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Dáil Éireann díospóireacht -
Thursday, 4 Mar 2010

Vol. 704 No. 2

Death of Children in the Care of the State Since 2000: Statements.

I welcome the opportunity to address the House this evening on this important subject. I apologise to the House that I do not have a written speech to share with Members. I hope they understand this is due to the short period of time I have had to prepare for this debate.

The death of any child in care is a tragedy, particularly when interventions that would be carried out in normal practice have not been carried out. I have said previously that in circumstances such as the one that has been the subject of public debate over the past 24 hours, the State has failed that young person. The State has rightly apologised with regard to clerical sex abuse and to institutional abuse and I certainly deeply regret the circumstances that led to the deaths of people whose deaths could have been avoided. It is a significant part of my work to try to order policy with regard to children in care. I am guided by the principle that the State should act in loco parentis, not just in the limited understanding of the Latin phrase in the legalistic context, but to truly take the place of the parent and provide support to the most vulnerable children in the State. This is our guiding principle and is the least we can afford to young people in this situation.

It is important we provide a context in the public domain for this debate. These young people, who display the most chaotic and challenging behaviour come into the care of the State for specific reasons, multiple reasons in some cases. These reasons have to do with traumas they have experienced in their childhood, for example bereavement, addiction problems, family breakdown, abuse etc. We cannot lock up children who present challenging behaviour in these circumstances whenever it suits us. We can only do this in limited circumstances, as outlined in High Court judgments and in practice. We can only do it for a time limited period. Therefore, these young teenagers who present this challenging behaviour and come into the care of the State are a real challenge for the State in providing care.

The assumption has been put forward in the House that reports on some of these individuals who have died in the care of the State have been gathering dust in my office. This is not the case. I remind the House that where reports have been written, they are often case review files and were not intended for publication. They were merely technical internal documents. I will go through the details on these in a moment. I know from comments made by the Opposition this morning that Opposition Members choose to ignore the basis on which these investigations are established. It is a fundamental part of our administrative system that we can carry out non-statutory inquiries from time to time. The basis on which people co-operate with non-statutory inquiries is on an understanding that their right to their good name and their constitutional right to privacy will be protected. We can be sure that if the precedent set yesterday is to continue, nobody will co-operate with a non-statutory inquiry because they can safely assume that some Member of the Houses will publish a report that is not meant for publication, the content of which is overly sensitive for dissemination in the public domain. It is impossible to expect those investigations to occur in the future if we carry on in that fashion.

I will now outline the circumstances, the state of knowledge of my office and the circumstances relating to ongoing reports with regard to cases on which Members of the Opposition have requested information. There have been nine cases, since 2000, of accidental death. Everybody in the House would agree that there are circumstances where pre-existing medical conditions occur. These are cases that are unavoidable and where there is no doubt in terms of intervention or the provision of the necessary supports. I will not go into the details of each case, but such medical conditions include leukemia and brain tumours, and there were other similar tragic medical circumstances. There were nine cases in that category.

There are eight cases in which reviews are continuing, for which I can provide only limited details. There was a suicide in 2006, on which a HSE report is almost complete. An inquest was carried out and the Office of the Ombudsman for Children is also carrying out an investigation arising from a complaint from a family member. The second is a suicide from April 2008; again, a date is awaited for the inquest. In this case, a review is expected in the next six to eight weeks. In the case of a suicide that took place in February 2009, an independent case review is under way. With regard to a death in 2006, a murder trial has recently been completed and an investigation into the input of social services is continuing. I note that the social service input in that case was of the first order. In the fifth case, a death in 2007 from overdose, the review is close to completion, while in a sixth case, a death from overdose in July 2009, a review is continuing.

The circumstances in the cases of DF and TF are well known, having, in the case of TF, been put in the public domain yesterday by Fine Gael. It was our intention, as I outlined yesterday and previously and as I requested of the HSE last Friday, that those two cases would be published in the near future.

There are six cases in which no further action is to be taken. The first is an overdose that occurred in 2000, for which no review was carried out because it was deemed at the time not to be necessary. By way of introduction to these cases, I must point out that it is now very much the practice not to ignore the duty to investigate such cases — they attract a serious case review automatically — but the practice in these earlier cases was quite different.

To which category of cases is the Minister referring?

These are cases in which no further action is expected. The second of these was an overdose in 2000, for which, again, no review was conducted. The third was an overdose in 2005. The details of the latter two cases were sent to HIQA in July 2009 to allow the authority to inform the guidance it has prepared so that both the HSE and the Irish Youth Justice Service can properly carry out reviews of serious incidents and deaths in care. It is also preparing a panel of experts to carry out this work. The fourth case, which took place in 2003, also involved an overdose. A confidential report, whose cover note indicated that it was to remain confidential, was completed and forwarded by the then health board to the Department of Health and Children.

