Vol. 776 No. 1
1. Deputy Dara Calleary asked the Minister for Children and Youth Affairs the number of special needs assistants being provided to children availing of the free pre-school year this year; and the way this compares to the number of SNAs provided to children availing of the free pre-school year in 2011; and if she will make a statement on the matter. [40667/12]
I am firmly committed to the transformation of Ireland's child protection and welfare services and to the establishment of a new child and family support agency. The necessary legislation is being prepared by my Department as a priority. It is anticipated the Bill will be published and enacted in the course of this session. It is my intention that the child and family support agency will assume statutory responsibility for services for children and families in January 2013. The final report of the task force that I established to advise on the necessary transition programme to establish a child and family support agency made recommendations on a number of key issues, including the range of services which, in the opinion of the task force, should fall within the remit of the new agency. These recommendations are being given detailed consideration by me and my Department in preparation for the establishment of the new agency.
The new agency, which will assume responsibility for children and family services that are currently provided by the HSE and the Family Support Agency, will be a dedicated agency with a sole focus. It will have approximately 4,000 staff and a combined existing budget of over €590 million. The agency will be headed by Mr. Gordon Jeyes, as the chief executive designate, who will be supported by a senior management team. The recruitment of this team is at an advanced stage. This is at the heart of our programme of reform of child and family services. The establishment of a single agency, underpinned by legislation and incorporating key child and family services, will provide a focus for the major reforms that are already under way under the national director for children and families, Mr. Jeyes. This reform programme contains a number of critical elements, including the continued and urgent implementation of a comprehensive change programme to improve the quality and consistency of these services. I have spoken on a number of occasions in this House about the lack of consistency in approach when families throughout the country look for services.
Additional information not given on the floor of the House
The reform programme also provides for the introduction of legislation to place Children First on a statutory basis; the establishment for the first time of a dedicated budget for children and family services in order to bring transparency and accountability to the use of resources to meet national priorities; the transition of existing HSE child protection and welfare and services into the new agency, the merger of the existing Family Support Agency with a budget of over €26 million into the child and family support agency and the consideration of the potential for further rationalisation of services for children under the new agency. At the heart of the new agency will be a new service delivery framework, which will differentiate between child welfare and protection cases so that family and child welfare concerns can be responded to by new multi-agency, community-based models for early intervention and family support. The new agency will represent the practical application of a new approach towards proportionate service responses, an approach which is central to the constitutional amendment on child protection which will be put before the people on 10 November.
I thank the Minister for her reply. I welcome her continued commitment to this agency. I ask her to clarify exactly when she hopes the legislation will be in place. As she knows, the timeframe between now and the end of the year is very tight. If she wishes to have the new agency up and running by January, she will have to bring legislation before the Oireachtas soon. The Minister will agree that early intervention is crucial. It is important to ensure there is early intervention in cases of child neglect. Will there be any additional recruitment for the new agency? How many staff have been transferred from other Departments so far? I presume this process has already started so that the January deadline can be met.
As I said, the new agency will have approximately 4,000 staff. We have established a shadow agency - an agency within an agency, in effect - within the HSE. Mr. Jeyes has been managing that process over the last year. We have reduced the number of managers from 34 to 16. We have provided for more direct accountability to Mr. Jeyes as manager. Those on the front line are now in much closer contact with their managers. The 4,000 staff will include staff from the child care and residential sectors and the Family Support Agency. A great deal of work has been done in the HSE to identify those members of staff who will fall within the remit of the new agency. The Deputy will be aware that my Department is responsible for services like the Family Support Agency, the National Educational Welfare Board, youth services and adoption and fostering services. Ongoing work is being done to identify the point at which other services might make the transition to the new agency. As the Deputy knows, the task force made a wide series of recommendations in its report. The new agency will be established and will be dealing with its core services by January 2013. Certain other services will move into the agency in the medium to longer term. It will depend on the outcome of the analysis and the decisions to be made by the Government. Ms Joan Carmichael of the IMPACT trade union is working as an independent chair to help staff to make the change. I welcome the broad support I have received across the sector as I have overseen the transition to the new agency.
