Health bodies clash over child care reports


THE HEALTH Service Executive and the State’s watchdog for health standards have clashed over a series of highly critical reports on residential homes for vulnerable children.

The main tension between the agencies arose following a report by the Health Information and Quality Authority (Hiqa) last March into Ballydowd special care unit in Dublin.

The Hiqa report criticised the HSE for leaving a vulnerable child separated from other young people almost continually for six months in the special care unit.

But in a letter to the chief executive of Hiqa, the HSE’s national director of child and family services Gordon Jeyes said the reports were not balanced and triggered negative media coverage.

Mr Jeyes said there had been negative media coverage of Hiqa inspections of special care units, and quoted headlines from various newspapers, such as the Irish Sun (“Care child does six months in seclusion”) and Irish Daily Mirror (“Fury at isolation of care unit child”).

“I am seriously concerned ... regarding editorial clarity of some recent Hiqa reports which have not been as balanced as the evidence demanded,” Mr Jeyes wrote.

He insisted that official guidelines for the care of the child who was isolated from others were being followed, and that the child had extreme behaviour.

He also criticised the structure of other Hiqa reports, as there appeared to be no “consistent layout and approach to the reporting of inspections of special care establishments”.

In addition, he questioned why the Ballydowd report had not been issued for a month after it was completed, and why another report of a separate residential unit – which “met every standard” – was not placed on Hiqa’s website.

In response, Niall Byrne, deputy director of Hiqa’s social services inspectorate, responded that the authority had “no control over the media coverage”.

“Hiqa has an obligation to report as an independent authority on the provision of care to young people, especially as those children are deemed to be vulnerable and at risk,” he said.

He added that the structure of all reports were consistent and there was no delay in publishing the Ballydowd report.

A separate report into another centre was not published as it was part of a “special arrangement established by the HSE” in order not to identify the young person, who was the only resident at the centre.

Other correspondence between Hiqa and Mr Jeyes shows serious concern by the authority over persistent failures by the HSE to tackle poor standards.

In December 2011, Hiqa’s head of children’s services, John Farrelly, wrote to Mr Jeyes to express dissatisfaction at the “persistent and ongoing lack of compliance” at a crisis intervention service for teenagers in Co Dublin. “The latest report is continued evidence of the inability and/or lack of willingness on behalf of the HSE to change practices to comply with relevant standards,” he wrote.

These included “persistent non-compliance” since November 2008 over a requirement that all children in care should have an allocated social worker.

On that occasion, Mr Jeyes expressed regret that Hiqa had been dissatisfied with the HSE’s response and said the executive would endeavour to ensure all recommendations were addressed.

Also in December 2011, Hiqa expressed renewed concern about the reporting and management of child protection issues at a residential centre in Co Cork.

Despite the HSE’s pledge to undertake a review of these concerns two years previously, the review had not been completed. In response, Mr Jeyes said he, too, was concerned at the delays and pledged that local management would respond.