The next case was a death by suicide in 2000. Again, there was no requirement for a review. The individual concerned was seen by a clinical psychologist on the day of his death, and the case was the subject of a response to a parliamentary question from Deputy Neville in 2003. The final case was a hit-and-run accident in 2002; again, no review was contemplated at that time.

These cases are all individual tragedies. It is important that, in bringing attention to them, we stress that there is absolutely no intention to cover them up. I have no agenda to protect any reputations, corporate or otherwise. It is my intention that all these reports be put into the public domain as far as possible, but in doing that we must balance the rights of individuals who co-operate with the inquiry and the family members who will be affected by the dissemination of such information with the public's right to know.

The public do have a right to know. Social workers do this extraordinarily difficult work on the basis of a vocation and morale is important. However, morale can be corroded by the absence of fairness and balance when discussing such cases and a lack of understanding of the context in which some of these challenging children come into the care of the State.

I will start by agreeing with the Minister that not only is it a significant part of his work to ensure the State acts in loco parentis to children taken into care, ensuring they are properly protected, but that it is the most significant and important part of his work. If I was Minister of State with responsibility for children and, within a short period of coming into office, learned that more than 20 children in the care of the State had died in a decade, I would want to know the exact circumstances that pertained to each child. I would want to know the care provided to each child and, if something went wrong, exactly what it was. I would wish to ensure that there was accountability and transparency, that investigations were conducted in a thorough manner and that reports were published and recommendations for change made, and their implementation monitored. Unfortunately, that has not been the manner in which this Minister of State has dealt with his child protection duties.

I acknowledge that many children taken into care present real challenges. Nearly all of them have come from troubled backgrounds. They need a great deal of support; different children have different needs and requirements. An alarming number of children, as detailed by the Minister of State, have died in State care as a result of suicide or overdose. Indeed, it is not always possible to distinguish between overdose and suicide, because where a death is labelled as being the result of an overdose, it may well have been suicide. All of this indicates that a significant number of troubled children in State care were not given the protection or provided with the services to which they were entitled. As in the case of TF, whose report was published yesterday and — rightly, I believe — laid before this House, it may well be the case with regard to many of these children that psychiatric assessments were not undertaken when they should have been and proper assistance provided, or, where assessments were undertaken, the recommendations and results were ignored.

The problem is that the Minister of State with responsibility for children lacks the authority and the statutory powers to ensure that whatever policy he intends, with good intentions, to implement is actually implemented. He also seems to lack the authority to ensure that where children die in care, information is made available not for some prurient reason or to find a person to hold solely responsible, but to ensure that recommendations are published and implemented and the same mistakes are not repeated.

I wish to give a brief insight into the manner in which some of these issues have been dealt with. The Minister has made reference to a young man whose initials he gives as DF. That young man's name has been mentioned in the media and in this House, but I will not violate his confidentiality. On 25 November 2008, I asked the Minister when the report into the death of this man, who entered our care system at the age of 14 and was dead by the age of 17, would be delivered. The Minister replied:

A draft report has now been received by the HSE. I am informed that a final report is imminent. . . . I understand that the findings of the inquiry will be forwarded to me once the report is finalised.

That was on 25 November 2008. The Minister is again telling us today that the report is about to be published. In response to a question in this House, he previously indicated that the report was imminent. We were told that in the House on 4 November 2009.

In dealing with these issues at a meeting of the Oireachtas Joint Committee on Health and Children on 6 October 2009, I asked the Minister of State about a number of young people who died in care. I stated:

We know that at least 20 young people, who were taken into care and for whom either health boards or the HSE had responsibility, have died over the past ten years. It is possible the numbers are greater. We know that at least 11 of them died from a drug overdose.

I went on to refer to some of these children and young people particularly. On that date the Minister of State told me the report on DF would definitely be published on 21 October 2009, although we now know it was not. He indicated the report on TF would be published on 19 October 2009 but that did not happen either.

What the Minister of State did not tell me on that or any other occasion when I and other colleagues queried in this House the number of children who died was that reports were being prepared on a series of other children and which were at various stages. The Minister of State still has not told us in the House how many completed reports have been received. He told us the report on DF is about to be published but I do not know what that means or when it will be published. We do not know how many reports he has received.

There are four reports.

We do not know how many reports are still sitting with the HSE, the contents of which the Minister of State is unaware. That is unclear. I am greatly concerned that if we do not have true transparency and accountability in our child care services, we will never implement properly the required reforms to ensure children are truly protected.