Is it still the Minister's intention to maintain a governance structure similar to that of the HSE? She mentioned that the agency will be answerable to its new director, Mr. Gordon Jeyes. Will it be directly answerable to the Minister of the day? Political accountability is crucial in this regard. I raised this issue when the Minister launched the agency earlier in the summer. Given that the HSE is disbanding its current governance structure, it is regrettable that the Department of Children and Youth Affairs is seeking to develop a similar structure in this instance. The Minister has said that the new agency will have a budget of approximately €590 million per annum. Will the new agency start with a clean bill of health? I hope that a deficit will not have to be carried by the new agency as it begins its work. That would not be a welcome move.
There will certainly be political accountability. The Government has yet to make a decision on the exact model of governance for the agency. Obviously, that will form part of the legislation, which will be brought to the Dáil before December. The Deputy will be aware that the task force which examined the various forms of governance in operation among international child protection services was strongly of the view that the agency should have an independent board, especially in light of the nature of its child protection work. I have not made a decision on that yet. The agency will certainly be accountable to me as Minister. Of course there will be political accountability. The Deputy also asked about the starting budget. I hope the agency will start its work in a strong budgetary position. We are all familiar with the economic situation and the financial pressures that are faced by all services at present. Members will appreciate that there are big demands on these services. The HSE child and family budget and my Department's budget both increased last year. I hope the agency will start its work in a strong budgetary position. I will work to that end.
2. Deputy Caoimhghín Ó Caoláin asked the Minister for Children and Youth Affairs the number of children who have sought aftercare on leaving the care system during each of the last seven years; the number of children who have received aftercare on leaving the care system during each of the last seven years; and if she will make a statement on the matter. [41028/12]
Section 45 of the Child Care Act 1991 places a statutory duty on the HSE to form a view on whether each person leaving care has a need for assistance. If it forms such a view, it is required to provide services in accordance with the legislation and subject to resources. Under the 1995 child care regulations , the HSE is required to consider a child's need for assistance, in accordance with the provisions of section 45, two years prior to the child leaving care. All young people who have had a care history with the HSE are entitled to an aftercare service based on their assessed needs.
The core eligible age range for aftercare is 18 to 21 years. The HSE policy allows for this to be extended up to the age of 23 years on the basis of a need for assistance.
As I have previously advised the Deputy, regular statistics for young adults in receipt of aftercare only commenced being compiled and published by the HSE after I took office in 2011. I am now receiving quarterly reports on the numbers leaving aftercare; therefore, we now have more up-to-date figures than were previously available. I believe I supplied the Deputy with figures for the years 2007 to 2010, inclusive. As of June 2012, the statistics indicate that 1,053 young adults were in receipt of an aftercare service. As I told the Deputy previously, the budgets for aftercare provision across the country have increased substantially. While regular figures were not available before 2011, we are aware that the number of children in aftercare has increased, for example, from 847 in 2009 to 1,053 in June 2012. I will be getting new figures at the end of September. I have asked the HSE if it can compile the precise information requested by the Deputy for the seven year period. Although I do not have that information available today, I will try to get it. We have given all the data we have available.
Additional information not given on the floor of the House
The basis of an aftercare service is an individual needs assessment which identifies a young person’s need for accommodation, financial support, social network support and training and education. The level of support required will vary for each individual from advice to accommodation to further education, employment or training and social support. The most important requirements for young people leaving care are for secure, suitable accommodation, as well as further education, employment or training and social support. The most vulnerable group of young people leaving care are those who are not in education and training and those who have left residential care. Young people with mental health problems or a disability are also in need of particular support. Aftercare provision incorporates advice, guidance, networks and practical support. It is essential that all young people leaving care are provided with the type of transitional support that their individual situation requires. The provision of an appropriate aftercare service has been highlighted as a key element in achieving positive outcomes for young people leaving care.
Some 90% of children in care are in foster care, a large number of whom remain living with their foster families, supported financially by the HSE, on reaching 18 years of age. Many of these young people continue in education and training, as planned. This remains a key component of aftercare for young people when they leave care.
The HSE national aftercare service is underpinned by a national policy and procedures document which has been developed in co-operation with the key stakeholders, including the voluntary sector agencies representing children in care and those involved in aftercare provision and my Department. The policy which was finalised in April 2011 commits to promoting and achieving the best outcomes for young people leaving care and ensuring consistency of support for these young people. The HSE has established an intra-agency national aftercare implementation group to monitor progress in implementing the national policy. The work of this group is ongoing and I have asked Mr. Gordon Jeyes, national director for children and family services in the HSE, to prepare a report on aftercare. This report will include, inter alia, the key findings of the group, examples of best practice, assessment criteria and effective aftercare supports. The report will guide the development of policy to underpin the strengthening of legislation for services in this important area.
