As the next two items relating to Newtown House are being taken together, each Deputy will have five minutes and the Minister will have ten minutes to reply.
Adjournment Debate. - Residential Care Centres.
I welcome the opportunity to raise on the Adjournment of the Dáil the Irish Social Services Inspectorate report on Newtown House high support unit, which was published yesterday. This is a sad, disturbing and frightening report and it is a commentary on our care levels in 2001, which in many ways beggars belief. Who would have believed, after all the reports, recommendations and exposure of past abuses that we would still have the appalling category of incidents and commentary on the levels of support which were provided to children at risk in Newtown House? I ask the Minister of State to publish an action plan as a matter of urgency to address the disturbing and serious issues raised about the care of children in the Newtown House report.
The report raises the most serious questions regarding the state of residential child care in Ireland and, in particular, facilities and services for young people at risk. We have had the Kelly Fitzgerald report and the Madonna House report, which we discussed in this House in 1996, and it is almost as if we have learnt nothing. The inspection of this case commenced on 17 August 2000 and, therefore, we are not talking about the distant past. We are talking about the services available to children in the Celtic tiger economy.
Last week, Mr. Justice Peter Kelly said that the services for children in this country were a farce given that 13 and 14 year old boys were being placed in hotels instead of highly secure units and given the specialist care which they need. Today's report is an indictment of current services. Newtown House is a unit specially set up to deal with referrals from the High Court to provide secure, special accommodation for young people at risk.
The report's findings included the following: young people were at risk due to injuries caused by the excessive use of physical restraint; young people were spending excessive time locked in their rooms; the atmosphere was one of continual crisis; the unit was in unsuitable buildings; there were unacceptable levels of staff turnover; there were very few permanent staff and they were mostly relief staff; and there was an absence of professional supervision for those staff and a lack of support for staff. The staff were very isolated and were placed in a difficult position. We all know how difficult is child care, particularly residential child care.
There was suppression of correspondence from children to a High Court and others. What action has the Minister taken to ensure that this will not happen again? Indeed, the judge saw only today the letter which was written by Kim O'Donovan. The tragic death of one of the former residents of Newtown House, Kim O'Donovan, has illustrated the potentially tragic consequences when care goes wrong. Is this the best Ireland can provide for its most at risk children? The report illustrates the critical role of an independent inspectorate and I congratulate it on its work. I hope it continues and that it will be supported in its work. The report clearly points out the need for an independent inspectorate in many other areas of Irish life and residential care.
The current situation is an outrage and totally unacceptable in a modern society. Announcing a national children's strategy rings very hollow indeed when the real day-to-day situation is revealed so starkly in this report. Announcements have been made about the provision of a great deal of money, but when this unit was examined it was clear that the money did not find its way to provide the necessary facilities, and I must ask why.
The Minister must immediately put in place a package of measures which will guarantee secure places for all disturbed children in appropriate settings. If there are barriers to providing secure places such as finding suitable, qualified staff, the Minister must take whatever action is necessary to remedy this problem. It has been dealt with in other countries and it can be fast-tracked and dealt with in an urgent way here. Nowhere is the need for a co-ordinated approach more urgently required than in relation to children. We know many of the reasons so many children are so vulnerable and we are also aware of many of the consequences. It is a political imperative that we take decisive action and not wait and lurch from crisis to crisis.
The public deserve to know what action the Minister is taking on foot of this report. What monitoring is in place? Are there other residential care centres that need to be inspected? What supports are in place for residential and child care workers? Why were staff paid less in Newtown House than in other similar homes? Will the Minister of State tell the Dáil when the results of the investigations into the excessive use of physical restraint will be made available? Will they be published? Will they be available to the inspectorate?
The Government can respond to crises in agriculture and in regard to refugees and asylum seekers. Surely we owe it to our children to respond appropriately and put the resources in place rather than wait for another report such as the one published yesterday.
I too welcome the opportunity to raise this issue. The Newtown House report, conducted by the Irish Social Services Inspectorate, has produced serious and disturbing conclusions, but it is not a surprise. It has been clear for some time that the State is failing to provide for disturbed children.
Last October, Mr. Justice Peter Kelly threatened to hold three Ministers in contempt of court if they failed to find suitable accommodation for a disturbed teenager. In spite of the litany of cases which had gone before the courts involving disturbed children, this was the first time that the State's failure to provide for these vulnerable children really came to such public prominence. The severe sanction threatened by Mr. Justice Peter Kelly highlighted the lethargy, confusion and inaction which has been the hallmark of policy towards children at risk. The judge was forced to issue this threat because in the past he met a brick wall of obfuscation and prevarication. Worse still, commitments made by Ministers before his court have been reneged upon.