We have paid lip service to child protection. We talk about a child-centred protection and welfare service and we have some amazing dedicated people in the social work and other areas providing that service but who are usually frustrated because they have to offer far too frequently a fire brigade service in protecting children. When they make recommendations on the steps to protect children, the resources and facilities are not there and children remain at risk. There are children walking our streets who continue to be at risk because of the failure of this Minister of State, his predecessors and the Government to ensure that children are properly protected.

The Minister of State participated in a television programme, "Prime Time", in early September. The mothers of DF and the late TF appeared on the same programme and were identified, and the Minister of State discussed matters relating to child protection. He said that we had a new and exciting period in child protection, and the process was going extremely well. The truth is that a large part of the recommendations contained in the report published yesterday remain to be implemented and the entire plan following the publication of the Ryan commission report has a very long timeframe for implementation. Most seriously, I have been arguing for a decade that we must give statutory force to our child protection guidelines but it took until July 2009 for the Government to acknowledge the necessity to do so.

The truth is there is a difficulty with credibility between what the Minister of State says and what happens on the ground. We have a profound obligation to ensure children are protected and it is entirely wrong to criticise the hierarchy for concealing incidence of sexual abuse while the State conceals incidence of children dying in the care of the State. We should not look for scapegoats and we must acknowledge the work done by social workers but if mistakes are being made how can those who work with children know what needs to be corrected if they are unaware of recommendations for change that are put in place?

I welcome the fact we have had this brief exchange but I want an absolute commitment from the Minister of State that we will put in place a transparent inquiry or investigative system guaranteeing that when a child dies in care or a child reported to be at risk is not given the protection to which the child is entitled and winds up as a victim of abuse again, that an independent and speedy inquiry will be conducted. There should be transparency and the reports and recommendations should be published. There should be a system to monitor the proper implementation of those recommendations. We must ensure, most of all, that no more children in the protection of the State die as a consequence of the State failing him or her.

I wish, by agreement, to share time with Deputy Burton.

That is agreed.

I will take six of the ten minutes. This afternoon's debate will only be an hour long and we need much more time in the House to deal with the issue. There is a significant matter relating to the credibility of the State in protecting the most vulnerable of children in the care of the State.

The information which has come into the public arena is that there are 20 cases relating to the deaths of children in the care of the State and about which various inquiries have been made. Essentially, we do not know the circumstances of these cases, despite the limited information given today by the Minister of State with responsibility for children. Having read the case which has been laid in the Oireachtas Library and seen some of the detail of what happened in that child's life before she died at an untimely age, there must be significant concern among the public and among us as public representatives as to what exactly is going on in the underbelly of Irish life where children are at such risk. The child in this case had her teeth knocked out at seven, was twice pregnant, was subject to drug use and was in and out of a variety of residences. She was entirely failed by the State.

This is just one case but there are many others. We know there are thousands of young people at risk who have not even been allocated a social worker. I listened to Ms Laverne McGuinness's comments today at the Committee of Public Accounts and to what has been said publicly. The HSE has indicated the 47 recommendations either have been or are being implemented, with care plans in place for children at risk. If some of them — up to thousands of children — have not been allocated social workers, how can there be care plans?

We must shed more light on this area. I share the concern expressed by Deputy Shatter as to what authority the State and more specifically the Minister has in this regard. We must put this information into the public arena, although there are obvious sensitivities and a need for protection of identities etc. There are also legal concerns.

None of these reports was published until this one was laid in the public arena yesterday. People must have a question of trust and credibility when the reports have not been published.

Would the HSE have published this report and the other report if it had not been prompted to do so? The Minister of State made the point that there are no further actions to be taken in respect of children who died of overdoses. We need public information and transparency. If a child in care died of an overdose, surely there has to be further action and more information put into the public arena. We have to know about these things before we can learn from them and ensure we protect children in future.

We will have an opportunity to ask questions, but serious questions need to be asked now about the facilities currently in existence for children in the care of the State, especially for adolescent children. Many of these children lead and have led chaotic lives. We need to know exactly how they are being protected and what kind of staffing is there. I understand that the HSE uses private organisations to look after some of the children. Some of them are obviously in foster care and some of them are cared for directly by the State. There is a unit in my own constituency called Coovagh House with only two or three children in it. Those children have very challenging behavioural problems, but this is an extremely costly unit for such a small number of children, yet there is a large number of children at risk on whose care the State does not spend much money. We have very little information on what is going on with the care of those young people.

This can only be the start of the debate on the issue. Much more light must be shed and there are many vulnerable children in the care of the State about whom we know very little. We now know the sad story of one young person, but there are many others out there and it is our duty as public representatives to ensure that we get the information we need, that the required protection is put in place, and that the Minister of State has the appropriate power to do that. If we do not learn from these tragedies, we will repeat them with these very vulnerable children over and over again.

