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Thursday, 22 Mar 2012

Priority Questions (Resumed)

Health Service Staff

Questions (2)

Caoimhghín Ó Caoláin

Question:

2Deputy Caoimhghín Ó Caoláin asked the Minister for Children and Youth Affairs the total number of Health Service Executive social workers that are now employed in view of the 45 retirements during February; if she will give a commitment that these 45 social worker posts will be replaced in addition to the extra 260 that she had already committed to creating; and if she will make a statement on the matter. [15956/12]

View answer

Oral answers (7 contributions)

The HSE compiles a monthly census of employment in the public health and social care sector. The latest data available is in respect of January 2012. This shows that the total number of social workers employed in the HSE and in directly funded agencies was 2,435 whole time equivalents, WTEs. The impact of recent retirements will be more fully reflected in future monthly employment returns. The latest information from the HSE in respect of the number of social work staff who retired in February indicates that 31 social work staff retired. That is the most up-to-date figure, not the 45 mentioned in the Deputy's question. It refers to the end of January, so the figure I gave does not necessarily mean there were 31. Clearly, there is a great deal of movement at present in terms of recruitment of new social workers as well as the retirement of other social workers.

The HSE is actively reviewing the impact of recent retirements at national and regional level. The national director of children and family services, Gordon Jeyes, will apply his discretion over the course of the year to the filling of vacancies, having regard to identified need and subject to services being delivered within available resources. The HSE has in place an agreed service plan for 2012 and the challenge is to ensure full delivery of the range of commitments set out in that plan.

I am very much aware of the financial and service challenges facing the HSE in 2012. The Deputy will be aware of the budgetary challenges we had to meet last year. The challenges are such as to require acceleration of the reform programme across child and family services, leading to 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.

The Government has made additional budgeting provision of €19 million for child welfare and protection services compared to the funding made available last year. This compares to a reduction of €14 million which was made in the HSE's 2011 national service plan which was approved in December 2010. The additional funding made available for 2012 provides further impetus to the comprehensive reform of service delivery which is under way and which is aimed at generating the best possible outcomes for vulnerable children and families.

My Department will be working very closely with the HSE throughout the year to ensure 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, one which is designed to strengthen significantly the policy, legislative and practice framework. Our shared goal is the delivery of appropriate, effective and consistent services, notwithstanding the very challenging and demanding circumstances in which these services are delivered.

I do not wish to be critical but the information is not as up to date as I hoped. It is now the end of March and the key date was 29 February in the context of the departure of staff under the incentivised pension arrangements or however one wishes to describe it. The figure is 31 and relates only to the end of January. My question suggests, from the information I have gleaned, that there were 45 departures in February and not just up to February. Does the Minister understand it to mean up to February?

Yes, 31 had retired by the end of February. I will clarify it for the Deputy. The figures are for the period up to the end of January. Of the 31, some might well have retired before February. Those figures are still being compiled. The Deputy should accept that there is a fair amount of movement at present. I will come back to him as soon as I have the full figures. The figure is 31 at present.

Yes. We will not pull this from both ends like a Christmas cracker. I would appreciate if the Minister reverted back to us with clarification as soon as possible, not just for myself but for my colleague Deputies who are directly interested in this. It is very important. The core point of this and previous questions on this issue is a concern about the number of social workers, particularly when they are needed more than at any time in our political experience. I am deeply concerned. As a Deputy at the coalface people are presenting as never before, not even during the worst times of the 1980s. Today there is a huge rise in the real need and social workers have a crucial role to play in that. I am deeply concerned that we are not in a position to respond properly to the problems.

There is a high number of retirements. I hear the Minister for Health respond that they are in a certain age cohort but the fact is that they are not being replaced. These are positions lost. They represent hands and heads that are no longer within the service. How will this impact on the establishment of the new family support agency? One would expect there would be increased provision, commensurate with the work and undertaking of that agency. Are there any plans or contingency plans for coping as we move towards the establishment of that new body?

I wish to make a number of points. A total of 262 extra social workers were recruited last year and the year before. It is, effectively, a 25% increase in the number of social workers dealing with child care, protection and welfare. If 25% more social workers were recruited in the child protection area prior to the retirements, it is important to acknowledge that. One can make the assumption, given the work rate of social workers, that even with the increased demand that clearly exists there is increased capacity to respond.

The Deputy says these people will not be replaced, but that is not correct. There is no moratorium on recruitment for social work positions. Gordon Jeyes has the authority to replace these positions as resources allow. Of course, the management of resources will be a key issue over the year given the various demands on the services. Where he sees the need to replace positions where vacancies occur, he has the authority to do that and to keep the teams at the right level to ensure the needs of the families presenting, and particularly the children who might be at risk, can be met and that those cases can be allocated.

I am aware of the figures the Minister shared previously regarding the extra number recruited. However, the real comparison that must be made at this point is between the level of social work numbers, WTEs, as against the number in previous years. Is there a 25% increase in the actual numbers altogether, apart from the recruitment, given the departures and retirements up to 29 February? What is the real position now in the last week of March? These are valid and reasonable questions. Gordon Jeyes might have the authority to replace workers, but only within the confines of the budget provided. It is not the case that he can simply add numbers. He must thereby subtract numbers in some other way.