Yesterday's report is another damning indictment of the State's failure to provide for vulnerable and disturbed children. I hope that it will be the last reminder to Government that the State has a mountain to climb in terms of providing for these children.
One of the most important findings of the Newtown House report relates to the high number of staff members who lacked the skills and training to carry out the work required of them. Given their lack of training, it is not entirely shocking that children were locked up inappropriately, and in one instance a child's leg was broken while being physically restrained. This finding highlights a much wider issue about the type of people employed in this demanding profession. I do not cast any aspersions on those who work in the profession. Secure units require the most skilled staff possible in the child care profession. In the case of Newtown House, it is clear that staff did not receive the required training and support and the type of staff needed were not recruited.
My fear is that other secure units may still employ staff who are unable to do their jobs properly because they have not received the required training, support or numbers. It is imperative that the lessons of this report do not remain a matter for the East Coast Area Health Board. It is critical that each health board makes an immediate assessment of staff, their training needs, suitability for the work in which they are involved and the support they receive.
While staff shortages present a problem throughout the service, it is vital that it is made attractive and rewarding for people to train and work in the area of child welfare. The pay, conditions and promotional prospects of those opting to work in this profession must be attractive enough to draw the best into the profession and retain them. There is a high turnover of staff in this area. As it is extremely stressful work, it is essential that those involved are provided with the training and support they require in order that they can provide light and a degree of hope for troubled children.
It is not good enough to attempt to ringfence the problems exposed at Newtown House and kick the report to touch by leaving the matter to the chief executive officer of the East Coast Area Health Board. While specific questions are raised in the report to which the local health board must respond, there is a wider picture of official neglect and underfunding of child residential services in general. All Governments bear a degree of responsibility for this appalling situation. In the light of this report there is a political and moral duty to respond and ensure the heartbreaking individual cases of which we are all aware and the historic underfunding at the root of the problem are not repeated.
It should be remembered that Newtown House was formally known as Trudder House and that that facility was closed down due to the appalling crime of sexual abuse. As we do not want history to repeat itself, we must learn the lessons to be learned. The Newtown House report must be a wake-up call for society and the Government in particular. We must have the honesty to recognise the failings of the past and the courage to introduce real reform. Children at risk and children in need of special care are often the most voiceless and the most vulnerable in society. The letter from a former resident which was supposed to reach the High Court, but never did is illustrative. Children at risk have been neglected and ignored by the State, in this case in the recent past. It should never be allowed happen again. The Minister of State must urgently spell out the steps the Government will take to end this scandal.
I thank Deputies Fitzgerald and O'Sullivan for raising this issue. I share their concern about the report of the social services inspectorate and wish to clarify the background against which it was prepared. I was approached by parents and a former staff member of Newtown House and, because of my concerns as a result of these approaches, I requested the social services inspectorate to conduct an inspection of the centre which was operating as a high support unit. This process was initiated last July and the report of the social services inspectorate was presented to me yesterday and published on the same day. Copies of the report were made available to the families involved in advance of publication.
I am concerned about the findings of the report, especially where good child care practice was not followed. The inspectors identified a number of areas where the unit had failed to meet the required standards for residential care centres. These were, in part, attributed to staffing difficulties, but also to the limitations of the building which was not purpose-built. The centre is now closed and I have asked the chief executive officer of the East Coast Area Health Board, the body which has statutory responsibility, to take urgent action to address the findings of the report. Resources have been made available to the health board for this purpose.
Inspectors considered that the staff in the unit had not always operated as a team. There were differences of view among staff about how best to manage the behaviour of the young people, resulting in a lack of consistency of approach to the provision of care. The inspectors accept that physical restraint may need to be used on occasion to prevent young people from injuring themselves or others or from causing serious damage to property, but they concluded that there were too many cases where physical restraint was used inappropriately.
The use of restraint did not always comply with the guidelines issued by the board. The board's chosen method is known as therapeutic crisis intervention which, when properly applied, should result in the subject being restrained without injury. The inspectors noted, however, that in some cases children had been injured during the application of restraint, including, in one case, a young person's leg being broken. The report indicates that managers had not sufficiently monitored the use of restraint in the previous four months.
Inspectors expressed concern about the number of times young people were locked in their rooms. They acknowledge that the separation of a young person from others is sometimes necessary to help return a tense situation to normality, but noted how young people had on some occasions been kept locked in their rooms for lengthy periods with only short breaks.
These are worrying findings and I have been informed by the board that a number of investigations are under way into matters referred to in the report. I have asked that these investigations be drawn to a conclusion as soon as possible while having regard to the need to ensure due process.