This debate is not about any kind of political point scoring, because there is a genuine concern on all sides of the House about what is happening to children who are often in extreme situations. However, the Minister of State has to be more forthcoming with the details about those children who died in circumstances which in any other jurisdiction would warrant an immediate examination and report. I am not talking about some kind of judicial inquiry, but a report on the facts of a death which would also be subject to an inquest, which would put information into the public domain about the circumstances and causes of the death, and which would in turn cause the HSE to explain publicly the circumstances leading to the death of a young person in custody.

I am very concerned that a culture of secrecy has developed in the HSE which is about secrecy for its own sake, and which seeks to avoid public discussion by concerned citizens about the best thing to do for very troubled children whose families may not be in a position to help them, or whose families may have absolutely failed them. That is the sad truth and that is why the State often has to step in for the parent. The HSE has developed an unnecessary culture of secrecy. It seems to me that there are endless cycles of reporting, but nothing gets published and therefore, the general public does not learn and the general authorities do not learn, including politicians, about what needs to be done to address a very difficult situation.

Why is the report on the DF case not in the public domain? How long is that report? The Minister of State hinted in his comments that in some cases where the facts are self-evident, no further action is taken. That is not good enough, because the death of a child is always important, even if that child has led an unsuccessful and troubled life. I know many staff who work in these situations and it is very difficult, but we are only going to learn if we are not afraid to talk about it in public. We know from other examples that keeping things secret represents the road to ruin.

My other difficulty with HSE policy is that everything in the HSE leads to crisis intervention. The dots are not joined up, so if a teacher becomes aware of a difficult situation, it is passed on like a game of "pass the parcel". As the child gets more difficult, he or she drops out until he or she is in total crisis. We know that some of these children sought crisis intervention themselves, but because it was not available, they could not access it and they later died.

The Minister of State needs to publish the information. He should not hide behind the fact that there are sensitivities. There are ways of getting this information out so that we can learn and try to introduce some kind of support framework over the lifetime of these children. We know that the problems usually start with the family when the child is very young. These things do not just happen overnight.

The admission by senior HSE assistant national director for children and families, Mr. Phil Garland, on today's "Morning Ireland", later confirmed by the HSE director of integrated services, Ms Laverne McGuinness, at the Committee of Public Accounts, that there are 20 reports on the deaths of children in State care awaiting publication, can only be described as truly shocking. No valid excuse was offered for the delay in the publication of these reports. They should be issued without further delay. They should also be forwarded to the Ombudsman for Children, the Health Information and Quality Authority and to the Garda Síochána. The identities of the children and their families can be protected if need be. They do not have to be published, because what is most important is that the facts of the cases are known and that the lessons are learned and acted upon.

In a parliamentary question on 7 July 2009, I sought information on the number of unpublished or redacted reports conducted by the HSE or the former health boards. I have never received a comprehensive reply, despite repeated follow-up questions to the Minister and to the HSE. I have been told that the information was proving "difficult to collate", yet this morning a HSE spokesperson was able to go on the air and acknowledge 20 unpublished reports on the deaths of children in State care. Why has this information been withheld over all these months? I hope this question will be answered and we find out why the Department and the HSE have failed to respond to a series of questions by Members on these and other matters.

The report on the tragic life and death of Ms Tracey Fay in State care has caused huge concern about the lack of adequate child protection services in this society. This is not a new concern. It has been repeatedly raised for many years, with thousands of children who are vulnerable and at risk still being denied access to initial assessments of their plight.

The Ryan report on the abuse of children in institutions and the report on abuse in the Catholic archdiocese of Dublin exposed the widespread and systematic abuse of children up to approximately the end of the 1980s. We must focus on neglect and abuse in more recent times and, above all, address the systematic failures that allow children to be victimised or neglected in 2010. That abuse and neglect has proved fatal in a number of cases, which was confirmed by the Minister of State in his opening remarks. That is why we are engaging in this debate.

In 1990, the Comptroller and Auditor General carried out a review of the then Department of Education's special schools. The review in question found that the children in those schools were not being accommodated in the particular institutions appropriate to their needs — which continues to be the case — that the facilities were not being managed properly and that the Department was not carrying out its overseeing role in a satisfactory manner. In 1992, the Committee of Public Accounts, having considered the Comptroller and Auditor General's report, recommended that the then Departments of Justice, Health and Education and the then health boards jointly address the problem of these special schools and the problems of all children in residential care.

