That goes to show — I think the Minister will agree — how ineffectual this type of debate is and how we need to review the procedures we use. Having said that, I regard these items as of tremendous importance. I do not suggest that some of the items referred to in the speech are not important but personally I feel that in the case of items that are so important, irrespective of the time constraint they are matters that the Minister should have expanded on. I am sorry he did not do so.
There are a number of areas where at this stage we are not clear as to what is the approach of the Government and the Minister. In the general area of children's services and children's law a vast number of proposals have been put forward in the report produced by the task force. A number of alternative proposals are contained in dissenting reports produced by a variety of different elements of the task force. There is no clear public statement yet as to what recommendation the Government will adopt in the context of the Children's Bill. This is something that should be discussed and dealt with in the House. The Minister is still in the position where his responsibility for children and children's services is shared with two other Departments. I should certainly like to have the Minister's confirmation as to what the position is. In particular I should like his confirmation that the recommendation of the task force that the Department of Health have sole responsibility for children and children's services will be adopted and acted upon. From my own knowledge in recent years there has been a variety of different administrative arrangements between Departments whereby it appears on occasion that the Department of Health would assume sole responsibility, but then the difficult responsibility that exists between Health, Education and Justice has on other occasions emerged out of the woodwork. I would like some indication of what present thinking is in that area, as it is very important to ensure co-ordination in dealing with services for our children. In the area of children's law, the vast majority of reforms are proposed in the task force on child care in the context of care proceedings. I expect and hope that most, if not all, of these will be adopted.
The area that is at this stage uncertain and upon which I hope the Minister will act and encompass within the context of the Children's Bill is the area of adoption. It is uncertain because the task force were unable to reach agreement as to what should be done in that area. The majority of the members decided they were not going to deal with the topic at all and I accept that that was not the Minister's fault. Equally, a minority of the members recommended a large number of changes in the area of adoption, many of which are worthwhile although some are not and could give rise to greater problems than exist at present. We do not know whether the new legislation will deal with adoption. I understand a junior Minister in the Department publicly indicated that another committee might be set up to look at adoption. I hope that is not the case because, in the context of the general area of children's services, we have had too many committees. We want a political commitment and a political decision to reform areas that are not controversial, where the problems are known to people working in these areas and which do not require a whole pletroversial thora of committees sitting and considering previous reports and making recommendations on top of other recommendations. Many of the matters that need to be dealt with in relation to adoption are clear. Many of the defects in the procedures and in the law as it exists at present are also clear. What they require is the political will to tackle them.
I will illustrate a small number of these as I do not feel it is fair to colleagues who want to contribute to the debate to go into them in depth. There is a recommendation that the area of adoption should be transferred from the Department of Justice to the Department of Health. From the few public comments that have been made, I understand that the Minister has accepted that recommendation. If so I welcome that decision because it is a step forward.
There is a need now to provide for adoption legislation to enable legitimate children to be adopted. The Government's policy on this is unclear, I cannot put it any further than that. There was a commitment from the previous Government to bring in legislation to provide for the adoption of legitimate children. Prior to June 1981 the Government refused to countenance such legislation although it was recommended by the task force on child care. It was also recommended by the Medico-Social Research Board in a report published by them in 1979 and reiterated in a report published in 1980. Such legislation is demanded by the number of legitimate children we now have in residential institutions who have no possibility of leading a normal family life and who will either be in permanent residential care for the rest of their childhood or in foster care, with all the uncertainties, difficulties and problems that can arise, especially in the event of a parent seeking to regain custody some years hence.
On 4 May 1982 I asked the Minister in this House how many legitimate children were at present in care and had been in care for over five years. The Minister replied that we have just over 900 legitimate children in care who are not living with their parents and who have been in care for over five years. Those children have no possibility of being adopted and probably have little possibility of an ordinary family life with the security attached to it that an adoption order could give them. There is no rhyme or reason why the facility of adoption should not be extended to these children. We have approximately a further 700 legitimate children who have been in care for under five years and, presumably, a number of these will shortly go into the over five years in care category. There is no reason why the facility of adoption should not be extended to them. I am not saying that whenever a legitimate child is placed in care he or she should be made available for adoption. Of course that is not the case. There are many good families who suffer terrible disasters because of health or other social problems who may need to place a child in short-term fosterage or in residential care for brief periods while the family sort out their problems. But, on the statistics available, we have in excess of 1,000 children at present who are prevented from having a normal family life because they cannot be adopted. I would ask the Minister to bring in the necessary legislation to allow these children to be adopted. There is no difficulty in providing that legislation.