The number of social workers has increased in each of the years 2009 to 2010, inclusive. The other point is that while obviously numbers are important, how one organises the services is equally important. There is a reform programme under way. I can give an example. Some of the social workers who previously worked in adoption, an area where there is a changing scenario, will be reallocated to work in areas where there is a higher priority.

The other point is that we managed to achieve an extra €19 million for the area of child welfare and protection. There was a reduction of €14 million in the previous year. Despite the difficult financial situation there has been an increase of €19 million for those services. In terms of the director having an opportunity to use those finances to reach out in an appropriate way, perhaps through family support services, this must be taken into account as well as the numbers. The numbers are important and they have increased. I will refer back to the Deputy with the precise figures. The number for those who have retired is down from 45 to 31 and there has also been the recruitment of an extra 25% in the child and family area. There are positive developments in this area, and it is important not to mislead the House by not pointing to some of the positive actions that have been taken.

Child Welfare Services

Questions (3)

Richard Boyd Barrett

Question:

5Deputy Richard Boyd Barrett asked the Minister for Children and Youth Affairs the number of child protection teams that are short of staff as a result of the moratorium on recruitment; the number of children at risk because of these staff shortages; her views on whether the number of those recorded as being at risk on the risk registers are an accurate reflection of the situation; and if she will make a statement on the matter. [15129/12]

View answer

Oral answers (5 contributions)

As Minister for Children and Youth Affairs, I have statutory responsibility for the child welfare and protection services. My colleague, the Minister for Health, in conjunction with the Minister for State with responsibility for disability, equality and mental health services and older people, has responsibility for mental health and disability services. I work closely with both, as I do with all members of the Government on children's issues. The question on the detailed service information sought relating to disability and mental health servcies would be most appropriately addressed to the Minister with direct responsibility for these services. The Minister of State, Deputy Kathleen Lynch, was in the House earlier this afternoon to reply to specific questions relating to services within her remit.

The HSE has adopted a planned approach at national, regional and local level to the management of departures as a result of staff retiring. We had a discussion about the social work side earlier. The overall situation is set out in the national and regional service plans for 2012. The HSE's overarching aim is to protect critical front-line essential services and use a range of measures to manage the staffing situation, which includes using the provisions of the Croke Park agreement and delivering greater productivity through the reform of service delivery. Where critical gaps in services cannot be filled through redeployment, reconfiguration or reorganisation of services, some €16 million has been provided in the national service plan for the filling of priority vacancies.

More generally, my Department works with other Departments to harmonise and co-ordinate policies relating to children. During the current year this will be achieved through the development of a children and young people's policy framework and an early years strategy. Both policies will address health outcomes for children and the co-ordination of services to promote children's health and well-being. This is the first time we will have had a national policy for the early years and we will look at the range of services we need to deliver to that age group and their co-ordination. At a policy level, this will involve working across Departments.

Additional information not given on the floor of the House.

My Department will be working with the Department of Health to address these issues, with a particular focus on those children with the greatest needs, including disabilities and mental health problems.

Child protection teams are based geographically in the local health area office. During 2010 and 2011, 260 additional social workers were recruited and assigned across the country to child protection teams and children in care teams. The latest data available from the HSE show that in January 2012 the total number of social workers employed in children and family services providing services for children at risk and in care was 1,220 whole-time equivalents. It is important to stress that there is no moratorium on filling social work posts within the overall public sector numbers. The national director of children and family services will apply his discretion over the course of the year to the filling of vacancies, subject to meeting overall employment targets and on the basis that services are being delivered within available resources.

The Deputy refers to cases being recorded on at risk registers. He may be referring to the establishment by the HSE of a national child protection register as part of the child protection notification system which records children where, following an assessment and a case conference, the view is that there is a child protection risk. I have been assured that all referrals of child welfare and protection cases are assessed by the duty or in-take team. Those cases identified as the most serious or urgent are allocated immediately to a social worker. Other referrals may benefit from referral to a family support service, while some cases may be referred to other services. The number of referrals to the team will always be significantly greater than those in the child protection notification system, as the majority of referrals are not assessed as involving a child protection risk.

I am advised by the HSE that there was a total of 29,277 child protection and welfare reports to it in 2010. A total of 16,452 of these reports related to concerns about a child's welfare, while 12,825 were related to child protection concerns, that is, physical, sexual, emotional abuse and neglect. Of the 12,825 cases related to child protection concerns, 1,556 were confirmed as abuse cases and notified to the child protection notification management team.