The Deputy will be aware that I am examining options, in association with the Attorney General, to strengthen legislation to make explicit the HSE's obligations in the provision of aftercare. The experience in implementing the national aftercare policies and procedures and the involvement of a range of important stakeholders in this process provide an opportunity to further improve policy and legislation in this area.
The Minister has responded to this question previously. I remain hugely concerned, which is why I continue to raise it with her. For her information, the last time she responded with figures up to the end of May 2012, the figure was 1,310. There needs to be a revisitation of the June figure as it could hardly have dropped so dramatically to 1,053. I am concerned about the process of establishing the figures.
Young adults 18 years and older need continuing support, particularly in these harsh economic times. As a parent of young adults, I am keenly aware of this, as many in this institution will affirm. As a substitute for birth parents, the State should treat those in our collective care no differently, which would be my certain wish. We must continue to protect vulnerable young people and our duty of care does not cease on their attaining their 18th birthday.
With all that has been exposed in recent reports, by which we are all deeply shocked, it is vital - I remake the case - to ensure a legal right to aftercare is included in the Statute Book to avoid future tragedies. The Child Care Act, as it stands, could be described as a hollow guarantee without including this legal right. There must be investment to ensure there will be sufficient resources in place to provide aftercare for all young people who require it.
I understand from previous responses that the Minister indicated ten additional dedicated aftercare workers would be recruited. Has she filled these additional posts yet? I understand there were already 45 dedicated aftercare workers in the HSE. Does the Minister accept the HSE's indication that aftercare must be provided according to needs and based on a needs assessment? Will she indicate how child or young adult friendly is this assessment? Are all young people being assessed post-care?
I appreciate the Deputy's interest in this issue and the reason for it. I share his view of the vulnerability of young people leaving care. We had the figure in 2010 of 2,000 young people leaving care. There is no question that there have been developments since, although I am not complacent about the matter. I will have to come back to the Deputy on the number of aftercare staff who have been recruited, but it is my understanding the recruitment did go ahead. I will confirm this for the Deputy.
There is now a national policy on aftercare, as the Deputy knows, and there has also been the very positive development of the establishment of the intra-agency national aftercare implementation group, of which EPIC, the group which works with young people to ensure their perspectives are taken into account, is part. The HSE has issued a directive that young people due to leave care be assessed.
I also said I would examine the legislation. When I bring forward the legislation to establish the new agency, I hope to bring forward within it a more explicit statement of the HSE's obligation in regard to aftercare. As the Deputy knows, my advice from the Attorney General, as well as my legal advice, has been that there is already a statutory obligation, but I will make it more explicit in view of the seriousness and importance of the issue. I expect to be able to include this in the legislation establishing the new agency in order that it will be very clear that it has the responsibility I will revert to the Deputy with the figures sought.
Will the Minister confirm that she is proposing a legal right to aftercare? To what extent is she prepared to move in terms of the new legislative provision? There are 100 young people leaving aftercare on an annual basis - perhaps the figure is even greater than this - and the number will continue to rise as more and more are catered for within the care system. Greater resources will be required into the future and it is essential we put them in place. Again, on the basis of the equality core value, those of us who are parents know that young adults continue to require our support. We should continue to treat children in our care no differently.
The Deputy will be interested to know that, for example, there are 614 young people between the ages of 18 and 21 years in receipt of aftercare and involved in education and training courses. There has clearly been a change in terms of the awareness of the needs of this group. Of course, it is important to point out that not every young person leaving care will be in need of aftercare. Some will obviously not want it or will just want to do their own thing and move on. There will also be quite a number of young people in the care system who will turn 18 and remain with foster families.
The Deputy's question points to the need for even more careful analysis of the figures. As I said - this is an issue I have had to confront across a number of areas - we need better quality information on precisely what is happening to young people who leave the care system. We are beginning to get this information. We are also beginning to see increased budgets and provision. Given the vulnerability of some young people in aftercare, as we saw in recent reports, we have to ensure we provide the very best quality service we can in order to help them make that transition from care.
