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Dáil Éireann debate -
Thursday, 22 Mar 2012

Vol. 760 No. 2

Other Questions

Question No. 6 cannot be taken as Deputy Éamon Ó Cuív is suspended from the House.

Question No. 6 lapsed.

Services for People with Disabilities

Pádraig Mac Lochlainn

Question:

7Deputy Pádraig Mac Lochlainn asked the Minister for Children and Youth Affairs her plans to support local childcare committees to bring professionals such as speech and occupational therapists into preschool services; if she will resource childcare committees to do this; and if she will make a statement on the matter. [15119/12]

The Chatterbox service, which facilitates early intervention in the area of speech therapy, is a successful collaborative social inclusion project between the Health Service Executive and the Cavan and Monaghan child care committees. The service was first introduced in 2004 and is funded under the health inequalities fund. It is proving to be an excellent early intervention tool, with a true partnership approach between the agencies involved. On a recent visit to the service I was pleased to see how effective it is. I said at the time to Deputy Ó Caoláin that it was a model that should be followed elsewhere. The issue links into the previous question on providing integrated services to young children in need of them.

Social inclusion services improve access to mainstream services, target services to needy groups, address inequalities and enhance the participation and involvement of socially excluded groups. The service is a primary health care project and is funded by the HSE. While I am very supportive of the initiative, responsibility for and funding of primary care services lies with my colleague, the Minister for Health. I continue to fund the child care committees. The committee in this instance has done an excellent job in terms of its role in supporting the implementation of the three national child care schemes and child care services generally, and has been involved in some of the initiatives.

In addition to the Chatterbox service in Cavan and Monaghan, pilot initiatives have been undertaken in other parts of the country to provide speech and language supports within child care settings. For example, the early years programme delivered by the Childhood Development Initiative in west Tallaght incorporates a speech and language service. This service offers support to children and training and support to parents and preschool staff. This speech and language service is being independently evaluated and the results will be available later this year. The development of the early years strategy will provide an opportunity to examine how we provide services and supports to children from birth to six years old. In that context we will have an opportunity to examine the type of service to which the question refers. We should examine initiatives such as these and they should inform national policy. They should also inform priorities for supporting children's development.

As I indicated to the Minister on the day of her visit, which was very successful, this was a matter we would address again. I do so today to gently urge the Minister to follow up on her positive response to what she witnessed on that day. It is important we try to emulate the example of the success of the Chatterbox service. The county child care committees are an appropriate vehicle for engaging with the greater number of preschool children today. They cater for approximately 95% of preschool starters.

It is not easy to say that.

I had to think about it when I had it said but I was right the first time. We do not expect the Minister to have a roll-out in train at this early stage following her visit but has she been able in the period since to engage within her Department to look at the concept to see how it could be done and whether it would be possible to find funding to roll out the approach across the board? Is it possible to ring-fence funding in that regard?

I knew Deputy Ó Caoláin would not delay in bringing the matter to my attention in the Dáil. I was very impressed with the service when I visited it on 17 February. I have spoken on the service since in the Seanad. As the Deputy is aware, county child care committees exist in every county. I spoke to the child care committee after I saw the service and suggested that the initiative which it had begun could be replicated and deserved to be. One way of taking it forward would be through the national child care committee system. I have initiated a new programme on county child care committees, namely, that they should work together at national level and begin to identify priorities at a national level as well as at a county level. This service is an example of an initiative which is all about getting services to families in an easier way for them. The service could be followed. I am awaiting evaluation reports from the community development initiatives which will also look at how well that type of service is working. Instead of parents having to go to appointments in a clinic, the services would be brought to them in a location where they are likely to be with their young children.

Would it be worthwhile as a first step to circulate for the information of other county child care committees, the tools employed and the concept itself in order to inform? It is only through the dissemination of information and the sharing of best practice ideas that we will germinate sufficient enthusiasm and realisation that there are other ways of doing things and that there is something that can be emulated in terms of the Monaghan county child care committee experience. The Minister's visit was very much appreciated. It would be important to take early steps to indicate good intent in terms of bringing the project to the widest possible attention, and I would encourage the Minister to so do.

I suggested to the Cavan and Monaghan child care committees that they circulate it and perhaps begin to have that discussion. If there is any way my Department can facilitate that, I would be happy for it to do so.

As I stated, I was impressed with the project. It is similar to the CDI project in Tallaght from which I am awaiting results. I would be confident that this is the kind of initiative that will be replicated. Certainly, I will be including it in my early years strategy as a model of good practice, as Deputy Ó Caoláin stated.

