Ombudsman damming of State neglect of child protection services
On Tuesday last, the Ombudsman for Children, Emily Logan published an investigation into the State’s implementation on Children’s First – the national guidelines on child protection which were published. In it she is very clearly reprimanding of the State’s failure to adequately protect children. This report (summary available here) is the first totally independent report since the publication of Children’s First in 1999 – the dozens of other reports were commissioned or carried out by HSE or other State institutions. Also it is the first systemic report carried out by the Children’s Ombudsman, up to now she has published reports on specific cases but not an overall system relating to children’s services.
And Emily Logan is very critical of the failure of state agencies – the HSE, the Dept of Health and the Office of the Minister for Children to fulfill some of their duties in relation to child protection. She undertook this investigation as under the law she has the right to. Her office is up and running since 2005 and she found that many of the complaints coming into her office were related to the partial or non implementation of Children’s First. In July 2008, the Minister for Children’s own report on Children’s First admitted that not all aspects of it were being successfully implemented and Logan felt that this warranted an investigation.
The main findings were
- a huge variation in what type of services were provided in different places
- no internal or external scrutiny –nobody inspecting the quality of care provided or no one even knows whats going on where
- the failure of agencies to work together eg HSE and the gardai and internal HSE staff– which is so crucial to child protection.
And while these findings have been heard before what is significant is that they are being said from her position of independence. Also she makes three points in particular which add value to the previous findings:
1. She details the failure of the health boards and the HSE to successfully implement Children’s First and based on that track record questions whether the HSE is the right place for child welfare and protection services at all. In many other European countries social care services including children are run separately to health and acute services often by local authorities. This means that they do not always lose out to budgets and priority to areas such as cancer care and Emergency Departments.
2. She details the chronology of what has happened since Children’s First (CF) and outlines 16 different initiatives, mechanisms and reviews that were undertaken in less than 11 years. These involved the old health boards, the health board executive agency, the Dept of Health, the office of the Minister for children, the HSE, the social services inspectorate, a specific audit of Cork and Kerry, the conjoint programme for action on children, a High level inter departmental group, the reviews of adequacy of services, revised CF guidelines, the list goes on and on… This chronology is the clearest indictment of State failure to adequately protect children at risk. Logan clearly concludes that there was ‘substantial effort’ to make CF happen, but to little real effect, that ‘there is no shortage of analysis, but far less action’. Also the chronology is important because she shows there was some considerable effort after the publication of CF in 1999 til about 2003, then between 2003 and 2008 very little happened. And there was two main things going on then – the reform of the old health boards and the formation of the HSE and a OMC review of CF. For five years there was a virtual stymying of any progress. on implementation on Children’s First. Also she formally reprimands some of these agencies which is within her legislative remit – she has made 11 findings of ‘unsound administration’ against the relevant public bodies –HSE, Dept of Health and Office of the Minister for Children, mostly the HSE.
And the third key area she has highlighted is the absence of both internal and external audit of child care cases. There have been multiple reviews and focus groups and expert groups etc but an audit as she details it would actually open up the children’s file to see how cases were managed, in what time frame, to what quality and what happened those children. In Cork and Kerry, there was an internal audit in 2003/4 but NOT ONE since then. And none in any other part of the country.
The Cork and Kerry audit find was according to Logan ‘very worrying’, with screening taking on average 21 days so that urgent cases were not speedily identified, initial assessments taking 95 days and 75% have no record of outcome although CF requires a record of outcome – of what actually happened the child. This is one of the 11 areas where she found ‘unsound administration’.
The HSE response to the report is keen to emphasise that improvements have been made since the investigation began – that Phil Garland has been appointed assistant director with responsibility for child and family services, they have the money to hire 200 additional social workers (a reaction to the Ryan report), that standardised procedures are being put in place. Also as of September 2011 (why so long away?), child care services will be open to external scrutiny from the Social Services Inspectorate based in HIQA.
Yet, there is still
- only a limited 24 out of hours child protection service outside of Dublin
- we still have fewer social workers per head than any of our neighbours, even after the 200 extra are added
- we really need to get all the services working with children working together, and have really quality training for Children’s First
- ultimately child protection is a marginalised services providing care for some of our most marginalised people. Unlike, for example, children in Crumlin hospital who have articulate, often high profile parents, children at risk come from some of the most needy circumstances and have no one to shout for them.
So what happens now? The ombudsman has given the HSE 12 months to implement recommendations, she says she is working positively with them and if there is a lack of progress she refers the issue to the Oireachtas. The HSE say that all efforts being made will show benefits soon. Lets wait patiently and see if 11 years on from Children’s First, child welfare and protection services are given the priority and resources they require.