3. Deputy Catherine Murphy asked the Minister for Children and Youth Affairs the input she has had in the preparation of the annual budget specifically in relation to proposed cutbacks in State funded services to children and young persons; the extent of consultation other Departments seek from her Department in the preparation of the budget; if she will provide a full list of State funded services to children and young persons which either partly or wholly come under the auspices of her Department including the total annual spend last year and to date in 2012 in respect of each; and if she will make a statement on the matter. [40656/12]
As the Deputy will be aware, the Government is engaged in consideration of budget 2013 and it would be inappropriate for me to comment in detail on budgetary discussions. My Department works in close partnership with other Departments on a range of cross-cutting issues in regard to both policy and provision as they relate to children and young people. I also point to the fact that my Department is in the process of developing a new children and young people's policy framework and that it is intended this overarching policy document will provide a seamless, whole-of-childhood approach to policy-making, including budgetary decision-making, for children and young people across the whole of government in the period 2013-18.
As regards the published 2012 Estimates for my Department, the Deputy might note that the full gross allocation for 2012 stands at just under €427 million, of which €418 million relates to current funding and the remainder to capital funding. Given the number of key priorities facing my Department which include establishing the new Child and Family Support Agency, holding a constitutional referendum on children's rights and the continued provision of the free preschool year in early childhood care and education, the resource allocation represents a 2% increase in funding when compared to the Estimates outturn of €419 million for 2011.
That shows the priority attached to the delivery of the programmes which come under my own Department. I was very pleased to obtain capital funding of €6 million towards child care this year. The Deputy will also be aware of the money that has been agreed and given by the Government so that we can take children out of St. Patrick's Institution. The capital fund for that is quite substantial.
With regard to my own direct remit, the Deputy will be aware of the child and family support programme, which includes funding for the Family Support Agency, the National Education Welfare Board, the school completion programme and child detention centres. With regard to early childhood, we have the free preschool year, and we also support a range of programmes including the national longitudinal study of children in Ireland, the national children's strategy, the lottery funding scheme, provision for the Ombudsman for Children, the Adoption Authority of Ireland and the constitutional referendum on children's rights, which will take place next month. That summarises the range of resources in my Department.
I thank the Minister for her reply. I am trying to work out the wider departmental position and do not want to engage in a debate about the budget itself. Every time I wish to pose a question I must ask myself whether it should be directed to the Minister for Children and Youth Affairs, the Minister for Health, the Minister for Education and Skills or some other Minister. Children are represented in almost every single Department.
In terms of children's issues, we are seeing things pushed to the limit and we have measurement by failure. Recently I have been made aware of a transport problem at St. Raphael's special school, the removal of the dental service for primary school children in my constituency and the fact that developmental clinics for babies are being seriously cut back, to give but a few examples. During last week's debate about the Department of Health, the filling of vacant positions in areas such as speech and language therapy and occupational therapy was raised. There may well be two priorities in that Department but children are the big losers due to the lack of such services.
I am trying to understand whether the Minister for Children and Youth Affairs sits at the Cabinet table as an advocate. Does she analyse what each Department is doing from the point of view of children? Does she examine the failures that occur, such as the curtailing of developmental clinics for babies, which is pretty serious? What approach does the Minister take where she sees such failures, and is there a proactive approach on the delivery side?
I thank the Deputy, who makes a reasonable point with regard to the cross-departmental nature of many of the services that affect children. Another way of looking at that is to ask how we should organise our services so that we get the best delivery for children. If the Deputy has not read the task force report on child and family services and how they should operate under the new agency, I would recommend that she do so. The report argues that the way we organise our services is not as friendly to children and families as it needs to be. It recommends that we try to deliver services to customers in a customer-friendly way so that they can readily access the services they need. There is an issue with regard to the structural organisation of some of our services.
In response to the point raised by the Deputy, there is clearly a whole-of-government responsibility to children. As Minister for Children and Youth Affairs, I have very specific responsibilities in the areas I outlined earlier, but some issues are cross-departmental. The issue of developmental clinics referred to by the Deputy, for example, is something about which I would be very concerned. As a member of the Government, I share in the collective responsibility when it comes to making decisions on budgetary matters and matters that affect children. I am engaged in detailed discussions with other Cabinet colleagues, through Cabinet sub-committees and through quite a number of interdepartmental working groups on an ongoing basis to ensure better delivery of services. I am also engaged in regular bilateral meetings, such as those currently taking place with the Department of Social Protection on child care services.
