I thank Senator Terry for giving me the opportunity to discuss waiting times at St. Louise's assessment and treatment service at Our Lady's Hospital for Sick Children in Crumlin. I am in a position to respond to the matters raised by the Senator.
St. Louise's unit is one of two units in the eastern region where children are assessed and treated following an allegation of sexual abuse. Children may be referred from a variety of sources, including general practitioners, social work services and accident and emergency departments. The Eastern Regional Health Authority is very aware of the need for services in the assessment and treatment of child abuse to be as responsive and integrated as possible. In any case of suspected child abuse, the priority is child protection, followed by referral for appropriate assessment and therapy.
Referrals to St. Louise's assessment team are prioritised on a case by case basis with special consideration being given to children aged five and under, alleged assaults which have taken place within the last 72 hours and children who present in extreme distress. These cases are placed on a priority waiting list. Due to the number of referrals to the unit which meet these criteria, the waiting time is approximately three to four months. Referrals which do not meet these criteria have an approximate waiting time of seven months. There are currently 44 referrals awaiting assessment where all information has been received and another 24 referrals are being processed. These are awaiting further information such as case conference reports, medical reports, Garda reports and health board reports.
Referrals to the therapy team are also prioritised on a case by case basis depending on clinical needs. Priority is given to children in extreme distress, presenting as mood disturbance or suicidal ideation, and to victims of acute assault. There are ten cases on the waiting list and another 11 are being processed which have an approximate waiting time of five months.
Where St. Louise's indicates there will be a waiting period for assessment and where there is concern for the child in the interim, a number of dedicated counselling services have been funded through the three relevant area health boards. These services address direct crisis referrals for children and their families. Examples include CARI, the Daughters of Charity family centre, and the Mater Dei counselling services. The Eastern Regional Health Authority acknowledges that ideally these young children and their families should be seen from the outset by dedicated child abuse assessment teams and that this work should take place in an integrated multidisciplinary setting.
I understand from the authority that the main reasons for the increased waiting times are the expansion of the service to include treatment as well as assessment, changes in familial structures which necessitate an increased number of interviews as part of the assessment process, significant numbers of custody and access related cases and the amount of time which staff are required to spend on court work. The authority considers a waiting time of seven months to be unacceptable and has initiated a detailed review of the current resources at St. Louise's and other relevant services in order to determine what action is required to provide a service more responsive to the needs of these young children and their families.
The Eastern Regional Health Authority indicates the review, which will include consideration of St. Clare's unit in Temple Street Hospital, will appraise current services by addressing referral, assessment and treatment processes. The initial analysis will also consider associated waiting times and numbers. It is acknowledged that these services cannot be looked at in isolation from the wider context of sexual assault service provision, including opportunities for alternative service provision and reference to best practice elsewhere. The terms of reference, including the timeframe for the review, are currently being finalised. A progress report on the review will be provided by the chief executive officer of the Eastern Regional Health Authority at the next board meeting on 3 April 2003.
Some preliminary work on the review has already been commenced by the researcher involved. A steering group consisting of representatives of the area health board, the hospitals and Eastern Regional Health Authority is being established. Interviews are being held this week to fill two vacancies in St. Louise's and additional consultant hours are being made available.
Regarding the overall issue of child protection, a sum in the region of €70 million in additional revenue funding has been made available to the Eastern Regional Health Authority since 1997 for the development of child care and family support services. The eastern region has experienced difficulties in recruiting social work staff in recent years. Due to recruitment and retention initiatives, the area health boards are reporting much lower levels of vacancies. They continue to make every effort to fill vacancies from existing panels and continuing recruitment campaigns.
I assure the Senator that I will monitor the situation closely. I am urging the Eastern Regional Health Authority to complete its review as early as possible and I am committed to ensuring that the current waiting times are shortened.