The position is that these recommendations were never acted upon. The schools in question represented the end of the line for troubled children who ended up in court because behavioural, social and family problems were not properly addressed at an early stage. That is still happening. The scandal is that it is happening along the pathway of so-called care provided by the State. The reports to which I refer were compiled in the early 1990s and sounded early alarm bells. Alarm bells have rung periodically in the interim, but precious little has been done.

Last year, the Ballydowd centre in west Dublin was closed following a damning report from HIQA. That closure raised major concern in respect of child services in this State. The centre, which cost €13 million to put in place, was only in existence for nine years but had to be closed as a result of its unsuitability for the troubled children held there. The HSE has presided over a facility in which, as HIQA stated, there were "not enough staff to run the unit consistently and safely". How could this have been allowed to happen? I refer here to contemporary events; I am not engaging in a historical reassessment.

HIQA's national children in care inspection report, which included the report on Ballydowd, is a severe indictment of the State's failure to protect children. It highlights "serious deficits in standards aimed at safeguarding vulnerable children, including lapses in vetting procedures for staff and foster carers working with children". These are issues that I and others have repeatedly raised in the form of parliamentary questions to the Minister for Health and Children and at the Oireachtas Committee on the Constitutional Amendment on Children, the meetings of which the Minister of State, Deputy Barry Andrews, attended on a regular basis.

The woefully inadequate state of our child protection services has again been exposed in recent days. There are insufficient social workers and other front line staff and support systems in place. Children are in grave danger but the necessary services are not in place to facilitate the interventions required. The nightmare is, therefore, happening every day. Evidence suggests that, as a previous speaker indicated, most of this abuse takes place in the family home. If the services are not put in place, then the State will be just as culpable as it was in the past when it conspired with the church to cover up the abuse of children.

The Minister for Health and Children, Deputy Mary Harney, who has ultimate responsibility, and the Minister of State, Deputy Barry Andrews, who has direct responsibility, must explain in detail how children have been let down so often. They must also indicate why these children continue to be let down by the State. They must act with urgency to bring the care of vulnerable children up to standard or else we will be presented with more Ryan reports in the years to come. The only difference will be that such reports will refer to what is happening in 2010. This problem is not confined to the past; it is current in nature.

The child protection crisis in this State requires a far more concerted and high-level approach than that taken by the Government at present. The essential steps that must now be taken should include the provision and resourcing of a full range of child protection services. The referendum on the constitutional amendment relating to children's rights, the wording of which has been agreed by the relevant committee, should be held as early as possible in the current year. This amendment is necessary in order to enshrine children's rights and protections in the Constitution.

Deputy Shatter referred to the Minister of State's position. I do not question the Minister of State's sincerity or good intent with regard to protections relating to children. I am also of the view, however, that while we have what can only be described as a secondary acceptance of the importance of child care as a result of the fact that only a Minister of State has responsibility for children, these matters will never be addressed in the serious manner that is required. I call on the Taoiseach, in the forthcoming reshuffle, to create a full Cabinet position of "Minister for Children". Such a development is vital. All of the reports that have been produced during this long, sad and sorry period in our history point to the need for such a Minister to be appointed. The children of this State, both current and future, deserve no less.

That completes the statements. We will now have a question and answer session. I will be calling on the Minister of State to reply at 5.40 p.m. I ask Members to be concise in the questions they pose.

I have a major difficulty with the Minister of State's contribution. Perhaps he might clarify the position. Mr. Philip Garland stated on radio this morning that there are 20 reports relating to children who died in care which have either been completed or are pending. Based on what the Minister of State indicated, the number in this regard is entirely different. He outlined a list of 22 children, nine of whom died of natural causes, 13 of whom were children in care who — save for one tragic case in which the child was murdered — he referred to as having died as a result of suicide or overdoses. In addition, the Minister of State said that some form of review is only taking place in respect of eight of these cases.

Unless I misunderstand the position, Mr. Garland has indicated that there are 20 reports that are either completed and awaiting publication or that are in preparation, but the Minister of State indicated that there are only eight such reports. Is he in a position to reconcile the figures? If I misinterpreted what the Minister of State said, I apologise. However, this is an important matter. Will the Minister of State also clarify the number of these reports that have been received within the Department? When will the report into the death of DF be published?

Questions will be grouped by agreement of the House.

Is the Minister of State aware of the number of children or minors who have absconded from care or foster care? Were they included in the facts he put before us? It is a very serious issue. Does the Minister of State have statistics on children who have died and whose deaths have not been investigated but who were children of mothers who were under 18 years of age? Without going into detail, at least one case has been brought to my attention where a mother was under 18 and a health board was engaged in her care. Her baby died outside of a proper place of safety for that child. Does the Minister of State have a statutory duty of care to have available accommodation for children of parents who are under 18?