When Deputy Collins was Minister for Justice he suggested there was a constitutional impediment to prevent such children being adopted. That is not the case. There has been a clear indication from the courts that there is no constitutional difficulty in the context of children who have been permanently neglected or abandoned and who are legitimate children. I am sure the Minister's officials can advise him that it has been made clear that there is not a constitutional objection to such children being placed for adoption. Even if there was, this Government would have a duty to hold a constitutional referendum. I believe there is general agreement throughout the country among social workers, health boards and adoption agencies that such children should be available for adoption. I respectfully suggest that such legislation would have no constitutional difficulties but, if the Minister is committed to providing for the adoption of legitimate children, that should be included in whatever constitutional referendum is to be held towards the end of this year or early next year.
Other problems in the area of adoption are too numerous to mention. I ask the Minister, in addition to dealing with the problem of legitimate children, to look at the need to deal with other problems now arising in the adoption process. There is the problem of a child who is placed for adoption but whose natural mother, prior to an adoption order being made, withdraws her consent or refuses to consent to the order being made. This is creating difficulties for adoptive parents who, from the time a child is placed with them, do not know whether an adoption order will be made in their favour even if they are assessed as being proper people to adopt and even if the child thrives with them. Adoptive parents are finding themselves in a situation where they may have to get involved in expensive High Court cases in order to adopt a child previously placed with them by an adoption society. There is a need to re-examine the whole system of consent to adoption and agreements to place. There is a need in doing this not merely to provide protection for adoptive parents and proper protection and advice for natural mothers, but also to ensure that the best interests of all the children who are affected in this area and who are placed for adoption are fully and properly protected.
Adoption is about ensuring the welfare of children, about protecting children, about finding families for children who need them. The difficulties that are arising in some cases of the adoption process are giving rise to fears and worries among many people who adopt or who have children placed with them for adoption. The vast majority of adoption applications are processed without doctors experiencing any great difficulties. However, there is a large majority in which difficulties arise which give cause for concern and create real worries.
Therefore, there is a need to provide a new form of placing of children for adoption whereby the natural mother would place a child for adoption, a brief period would be allowed to pass during which she could reconsider and change her mind, but after that period she should not be allowed to do so. The child would then be placed for adoption and the charges with whom the child would be placed would know that the mother could not come in and withdraw consent.
These matters should be examined very seriously. We should look at the law in Australia which provides protection in this area. Through my contacts with natural mothers I know that many of them would welcome a change of this nature. Many natural mothers, when they place their children for adoption, suffer great emotional stress and difficulty, a great deal of certainty attaches to it, and this is a period of serious stress for them. When they have gone through a proper counselling service and understand their situation and have finally made the difficult decision, they want their children to be adopted, they place them with adoption agencies and then sign agreements. Many of them, having signed those agreements want to go off to reorganise their lives and start anew, and not have to look back on events which had been distressing. The present procedure which requires a natural mother to go in months later, again to sign a consent on something she has already signed, reopens the wounds and prevents that woman's life from being reorganised.
Therefore, it is in the interests of everybody, of the natural mother, the adoptive parents and particularly the child placed for adoption, that this problem should be dealt with. There are many other problems, and I understand that in the childcare legislation which the Minister is about to introduce, there will be greater legal protection and more extensive provisions in the area of foster care and foster services.
In that new legislation, if the Minister does not deal with adoption he will be covering only half the problem because adoption and fostering services should be integrated as part and parcel of the child care system—it is not something separate — and if a Bill dealing with children's law does not contain provisions to amend existing adoption law, if it does not contain provision in certain cases for the adoption of legitimate children, it will be defective.
In recent times we have had sad cases of battered children coming before our courts. I do not think the matter is being treated with sufficient seriousness. Last year we had three children dying as a result of non-accidental injuries, or what is more emotively referred to as child battering. Three different sets of parents were sent to prison. In two out of those three cases there was clear evidence before the courts that the health authority — in both cases it was the Eastern Health Board — were aware that the children who died had been at risk. In each case the family had come to the notice of the health board. One parent in each case had previously been before the courts. In one case, the father had been sentenced to nine months imprisonment for viciously assaulting his three-year-old daughter. The second was a case in which the father had been convicted in a criminal court and the foster mother, only two months before the child's death, had been before the District Court and convicted of child neglect. In both cases there was no excuse for not having had the children taken into care.
It is a matter of grave concern that necessary action was not taken. Independent inquiries into the deaths should have taken place. I ask the Minister to hold such inquiries. I understand the Department have been conducting their own investigations but there has not been any public indication of the results of these investigations: there have been promises that a public statement will be made as to the results of the investigations. That is not a satisfactory procedure. In dealing with non-accidental injuries, the health boards are following guidelines introduced by the Department in 1980 and it is not fair to ask any Department to investigate themselves. It could very well be that the guidelines are defective: perhaps the health boards did everything possible but that they had the wrong guidance from the Department's guidelines. I am not saying that was so, but it could be. It could also be that health board personnel made wrong judgments. It could be simply an accident, but these problems were not followed up properly. Whatever the nature of the problem, the deaths of two children in a year, whose families were on notice to the health authorities as families with whom children were at risk, merit a proper formal investigation of an independent nature. I do not believe that the type of investigation that has been conducted by the Department will provide the necessary information or will do what is necessary, that is, satisfy the public that our children's services are adequate to provide proper protection.