There are two answers to the Deputy's question. One relates to how we actually deliver the services at present, what Departments they are organised under and how seamless the services should be. The second relates to the fact that there is a whole-of-government responsibility in terms of child-proofing policies and decisions. The concept of equality-proofing was accepted some time ago but that still has a long way to go. The Government must be sensitive to the cumulative impact of decisions on children and families. I have a particular responsibility to interact with other Ministers in that context.
I agree with the Minister's point about how services are delivered, but I ask that when talking about children we refer to them as citizens rather than customers. It is more reflective of the fact that children have an entitlement to services. Will the Child and Family Support Agency be responsible to the Minister in the same way that the HSE is responsible to the Minister for Health? It will be very difficult to maintain proper scrutiny if the agency is at arms length or outsourced, so to speak. As members of the Opposition we are supposed to hold the Government to account but, in the case of the HSE, for example, it is really difficult for us to figure out how services are run. It can take ages to receive replies to questions and so forth. How does the Minister anticipate the agency will work? That will be critical if we are to move towards a different model of service delivery.
The new agency must be established by legislation, which will be before the House. The governance of the new agency will form part of that legislation when it is presented for debate before December. The Government has yet to take some decisions regarding the new agency. In response to the question of accountability that the Deputy raises, it will be far easier to achieve accountability with an agency that is dedicated to this area with a sole focus, as opposed to being part of a large organisation such as the HSE. In the latter organisation, managers have multiple jobs and multiple focuses. As I said in an earlier reply, we have reduced the number of managers from 34 to 16 and there is much clearer accountability. It is much closer from the front line to management. Gordon Jeyes has made the point repeatedly that accountability is essential. There will be clearer political and front-line accountability because we will not have several layers of management in the new agency. The governance structure will form part of the legislation that I will bring before the House in the coming weeks.
4. Deputy Éamon Ó Cuív asked the Minister for Children and Youth Affairs if she has had discussions with groups representing childcare providers regarding the impact that Minister Burton’s proposed sick pay proposals would have on the provision of childcare services and the additional costs such a measure could impose on these services; and if she will make a statement on the matter. [40692/12]
As Minister for Children and Youth Affairs I have prioritised early years care and education. International evidence shows that early intervention can improve outcomes for children and families, particularly with regard to emotional, cognitive and social development. However, child care takes many forms, consisting not only of early years interventions but also of services such as after-school care for school-aged children. Child care is used by families in many different ways.
With the exception of a small number of nurseries subsidised by the HSE and preschools funded by the Department of Education and Skills, the State does not operate child care and play school services. Child care services are generally operated as either commercial or community not-for-profit concerns. Child care costs are dictated by the costs for service providers and by the market. According to a survey of child care providers carried out by Pobal in 2011, the average cost of a full-time child care place is €165 per week, with the cost of a place for a younger baby approximately €10 above that. However, prices vary across the country.
I appreciate the point the Deputy makes that child care costs continue to be a significant challenge and burden for many families.
I also appreciate that the child care costs for parents in this country are high relative to other countries. That has been commented upon in various reports in the past decade, including by the OECD. The Government does support a number of child care programmes through the provision of the three separate child care support programmes: the community childcare subvention, CCS, programme. I have seen examples all around the country of the support the programme gives to local families in the community; the childcare education and training support, CETS, scheme which helps where parents are involved in education and training; and the early childhood care and education, ECCE, programme which funds the universal free preschool year. These programmes are administered by my Department.
We are lucky to have 94% of young children who are eligible benefitting from the universal free preschool year, which is available to all three to four year olds in the country. I commend the work of my predecessor in introducing the scheme when the early child care payment was abolished by the previous Government.
Additional Information not given on the floor of the House
Protecting and, if possible, further developing the universal free preschool scheme has been a key priority for me and the Department. In last December’s budget I secured an additional €9.8 million in funding to maintain the universal free year which has seen an increase of approximately 3,000 in the number of children participating in the programme. In 2012, the total expenditure by my Department on the three child care programmes is expected to exceed €240 million. These programmes have been maintained despite the ongoing need to reduce Government expenditure and these schemes represent a significant investment in supporting parents with the cost of child care.
