Dáil Éireann Debate, Tuesday - 17 December 2013
93. Deputy Thomas P. Broughan asked the Minister for Children and Youth Affairs the actions she will take in tandem with the newly established Child and Family Agency to reduce and ultimately eliminate the number of Irish children placed in residential care outside of Ireland who are detained under special care orders and therefore provide the necessary care and supports to these children in this jurisdiction. [53792/13]
View answerThe HSE Children and Family services provides a comprehensive range of placements for over 6,400 children in care within residential and family based placements. Placements are planned and provided on the basis of the individual needs of each child. Where possible children are placed within their own extended family network and within their own community. Currently 92% of children are in the care of the HSE are placed in foster care which is a very positive aspect of HSE care service provision and very high by international standards.
In a very small number of circumstances it is necessary to provide placements in other countries in order to meet the individual needs of some children. In some circumstances it will be necessary to facilitate a foster care placement within the context of the child's extended family or family network. There are also cases in which the foster family is moving abroad and it is in the best interests of the child to remain with the foster family. There are also a number of circumstances in which children in the care of the HSE may be placed outside the jurisdiction with specialised therapeutic inputs from child psychiatry and psychology. All such placements abroad are made with the permission of the Courts. Placements in Special Care, whether in Ireland or abroad only occur in extreme circumstances and under the jurisdiction of the High Court.
The need to provide Special Care placements outside the jurisdiction into the future cannot be avoided in a very small number of cases in order to ensure the best interests of some children with specialised additional needs. The referral of children abroad for specialised therapeutic interventions is an established feature within our health and social care system and decisions in each case are made in the best interests of the individual. The units in which the children are placed are inspected and regulated by their national authorities and the HSE is attentive to the standards of care delivered in these specialised units. The level of requirement of these services for children is closely monitored by the National Director of Children and Family Services. Currently there are 17 children in placement in Special Care in HSE Units and 10 in placement outside the jurisdiction under the jurisdiction of the High Court.
Assessment, Consultation and Therapeutic Service (ACTS) is a new national specialised clinical service which is being developed by the HSE Children and Family Services in order to provide multidisciplinary consultation, assessment and focused interventions to young people who have high risk behaviours associated with complex clinical needs. These therapeutic inputs will be provided in a flexible, timely and responsive manner with a focus on improving outcomes for young people and their families. ACTS also supports other professionals in their ongoing work with young people and their families. This includes on-site therapeutic services to the national high support unit and special care units and the children detention centres. Assessment, consultation and focused intervention services for children at risk in the community of placement in high support, special care or detention is also a function of the ACTs team.
ACTS is a multidisciplinary service which includes psychology, social work, speech and language therapy, counselling and social care. It is supported by contractual sessions from child and forensic psychiatry. ACTS is led by a management team consisting of the national manager and three heads of discipline whose central responsibility is the implementation of systems of clinical governance to support the best outcomes for children with particular needs. This is done through effective planning, implementation and evaluation of treatment programmes and protocol driven interventions. It also involves the provision of high quality clinical supervision and monitoring of professional development needs of staff. It is based in Dublin with regional clinics in Cork and Limerick.
The HSE is currently implementing a capital development programme for Special Care services in order to ensure that there is sufficient capacity to meet the needs of children requiring this specialised type of care. The first phase of the programme is underway with improvements to facilities in Dublin completed and the extensive refurbishment of the unit in Limerick complete. Planning is well underway for phase 2 of the programme which will include a significant expansion of the capacity of the service in 2014/2015.
