Under the Child Care Act 1991, the Health Service Executive has a duty to promote the welfare of children who are not receiving adequate care or protection. The policy of the HSE is to place children in care settings, preferably in foster care, as close as possible to their home and community. A total of 6,259 children were in the care of the state in July 2012, the vast majority of whom were in foster care.
A very small minority of young people under 18 years of age have highly specialised needs arising from severe behavioural difficulties, due to their childhood experiences or in some cases as a result of injury, accident or disability. The care needs of those young people are generally met by directly provided residential services or services commissioned by the HSE within this country. For this small number of young people, the HSE is on occasion and in exceptional cases required to make arrangements for their placement in care and treatment facilities outside of the State, primarily in the UK, to allow for access to an individually tailored mix of care and highly specialised therapeutic services and psychiatric treatment not available in this country. This is done on as infrequent a basis as possible and only where such placement is considered to be in the best interest of the child. The HSE has a national protocol in place for such children.
The HSE has advised me that as of 21 September 2012, eight young people were detained in out-of-State secure placements. Four young people are in St. Andrews, Northampton at a cost of €12,582 per week, per child; two young people are placed in Kibble, a specialist facility in Scotland, at a cost of €6,685 per week, per child; and two young people are placed in Boystown Nebraska at a cost of €2,017 per week, per child.
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The HSE ensures that these placements are suitable. The units in which the children are placed are inspected and monitored by their national authorities and the HSE is attentive to the standards of care delivered in the specialised units. The level of requirement for these services is closely monitored by the HSE's national director for children and family services and my officials.