All of the evidence shows that if we reach out to children at an early age when they have a speech disability or any other disability such as an emotional or cognitive disability, in many cases the disability reduces and is dealt with more effectively.

I am pleased that Deputy Ó Caoláin raised in the House what is happening in this initiative in Cavan-Monaghan. It is one that certainly can be replicated. It would be interesting to hear the response of the professional organisations as well. I will arrange to get a response from them and I will communicate with Deputy Ó Caoláin on that.

Taking up from the points Deputy Ó Caoláin made, the importance of providing these services to children at a fairly young age cannot be over-emphasised. I would ask the Minister to look also at the crossover between children going from early years to primary school, in particular, in terms of ensuring those with speech and language difficulties get the services they require. If their needs can be addressed at that age, it has innumerable benefits down the road. It can ensure a child can catch up and be in a position to keep pace with his or her education as he or she goes on.

I ask the Minister to intervene in a particular case on which I am working in Drumfries national school in County Donegal where they are trying to set up a new class for a number of children who require speech and language assistance but are encountering difficulties because of the lack of speech and language therapists within the HSE in the area.

I thank Deputy McConalogue.

If the special class cannot be set up to allow those children come up to speed with their speech and language over a period of a year or two, they will instead have to get resource hours at a national school. If one were to add up these costs, they would be similar but with a much poorer outcome in the latter case for those children.

I thank the Deputy.

I ask the Minister to bring her good offices to bear, working with the Department of Health and the Department of Education and Skills, to ensure the case is addressed.

Perhaps the Minister could also look at conducting an assessment of the position across the rest of the country to ensure children coming from preschool get into special classes which cater for specific speech and language needs.

I call on the Minister to reply on the wider question.

Deputy McConalogue makes a good point on the transition point between early childhood services and primary school. That is something we need to manage. There is scope. I discussed this issue with the INTO when I met its representatives yesterday. They stated that in many instances, the preschool year is a considerable help because intervention is occurring at an earlier stage for children who need it, and those children are better prepared when they come attend primary school.

There is scope for shared speech and language therapists posts in a collaborative approach with a local service provider, whether it is with a school, as in the instance Deputy McConalogue suggests, or with a community initiative. There have been difficulties in recent years due to the lack of numbers of speech therapists but, in principle, the initiative Deputy McConalogue describes and the one we discussed are important. If Deputy McConalogue wishes to communicate directly on the case he mentioned, I will certainly follow it up.

Health Service Staff

Seamus Kirk

Question:

8Deputy Seamus Kirk asked the Minister for Children and Youth Affairs of the 60 additional social workers that were to be recruited in 2011 as part of the Ryan Report Implementation Plan, the number that have actually taken up their posts and the number of social workers who have retired as part of the early retirement scheme; and if she will make a statement on the matter. [15844/12]

The HSE provided for the recruitment of an additional 62 social workers in 2011. The recruitment process is being managed by the HSE national recruitment service. The executive indicated in December 2011 that all of these posts had been either filled or accepted. I am advised by the HSE that 51 individuals have taken up duty with the remainder expected to come on stream in the coming weeks. Obviously, individuals must serve out notice in jobs they hold already. My Department will continue to monitor the position closely in terms of recruitment of additional personnel.

The additional social workers are being targeted at priority areas of the service having regard to an overall assessment of workload undertaken by the national director and his team. The recruitment of the additional social workers is one element of a wider change agenda within the HSE, through which we can deliver better outcomes for children and families. This reform agenda will lead to the establishment of a new child and family support agency which will provide a dedicated focus on child protection and support families in need.

The latest information from the HSE indicates that 31 social work staff retired in February. While this number is relatively low in the overall context, it will, none the less, require a considered management response by the HSE. In this context, the national director of children and families services, Mr. Gordon Jeyes, will apply his discretion over the course of the year to the filling of vacancies, subject to this not compromising the achievement of employment targets and subject to services being provided within available resources.

I am conscious, as Members would be, of the financial and service challenges facing the HSE in 2012. This is the case across all care groups. These challenges are such as to require an acceleration of the reform programme which is a central element of the wider programme of reform for child and family services, including the establishment of a new and dedicated children and family support agency to which the Government is fully committed.

Additional information not given on the floor of the House.

My Department will be working very closely with the HSE throughout the year to ensure that the priorities set out in the HSE national service plan are implemented where they relate to children and family services. We have set an ambitious programme of work which is designed to strengthen the policy, legislative and practice framework significantly. Our shared goal is the delivery of appropriate, effective and consistent services, notwithstanding the challenging and demanding circumstances in which these services are delivered.

