Written Answers. - Child Care
Minister for Health
if his attention has been drawn to the continued and extensive use by health boards of bed and breakfast placements for children who require care; and if he will make a statement on the matter.
Minister for Health
if his attention has been drawn to the fact that children continue to be admitted to hospitals for social reasons; the action, if any, he proposes to take to have this practice ended; and if he will make a statement on the matter.
I propose to take Questions Nos. 104 and 106 together. The Deputy raised this matter in the house three weeks ago. On that occasion I stated, inter alia, that I would forward details in relation to the number of children in care accommodated in hospital beds, bed and breakfasts and ault hostels in 1995 to the Deputy as soon as they become available.
The position is that section 5 of the Child Care Act, 1991, requires health boards to take such steps as are reasonable to make available suitable accommodation for homeless children up to 18 years. Health boards are developing a range of options to enable them to discharge their responsibilities under this section. These include emergency hostels and other forms of residential accommodation; day care programmes for adolescents who are currently homeless or at risk of being homeless; out of hours social work services targeted at homeless children; special foster care services for out of home adolescents.
I have stated on a number of occasions that I do not regard the use of bed and breakfast accommodation as an acceptable response to the problem of youth homelessness. Indeed my Department has made it clear to the health boards that if, in cases of emergency, there is no alternative to the placement of a homeless child in this form of accommodation, immediate steps should be taken to secure an appropriate hostel, residential or family placement for the child. However, at the same time, I recognise that the occasional case may arise where the provision of bed and breakfast accommodation may be appropriate for a youngster who is only seeking overnight accommodation in response to a specific unforeseen situation. I am not aware of the extent, if any, to which children are admitted to hospital for social reasons. I have asked the health boards to report back to me on this issue. My firm intention is to minimise the use of bed and breakfast accommodation and hospitals in such instances to the greatest possible extent.
The Eastern Health Board, in whose area the problem of youth homelessness is mainly concentrated, is pursuing a number of strategies to reduce its use of bed and breakfast accommodation and the number of young people in such accommodation has been reduced significantly. In January 1996 the board established an emergency-short-term care facility which can cater for up to 14 young people who are temporarily out of home or are awaiting a more long-term placement. The 1995 Child Care Action Plan also provided for a further range of important new child care developments, including the provision of additional residential places and an expanision of the board's out-of-hours social work service into a 24 hour crisis intervention service for all children. Services for children out of home were expanded during 1995. These included a day project for children out of home or in crisis. Funding was also provided for a new service targeted at unattached adolescents and focused on vocational training and social skills. Additional support was also provided to existing residential services for children at high risk and after care services for boys and girls.
The Health Estimate for 1996 includes provision for a further investment of £5 million in the child care services. This brings to £35 million on an annualised basis the total additional funding that has been provided for these services since 1993. I am satisfied that the measures I have outlined greatly strengthen the capacity of the health boards to provide appropriate accommodation and services for these vulnerable children.
Minister for Health
if he intends to establish an independent system of checks on social work and residential care staff regarding criminal offences against children.
A number of important measures have been and are being taken to try to guard against offences against children by child care staff. These measures are designed to protect children by ensuring that convicted child abusers are not employed in residential centres. Guidelines on recruitment of staff to children's residential centres were issued by my Department in November 1994. Under these directions employers must obtain Garda clearance on all staff being considered for appointment to a children's residential centre. These directions were extended in September 1995 to the recruitment of staff to any area of the health services where they would have substantial access to children and vulnerable individuals. I wish to point out that Garda clearances are only one aspect of attempts to protect children from abuse. It is equally important that employers check references of potential employees and that they have adequate supervision mechanisms of staff working with children. I also wish to emphasise that excellent work is being performed by social workers and residential care staff, the vast majority of whom are above reproach and share our revulsion at the very idea of any child being abused or exploited in any way.
Under the Child Care Act, responsibility for monitoring standards in children's residential centres operated by voluntary bodies rests with the relevant health boards while responsibility for monitoring standards in centres run by health boards rests with the Department of Health.
New regulations under the Child Care Act in relation to the placement by health boards of children in residential care came into force on 31 October 1995. The regulations require health boards to satisfy themselves as to the standards that obtain in children's residential centres. Health boards are required, among other matters, to satisfy themselves that appropriate standards, care practices and operational policies are operated in residential centres catering for children placed by the boards. The regulations also require health boards to visit, supervise and review children in their care on a more systematic basis than before.
In particular, the regulations require each health board to satisfy itself that adequate arrangements are in place at each residential centre to guard against the risk of injury and for the reporting and recording of accidents and injuries affecting children residing there; satisfy itself that procedures are in place for the prompt notification to the board of significant events affecting children placed there by the board; arrange for the supervision of children placed in residential centres by the board. It requires that a child be visited as often as may be necessary, but the maximum intervals between visits will be three months during the first two years of the placement and six months thereafter; arrange for the periodical review of each child placed in a residential centre. Reviews will be carried out at intervals not exceeding six months during the first two years of the placement and thereafter at least once in each calendar year.
The new regulations also empower an authorised officer of the health board to enter and inspect a children's residential centre as required and to take the necessary action to ensure compliance with the regulations. Furthermore, the regulations permit the inspection, by a person acting on behalf of the Minister for Health, of the practices and procedures operated by a health board in relation to the provision of residential care services.
In addition, Part VIII of the Child Care Act contains important new provisions in relation to the supervision and inspection of children's residential centres and will provide a statutory basis to the residential care sector. In relation to the introduction of Part VIII, much of the ground work has been done. A working group has already prepared a draft guide to standards in children's residential centres which will form the basis of the regulations to be prepared under Part VIII of the Act. My Department has circulated this draft guide to all agencies concerned with the provision of residential care for children on the standards which should obtain in such centres.
The guide addresses a range of issues relating to residential care and pays particular attention to the need to ensure that children in care are not exposed to any risk of abuse. It highlights the importance of agreed child protection procedures for residential centres which would define policy in relation to the prompt reporting and investigation of any suspicions or allegations of abuse or neglect of children while in residential care. Such a policy would also ensure that staff are equipped with the necessary skills to recognise and deal with any signs or symptoms associated with bullying, scapegoating, harassment or abuse. I have given a commitment that Part VIII, and the remaining provisions of the Child Care Act, will be implemented by the end of the year. This commitment will be honoured.
I have also announced my intention to establish, at a national level and on a statutory basis, an inspectorate of social service in the Department of Health. This inspectorate will be responsible for quality assurance and audit of child care practice, and will undertake inquiries on on behalf of the Minister for Health. I am confident that, together with the important new provisions relating to residential care under the Child Care Act, this will improve the safeguards and procedures for the protection of children in residential care.