The standardised business process to ensure consistent definitions for the purposes of information reporting is being worked out across all 32 LHOs in the HSE. I anticipate that the information available in 2012 will be of a higher standard. Since taking office last year I have been dissatisfied with the quality and accuracy of information available from the HSE on child protection, as well as the HSE's capacity to provide timely and meaningful information. I am pleased to inform the Deputy that significant progress is now being made by the HSE to remedy this. A major information technology project, the national child care information system, NCCIS, has now gone to tender. The NCCIS will be the central system supporting social work services. As a social work case management system, it will be used to record and store the case history of every child and other clients of the service. Management information will be derived automatically from it.

The aim of the NCCIS project is to identify and procure an easy to use technology solution to support this type of case recording and automatically provide management information. A first step was to develop agreed and consistent definitions and business processes across all social work offices. In this regard, a national standardised business process has been rolled out nationally. This will ensure the definitions used are consistent, for example, to ensure the number of recorded referrals relates to individual children, not families. I am confident that the process being led by Mr. Gordon Jeyes, the HSE national director of children and family services, will deliver the information needed.

As the Minister acknowledged, my original question was related not only to child protection teams, I also asked about child mental health teams, early intervention teams and disability teams, as well as the staff shortages in these areas. It is not acceptable for the Minister to say, in a bureaucratic way, that they are within the remit of another Minister. She is Minister for Children and Youth Affairs, not just Minister for child protection teams or social workers.

The Government talks about the need for joined-up thinking and co-ordination and its commitment to child protection. In her press release last Tuesday the Minister said there must be "robust safeguarding arrangements within all organisations working with children". Therefore, there must be joined-up thinking and co-ordination. We should be able to get an answer from the Minister on how the various services working with children are staffed, whether there are staff shortages and the problems they might cause. The Irish Medical Organisation has reported massive shortages in child mental health teams. For example, one team lost one third of its staff in the last year owing to retirements, staff going on maternity leave and redeployments. It now has eight members of staff, instead of the 38 recommended in A Vision for Change and can do only emergency work. It is part of the Minister's responsibility to say this is unacceptable. Children are being put at risk as a result.

I welcome the Government's commitment to publish the Children First guidelines, but what is meant by "shortly"? Publication was promised before Easter. Will publication be matched by the provision of resources? How can we seriously talk about child protection if we have child mental health teams with eight staff instead of the necessary 38? That is not child protection.

When we talk about Children First, it is important to be aware that a cross-departmental group is working on the issue. The Deputy is right when he says ensuring the safety of children involves cross-departmental work. We have a cross-departmental group working with the Garda and others are represented in the group which is looking at implementation of Children First. We must go right down through the Departments of Health and Education and Skills to ensure the guidelines are being implemented and deal with any issues that might come up, whether in schools or elsewhere. Only yesterday I had a meeting with the Irish National Teachers Organisation to discuss how the guidelines were being worked through in schools.

On Deputy Boyd Barrett's point on mental health, I am most concerned that young children and teenagers would have access to mental health teams. I discussed the matter recently with the Minister of State at the Department of Health, Deputy Kathleen Lynch, who assures me that there is access for those aged up to 18 years in child and adolescent mental health teams throughout the country. I have outlined the situation on shortages. The aim is to concentrate on critical, essential, front-line services. A total of €16 million has been allocated for that purpose. In that context it is important to note that €35 million has been ring-fenced by the Government for the development of those mental health teams, including the child and adolescent mental health teams. The Minister of State, Deputy Lynch, with whom I liaise and work on the issues, indicated that 20 extra beds have become available for inpatient use for young people. There is progress in the area.

In so far as there is any progress, I welcome it. Surely the whole point of the Ministry becoming a senior one is that it must have an overview of child protection. In a certain sense the Minister should not respect ministerial demarcations because otherwise one could ask what is the point. Talk of €16 million for priority cases and front-line services does not address the point that is being raised by the IMO, namely, that there are chronic shortages of staff for child mental health teams.

The one example I have given the Minister is of a situation where there are only eight staff where A Vision for Change suggests 38 are necessary. That is a chronic shortage. It is difficult to see how children and teenagers who require those services are getting them. In fact, we are being told the services are only taking emergency cases. This is a real problem. The Ministry must have an overview and must blow the whistle. Otherwise, all the commitments in the world in Children First mean very little.

I accept Deputy Boyd Barrett's point on working with other Departments. I assure him that I am doing that. I am taking an overview. The policy overview on these issues is extremely important. That is why we are having the interdepartmental meetings on mental health as well as on how Children First, for example, is being implemented.

Deputy Boyd Barrett asked me also about child protection teams. I have already indicated - as I am sure the Deputy heard - that an extra 25% of social workers were recruited. An extra €19 million has been allocated. That must mean better services for children. There is no question about that, given the 25% increase in social workers working with families coming to the HSE, for example, and an extra €19 million being put into services. I agree that demand exists and that families have serious issues that require a prompt response. I am working cross-departmentally on the issues raised by the Deputy and I will continue to do so.

A new national children's strategy is being developed this year. It will look at children from birth right through to the age of 18. I accept that any development of a national children's policy must look at issues such as how we deliver mental health services, disability issues and other areas. As Deputy Boyd Barrett correctly pointed out, there has been a need for co-ordination on these areas.

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