This morning on the Order of Business, the Minister for Transport mentioned that ten children had died from natural causes but this afternoon, the Minister of State told us there were nine. I find it difficult to accept the Minister of State could not provide us with a statement, given all the back-up he has in the Department. It would only have been a matter of photocopying his notes.

A number of other issues must be considered. Surely the lack of psychiatric services for children has an important bearing on what is happening as must the lack of social workers, which was alluded to this morning. We do not have the number of them recommended in some of the reports. Ballydowd was referred to and it is an interesting case as of the ten issues raised about the facility nine related to management yet the solution was to move the children and the management to a new location. Will the Minister of State comment on this?

How long does the Minister of State believe is reasonable to allow for due process? A child died in 2002 and eight years later we are still waiting for a report. By anyone's measurement that is totally unacceptable. Will the Minister of State put in place a timeline for all future reports to be delivered to the House? We cannot have these interminable delays; they give the impression of a cover-up, like it or not. I accept that nobody in the House would wilfully cause harm to children or want to see negligence causing harm to children. Of the nine cases we are told died from medical causes, brain tumours and other conditions were mentioned. Were any deaths caused by septicemia, pneumonia or complications in pregnancy?

To answer Deputy Shatter's question on the numbers, DF and TF were counted as one case; I consider them to be two cases. I am aware of two additional cases which were not in the original 20 cases mentioned by Mr. Garland this morning and which are due to be published. They were the 5th and 6th ongoing cases to which I referred today. One of these was a death in 2007 from an overdose on which the review is near completion. The other was a death in July 2009 of an overdose and as this is more recent a date for completion is not to hand.

The Department has four reported cases including the DF and TF cases. With regard to cases where no further action was deemed necessary I referred to one involving a death in 2003 of an overdose where the report was completed. At that time, the individual was in the care of the north-eastern health board and the covering letter which accompanied the HSE report stated a copy was being provided under confidential cover and that the contents of the report included reference of a sensitive nature to the deceased, his extended family and in particular his younger sister who was a minor in care. It advised that the report and the information contained in it were privileged. In the current dispensation that would not be allowed to be the end of the matter. I might clarify that later. The last of the four I have in my possession relates to a death in 2000. I pointed out it had been the subject of a parliamentary question tabled by Deputy Dan Neville in 2003. The individual had been seen on the tragic day of death by a clinical psychologist.

On the question of how many minors have absconded from foster care——

Is there a timeline for publication of DF?

I will finish answering these questions as some of the points are worth going through.

To answer Deputy O'Dowd, I do not have figures for minors who have absconded from foster care and nor do I have figures for children of minor parents where the parents are in care. I will investigate that matter and undertake to come back to the Deputy without delay.

The person in question was under the care of a social worker. She may have been living with——

Does Deputy O'Dowd want to know about cases both where someone is known to a social worker or in care?

The person's mother kicked her out of home. She was homeless.

If the person was homeless she should have been in the care of the State if she was a minor.

The person had nowhere to go and her baby died as a result of a lack of action from the health services. There was no place of safety for the child.

I will undertake to provide that——

I brought it to the attention of the health board.

If Deputy O'Dowd provides me with the facts of the case I will undertake——

I asked a parliamentary question on it last year.

I will try to get the information for the Deputy as soon as possible.

That is what happened.

The Minister for Transport did refer to ten cases of death by natural causes. I examined the details of those cases and one of them was a suicide from 2000. I am not comfortable with describing that as natural causes although it was furnished to me in that fashion. It dates back to 2000 so it would not be appropriate.

There is a lack of therapeutic interventions. I did not set child protection as a priority in my ministry for nothing; I did it because there are gaps and, in some cases, duplication. To characterise the response of the Government today as inertia is very unfair. No comment was made about the implementation plan on the Ryan report except to criticise it because the timelines were not ambitious enough. Every child protection agency in the State welcomed the implementation plan and welcomed the very ambitious timelines contained in it. They welcomed the fact that we are committed to providing extra therapeutic interventions and that we are going to deal with multi-disciplinary assessment of people in special care, high support and residential care. They welcome the fact that in the budget for 2010 — and let us be honest it was against the head in terms of existing resources — €15 million was provided by the Minister for Finance to ensure that the implementation plan would be enacted.

Deputy Reilly asked about Ballydowd. The new assistant national director, who was on the radio this morning, has a very clear view of what he wants to do with special care and high support, which is about co-location. I agree with Deputy Jan O'Sullivan that we need a fuller debate on these issues. They are worth that and certainly worth as much time as the House can afford to give this important subject in the future.