The position of social worker is crucial to the child protection system. That is why, as a result of the Ryan report, 270 additional social workers were to be recruited, according to the recommendations of the report, in addition to the back-filling of existing posts in the system.

The Minister stated that 31 retired in February alone. Are we to take it that the other 14 who she mentioned in the context of the previous figure of 45 will now not be retiring and have not taken up the early retirement option? I dispute the Minister's categorisation of social worker posts. From an initial tally, I was looking at a figure of approximately 70 for the number of retirements from social worker posts of different categories of child protection.

The Minister mentioned that an additional 25% of social workers were recruited in recent years in the area of child protection. However, little of this has taken place since she entered Government. In fact, according to the Minister's figures, last year there were only ten additional social workers in posts at the end of year. We now see that 51 of the 62 who were to be hired last year are in posts and, alongside that, the Minister stated that 31 retired in February. We are moving from the previous policy of ring-fencing the number of social workers required for the system to divesting responsibility for that to the discretion of the HSE. It is a backward step.

The Minister should set a target for the number of social workers needed in the system in line with the policy followed to date. It is necessary if we are to ensure the remaining gaps in the child protection system are addressed.

Deputy McConalogue is making incorrect predictions and assumptions, as he did in this House in July, September, November and December last. On each occasion he predicted that for 2011, the 60 posts recommended by the Ryan report and which I committed to recruiting would not be recruited and that the overall number of social workers would have gone backwards. On all four occasions and on both counts he was wrong. The 60-62 in fact were recruited and the total number of child and family social workers increased by 37 in 2011. Those are the facts.

The Minister's figures referred to ten.

Those are the facts. The Deputy said on four different occasions that I would not recruit the 60 social workers-----

I asked whether they were in their posts and they were not. Only ten were in their posts whereas 31 have retired.

Some 51 out of 62 have been recruited and are in their posts. In other words, 51 of the 62 posts recommended by the Ryan report have been filled . I can confirm that there have not been 45 retirements but 31, and some of those retired in January. It is clear that the recruitment has gone ahead and, while a small number are still to be recruited, the commitment to 262 additional social workers, which was what the Ryan report recommended, has been met. The Deputy should acknowledge this.

What about the 31 who retired in recent weeks?

I have explained that with 31 retiring, given there is no moratorium in regard to the social work posts, the director of child and family services, Mr. Gordon Jeyes, has the discretion to assess, as he must, where those vacancies have occurred, to examine the need and to make appropriate decisions, based on the information he has, in regard to social work generally. He will make those decisions. The situation is that 51 of the 62 additional posts recommended by the Ryan report are in place and there are 31 retirements. The director of child and family services has the authority to analyse what posts need to be replaced and what is the order of priority, given the resources he is managing and the challenging financial situation he faces.

Child Care Services

Dara Calleary

Question:

9Deputy Dara Calleary asked the Minister for Children and Youth Affairs her plans for improving regulation of the child minding sector; and if she will make a statement on the matter. [15832/12]

I recently announced that my Department has begun work on Ireland's first early years strategy. I have received Government approval for the approach I am taking in developing this strategy. I hope that, with all Deputies co-operating, it will be an innovative and dynamic blueprint for the future development of Ireland's early years sector aimed at providing a coherent approach to seeking to improve the lives of children from birth to age six. One of the issues of policy which I have identified for consideration in the preparation of the new strategy is the development of the childminding sector as a fully integrated component of early childhood care and education, in particular for the under-one age group.

At present, preschool services are regulated under the Child Care (Pre-School Services) (No. 2) Regulations 2006, as provided for under Part VII of the Child Care Act 1991. Services providing care for children who have not yet commenced primary school are required to notify their service to the preschool inspectorate of the HSE and are subject to regular inspection and report by the inspectorate. Services covered by the regulations include full-time, part-time and sessional services, as well as childminders taking care of more than three preschool children from different families in the childminder's home. Childminders taking care of not more than three preschool children from different families are not covered by the regulations, recognising parental choice to place children with friends and neighbours, and the challenges of the excessive regulation of the more informal arrangements chosen by parents.

The national guidelines for childminders, compiled by the National Childcare Co-ordinating Committee, which oversees the development of an integrated child care infrastructure throughout the country, provide guidance to childminders on good practice and assist them to decide whether they are subject to the regulations, as well as providing other useful information on the role of the childminder in the provision of child care services.

Additional information not given on the floor of the House.

