstances where children have to share facilities with adults in an acute hospital setting that the hospital management should establish protocols which take account of the sensitivities and needs of all patients concerned, particularly in relation to the children.

I am committed to providing acute care in an environment appropriate to the needs of all patients in line with established best practice. I am also conscious that where emergency treatment is required the provision of the treatment is the priority rather than the surroundings in which it is provided.

However, I would be concerned at any situation where children may be inappropriately accommodated in adult wards. I have therefore asked my officials to examine the content of the report. On completion of this examination my Department officials will discuss any issues which arise in the course of this exercise with the chief executive officers of the health boards and the chief executive officers of the major acute hospitals in the Dublin region. My Department officials will then be in a position to meet representatives of Children In Hospital, Ireland to discuss its report in greater detail.

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