Government knew about inaction highlighted by children's ombudsman

Issues raised recently by the Children's Ombudsman were highlighted almost four years ago by the SAVI report, but its recommendations were largely ignored. By Emma Browne

Areport by the Children's Ombudsman on complaints about Irish child protection services highlights inadequacies that the Government and Health Services Executive (HSE) have known about since 2002.

The report deals with 61 child protection complaints that came into the Ombudsman's office between April 2004 and December 2005. These complaints highlighted problems with access to initial services – in particular problems reaching the HSE by telephone to report abuse; lack of information and awareness about child protection services; delays and inconsistencies in service provisions; and lack of appropriate service post-disclosure, particularly problems with getting psychiatric treatment if needed, and in some cases children who reported being abused by adults were later placed in adult psychiatric institutions.

Many of these inadequacies were identified in a report done in 2001 called 'Sexual Abuse and Violence in Ireland' (SAVI). The SAVI report said that one in five women and one in six men reported child sexual abuse. Some of the major recommendations they made were that information on sexual abuse and on services available to those abused were needed; also the issue of disclosure and how best to deal with it needed to be addressed.

In relation to the provision of information they recommended a public awareness campaign and key to this was a national helpline. They said that a public launch of this should happen in 2003. The Department of Justice ran a campaign in relation to rape and sexual assault. However, there has never been a nationwide campaign addressing the issue of child sexual abuse. Additionally, no national helpline has been opened. As a result of the Ferns Report recommendations the Government recently announced that they would conduct an awareness campaign on child sexual abuse. No date for the implementation of this has been set.

In relation to information on services, SAVI recommended that posters, leaflets, video and internet resources be provided to give information on the services available. We asked the HSE what information on services had been developed since SAVI. They said, "Posters, free-phone lines, and material published by voluntary groups which are funded in the main by the HSE... Health Promotion have developed leaflets... information leaflets about counselling service have been widely circulated."

In relation to disclosure the SAVI report recommended that a multi-agency group be set up to identify and propose methods of reducing barriers to disclosure. This has not been done. Central to the recommendations of the SAVI report was that a Consultative Committee on Sexual Violence be set up. This has not been done and instead, the Department of Justice announced in February 2005 that the National Steering Committee on Violence against Women would undertake to look at the recommendations from SAVI.

Additionally, internal HSE reviews on the adequacy of their child protection services identify similar problems to those complained about to the Ombudsman's office.

Under Section 8 of the 1991 Children Act, health boards (now the HSE regions) are required to carry out a review of adequacy of child and family services every year and report to the Minister for Health and Children on it. The 2004 reports from five Health Board Areas identify similar problems in their child protections services – lack of staff, lack of psychiatric services and lack of information on services. There were ten health boards in 2004, but three reports have not yet been published, one is a draft and the other report found no child protection inadequacies.

The East Coast Area Health Board (now HSE Eastern region) identified the lack of provision of mental health services for 16-18 year olds as a problem. It also said: "The quality and availability of information in relation to child care services and the capacity to effectively share this information both at the local, regional and at a national level is unsatisfactory."

The Mid-Western Health Board identifies the following inadequacies in their services : "Difficulties in recruitment and retention of staff in relation to social work… the non-availability of appropriate medical staff specialising in forensic examination of children where allegations of sexual abuse have been made… the need for designated assessment and treatment services for young people with psychiatric illness."

The North-Eastern Health Board said they also had problems filling posts in child care. They said "key inadequacies" were "the areas of treatment services for children who have been sexually abused".

The Northern Area Health Board said there were problems with staffing as well, including the unfilled position of Deputy Director.

The Southern Health Board reported problems with psychological and psychiatric services for children. "The waiting list to provide assessments needed means that children and families have been left in situations of risk," it said.

The Ombudsman says that she believes the issues raised by the complainants are "already known to the relevant authorities". She also cites a recent report done by Dr Helen Buckley that said the current child protection system is failing to engage the needs of vulnerable children. Under the Child Care Act 1991 the HSE had a statutory duty to promote the welfare of children not receiving adequate care and protection. Emily Logan recommends that "a comprehensive evaluation of child protection services provided by the HSE," is required.

Groups working in the area believe that problems in child protection services stem from deficiencies with the implementation of 'Children First – the national guidelines for the protection and welfare of children' brought in in 1999.

The Children's Rights Alliance say "The poor quality service described by the report (Ombudsman's ), we believe, is reflective of the significant difficulties which remain on the ground in implementing the Children First and in coordinating services for children." They say that the guidelines have yet to be rolled out properly and some areas of the HSE are currently not operating under the guidelines. They recommend that the guidelines are put on a statutory basis to ensure they are complied with. The North Area Health Board's Section 8 report said that they had seen a "slow implementation of 'Children First' both nationally and regionally". The charity Children at Risk in Ireland also point out that there is a lot of regional variation with the way the guidelines are implemented. They also back the call for the guidelines to be put on a statutory basis.