I cannot anticipate a timeline for publication. I must reiterate that these are delicate issues. I had a discussion with Lord Laming in the UK following the Baby P and the Victoria Climbie cases and the same problem arises there with regard to putting reports in the public domain because of the difficult exercise of balancing the absolute right of the public to know and have a window into our child welfare and protection service and the interests of health professionals who co-operate with inquiries and the families of the unfortunate victims.

I asked about septicemia, pneumonia and childbirth.

I have serious time constraints.

At the outset I indicated that nine children had died from accidents or complications arising from existing medical conditions. They included a child with heart problems associated with Down's syndrome, a child with cancer, a child who had a brain seizure, leukaemia, a child with a brain tumour, a child who died of an asthma attack while asleep, a child who died of natural causes during a surgical procedure and a child who died in a road traffic accident.

Will the Minister of State clarify what he meant — if I understood him properly — by stating that the DF and TF cases were being treated as one case? They are two very different cases.

Other countries are much quicker at completing these investigations and publishing reports. The cases referred to by the Minister of State date from 2000, 2002 and 2003. Will the Minister give us an undertaking that he will ensure information is put into the public arena as soon as possible where that can be done? Specifically on the reports the Minister described as being completed or where no further action is required, are there recommendations in those that can be put into the public arena? I accept that it might not be possible to put facts on specific cases into the public domain but there must be recommendations on some cases that could be put into the public arena. Is there a procedure in place for children who are at risk of death or serious harm within the child protection service and the service for children in care so that a mechanism can be put in place wherever there are signs that a child is at serious risk? Are there procedures in place in order to prevent the deaths of such children?

How extensive is the report on the DF case? Is it true that in some cases those reports are a mere couple of pages? That is important because the Minister is giving the impression that some of the reports are so extensive and involve significant numbers of people and that is a reason for not publishing them, but I understand that some of the reports are extremely brief and may only run to, at most, a couple of pages, which may be recommendations. Why should those kinds of reports not be issued?

If a child dies in the unfortunate circumstances we are describing, is there a protocol in the Department that the HSE has to notify the Minister and that the timeline that has been referred to by others then commences? The Minister said he spoke with his British counterpart about two cases in the UK, including Baby P, but the hallmarks of most of the UK cases — even though the inquiries have caused convulsions in UK social services — have been that they have all taken place within a fairly rapid timeframe. Does the Minister have a timeframe for cases when a child dies in the care of the State involving some kind of reporting mechanism to the Minister, and that if the circumstances are not natural then an inquiry takes place and there is a procedure whereby within a three month or six month timeframe a preliminary report is made and then a public report? What is happening is that we in this House are relying on the work of journalists in particular to highlight most of those cases.

I believe the Members of the House and the public generally are very concerned about the timeliness of this report and others. Is an initiative now being taken with the HSE to ensure the timeliness of reports and also that some person might be made responsible for such reports and all of the guidelines to be set down by HIQA on reports?

Recommendations arise from the reports. A total of 47 recommendations arise from the TF report. Deputy O'Sullivan indicated that currently there are a number of reports in an embryonic state where there might be recommendations already in place which perhaps should be acted upon. The Minister outlined that the recommendations "are being implemented". Will he explain how the recommendations are being implemented and whether he has confidence that they will be implemented in full?

Does the Minister accept that the Deputies who are participating in the debate this evening are not pressing for the exposure of the names or any other means of identification of the children or families concerned? Will he indicate therefore his agreement to publish all of the reports, given that they must contain the outline of the tragic circumstances that applied in each of these cases of children in State care, recommendations as to how to better address the care needs of those children and others in similar circumstances and to allow us the opportunity to debate how to ensure the implementation of those recommendations?

There is some doubt as to the exact number of reports but reference has been made to 20. How many of the reports, if any, were referred to the Ombudsman for Children, the Health Information and Quality Authority and the Garda Síochána? Those three bodies would and should all have an interest in those reports, especially where there are tragic circumstances involved and questions as to the care regime that was in place.

The report from HIQA on Ballydowd was presented in the course of the tenure of the Minister, Deputy Barry Andrews. That report stated that there were serious deficits in standards aimed at safeguarding vulnerable children, including lapses in vetting procedures for staff and foster carers working with children. What has the Minister done to ensure that situation no longer applies in any other care setting today or into the future?

I wish to deal with the questions as quickly as I can in the limited time available. I am not entirely sure why the DF and TF cases were treated as one because they are not related to each other.

They are not related at all.

There are very few similarities but they were to be published at the same time. The TF case report has been published. I have been informed that the family of DF is not entirely comfortable with the publication of the report in full.

In reply to Deputy Burton's question, the report is 65 pages long. It is reasonable to expect we will do a review of the older cases where no action was proposed. We could do that and examine the recommendations and make a report to the House on that.