The 2006 regulations replaced the earlier regulations, introduced in 1996, and made a number of improvements to the regulatory environment, including the introduction of a requirement for all staff and students working in a preschool service to have been vetted by the Garda. The main focus of the child care regulations is to ensure that services adhere to appropriate standards of health and safety. The 2006 regulations also refer specifically to the educational development and well-being of children and the need for services to ensure appropriate age related activities and material are in place.

As is the case with all regulatory requirements, the child care regulations set the minimum standards with which services are legally required to comply. However, my Department is proactive in promoting and developing the highest standards of care and education throughout the sector, given the important role these services play in this crucial phase of children's lives. In December 2010, national quality standards for preschool services were published by the then Office of the Minister for Children and Youth Affairs. These provide a framework within which services are encouraged to work towards best practice and a child-centred approach in their provision of early childhood care and education to preschool children. In addition, almost every preschool service in the State is now participating in the free preschool year in early childhood care and education, ECCE, programme, which is implemented by my Department. The ECCE programme introduced significant new requirements to ensure quality provision in preschool services.

All preschool leaders are required to hold an accredited major qualification in early childhood care and education. In addition, a higher capitation rate is in place for services which employ more highly qualified staff. This is acting as an incentive to service providers to improve the quality of their services and increasingly higher numbers of services participating in the ECCE programme are qualifying for the higher capitation.

A further aspect of the ECCE programme is the fact that it requires services to implement Síolta, the early education framework developed by the Department of Education and Skills. The programme also encourages services to implement Aistear, the early education curriculum for children from birth to age six. My Department will continue to review and monitor the regulatory environment for preschool services as well as supporting quality developments within the sector.

There are 73,000 families with preschool children relying on child care providers to enable them to work. However, the regulation and administration of the current regulations is patchy in many instances. It is from talking to people working within the system that one hears of the limited ability of the HSE to inspect childminders who should notify to the HSE but do not. This is an issue the Minister needs to examine further in regard to-----

A question, please.

Does the Minister intend to introduce additional regulations to enhance the ability of the HSE to check an inspect childminding operations which have not been notified?

Obviously, inspection of childminding facilities is critical and very clear rules are laid down in that regard. If the Deputy has information about any service which is not being inspected and which has been brought to his attention, I advise him to contact the HSE or my Department. We have very vigilant oversight. When I visit centres throughout the country, I hear of the ongoing challenges in regard to inspection, which the centres are happy to meet. There is a very proactive inspectorate. However, if there are services operating outside of that of which the Deputy is aware, he should bring them to the attention of the HSE.

One of the initiatives I would like to see in regard to childminding is more contact between childminders, who are often somewhat isolated, and local services. There is scope for work between the two. The child care committees are also working very proactively with the National Childminding Association of Ireland, which I have met on a number of occasions. Just last month, I launched a childminding development grant scheme, which has been welcomed by everyone in the sector and which seeks to encourage people to discuss standards and training and to access educational support. A lot is happening in this area.

The regulations are very important and a particular point is that staff must be vetted by the Garda. When the Government came into office, vetting was taking 13 weeks but it is now taking an average of two weeks. There has been a huge initiative in regard to vetting and dealing with the chronic delays which have been a feature in recent years.

Mental Health Services

Mary Lou McDonald

Question:

10Deputy Mary Lou McDonald asked the Minister for Children and Youth Affairs her plans to improve interdepartmental approaches in relation to child and adolescent mental health services; and if she will make a statement on the matter. [15116/12]

Child and adolescent mental health services are the direct responsibility of my colleague, the Minister for Health, in conjunction with the Minister of State with responsibility for disability, equality, mental health and older people. I work very closely with both Ministers, as I do with all Government colleagues, in regard to children's matters. Nevertheless, specific responsibility in regard to child and adolescent mental health services resides with the Department of Health and the Health Service Executive. I am aware that €35 million extra funding has been made available for mental health and that child and adolescent mental health services are a priority area for investment.

Key to the development of child and adolescent mental health services is the establishment of multidisciplinary community-based teams, of which 61 are in place. Special funding allocated to the HSE in 2012 will in part be used to strengthen these community child and adolescent mental health teams by ensuring, at a minimum, that at least one of each mental health professional discipline is represented on every team.

In the context of the establishment of the new agency, consideration has been given to the interface with specialist health services to improve the experience of children and families. In this regard, the task force on the child and family support agency recently met the HSE's assistant national director for mental health and the national clinical director for child and adolescent mental health services. I understand they had a broad-ranging discussion on the development and the interface between the child and family support agency and these services. The national children and young people policy framework being developed by my Department in association with other Departments will complement this effort. As part of this process, we will outline the interaction that must take place to ensure children have access to services. The framework will be published this year and cover a five year period. It will address the issue of priorities across children's services and the need for linkage to ensure services are delivered in a joined-up fashion, much as we discussed earlier in regard to speech and language services.