The public need to be reassured that whatever defects and problems arose in these caes will not recur. The reason for such an inquiry is not to find scapegoats and say they were responsible, it is not to pick out some director of community care, or social worker, or doctor, and say they are responsible for a child's death. The reason for such an inquiry is to find out the problems: were they administrative, were errors of judgment made? If errors of judgment were made, the inquiry should clarify them and so ensure that in future such errors of judgment will not be made. In that way defects could be discovered and the public would be reassured that any such loopholes would be dealt with.
Existing children's law, however bad, no matter how many reforms are required, has been more than adequate —I speak from knowledge of the cases I have spoken about — to have afforded each of the children no longer alive the proper protection they were entitled to. Reforms of the law would not have affected in any way the legal situation of those children. They could have been taken into care: their parents had been before the courts and this placed a duty on the health boards to take the children into care, if necessary by taking the necessary proceedings.
If, for instance, proceedings had been under the Children's Act, 1908, and if for some technical reason the proceedings had failed, the health board should have applied to have the children made wards of court and there by afforded them the protection to which they were entitled. Therefore, it is disingenuous to say these problems will be solved when we introduce a Children's Bill. I regard the problems that arose in these cases as administrative, procedural. They are problems that can be tackled now and they will have to be dealt with in new legislation. I hope the Minister will seriously consider holding the type of inquiry I regard as necessary in this area. As regards non-accidental injury to children, there is a duty on health boards to have training in this area for their personnel who come into contact with the problems and deal with them. On 4 May in a parliamentary question I asked the Minister if he was aware of any health board which provided any specialist training of any nature for any personnel and the answer was that the Minister did not know or that he would look into the matter. This is part of the problem. We are asking committed personnel in health boards to undertake tasks for which the boards fail to provide training.
In the light of recent events there is a duty on the Minister to ensure that each health board provides specialist training for the staff involved in non-accidental injury monitoring and for those attached to community care teams. As regards the legal aspect, it is not sufficient to rely on the fact that if a lawyer is acting for a health board he or she is automatically fully conversant in all areas of the law. If specialist training is provided, it should be provided for lawyers attached to health boards or who act for them in children's cases to ensure that the full protection that exists under the law is made available to young people.
I regret that there has been no detailed comment by the Minister on any of these areas of children's services. It is of vital importance. In the context of the Department of Health, children's services are very much the cinderella area. Part of the reason for this is due to the multi-ministerial responsibility, where the buck has been passed over the years between the Ministers for Health, Justice and Education and back again. There is a need for a coherent and committed approach which reflects political will. The time has passed when a Minister should resort to asking for more committees to produce more reports in any area of law dealing with children. I regret that the Minister did not refer to these areas. I look forward to the Bill concerning children. I hope it will deal with some of the areas I have referred to.
The problem of Women's Aid has been mentioned. This is a voluntary organisation which has provided a service over the years which the State has never been prepared to provide. They have great financial difficulties. A commitment was made by the previous Government to provide £200,000 for them. What is the Government's position on that? Will the necessary funds be forthcoming to them? What assistance will be afforded to them in Dublin? Will any similar assistance be afforded to them outside the Dublin area to deal with the grave problems of battered wives and emergency-type accommodation which Women's Aid was set up to provide?
I appreciate the concern expressed by the Minister about drug abuse and young people and alcohol abuse. I welcome the fact that he intends to take some action in this area. Still being new in the House, I am cynical when politicians say they will take action on the drug problem. The subject of drugs makes for fine sounding speeches and grab tremendous newspaper headlines: "Minister so and so to act on drug problem". When the verbalisation stops the State fails to tackle the problem. We are a great society. We con ourselves into believing that if we talk about a problem we are doing something about it. I hope the Minister will do something which will involve a real commitment in this area. For far too long we have had this problem. It is a problem — I do not say this in relation to the Minister — which some politicians have milked for the purpose of cheap newspaper headlines without doing anything to tackle it.
I welcome the Minister's commitment in this area and the idea of preparing educational material to circulate in schools. I also welcome the fact that there is a pilot scheme commencing in this area which will be extended to all schools from September 1982. I ask the Minister to include something else in that project. The Minister referred to extending the provisions which exist in the 1908 Act to the new Childrens' Bill. There is a provision in the Act which prohibits the sale of cigarettes to children under 18 years of age. It is proposed to extend this provision in the new Bill to other products which may be precribed by the Minister. The provision in the 1908 Act is something which is honoured in the breach rather than the observance. Most people are unaware of the provision which prevents the sale of cigarettes to children under 18 years of age. Nobody takes any notice of it and it was never enforced. Whatever about the dangers of drugs, there are more people dying from cancer resulting from smoking than there are from drug abuse. It is time that we took this area far more seriously.
