Dáil Éireann Debate, Tuesday - 16 December 2008
69 Deputy James Reilly asked the Minister for Health and Children if her attention has been drawn to the fact that 400 children with disabilities in residential care are not protected by an inspectorate and that those children are three to seven times more likely to suffer abuse; the immediate action she will take to address same; and if she will make a statement on the matter. [45859/08]
View answerChildren with disabilities who require residential care may be accommodated, depending on their needs, in generic residential centres, under the Child Care Act 1991 or in specialist residential services for children with disabilities.
A total of 400 children are accommodated in generic children's residential centres, under the Child Care Act 1991. Those include some children with disabilities whose needs for residential care arise out of the responsibilities of the HSE under the Child Care Act rather than because of their disability. The centres are subject to statutory inspection. The Office of the Chief Inspector of Social Services in the Health Information and Quality Authority has responsibility for this function.
The statutory framework which underpins this work is laid out in the Child Care (Placement in Residential Care) Regulations 1995. In addition, national standards for children's residential centres, set down in 2001, have been in operation and are based on the requirements of legislation, regulation and findings from research. The standards allow inspectors to form judgments about the quality of services provided in those centres. Areas covered by standards include child protection and children's rights. Currently, 227 children are placed in specialist residential centres for children of which 200 children have an intellectual disability and 27 children have a physical and sensory disability.
All services for children with disabilities are covered by the national guidelines for the protection and welfare of children, Children First, published by the Department of Health and Children. Residential centres for children with disabilities are required to ensure that there are appropriate policies and procedures in place for the identification, reporting and management of any concerns in regard to abuse of children in those centres.
In November 2007, the HSE prepared a guidance document that sets out the standards expected from all residential service providers for children with disabilities who are not placed in such settings under the Child Care Act 1991.
Additional information not given on the floor of the House.
The guidance document was prepared by a working group, comprising HSE staff, including an inspector of residential services, service providers and the National Disability Authority. The guidance document is currently being operated on a non-statutory basis.
The HSE is currently finalising a framework for the protection of all vulnerable service users, including children. This framework will include a revised definition of abuse along with standards and guidelines to ensure protection of all vulnerable service users, including children with disabilities. The proposed framework will be completed in February 2009.
The Health Information and Quality Authority which was established in May 2007, has responsibility for the development and monitoring of standards. HIQA has recently undertaken a public consultation on draft national quality standards with regard to residential settings for people with disabilities and is now in the process of finalising the standards and plan to submit them to the HIQA board in early 2009. These standards are intended for adults. HIQA has also developed a set of standards for children which has been circulated, for comment, to its national advisory committee on standards. It is expected the children's standards will be finalised in the new year.
In deference to my Labour Party colleague, Deputy Jan O'Sullivan, I did not wish to encroach on her time but the Minister just made an extraordinary statement. She has told this House that between 8 p.m. and 8 a.m. there are only 20 attendances at the accident and emergency departments of the three children's hospitals in this city. I find that very difficult to believe. I would like to see an input into this from the people who are working in those accident and emergency departments. Before I address the question, however, I want to say that cutting down on accident and emergency departments seems the most cynical move yet to reduce the numbers on trolleys. There will not be room for the trolleys in the four accident and emergency departments that are left. It is outrageous.
The Deputy may address a supplementary on the question that is tabled.
Turning to the Minister of State's response, the bottom line is that there are 400 children who remain in institutions that are not subject to any inspection. The Minister of State has been asked when this glaring deficit will be corrected because, statistically, these children are three to seven times more likely to suffer abuse, given the nature of their disabilities and their inability to report. I again ask the Minister of State when HIQA standards will be brought in and it is empowered to inspect and protect these children. We have a duty to them because they are the most vulnerable children in our society. The standards need to be introduced as soon as possible. If we can stay here all night and pass laws in relation to banks and guillotine health Bills to take the medical card off the over-70s, surely we can address this issue before Christmas and ensure the safety of these children.
I do not believe there is any need for the Deputy to raise the medical card issue again; the House knows his position on that matter. He should not rehearse all that again, since he changes his position so often. My position is very definite. I am making the very direct response to the effect that he should have known this because he attended the committee meeting recently at which HIQA representatives were present. They made it quite clear that while they are prepared to carry out the inspections, they are waiting on funding from this Department. The Department, in turn, is working with HIQA to ensure that the initiative will start some time towards the middle of next year.
It is mañana again.
No, it is not mañana, but it is a stance I have adopted and will maintain. I will not change my mind next Sunday, having said something else in the newspaper last Sunday.
The Minister of State's problem is——
We will not have a shouting match. Neither the Deputy nor the Minister of State will ignore the Chair. We will not have a screaming match in our national Parliament.
I apologise to the Leas-Cheann Comhairle. The Deputy finds it difficult to be reminded of things that happened six months ago. He prefers to concentrate on matters that might occur ten years hence.
Could I attempt, without interruption if at all possible, to avoid a balling match and just make the point that HIQA was quite properly set up by the Minister for Health and Children, recognising as she did the need for a quality authority, for which she has to be complimented? She made the position quite clear to HIQA regarding the standards that were to be brought in, first of all, for the elderly. Our priority now is to ensure that the people in such homes are properly supervised. That commitment is alive and well and will not be changed by an interview in some paper in six months' time.
I remind the Minister of State that we already have reports of abuse of children in these circumstances with the Brothers of Charity. We had those reports before the meeting of the health committee. This is his area of responsibility. I want him to show the same enthusiasm that he and his Government have for guillotining Bills to institute cuts and apply that enthusiasm and energy towards ensuring that these children are protected through law.
If we were dealing with people who have the patient in mind in every aspect of health and were not promoting certain disciplines, to get a greater slice of the health cake, we might be able to do things much quicker. I refer to Deputy Reilly's position.
I am talking about children who are being abused.
I did not ask for your usual ignorant interruptions, Deputy, if you do not mind.
We are talking about children who suffer——
Am I responding to Deputy Shatter? Did you ask a question on this issue?
——and the Minister of State has a duty to protect them.
If Deputy Shatter will "excuse me, sir", as you are often quoted as saying, could I please have the right to respond?
I ask the Minister of State to speak through the Chair.
The Minister and I have a plan which it is intended to implement next year. These are not mere words about future intentions, but rather a statement of support for my senior Minister who set up this authority in the first place.