The focus of my question was the need to enhance interdepartmental approaches. While I recognise that the bulk of this issue falls under the aegis of the Department of Health, we have made the point across the Chamber - it has been accepted by the Minister - that there is an onus on her to take the lead in ensuring best practice is followed. It should not simply be left to the Department of Health. It is very important that the Department of Children and Youth Affairs is a lead player in all of this.

Although it does not come directly within the Minister's remit, I draw her attention to the several capital works proposed in increasing the number of inpatient beds across the State for child and adolescent psychiatric care. I understand the current complement is made up by 12 beds in Dublin, 12 in Cork and 12 in Galway. It has been signalled that a further 16 beds will be commissioned in the course of this year, including a number in Cork and Galway. There is also work signalled at two sites in the greater Dublin area, at St. Vincent's Hospital, Fairview, and St. Loman's Hospital, Palmerstown. Does the Minister have an update on these developments? If work on either of them has commenced, what stage has it reached?

In regard to child and adolescent mental care services, I have pointed out on several occasions that north of a line running from Dublin to Galway, there is no inpatient care support available. Does the Minister agree that this is one of several areas in which there is potential for co-operation, including cross-Border co-operation, in the provision of services? There are several appropriate locations where such co-operation could be facilitated, not least in my constituency which has been very much to the fore in developing mental health services. Great credit must be given to those at the coalface in the provision of this care. We are strategically located in terms of co-operation and working together on a cross-Border basis. I appeal to the Minister to consider this in the context of meeting future needs.

On the development of inpatient facilities, psychiatric bed capacity for children and adolescents has increased from 12 in 2007 to 44 at present, comprising 12 beds in Dublin, 12 in Cork and 20 in Galway, with a further eight beds planned to be commissioned in Cork during 2012. Additional beds will also be provided in the Dublin region. Work has already begun on the second phase of the child and adolescent unit at St. Vincent's Hospital, Fairview, which will increase capacity from six to 12 beds. In addition, the Health Service Executive's service plan for 2012 commits to the development of an eight bed inpatient facility for adolescents at St. Loman's Hospital, Palmerstown. A new child and adolescent day hospital will also open in Dublin shortly. It is envisaged that the provision of improved community-based services, coupled with the increase in bed capacity, will bring an end to the practice of placing children and adolescents in adult psychiatric facilities which is completely unacceptable in this day and age.

As I said, north of a line running from Dublin to Galway there are many services that tick the relevant boxes but nothing is available in terms of providing inpatient care. I ask the Minister to address this issue.

In regard to child and adolescent psychiatric services in the north Dublin region, the Minister will be aware that there are only six beds at St. Vincent's Hospital and very little support is available for 16 and 17 year olds. I have contacted her about several families in difficulty and she has responded positively. While I welcome her reference to six additional beds, nonetheless there remains a significant lacuna in this area. On the multifaceted care teams she has indicated are being established, there was a recommendation from the Mental Health Commission that 15 to 25 year olds be catered for within that provision. Will that type of service be provided, with psychiatrists who look after adults and those who specialise in the treatment of children working together?

Does the Minister propose to take any action to deal with the issue of eating disorders? A recent Scottish study shows that up to one quarter of children in the mid-teenage years, both boys and girls, suffer from eating disorders. Is tackling this issue a priority for the Minister?

My colleague, the Minister of State at the Department of Health, Deputy Kathleen Lynch, is addressing many of the issues raised by the Deputies. I am also liaising with her in the context of my concern and interest in these issues. According to the HSE, one in ten Irish children and adolescents suffers from a mental health issue. As such, it is extremely important that resources are available to meet their needs. There is a variety of ways by which this can be done. It is not simply about the mental health care teams, it is also about other services working with the young people concerned.

In regard to the services available in Deputy Broughan's area and Deputy Ó Caoláin's observation about the potential for cross-Border co-operation, decisions have been made on the provision of beds, as I have indicated. We are working from a very low base in these services.

I can only agree with Deputy Broughan on the issue of eating disorders. It is a source of serious concern that some 25% of three year olds have obesity issues. Service provision is a slightly different issue, although it is related to the broader issue in some ways. A number of new beds have been made available. I do not have the precise figures, but I will be happy to correspond with the Deputy in that regard.

Written Answers follow Adjournment.

The Dáil adjourned at 5.50 p.m. until 2 p.m. on Tuesday, 27 March 2012.

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