It is time the no-smoking campaign became a serious one rather than a sentence appended to a packet of fags or a large advertisement indicating that smoking damages health. It is a campaign which has not been dealt with in the serious fashion it should be. The State has an interest in both drink and cigarettes. On the one hand, we try to discourage people from abusing drink and smoking cigarettes, but we also earn revenue from their use. Cigarette smoking starts in school and has been with us for many years. There are children of eight years and nine years who are addicted to cigarettes. No serious campaign has been run in the schools to counter the problem. I hope the Minister will include it in whatever campaign he starts in this area. We fall far behind our colleagues in Europe in our approach to cigarette smoking. We cannot force adults to stop smoking and no Government would survive if they tried to do so. However, we can educate the youth in such a manner as to ensure that they do not grow up addicted to nicotine in a way which for many of them will result in their lives ending by way of cancer, which nicotine is a direct catalyst for. I hope the Minister will start a campaign to stop children smoking and educate them on the dangers of smoking. The existing campaign is a joke and is not taken seriously. The reason the cigarette industry co-operates with it is because they know it is a joke and has little real impact on the sale of cigarettes.
There is one other matter I should like to take up in the context of the Minister's remarks, indeed in the context of drug abuse. I cannot recollect whether this arose directly in the Minister's speech or out of a report circulated and on which I compliment the Minister — indeed I wish I had had greater opportunity to examine it before today — but the report referred to the different approaches of different hospitals to the amounts of drugs being used or prescribed. This varied approach about the prescription of drugs for adults and young people, particularly adults, is reflected in the medical profession, where some doctors will prescribe drugs in certain circumstances and others will not — drugs, some of which can have a tranquilising effect or the reverse and on which many people in our society are now dependent. I would hope we could highlight the problem thereby created. I come into contact with far too many people who are on tranquilisers, who have no major health problems but who because of their difficult family or social circumstances — so that they can come to terms with their situation — are being tranquilised into acceptance.
There is a need in the medical profession to seek a greater degree of understanding in the area of drugs. Here I would lighlight the problems with which I have been dealing professionally over the years in the area of marital breakdown. Far too often one comes across the battered wife who has been assaulted for years in her family home, who has lived in that situation, in a sort of twilight zone, tranquilised into a form of acceptance that they are the realities of life in the latter half of the 20th century. Very often all such a person requires is the help and support of a social worker or legal assistance. In some areas of the medical profession there is the need to ask that they be somewhat more alert than they have been in the past, in particular in prescribing tranquilisers. Lest anything I say be taken as a slight on the medical profession, I should say I do not wish it to be so taken. I pay tribute to the great number of general practitioners who provide a service way beyond the call of their duties, not merely dealing with medical problems but social ones as well. In some instances there has been a lack of perception of the reason people are looking for tranquiliser-type prescriptions. Often there is too great a readiness to provide them instead of other remedies and assistance which would be more appropriate.
The Minister referred to his commitment to the psychiatric services and those for the mentally handicapped. In this context, indeed within the context of our general hospitals, it is my understanding that we now luxuriate in the knowledge that we have something in the region of 120 units of accommodation available throughout the country but which are not being used through lack of adequate funds. This can be listed from county to county, particularly in the context of psychiatric units and units for the mentally handicapped. For example, there is a psychiatric unit in Carlow which has been available since 1981 but which, as far as I am aware, is not functioning. Then there are psychiatric units and units for the mentally handicapped in Cork. The same applies in Donegal. In Dublin there is a whole series of units available for use but in respect of which funds have not been made available for the necessary staff to enable them function. In St. Michael's House in Ballymun there are available 50 residential units for the severely-mentally handicapped which I understand are not being used. I understand also that there are six specially built bungalows that have been in existence there for something like two and a half years, that have not been fully used or taken up and where one or two only are at present operational. St. Michael's House in Kilmacud in my constituency at present can provide additional places for children in multi-handicapped units but they are not in a position to utilise these. Again, St. Michael's House in Rathfarnham Castle is in a similar situation.
I have talked about the children's services being the cinderella of our health services. The whole area of our psychiatric and mental handicap services would not even qualify as the cinderella of our health services because they have long been ignored, not fully or properly provided for, lacking a proper and coherent policy approach in the sense that, while we have policies, we do not fully and properly implement them but rather engage in a form of ad hoc-ry in dealing with them. I hope the Minister will tell us what will be the situation in the next 12 months in these various psychiatric and mental handicap units, those that are built, available, providing potential places but which cannot at present be utilised due to the absence of the necessary funds.