It is good that the Minister acknowledges her predecessor an odd time. She cannot simply wash her hands and say markets dictate the cost of child care. It is too big an issue. The Minister correctly outlined the various figures that have been bandied about on the cost of child care. It costs up to €1,100 a month in parts of Dublin for child care. The cost is restricting the ability of people to return to the workplace. It is more expensive than the average monthly mortgage and something must be done about it. A significant amount of money was invested in community child care facilities in recent years. We should consider providing more community facilities because they provide greater affordability of care. At the same time community child care facilities are being attacked by the savage cuts to the community employment schemes. I am a board member of a community child care facility. Without the community employment scheme workers on the staff it would not be possible to continue in existence. I urge the Minister to examine the issue seriously. We must bring about a situation whereby child care in this country is affordable. The cost of child care in this country is one of the highest in the OECD. That is not acceptable and something must be done to address it. The Minister could consider splitting maternity leave between parents. We must be innovative in how we approach the issue to ensure that we reduce the cost of child care because it is unsustainable.
I share Deputy Troy's view on the provision of child care facilities. I have worked over many years to ensure that parents have proper child care available to them. What has happened in this country in the past ten years is that instead of delivering a universal free service the money was put into, for example, the child care supplement, which was then withdrawn. A total of €1.2 billion was withdrawn from that payment but it was put into the ECCE scheme. We have tended to focus on direct cash payments to parents rather than developing the kind of service Deputy Troy says ought to exist. I would like to have seen such a system being developed in recent years but it was not and now parents are paying the price of commercial rates which are very high. I agree with Deputy Troy that they are like a mortgage for many parents. I fully understand the situation parents face. It is extraordinarily difficult for families and makes it extremely difficult for many families who want to avail of those services to combine work and family life.
As Deputy Troy indicated, there are 950 community services throughout the country. They have been built up in recent years and they are participating in the CCS programme all over the country from which 25,000 children benefit, in addition to 90% of three to four year olds. I would like to see a second ECCE year. I would like child care to be provided for all children between the ages of three and five before they go to primary school. I would like to think that when the budgetary situation improves and we are in a position to put more money into child care that will be one of the places it will be invested.
The Minister has agreed with much of what I said on the need to tackle the cost of child care. What will she do to tackle it? She is lucky and honoured enough to be Minister for Children and Youth Affairs. She has the authority to bring about changes. What are the Minister's plans to ensure change is introduced? We will support her and bring ideas to her.
The first thing I have done, which is important given the budgetary situation I inherited, is to ensure I got the extra budget I needed to keep the ECCE scheme available as a universal service for all three to four year olds. I also ensured that we can continue to provide the community childcare subvention programme and the CETS programme which assist parents in education and training. As the budgetary situation improves and finance becomes available it is one of the areas on which I would like to focus. Currently, I am keen to ensure we maintain the current range of services. That is why I was pleased that the budget in my Department and the part of the HSE budget that deals with child and family support services were increased by 4% at a time when many Departments face huge cutbacks.
It is expensive for the State to provide child care. I wish it was possible for us to do more at the moment but I want to maintain what we have and focus on quality because that matters as well in terms of the delivery of services. We must continually examine the quality of schemes and the inspection regime. A range of areas require attention and I am currently focused on them.
5. Deputy Caoimhghín Ó Caoláin asked the Minister for Children and Youth Affairs the number of children currently receiving special care in overseas facilities; the facilities in which they are placed; the cost of providing treatment in each of these facilities; her plans to ensure that children with special care needs receive this care within this State. [41029/12]
Under the Child Care Act 1991, the Health Service Executive has a duty to promote the welfare of children who are not receiving adequate care or protection. The policy of the HSE is to place children in care settings, preferably in foster care, as close as possible to their home and community. A total of 6,259 children were in the care of the state in July 2012, the vast majority of whom were in foster care.
A very small minority of young people under 18 years of age have highly specialised needs arising from severe behavioural difficulties, due to their childhood experiences or in some cases as a result of injury, accident or disability. The care needs of those young people are generally met by directly provided residential services or services commissioned by the HSE within this country. For this small number of young people, the HSE is on occasion and in exceptional cases required to make arrangements for their placement in care and treatment facilities outside of the State, primarily in the UK, to allow for access to an individually tailored mix of care and highly specialised therapeutic services and psychiatric treatment not available in this country. This is done on as infrequent a basis as possible and only where such placement is considered to be in the best interest of the child. The HSE has a national protocol in place for such children.
The HSE has advised me that as of 21 September 2012, eight young people were detained in out-of-State secure placements. Four young people are in St. Andrews, Northampton at a cost of €12,582 per week, per child; two young people are placed in Kibble, a specialist facility in Scotland, at a cost of €6,685 per week, per child; and two young people are placed in Boystown Nebraska at a cost of €2,017 per week, per child.
