Vol. 519 No. 6
19 Ms Shortall asked the Minister for Health and Children if he will outline the State's proposed care arrangements, if any, for the 16 year old girl currently before the courts who is at present being held in a psychiatric hospital under sedation; and if he will make a statement on the appropriateness of these new arrangements in meeting this girl's care needs. [14616/00]
Deputies will be aware that this case came before the High Court recently and the judgment was issued yesterday. The position is that the High Court agreed that the child could remain in the care of the relevant health board and could be held in a psychiatric unit as an interim measure. The State proposed that a special unit be provided and the court made an order to this effect. The Department will ensure that all necessary funding will be made available for this purpose. A house is currently being adapted for use by the girl in question and work on this will be expedited. I am confident it will be ready before the 23 August deadline set by the court. Pending completion of this work, in the interests of the girl's safety and security, she will be kept in a psychiatric unit and I understand that some internal reorganisation of the unit will be undertaken to ensure that conditions, while still unsatisfactory, can be made more acceptable. The underlying reason for the necessity to respond to the needs of this girl in the manner which I have outlined is the unavailability of a suitable unit in which to place her.
The requirement for such units was identified in 1995 in the FN case. However, the necessary building programme was not commenced at the time. By the end of 1996 there were only 17 places which could accommodate children with serious behavioural problems. Today there are more than 60 such places and this is primarily as a result of initiatives taken by the current Government.
By the end of 2000, a further 39 such places will be available with another 56 due to open in 2001-02, bringing the total by early 2002 to 157. I share the concerns of the High Court and the other parties to the proceedings, that any child in need of special care and protection should have to be detained in an unsuitable environment but, in this case, it was the only option available. I am committed to ensuring the availability of suitable places for the cases of such children and the Government will provide the necessary funding to achieve this.
Is the Minister ashamed that there is a 16 year old girl being held under sedation in an adult psychiatric hospital and that because of the failure of her Government to provide appropriate services there is this unacceptable situation? The Minister has spoken today about an undertaking to provide a house for this child. Could she tell us what kind of service will be provided for this seriously behaviourally disturbed child in a house? Does she accept that the succession of placements and ad hoc arrangements over many years have seriously compounded her behavioural problems and her distrust of those charged with her care? What kind of care arrangements and care plan does she intend for this child?
All parties who were in power during the 1990s, particularly those in power from the time of the constitutional case in 1995, should be ashamed that facilities were not put in place, arising out of the commitment given to us by the High Court at that time, when it was identified that we needed secure units. Unfortunately, no progress was made between 1995 and 1997.
Between 1995 and 1999, which was the real disgrace. The Minister is deliberately misrepresenting this. A court order in 1999 was required for the Minister to start doing anything.
Deputy Shatter should not intervene, it is most disorderly during Priority Questions.
Immediately on coming into power this Government allocated £25 million in capital projects to provide 110 extra places. Unfortunately, the provision of those places takes time. The planning and building of those places is only now coming on stream. Had they been made available between 1995 and 1997, we would not have found ourselves in the situation where this child and other children like her are looking for special care. The house which has been provided for this young girl and two others in similar situations will be a secure environment because, as was said in the case, people have not ever come across a case like it. She needs a place for her own security and welfare. She will be provided with all of the psychiatric and psychological care and therapy identified for her. It is envisaged that at the end of this year and into next year, when all of the places come on stream and the full revenue and capital funding which is being provided by this Government is made available, all of the care arrangements can be put in place in a proper environment for these children.
It is not possible to have a secure environment in a house. A proper purpose built facility is needed. Facilities and the physical surroundings are one aspect of this. Probably the more important aspect, with which I am sure the Minister would agree, is the care plan.
The Deputy should put a question.
Would the Minister accept that the care plan is the important matter rather than talking about the number of places? Will she confirm that there is no clear therapeutic care plan being followed currently in the care of this young girl and would she further acknowledge that the failure of the State in this case to adhere to the recommendations of various psychiatric and psychological assessments, which in the instance of this girl have been made over several years, has been a major contributory factor in the current condition and state of this girl?
I will not confirm that a care plan has not been provided for this girl. A care plan is being provided and has in the past been provided for her and has been followed.
Sedation is the care plan.
No, a proper care plan has been devised because the child has been in care over several years in different places at different times.
And the recommendations have been ignored.
The Deputy should not intervene while the Minister is on her feet.
The physical environment is an important aspect because for a child who tends to be suicidal, it is important that the physical environment should be such that she should be safe first of all and then that the care plan should be put in place. Deputy Shortall, as a former chair of the Eastern Regional Health Authority, will be aware of the various needs for health boards and particularly for places, which is the question raised. Unfortunately not enough was done in that capacity over past years.
Does the Minister accept her failure?