The report draws attention to the fact that correspondence from a resident had not been forwarded to the High Court. Given that children are placed in such centres under High Court orders, there is a clear constitutional right of access to the High Court, and I regard the failure to forward this correspondence as a serious matter. I immediately asked the chief executive officer of the board to ensure this was forwarded. It has now been done.
Inspectors were concerned that, given the complexity of many of the young people's needs and the sometimes challenging nature of their behaviour, the staff were unable to access quickly appropriate support services such as child psychiatry and psychology services. I have asked each health board to ensure children in residential care receive priority for psychological and psychiatric services in order that they receive the therapeutic care they need.
Inspectors concluded that staff needed more support to help them with the difficult task they faced. They also considered that the board's monitoring arrangements for ensuring compliance with residential child care regulations were inadequate and needed to be improved. As a result of the findings of the report, I have asked the chief executive officer of each health board to report to me on the arrangements they have in place to safeguard the rights of children in residential care.
We all recognise that working in residential care is particularly challenging and that staff must be provided with the relevant training and support. A fundamental review of the training available to child care workers in is already under way with a view to upgrading the qualifications and skills of staff working in the area. Work is ongoing between the Department, employers and IMPACT, while discussions are taking place with colleges to develop courses which are more appropriate for work in residential care. The current economic climate makes the recruitment of staff difficult and health boards need to be conscious of this. In response, some health boards have recruited staff from outside the State.
Investment in child care services, including early intervention and prevention, has resulted in a number of posts being made available, up to 600 or 700 this year, including family support and community work which is a more attractive option for some workers. As staff in residential care find the work stressful, I have asked all health boards to strengthen their support for managers and staff.
There were a number of positive findings from the inspection. Inspectors found a number of good examples of partnership in working with social workers and noted that the cases of young people were regularly reviewed. The unit facilitated family visits and sometimes provided transport to help parents visit the unit. Some of the parental visits were, however, subject to supervision by staff, a source of grievance for some parents. As well as safeguarding the rights of children, the rights of parents and families must also be upheld as the aim must be to reintegrate children with their families as soon as possible. The report noted that all of the residents were provided with education on the premises and there was evidence that some of the children had made excellent educational progress.
This report demonstrates the importance of having an independent inspectorate system for our child care services. It was for this reason the Government established the social services inspectorate in 1999. The inspectorate in the first three years is concentrating on the child care area and in particular on health board residential child care services. To date, about half of the centres have been inspected and I acknowledge the important work the inspectorate has done so far, in a spirit of partnership with the health board management and staff and other providers of services.
Because of the importance of this work we are moving to strengthen the inspectorate. The key position of chief inspector was recently filled and an additional inspector is to be recruited. This will bring the number of inspectors to five and will enable the SSI to complete the inspections of the health board residential child care facilities to ensure that all centres meet the required standards. It is important to state that resources have been given to each health board to enable it to implement the recommendations of the SSI and the Department closely monitors progress. It is also the intention to place the inspectorate on a statutory basis.
The Newtown House report should be seen in the context of very considerable developments in our child care services. Since this Government came to office in 1997 it has invested more than £90 million extra revenue in the development of our child care services including new child and family support services, such as specialised fostering and early intervention projects to allow health boards to provide a range of appropriate interventions which will place specialised residential care in an appropriate context.
This additional funding has allowed the health boards to increase the number of high support and special care places available from 17 in 1996 to a current total of approximately 70 places which includes one-third of the 24 places in the purpose built special care unit at Ballydowd in Dublin, which is being opened on a phased basis.
Plans are under way to develop an additional 56 places nationally by the end of the current year. Including special arrangements for individual children which will continue to be provided, this will bring the total number of places available to about 160 at a total capital cost of approximately £30 million.
Other important legislative changes are pending. The Children Bill, which is currently before a committee of the House, contains a number of significant measures for non-offending children who are in need of special care or protection. These include Part 3 of the Bill, which empowers health boards to apply to the courts for special care orders to detain non-offending children in need of special care or protection and Part 2, which introduces the Family Welfare Conference on a statutory basis for the first time. I hope also to publish the legislation for the ombudsman for children shortly.
The Government also recognises that research is needed to establish what works in responding to the needs of children. Policies must be underpinned by solid, research based evidence. In this context, a £200,000 annual research fund has been established under the aegis of the National Children's Office as part of the national children's strategy for research into the needs of children in care.
Children admitted to residential care have already experienced a great deal of adversity and difficulties in their lives. It is important that this very vulnerable group of children receive services of the highest quality. The safety and care of those children must always be our primary concern. What is important now is that we learn from these reports and continue with the important work already under way to further develop our child care services.
The Dáil adjourned at 10.35 p.m. until 10.30 a.m. on Wednesday, 28 February 2001.