Additional information not given on the floor of the House
The HSE ensures that these placements are suitable. The units in which the children are placed are inspected and monitored by their national authorities and the HSE is attentive to the standards of care delivered in the specialised units. The level of requirement for these services is closely monitored by the HSE's national director for children and family services and my officials.
I thank the Minister for her reply. One of the elements in my question was to inquire about her plans to ensure that children with special care needs receive care within the State. On the previous occasion we addressed the issue the Minister said on the record - she laid emphasis on it - "that the referral of persons abroad for specialised therapeutic interventions is an established feature within our health and social care system." I am concerned that such referral has become an established feature of the system. This is an important issue. The Minister indicated that a small number of children are affected but the cost factor week-on-week is substantial. Do the figures the Minister cited take into account the cost of facilitating family visits and social worker visits from this jurisdiction to each of the placed children?
Does that happen? How long have the small number of young people been in this care and what is the long-term plan for them? These are young people but what about their further care in life as they grow older? Has the Minister examined the cost of providing treatment here for that particular cohort of young people? Has there been any exploration in conjunction with authorities north of the Border to examine the greater viability of providing these specialist care supports to children on a North-South basis on the island of Ireland, thereby eliminating the expensive costs of flights and all the other ancillary costs that must accrue as a result of their being placed on the neighbouring island of Britain, or as in two of the cases cited by the Minister, in the United States?
We accept that on occasion we must send children abroad for highly specialised care in medically complex cases, for example to Great Ormond Street Hospital, because it and others are global centres of excellence. Other countries also send children there. We must accept that for children with highly complex and challenging behavioural difficulties sometimes their best possible care can be provided in overseas specialist centres. That is why we are using these services - we do not have them in this country at present. We will certainly have looked to see if such services were available any place on the island; that would have been taken into account. These services would have been chosen very carefully for the children involved. Given there is such a small number of children involved, I do not wish to say anything that would identify them but suffice it to say that there are very complex care and behavioural needs involved, including emotional and sexual difficulties, and these children need very specialised care.
That said, I have indicated previously in the House that I believe our special care facilities, high support units and detention services in this country represent an area that needs attention. We need more clarity in regard to how this care should develop in the future. I have met with the relevant people and have an examination under way at present of how we are organising those services because I am not satisfied with the organisation or national planning in their regard. I believe the people on the front line are doing a very good job, as well as they can do it, but in terms of policy direction and future development of those services the work has simply not been done and it needs to be done. We have to see the referral of those children in that context. We do not have the services for them in this country. Perhaps for some of them we will be able to provide those services in the future.
I assure the Deputy the costs are per week in the unit so this does not include the various observations he made in regard to other costs. I assure him also that the social workers are in contact with those children and the services are in constant contact with the providers. We have experience of children doing extremely well in these units, and returning back to Ireland and doing well, either independently or with their families.
I absolutely concur with the Minister's reference to Great Ormond Street as being a centre of excellence on a global stage but this is not what we are talking about here. Rather we are talking about particular care settings in regard to very complex cases. It is not just about specific procedures. The instances the Minister cited are placements for care needs and supports that are not currently within our system. Has any serious assessment has been given, even a rough, off the top of the head kind, of the total costs, apart from those of family visits? The Minister has not clarified whether social workers from this jurisdiction visit these children in their overseas placements. One is talking about in the order of in excess of €400,000 per annum for some of those individual children, which is substantial money. Will she clarify whether an assessment has been done as to the potential of providing that care support on the island of Ireland? We might not be talking about eight cases but a smaller number, and perhaps collectively we might be able to ensure those facilities here, which would be more easily accessible to families and all others who have a role to play.
I refer to the Deputy's point on care. What these young people are receiving is not simply residential care. The reason I compared it to Great Ormond Street is that they are getting the kind of treatments and care and psychological interventions that are simply not available to them here. I assure the Deputy the social workers are in contact with the children and do visit them. The reason these services are being used is that, having assessed what is available in Ireland, the kind of specialist help these young people need, in the residential care settings such as they are being sent to, is just not available here. I assure the Deputy that as part of my work in regard to high support and special care, the question of whatever specialist services we can provide in Ireland will clearly form part of that. Right now, however, we do not have these services in the country.