A special care order should have been recommended for TF. That is what is recommended for children displaying the most challenging and at-risk type of behaviour. A special care order would be appropriate to try to stabilise the situation and then a step-down to high support and residential care and foster care. That is the correct approach rather than placement in a bed and breakfast which is completely inappropriate.

It is worth pointing out that the kind of recommendations that emerged from the TF case have been acted on. Reference is made in the Ryan implementation report to multidisciplinary assessment teams for special care and high support. We have gotten rid of bed and breakfast accommodation for children in care. We have introduced transfer protocols to address a very serious problem. We have ensured that care plans are not only prepared but they are also updated regularly.

The Baby P case report was never published. They have that problem in the UK as well. It might never be published. An executive summary was published and that was the extent of it.

But that might be adequate.

That is the fact of the case. I accept there have been failings in the past. I do not hesitate to say that. I accept the genuinely motivated points that were made by Deputies opposite. I am not being party political in saying that it is not appropriate to publish reports such as this on the Internet without proper consideration of the consequences for family members. We have to protect the constitutional rights of individuals. We must also protect the ability of the State to carry out non-statutory inquiries so that we can elicit information in a timely way in the future.

Is that not the problem; timely can mean eight years?

It would be an unfortunate precedent if that were to continue. We do not pay lip service to child protection. We have tried to set out a very ambitious timeline on the implementation of the Ryan report recommendations and we have backed it up with a financial commitment. Far from being a lengthy timeframe, it is very ambitious.

Is the Minister of State informed when the death of a child in care occurs? Is there a process for initiating an inquiry and setting a timeframe for it?

I intend to come to that but I would first like to finish the point I am making.

Will the Minister of State also answer my questions?

I will try to do so.

If Members would allow the Minister of State to reply, they might get the answers they require.

The Health Service Executive established a review group in May 2009 to review reports issued pursuant to the deaths of children in the care of the State since 2000. Its terms of reference were to identify key themes and issues common to the reports. Its recommendations included that a review template be developed to ensure reviews follow a standardised format and that a case review panel be established. The working group was established by the HSE to develop the child death and significant case review protocol. In our implementation plan we recommended that the Health Information and Quality Authority develop guidance — which it has almost completed — for the HSE in respect of the review of serious incidents. Such reviews will be reported to HIQA, the Department of Health and Children and the youth justice service.

HIQA should work alone in these matters. The HSE should not be allowed to investigate itself.

We will also develop a panel, both internal and external, with appropriately skilled professionals to undertake investigations. In all cases of serious incidents or deaths of children in care or in detention, HIQA will review the initial circumstances of the case and how the HSE set about its investigation. That is the correct response to any such tragic cases in the future.

The HSE cannot be allowed to investigate itself. Those days are over.

Will the Minister of State be informed if a child dies while in care?

Before the Minister of State takes supplementary questions, will he be so good as to answer the questions already asked by me, namely——

There will be no supplementary questions, the time for the debate has expired.

——whether any of the reports about which we have spoken was referred either to the Ombudsman for Children, HIQA or the Garda Síochána, and what action the Minister of State has taken in regard to HIQA's report on Ballydowd?

Is the Minister of State informed if a child in care dies?

No, HIQA is informed.

Is the Minister of State informed?

I have answered the Deputy.

The Minister of State has said he is not informed.

That is correct.

That is outrageous.

He should be informed.

This is not a party political issue. The Deputy has said so herself, yet she is descending into that type of play. Let us be constructive about this.

I am not being party political. It is outrageous that the Minister of State would not be informed.

The time for statements has expired.

I am prepared to take on board constructive recommendations from the Opposition, but there is no point in being party political.

With respect, regardless of who is on that side of the House, the point is that the Minister of State should be informed.

Deputies opposite are being overly party political.

We are way over time on this matter. I ask the Minister of State to conclude.

With respect to Members, I am trying to answer the question put to me by Deputy Ó Caoláin on whether there has been involvement by the Garda Síochána and the Ombudsman for Children. The latter is involved in only one case, where a complaint was made in regard to an individual by a family member of the person who died. In regard to the Garda Síochána, the Children First guidelines, which were introduced in 1999, set out the proper protocols in terms of reporting and notifying the Garda. I understand five cases were reported to HIQA, which formed part of its preparation of the guidance it has now furnished in draft form to the HSE and the youth justice service.

Will the Minister of State clarify whether he will seek to be informed of any deaths of children in care?

That concludes statements. We are way over time.

Informing the Minister of State of any such case is fundamental.

Will the Minister of State seek to be informed in the future?

The statements have concluded.

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