Dáil Éireann díospóireacht -
Thursday, 2 Jun 1994

Vol. 443 No. 6

Adjournment Debate. - Child Care Facilities.

Ms F. Fitzgerald

I thank the Chair for giving me an opportunity to raise the closure of Madonna House and the implications for child care. Will the Minister outline the plans of the Department of Health for the future care of children in the care of Madonna House? The Irish Association of Care Workers, an authority in this regard, stated that the closure will create a major void in the already underserviced sector of child care provision.

Last week I raised the appalling situation in which bed and breakfast accommodation is being used for children in the care of health boards, especially in the Eastern Health Board area. Specialists have expressed concern about the lack of residential places for young people in need of psychiatric residential care, particularly in North Dublin. There is also a crisis in regard to providing residential care for children, particularly for those most at risk.

There are 3,000 children in care here, one-third of whom are in residential care. Child care has changed dramatically over the past number of years. We are now aware that the majority of young people in residential care should not be there, family care should be provided for them. It is clear that we must have greater parental involvement when children are admitted to care and there is also a need for a complaints procedure for children and parents. One cannot over-emphasise the need for staff selection and proper training and recruitment procedures, with posts advertised publicly, if standards are to be maintained in residential care. We must support community care, but there will always be a need for good quality residential care. I want to highlight the importance of standards in residential care, but I am precluded from raising a number of issues because court proceedings are pending in regard to Madonna House.

I have some general concerns to which I want the Minister to respond. I call for an independent inspectorate of residential homes as it is appalling that such an inspectorate is not in place. In doing so I do not wish to undermine the excellent work carried out by workers in residential care services. As a former social worker I have first hand experience of their work.

Is the Minister satisfied with the arrangements in health boards for monitoring residential services? Are there agreed standards and is the Minister satisfied with the current internal inspectorate established recently? Will he re-examine the scheme immediately? Children's homes were closed previously for a variety of reasons. Surely this should have led to the establishment of an independent inspectorate as has happened in England and Northern Ireland? Children are vulnerable whether in family or residential care and we are slowly beginning to realise the terrible damage that can be done to children by physical and sexual abuse. Thankfully, as a society we are becoming more child-centred and concerned about the protection of children's rights. There is no one way of protecting children, a range of measures is needed. Who is responsible for protecting the rights of children? Staff of residential homes and religious orders have trade unions and other organisations to protect and support them. If children's rights are to be protected in residential care an independent inspectorate with clear powers is necessary.

Ms Burton

I confirm to the House that the Minister for Health has been advised by the Sisters of Charity of its decision to phase out Madonna House, the residential home, it operates, which caters for children in the care of the Eastern Health Board.

This decision follows a review by the Order of the future of Madonna House in the light of changing needs and new approaches to the provision of care for children who, for whatever reason, cannot live at home. In its announcement, the Order cited a number of reasons for the closure including: the outdated institutional structure, with its centralised facilities; the physical layout of the buildings and, in particular, the proximity of the five separate units to each other, which make it difficult if not impossible for the units to develop separate services with individual identities and its isolation from the community care areas from where most of its clients come.

Madonna House was originally established by the Sisters of Charity in premises on Merrion Road in the early 1950s to provide temporary care for babies and very young children. The service was transferred to its current premises in Blackrock in the early 1970s which were designed to deal, in the main, with young infants.

In the years since then the demand for residential care for young children has sharply declined. The policy of the Eastern and other health boards, has been, firstly, to support parents and families so that children can remain at home or, where this is not possible, to provide care for children in a family setting, whether in small residential units or with suitable foster families. This change in approach is in keeping with modern child care thinking and has been endorsed by experts in the field, including the task force on child care services. It is supported by the Minister for Health and is reflected in the Child Care Act with its emphasis on the development of family support services and on providing children with alternative care in the most appropriate settings.

The change in approach can be seen in the fact that in the last ten years the percentage of children in care who are fostered has increased from 50 per cent to almost 75 per cent with a corresponding reduction of the percentage in residential centres from 50 per cent to 25 per cent. The number of children in residential care across the country is now about 750. Madonna House alone had about 60 places making it by far the largest and most institutionalised centre in the entire child care system.

However, while the number of children in residential care has fallen, there has been no reduction in the complexity of the problems that children entering residential care present. Increasingly, the residential services are being asked to deal with children who are the most troubled and the most troublesome, the most damaged and the most disruptive in the child care system.

To put it briefly, Madonna House found itself in a situation where the client group it set out to serve was no longer being placed in residential care. Instead it was being asked to deal with older children with more complex problems which the facility had never been designed or intended to serve.

Undoubtedly the closure will create short term problems for the Eastern Health Board. The first priority is arranging suitable alternative accommodation for the 30 children living in Madonna House. The board has appointed a senior social worker to co-ordinate the relocation of these children. It is hoped that most of them can be placed with foster parents. In this regard, the Minister for Health is making additional staff and other resources available to the board to enable it to quickly recruit more foster parents and to expand its carers' scheme, which provides family care for adolescents.

The board also intends to provide a number of small locally-based family group homes. These facilities will be available to the board on a long term basis to replace the places no longer available at Madonna House.

As both the Deputy and I indicated, the closure of Madonna House is perhaps an inevitable consequence of the shift in emphasis within the child care services from large institutional-type residential care to fostering and small scale family-style residences and I am sure most Members would welcome that development. A number of other residential centres are reviewing their operations to determine what part they will play in the child care services of the future, particularly in the light of the emerging need for more specialised provision for disturbed and damaged children and adolescents. The Minister for Health has asked me to assure the House of his support for any changes or developments which will make our child care services more responsible to current needs. I will convey to him the Deputy's comments in regard to an inspectorate.

The Dáil adjourned at 5.10 p.m. until 2.30 p.m. on Tuesday, 14 June 1994.